I just wanted to share this story to everyone, and maybe get some sort of feedback as to your own experiences.
I used to work in a community hospital in Southern CA in a telemetry floor. Back then, we were used to have 5 patients to take care of, plus an occasional 1-2 more to cover LVNs. I worked day shifts, so it can get pretty busy especially with the fast turnover of patients. One thing I really appreciated working there was the fact that we were well staffed with adequate CNAs, getting about 4 of them with a total unit census of 30 patients. That was tremendous help for us RNs and LVNs because we can concentrate on other tasks that licensed healthcare givers are counted on to do; such as educating patients, passing meds, comprehensive documentation, double checking charts, and updating plans of care, among others. Our valuable nurse aides would take care of the patient's other essential needs that is well within their scope of practice like hygiene, nutrition, vital signs and other basic needs, even answering call lights. In the 2 years I worked there, patients were kept happy and safe, staff had good camaraderie, and no patient had a fall incident as far as I would recall.
I recently moved to the Bay Area and have since been working in what was said to be a reputable hospital. At their telemetry unit, we get 4 patients to each RN, but we are staffed with one CNA for 27 patients... whew. If we get more than 27 patients, we get 2 nurse assistants. At nights, we often get one CNA only and if one patient requires a sitter, that CNA is assigned to that task and we are left to do primary care with all our patients. I feel that this is unsafe both for the licensed staff and the patients as well. In 6 months that I have been working there, we have had 4 falls already and a lot of complaints from the staff, but no change has occured. I feel like I got tired more easily the last 6 months compared to the 2 years where I previously worked.
I have observed that RNs get burned out easily with this going on, affecting their patient care and performance. I have tried to look up policies or laws as to proper nurse assistant staffing here in California but unable to find any. We RNs were happy about our patient ratio laws, but if we get shortchanged with improper nurse aid staffing then patient care still gets compromised. Maybe the employers do this for logistical reasons, but then again patient safety is what its all about, isn't it?
It was, in my NS, and I'm glad for the experience. The only downside to that is that the aides that I used to work side by side with as an aide seem to think that because I used to be a CNA, I don't need their help! I pretty much do total care because the aides are never to be found when I need them, and when I ask for help, they are quick to tell me how busy they are and why they can't do what I'm asking, assuming that I'll "understand", because I used to be an aide.
Of course, a big part of the problem is that we don't have enough aides. I think the current system of making assignments, which is dividing the unit census up evenly between aides, should be replaced with a different system. I favor assigning one aide to two to three nurses.
I can do my job without an aide, as I often do, since they don't seem to think I need their help, but I'd rather not. They are truly vital.
At the very least, I think all nursing students should have some experience in the PCA/CNA role before graduating. I spent my summer doing an externship which was basically working as a CNA with a few other benefits, and I learned just how difficult a CNA's job can be first-hand. I also learned a lot about communicating with everyone: CNAs, RNs and MDs, and getting my job done early meant asking if the other CNAs needed help, not sitting on my rear end. I'm grateful I had that experience, I think it will make a big difference for me as an RN because it taught me to respect and be grateful for EVERYONE, especially the CNAs.
I truly believe that you can usually tell who was a tech before they were a nurse just by their attitude. I've been saying for years that your tech can make or break your shift. I'm blessed that we have some phenomonal techs on our floor; it's meant that I can fairly consistently get home on time in the morning to get my kids off to school.
I truly believe that you can usually tell who was a tech before they were a nurse just by their attitude. I've been saying for years that your tech can make or break your shift. I'm blessed that we have some phenomonal techs on our floor; it's meant that I can fairly consistently get home on time in the morning to get my kids off to school.
ain't that the truth. I know as a CNA when I worked in the hosp. If I had a RN witrh RNitis who for some unknown reason thought she was better than the CNA and sat on her butt or hunt me down (while I was in a patients room giving a total bed bath by myslef) to get a freaking pillow for her patient. I was less willing to help her...She suffered really bad from CNA seperation anxiety !!
ain't that the truth. I know as a CNA when I worked in the hosp. If I had a RN witrh RNitis who for some unknown reason thought she was better than the CNA and sat on her butt or hunt me down (while I was in a patients room giving a total bed bath by myslef) to get a freaking pillow for her patient. I was less willing to help her...She suffered really bad from CNA seperation anxiety !!
I used to think that way when I was a CNA, and I still see CNAs doing as you describe. Now, as an RN, I can understand why some RNs hunt down CNAs for seemingly small tasks, and I have a lot more empathy for those RNs that I had not totally respected as an aide. Now, I can understand why some RNs do that sometimes, and I wish the aides would just cut us a little slack. If you are busy when an RN approaches you with a task, instead of copping an attitude, just tell her/him that you are busy at the moment, but will do said task when you are finished, and then follow through. Cooperation and respect is a two way street, and I see far too many aides behaving as if it is one way; myself included when I was an aide. I'm actually quite embarrassed when I think back.....
I used to think that way when I was a CNA, and I still see CNAs doing as you describe. Now, as an RN, I can understand why some RNs hunt down CNAs for seemingly small tasks, and I have a lot more empathy for those RNs that I had not totally respected as an aide. Now, I can understand why some RNs do that sometimes, and I wish the aides would just cut us a little slack. If you are busy when an RN approaches you with a task, instead of copping an attitude, just tell her/him that you are busy at the moment, but will do said task when you are finished, and then follow through. Cooperation and respect is a two way street, and I see far too many aides behaving as if it is one way; myself included when I was an aide. I'm actually quite embarrassed when I think back.....
i normally do..but this one particular nurse thought I should be stuck op her butt the whole shift. I worked ICU with 15 other nurses and 36 patients and i was the only CNA and i had a list of my own duties that included 10-12 complete total bed baths on vent patients.
It was not an easy task to get done when I was hunting down 5 pillows while said nurse spent 1o minutes trying to find me.
Specializes in Community Health, Med-Surg, Home Health.
I used to think that way when I was a CNA, and I still see CNAs doing as you describe. Now, as an RN, I can understand why some RNs hunt down CNAs for seemingly small tasks, and I have a lot more empathy for those RNs that I had not totally respected as an aide. Now, I can understand why some RNs do that sometimes, and I wish the aides would just cut us a little slack. If you are busy when an RN approaches you with a task, instead of copping an attitude, just tell her/him that you are busy at the moment, but will do said task when you are finished, and then follow through. Cooperation and respect is a two way street, and I see far too many aides behaving as if it is one way; myself included when I was an aide. I'm actually quite embarrassed when I think back.....
I also get embarassed when I think back at some of the thoughts and comments I made to nurses when I was younger. Not doing vitals on time, forgetting to report an abnormal IMMEDIATELY, thinking that they are sitting on their butts while I'm running around doing all of the work...I remember WELL and now, I cringe when I remember some of the spots I probably placed people in...and how they perceived me as a person and collague...
Nursing assisstants are an important role in the nursing profession no matter what anyone's opinion may be. I was also an aide during and before nursing school and it definitely helped. I can see others who have been aides prior to going deeper into the nurisng profession simply by their actions and care they put into their work. I truly appreciate the aides who i work with no matter their skill level because they all bring somehting a little different to the table. Some are allowed do certain skills while others are awesome with basic care and can make the best of the worst situation. Believe me, you are definitely appreciated and we are glad to have aides working with us as nurses. keep up the great work and never give up. Remember each of those pts enjoy having you around because that means someone will not let them be alone...
if you are busy when an rn approaches you with a task, instead of copping an attitude, just tell her/him that you are busy at the moment, but will do said task when you are finished, and then follow through. cooperation and respect is a two way street, and i see far too many aides behaving as if it is one way; myself included when i was an aide. i'm actually quite embarrassed when i think back.....
i definitely agree! i'm a cna and in nursing school right now, so i am currently experiencing both sides of the argument. i have seen that not only do the nurses respect me more for being cooperative with them, they actually help me more! being an rn is a stressful job that carries a ton of responsibility with it. as a cna, i recognize that the nurses not only have to pass meds, do accu checks, admit patients, discharge them, do patient education, etc etc etc, but they also have to chart a ridiculous amount. so when i see a nurse sitting at their computer, supposedly "sitting on their butts," they are most likely charting the dozens of things they need to chart. and so what if they are just sitting for a second?! everyone needs a break.
other cnas that i work with complain about their workload and get very snappy with the nurses. there is a nice way to say you're busy, such as "i'm sorry, i'm in the middle of something. can i help you in 10 minutes or so?" or sometimes you simply need to prioritize tasks. if you are in the middle of passing trays and the nurse needs help changing a diaper, of course you should help the nurse first. no patient should have to sit and wait with a poopy butt just so everyone can eat right then.
long story short, i suppose, respect and consideration are a must. not only in the hospital setting, but in life.
I'll never forget the night when my CNA interrupted me while I was busy with another patient and told me bluntly: "Roy, you need to come take a look at this pt."
She knew I was busy with that patient. Pt. was a fresh admit and I was busy assessing the pt., starting an IV etc.; but she stood her ground.
She'd had some years under her belt and I was a new nurse. Somewhat impatiently, I asked her what the issue was.
"I can't get a BP on the lady in 71D."
I'd assessed that patient barely 2 hours ago. She was fine.
Without thinking, I dismissively told her "do a manual BP on her. I'll see her soon".
To her credit, she didn't admonish me. Calmly she told me, "way ahead of you. I tried. On both arms. I still can't get a BP on her".
The tone of her response made the hairs on my neck stand up right. I excused myself from my pt. and hurried over to 71D. Sure enough, not only could I not get a BP - I could barely feel a femoral pulse...
Pt. ended up being transfered to the ICU (she died a couple days later. Nothing we could have done about it - she had end stage cancer with mets everywhere).
But that night taught me a very valuable lesson - don't 'brush off' your CNAs when they tell you 'something is wrong'. It doesn't hurt to check and at the very worst you've re-checked your patient and made sure they're doing ok...
I got back from my dinner break tonight, expecting eight o clock vitals to be done. I saw none written on the grease board. I saw none in the computer. When I saw the aide, I asked if she had had a chance to do any. She said "No, I was waiting to ask you which ones you wanted done".
Virgo_RN, BSN, RN
3,543 Posts
It was, in my NS, and I'm glad for the experience. The only downside to that is that the aides that I used to work side by side with as an aide seem to think that because I used to be a CNA, I don't need their help! I pretty much do total care because the aides are never to be found when I need them, and when I ask for help, they are quick to tell me how busy they are and why they can't do what I'm asking, assuming that I'll "understand", because I used to be an aide.
Of course, a big part of the problem is that we don't have enough aides. I think the current system of making assignments, which is dividing the unit census up evenly between aides, should be replaced with a different system. I favor assigning one aide to two to three nurses.
I can do my job without an aide, as I often do, since they don't seem to think I need their help, but I'd rather not. They are truly vital.