nurse aides rules

ktwlpn, LPN · Feb 24, 2001

Originally posted by reylem:
I would like to get feedback from the group on the topic that in some nursing homes, nurse aides rule. I have worked in facilities where charge nurses are afraid of the nurse aides. They complain that have noticed nurse aides sleeping on the job,
running their mouth throughout the shift,
taking lunch and break hours longer than required, yelling at the residents, ignoring residents' calls and what have you. But they are afraid to write them out for fear of retaliation. I am always the first one to bring this out to the administration. May I know if any of you out there experience the same.

I have been charge nurse on my unit for 4 months and had a very rough time with a particular group of CNA's.i had heard for years that this facility "is run by the aides" and now I have seen it myself.I decided to let the situation ride for awhile and handle it myself without going to administration.After a few days off I walked into a carefully laid trap-seems a few of them got together and reportd ME...luckily I had been documenting for my own protection and was able to back up my side of the story...but I should have given someone a head's up before the situation escalated.These women were disrepectful-questioning my nursing judgement and my authority in the middle of the pt care area...After finding out that I do have the support of my ADON-who encouraged me to stick it out in the unit I spoke with a few of them myself and things are alot better.Everyone has a different nursing style-I think they do respect me now that they understand me better...I have worked with a few unstable people over the yrs but am usually not really afraid...most threats of retaliation are just that..I will write up an aide-but I also keep a file at home. I know several nurses that do this also.If you are afraidof physical confrontation or vandilism make sure you are documenting and reporting everything.If you are really feeling threatend don't wait for the administration to go to the police-do it yourself

....good luck

chili2641 · Feb 25, 2001

I agree with your position. I think part of the problem is this. Imagine being trained for a couple of weeks on basic nursing duties. After the training you are thrown into this complex world of nursing. There seems to be a secret handshake that the nurse aid never learns. The nurses have nursing school in common they are the experts. You are told to do things but have no idea why you are doing them. Some nurse aids want to become nurses and for what ever reason they have not been able to do so. Some nurse aids are living off of the welfare system and they are mad at the nurse even resentful at times. We are told to be professionals what does that mean? I have heard nurse aids refer to themselves as buttwipers. What does that tell you? Good observation some nurse aids feel that they need to have some control. Take it a step further. Why do they feel this way? I am not looking for some deep analysis from you. I know you are not a psychologist. But you brought it up so it must be a problem for you. One thing I have learned from this BB is that nurses are good problem solvers. So what is the solution?

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Nursing assistant

ktwlpn, LPN · Feb 25, 2001

Originally posted by chili2641:
I agree with your position. I think part of the problem is this. Imagine being trained for a couple of weeks on basic nursing duties. After the training you are thrown into this complex world of nursing. There seems to be a secret handshake that the nurse aid never learns. The nurses have nursing school in common they are the experts. You are told to do things but have no idea why you are doing them. Some nurse aids want to become nurses and for what ever reason they have not been able to do so. Some nurse aids are living off of the welfare system and they are mad at the nurse even resentful at times. We are told to be professionals what does that mean? I have heard nurse aids refer to themselves as buttwipers. What does that tell you? Good observation some nurse aids feel that they need to have some control. Take it a step further. Why do they feel this way? I am not looking for some deep analysis from you. I know you are not a psychologist. But you brought it up so it must be a problem for you. One thing I have learned from this BB is that nurses are good problem solvers. So what is the solution?

You are so right Chili.When I was a cna I was happiest working with nurse who took the time to try to explain the rationale for a given task.I often try to do the same when I have the time...in between meds treatments paperwork and yes-wiping the occassional butt.I don't think that is degrading-it is not glamorous of course but it needs to be done...I think that the kind of people the original poster was talking about may be the ones that think the world owes them a living-like you mentioned,living on welfare and being pushed into work that they resent...how do we fix that problem? Wouldn't they be angry at anyone in authority? I think that no matter what class or background you come from you need to be encouraged to go by the rules...I remember when they started the welfare to work program at the county facility several yrs ago..a very small percentage of the trainees stayed on and worked past the time required to keep their benefits-and they hated it-all the nurses and the residents too..I am all for welfare reform but placing these people among a population incapable of protecting their own best interests is a mistake..But-getting back on track here-if you work on an automobile assembly line-you know you are building a car but do you know exactly what the widget in your left hand does when it is attached to the carcass flying by you on the belt?I hope I didn't offend anyone with my simplistic generalizations...our society is full of chronic malcontents-always trying to buck the system one way or the other...drives me crazy-I don't mean to single out a particular group..

chili2641 · Feb 25, 2001

Yes, I completly agree with what you have said. I am afraid if our economy keeps going down the tubes. Nurse aid work will look very attractive to the wrong people. Resentment for having to do this work and bad feelings towards nurses will sky rocket. I think we can all agree that not every one is cut out to work in nursing. This is something to watch out for!

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Nursing assistant

Melanie28 · Feb 28, 2001

I have been an LPN for almost 7 years and I've worked at 3 different facilities with the same company and it really is the same where ever you go. We are told that we are the "charge nurse" and we have the responsibilty to supervise the CNA's to make sure their doing their jobs and for the most part there are some excellant cna's, who you dont even have to tell what to do, they just know their business and they take very good care of their residents. But there are some who are just not going to work no matter what. And when you tell/ask them to do a specific duty they back talk and mouth off, stomp around, cuss and whatever. Then as charge nurses when we do write them up they are in the DON's office crying that the LPN was being mean or unfair and nothing is done to them, that's just telling them and others that they can get away with anything and it causes the senior cnas to be resentful because their working their butts off and so and so does whatever he/she pleases. This has happened alot at one facility where I worked. Writing cnas up didn't do any good whatsoever. We were told that we had to take charge but we didn't have any authority. The cna's would just joke about how many times they had been written up and this made the LPN's look like jokes. I know that this was the DON's fault because she didn't back the LPN's up. Even after getting a new DON the same thing would happen because the cna's were used to getting their way. There were even cna's who were fired and would be rehired a couple of weeks later, just to go back to doing the same old thing. It got to where the LPN's wouldn't even bother to say anything anymore. We had it so bad there for a while that tires were slashed in the parking lot, cars were keyed, cna's would accuse fellow cna's who they didn't like personally of abuse of a resident, which the administrator had to report and invesigate. I was in 2 state investigations because of a cna telling that she saw/heard someone abusing a resident. Several people knew that the situation never took place. It was just someone out to get them because they didn't like her. That cna is now an LPN at the same facility. I dont know what the deal there was but the cna's were definately running the facility, and from what I hear they still are. I have heard so many gripes and complaints from cna's that they have so much to do so little time nothing to work with and so little pay. Not all cna's do this but many do. I just cant feel sorry for them who do that. No one is putting a gun to their heads making them work in a nursing home. They dont have to be cna's. As miserable as some of them are to hear them tell it I wonder why they just keep on. It is an extremely hard job and stressful physically and emotionally. There are people who handle it very well though and go above and beyond the call of duty. I put the blame on the DON and the Administrators who cannot take charge of their positions and weed out the people they let get by with running the facility. The main ones though, the only ones who count in all of this are the ones who suffer most and that's the residents.

Ribbit · Apr 1, 2001

Originally posted by reylem:
I would like to get feedback from the group on the topic that in some nursing homes, nurse aides rule. I have worked in facilities where charge nurses are afraid of the nurse aides. They complain that have noticed nurse aides sleeping on the job,
running their mouth throughout the shift,
taking lunch and break hours longer than required, yelling at the residents, ignoring residents' calls and what have you. But they are afraid to write them out for fear of retaliation. I am always the first one to bring this out to the administration. May I know if any of you out there experience the same.

I Have been a nurses aid for many years and have worked in nursing homes and hospitals, If the aides rule then it is an administration problem, And if there is abuse of any kind going on in your facility it should be reported at once no matter who is doing it . I am very proud to be a cna and think I am good at it, I know that alot of cna do resent nurses because they put us down. But I have also found that if you do your work the best you can and care, you will get the respect that you deserve. But I also believe that most of the nurses that I have seen couldn't make it without the aides. We do alot of work for them so they can do their work. And I also think that it should be harder to become a cna, there are to many out there that shouldn't be taking care of people in anyway. It's not a job that you can do just for the money.

destiny5255 · Apr 7, 2001

Originally posted by reylem:
I would like to get feedback from the group on the topic that in some nursing homes, nurse aides rule. I have worked in facilities where charge nurses are afraid of the nurse aides. They complain that have noticed nurse aides sleeping on the job,
running their mouth throughout the shift,
taking lunch and break hours longer than required, yelling at the residents, ignoring residents' calls and what have you. But they are afraid to write them out for fear of retaliation. I am always the first one to bring this out to the administration. May I know if any of you out there experience the same.

I would like to make a reply regarding the above: I also work in a LTC facality and

have for 32 years I have never seen or went thru this problem mine was always cna's

that would not work or do proper pt. care but for everyone that would not I had 5 cna's

that were excellant they were my right arm and I trusted them a lot.Not to mention

how much they were loved by the pt's themselves. But I do know that cna's are

not always given the respect that most of them deserve and as Nurses we all do need to work to gather because it will take us all to help do proper pt care and make a difference in even one pt.s life so that they can have the safest environment that they

deserve.As for the cnas that are not true cnas that's where we as Nurses need to band together and either reeducate them or relieve them of their positions for they

can not only be a danger to us or the company they work for but to the pt as well

and my main cincern has always been and always will be my pts wellbeing. I do

think cnas need more education because education has never hurt no one but only tended to improve us and make us better for it so yes I'm alwyas for anyone bettering themselves

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destiny5255

SYDNEY · Jun 25, 2001

Due to the lack of time while in-facility to sit down and explain rationals, I use my hobby (the computer) to put together mini-inservices for the cna's that I work with. I type up whatever issue needs addressed, the "right way" to do it, and the rationale behind doing it the right way. Some roll their eyes at me, but most thank me for the gentle reminder that keeps all of us on our toes. - They may not get CE credit for it, but its better than being cited by a preceptor for doing something you knew better than to do in the first place but just kinda short-cutted along the way.

sWolfie · Jun 25, 2001

I think you should write the CNA's up. As a CNA, we are not being paid for sleeping or yelling at the residents, we are there for the residents. Some CNA's like to give the new charge nurses a hard time to see if they are going to be tough enough to work there, other's....well, they are just there. They also like to see how far they can push the charge nurse until she breaks....then it's all kewl.....unless you have the ones who say she/he is a b**ch for freaking.

I made the comment on another thread about being a certified butt wiper...so if you saw that here, that was me. That's what all the aides (where I work) call each other, we had an RN degrade us and always called us that....it stuck.

I just wanted to say I know where the charge nurses are coming from, and they should stand their grounds....not let the CNA's walk all over them.

Peace!!!!

"S":D

SYDNEY · Jun 26, 2001

Well, some are good nurses without being good leaders. It accomplishes nothing to demoralize your staff or make yourself their enemy. If you get down to it, in long term care, we're all "butt wipers", but there's a whole lot more that both nurses AND CNA's do while on the job. I work nights, and have a great deal of respect for the CNA's that I work with. It may be because they're an extraordinary group, or it may be because I started off in LTC in the laundry dept., moved my way up to CNA, and then went to nursing school. So I can appreciate the aspects of everyone's participation in providing good care. I'm usually the first in battle to defend my staff from others who say that nightshift does nothing. In addition to keeping residents clean, dry, moisture barrier inplace, turned, hydrated, etc. they also take out the dirty dishes and trash that the other shifts left in residents' rooms, and clean up the facility from the daily grime. One time dietary was complaining about all the dirty dishes nightshift was bringing down and leaving to be washed, so the DON gave us a "chat"..um, excuse me...dietary is closed in the middle of the night. - My staff is just cleaning up other shifts messes, not making them.

I've at times stood outside a resident's room listening while a cna does her job. A common misconception is that residents sleep at night (LOL). I think the reason I love nightshift so much (but can't get through to my hubby) is that because its night time and no one else is there, we actually have more time to provide one on one and listen to what the residents are saying, and that makes them feel cared for. And on that note, its time for me to go to work!

Catsrule16, RN · Jun 26, 2001

When I was a CNA, the nurse I gave the hardest time to was one who she was above everyone else. Wouldn't take the time to explain what was expected or even assist with care when needed. Almost like she forgot the basics of Nursing! As a Nurse, I got more respect and understanding by showing the aides I knew what their job requires. I offered to help turn a resident if they needed help (especially when i needed to look at skin) or feed a resident if need be. I thanked them and complimented them. I also asked for their advice from time to time to help them feel more a part of the care team. By setting our goals on the table from the beginning, we were able to work towards the good of the resident.