Nurses who let NAs Boss them around

PhePhe, RN · May 31, 2003

You know, I have heard nurses aides say that the nurse HAS to help, and just because they are an RN doesn't mean they don't have to do patient care anymore. Yes, nurses are supposed to help, but they have other duties that the nurses aides do not. The nurses aides do not have to pass meds, check charts, do treatments, accuchecks, IV /IV meds etc. So why is a nurse supposed to do half the nurses aide job plus all the other professional duties? The acuity is so much higher now than it used to be, whether hospital or LTC facility. This logic doen't make sense.

Why can't the nurses aide get another nurses aide to help, when the other one is not busy? Why do they have to "wait" for the nurse? In my opinion this is done on purpose, as I have heard many NAs talk about the "nurse who thinks she's too good for patient care".

I used to be an NA, and I worked with the other NAs to get the job done, when the RN was busy. We wouldn't dare be insubordinant to the RN, by saying "no" to requests that are within the NA job description.

Gator,SN · May 31, 2003

These Nursing assistants should have my old boss......

My Job description was outlined very clearly in a list of duties to be performed daily. #'s 1-35 addressed these issues.

#36 stated: Any other duties requested/assigned to the nursing asistant by the nursing staff that he/she is able to perform.

There was no mistake about what I was expected to do at work...ever!

Gator

MandyInMS · May 31, 2003

There is no reason the cna's can't work together...and "NO" is not an option in my book...do the job or go home...that is just unreal!!! I mean, could I just come to work and only pass the meds on the pts I 'felt' like doing? only deal with the 'good' pts and neglect the more pesty ones? not call a MD because I wasn't in the mood?not chart on a more critical pt/check their charts for new orders cuz' I didn't have my supper yet?I think not.

Disablednurse · May 31, 2003

The thing about it that makes me so mad is that they are told upon being hired what their job duties will be. If they do not want to do that, then don't take the job. I know they gave me a detailed job description and I have read theirs. If you don't like the job description go to McDonalds and sell hamburgers.

ktwlpn, LPN · May 31, 2003

I think that the field draws the type of people that it does simply because of the pay and the relative lack of training need ...Around here if you have no other skills working as a cna can earn you a living wage.I have worked with people totally lacking any couth or social skills-don't get me wrong-I know some awesome nursing assistants..and many others with no respect for themselves or others and low self esteem.Some hardly know how to have a polite conversation with a co-worker and they do NOT want to get along.They like to call attention to themselves and do that by causing friction on the unit It is scary that some of these people are entrusted with caring for helpless patients-often unable to speak for themselves or defend themselves.We have to really monitor their activities very closely-as well we should because ultimately we are responsible for the resident's well-being...I walked into the lounge today to eat my lunch at 2 pm-long after the aide's breaks were over-and the whole staff of 6 were sitting in there-we have a 44 bed secure unit....I really felt like throwing a FIT but I restrained myself...This crew b*tches and moans every day-they think they need more help...They have plenty of time to sit around IMHO...When they start tomorrow AM I will remind them of what happened this afternoon....It is SOOO frustrating....Everyone is so darned worried that they will have to do a little bit more work then the next person.....

sweetbaby · May 31, 2003

:confused: Leadership training would help a lot. I used to float at the LTC facility and was "bossed" around by the NA. Well guess what now I am the perm nurse on that unit and with the same NA who remember me green. The first few weeks were dificult, now we work very well together as a team to care for our Alzheimers residents. The facility has had many changes in managment, our DON has worked hard with the nursing staff to sort out the rif raf, including some nurses who let the NA get away with "everything"

With a lot of restructering of the nursing dept. the power to the nurses has been returned. Now our title of Charge Nurse really means we are in charge.

allscrubs · May 31, 2003

I do not know where to even start with this subject. I can start by saying I am a NA right know and start my core classes this fall for my BSN. It sounds as though you are putting a lot of blame on NA's and management. aren't you written these NA's up? Its not always the NA for turnover for nurses that is a pathetic excuse. Being that I will be able to see both views, I have seen some really terriable nurses and terriable NA's. You all know what are job duties are upon hiring. If your heart is not in it, get out. And I agree the patients are the ones that suffer from this. Nurses complain about all the work they have to do and there pay, well look at the NA's salary? Up their training and their pay, we might find good people to become an NA. But that is not the reason Nurses have such a high turnover! Its also how you approach people and make them feel a part of the team, you lead by example. Anyone in nursing should get payed more then what we do, because we do, do a lot. But take that up with your state legislation.

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · May 31, 2003

I can't say that I find this to be too much of a problem for me. But I have witnessed it once with another nurse.

I was standing outside the patient's room charting a PICC dressing change. The nurse was inside, tending the patient. The nurse aide was outside the door when the doc came along. The doc started asking how the patient was, how is B/P was, etc... The aide was actually answering and the doc was listening. I have nothing against aides interacting with docs, but in this particular situation the aide really stepped outside of the bounds. I said to the doc, "the nurse is in there, she can tell you how the patient is doing." The nurse was very easygoing in nature, and I don't think she would have said anything.

Teshiee · May 31, 2003

I agree with all of you are saying. A nursing staff is only good as the managment support. It is really frustrating. I was working in a nursing home as a LVN charge nurse and I had to assign a cna a difficult patient. Well I was very fair because at least I rotated this patient so everyone can have a break well this cna flat out refused and left the premises. I would have terminated her on the spot. When I spoke to the DON she said she would handle it and before I knew it the cna was back on the floor working as if nothing ever happened. I gave up. That following week I resigned. I feel that if I can't delegate my duties as a charge nurse let your cna's do it. Now that I am a RN I will not work in an area with delagation too much drama! Until the management get off their ass and enforce what RNs and LVNs do they can have it.

night owl · Jun 1, 2003

I've said a few times to some of our NA's, "Look, I didn't come knocking at your door for this job, you came here wanting it. Now that you have it, you're telling me you don't want to do it?" What gives? They usually change their attitude. I tell them I'll help you any way I can, but don't forget, when I can't, it's because I also have a job to do which you can't help me with. I do pt care as much if not more than some of them because they either 1. Don't want to answer the call bell and get whatever the pt is requesting, 2. Are either sleeping and cop an attitude when you wake them which I will wake them anyway, 3. Are off the unit chit-chatting with people on other units, 4. Outside smoking, (every 20 min) 5. On the phone chatting with other friends and the list goes on. JUST COME TO WORK AND DO YOUR JOB, that's all I'm asking, nothing major like build a nuclear bomb, just do what you were hired to do and preferrably without the lip service. That's not too much to ask for is it?

ktwlpn, LPN · Jun 1, 2003

Originally posted by allscrubs
I do not know where to even start with this subject. I can start by saying I am a NA right know and start my core classes this fall for my BSN. It sounds as though you are putting a lot of blame on NA's and management. aren't you written these NA's up? Its not always the NA for turnover for nurses that is a pathetic excuse. Being that I will be able to see both views, I have seen some really terriable nurses and terriable NA's. You all know what are job duties are upon hiring. If your heart is not in it, get out. And I agree the patients are the ones that suffer from this. Nurses complain about all the work they have to do and there pay, well look at the NA's salary? Up their training and their pay, we might find good people to become an NA. But that is not the reason Nurses have such a high turnover! Its also how you approach people and make them feel a part of the team, you lead by example. Anyone in nursing should get payed more then what we do, because we do, do a lot. But take that up with your state legislation.

You will discover exactly what we are talking about soon enough.You do bring up a good point-we also must take some responsibility.I work with many nurses that will turn a blind eye to problems(for various reasons) If we document consistently then the administration will take action-they need the documentation to protect themselves if they let someone go and that person takes action against them.Also-as for working as a team-that's all good but you still have to be able to give direct orders with confidence that your staff will follow-and not stand there and fuss about why they don't feel likr doing what you are telling them to do....How many times can you remind someone to make sure that Mrs SO and so gets COFFEE with lunch? Or-"Don't forget Mrs s and s's dentures? I give meds at least 3 times a week to all 44 of the residents on my unit and believe it or not I know what kind of juice they each prefer-and how they take their meds...But I work with staff that don't remember to put SHOES on people-and last week I was going to help someone brush her teeth-not ONE of the 6 staff members on the unit that day had a tube of toothpaste in their caddy....Come on....How much training is neede tod wash and dress someone? You use toothpaste every day yourself,right? Excuse my rant-it's been a long weeken on.....

SharkLPN · Jun 1, 2003

>>Nurses complain about all the work they have to do and there pay, well look at the NA's salary? Up their training and their pay, we might find good people to become an NA.

Actually, that can backfire; People will seek out NA jobs for the pay, and not for the duties it involves. Then you'll end up with more laziness, bad attitudes, etc.

I was stunned recently when two of my usually great NAs complained up and down about the family of a pt staying with her, but not helping the patient with her care - ie, cleaning her up when she was incontinent (the pt was having lots of diarrhea that night). I pointed out that our job is to provide that care to their mom, not to sit in the back room watching American Idol.

Needless to say, the rest of the shift was a little tense. But really, just because family is present doesn't mean that they want to wipe mom's tush. I would, but that's because it's a duty that I'm accustomed to. Other folks out there just simply can't bring themselves to do it, and I can't blame them.