Nurses who let NAs Boss them around - page 8

When will nurses ever learn to delegate? When will nurses ever collectively stand up and get some backbone--Fight for higher wages, and better benefits like a company matching 401K plan? I get sick... Read More

  1. by   Jayney
    Hellllllo Nurse,

    I'm not telling anyone it isn' t OK to discuss this, it's a very valid topic and problems arise from the CNA/LPN/RN relationship everyday. Just trying to say that it's understandable that some CNA's might be defensive on reading some of the comments here.

  2. by   Yankee in Texas
    Not wanting to be in a defensive stance. I have seen both side of the fence as well. As a new grad, I am coming into the field understanding both roles, while learn the role of an RN.

    Unfortunately, the good CNAs are pre-judged with the bad. There is no excuse for poor or the lack of work ethics. Yet. some CNAs are in an attack mode up front due to pre-judged notions. Yet, Two wrongs don't make One right.

    Each member of a team MUST work together and make it work for the nonmaleficence of the patient. If things are that bad, then management must step in to create an environment in which conflict is dealt with in a cooperative/constructive manner and not in a competitive/destructive way.
  3. by   PhePhe
    Ideally all nursing staff must work together. Years ago, I worked on a 24 bed general surgical floor that was really busy. We had 3 teams of an RN and an aide or LPN. When one team was done, we always went to see if the next team needed help. We were not finished until ALL teams were caught up.

    The difference is now, the RN may find herself in a situation where the person he/she must delegate tasks to may refuse or ignore him/her. This is what I am taking about. This a pressure of being a RN. Sorry if some NAs take offence. I and others have said all along that there are good NAs. But look at all the RNs who are reporting problems here? This is not an issue to be swept under the table. NAs can start their own thread, "NAs who feel RNs Boss them Around". Every response from an RN should tell you that "delegation" is part of the RN job description. Being "Bossy and nasty" are not.
  4. by   Gator,SN
    how would you feel if you overheard a bunch of doctors complaining about how lazy nurses were?
    I'd probably start laughing since without nurses, the docs wouldn't know what was happening with the patients half the time and are clueless to most of what they do.
    My own family physician doesn't even give injections!
    Yep, I'd be laughing........

  5. by   Liddle Noodnik
    Originally posted by Yankee in Texas

    Yankee: " Not all of us are lazy !! "

    ABSOLUTELY NOT! There are some CNA's (we dont' have pcas/techs) who are JUST INCREDIBLE! I bet you are one of them!

    Yankee: "why must I go get another tech/NA to assist me when it is NOT HER PATIENT!! "

    IF there is a CNA or whatever who is playing on the computer or reading the paper at the desk, and NOT on break, why not, if I am giving meds or doing my charting? Does that seem fair, or no?

    Yankee: "THE TECH (me) needs to get her head out of those books and help me." "

    Can she say BREAK -- room??? I would assume no one is allowed to go there unless on break. If you are on break, supposedly someone is COVERING for you who can help, or there is someone else available. If chaos reigns, then she could ask you, and you could take a break later. Communication (DIRECT communication) goes a LONG way!

    Yankee: "Anyway, I as a GN to RN, respect the CNAs/PCTs. They do the grunt work that we are not able or unwilling to do. They are a valuable asset to the nursing team. Let them know this, because without them that fundamental patient care would STILL have to be provided!"

    AMEN! I think those of us who HAVE been CNA's find it hard to FORGET where we came from and are a little more understanding. From what you've written, I'd say your staff is lucky to have you, as an aide and as a nurse! Are you staying on once you get your RN? Hey, good luck, BTW!
    Last edit by Liddle Noodnik on Jun 12, '03
  6. by   Liddle Noodnik
    Originally posted by PhePhe
    here? This is not an issue to be swept under the table. NAs can start their own thread, "NAs who feel RNs Boss them Around".
    I have been thinking it would be good for the RN's to say what they would like from their CNA/other. Also for the CNA to say what they need from their nurse.

    For example:

    I would like the CNA's/etc. assigned to my patients to be either at the desk or near his/her assignment, or tell me when they are on break, so I know where to find him/her.

    I would like my CNA/etc. to let me know when vital signs they took are out of whack rather than just write it in the book.

    I would like my CNA/etc, if instructed to wait for v/s on a patient that is sleeping, that they take the v/s if the patient DOES awaken ie for a bedpan, med, etc.


    Kind of insulting isn't it? But these are issues I deal with all the time. There are some obviously who don't NEED the instruction manual!

    I'm sure the CNA's/etc can come up with stuff that's equally insulting. GOOD! Sometimes people can be oblivious. Even me, sometimes!
  7. by   PhePhe
    I like your style. I can guarantee you would get major atitude if you spoke those simple clear requests!

    I am with you all the way! I'll try it at work today
  8. by   ktwlpn
    I think this thread is great and am glad that it has opened a dialogue between nurses and cna's...I hope we can keep it civil(I think we can) and continue to learn from each other....I think Zoe gave the first important lesson-we have to make our expectations very clear-we can't expect anyone to read our minds and know what we want them to do or expect them to automatically do it all.....We can avoid many problems by strictly following this guideline.But when you ask? tell? instruct? staff that you are supervising to do something and get attitude it is tough to remain cool.... it's a learned skill and I don't think many nursing programs spend enough time on it...I have several awesome cna's on my unit and a few that need a bit more motivation and instruction.I also work with a borderline personality(I know because I recognize many of my own borderline personality characteristics in her:chuckle ) She is a very disruptive influence on the unit.It has been interesting to watch the power shift on the unit in the time I have been there-the pack mentality has been very evident.It's the "ME show all the time" with her-she really is a text book case-very interesting.And she is a pathological liar-smart and manipulative.A real challenge-but tough to manage...
  9. by   Neicee
    Great comments! I have seen all of the above examples expressed. There are not enough hours in the shift to complete all of the ADL's for your patients, medications, and documentation. I have worked for civilian hospitals and I have had to stay over my shift many times to complete charting while the nursing assistants clocked out and left on time. I have said many times, the nurse can do the CNA's job, but the CNA can't do the nurse's job! Now I work at a military hospital. The only differrence is there is a lot more paperwork than the civilian sector. The nurse/patient ratio is lower, and most of the time there is enough staff. The only problem is no communication. There can be a truckload of staff, but if there is no communication things don't get done! I make rounds on my patients regularly. It is frustrating to find the CNA's sitting around and only going into rooms when the call light comes on. There are really good CNA's out there and I have worked with a few of them. I can't stress that team work is the key. After getting report a game plan should be made between the nurse and the CNA.
  10. by   live4today
    I work with some really terrific nursing assistants. I've only encountered a couple problems in this area, but for the most part, I give a thumbs up to the many nursing assistants I have met and had the pleasure of working beside in my 16 plus nursing career. I use to be a nursing assistant myself during my final year of nursing school, so I've never forgotten what they do, or how they feel on the job, etc.

    Here's to all the nursing assistants who work their buns off on their jobs and get very little recognition for it: :hatparty:

    From a former Nursing Assistant turned RN
  11. by   ktwlpn
    I'm resurrecting this thread because I had a lousy experience today and need to vent .I have gone back and re-read many of the other threads on this same topic...It's the song that NEVER ends....I am one of 3 fulltime nurses on a 42 bed unit-and am only in charge once a week(or more when the charge nurse is on vacation-as she is this week) I am so tired of asking people to do something and being mouthed off at....Yesterday and today 2 different staff members gave me attitude.The situation involves a demented and often combative resident.We have been working hard-care planning galore and even consulting staff development about her and are trying to come up with ways to provide care to her and insure safety for ALL....I can't have staff screaming at me in the hall "She scratched me and tore my shirt-She can just stay in bed all day" She's in her 90's and can give you a good hurting when she pinches a hunk of meat but I don't think she can break anyone's bones....She is a 3 person HOyer lift now-and due to NUMEROUS skin tears the care plan has been discussed with the staff over and over...I told them this am to try to give he am care early but not to go back to try to get her up until close to noon-hoping that she would settle down and be more amenable...The cna FREAKED on me-Finally he did go in the room and work the lift while another cna and I put the lift seat under her-I held her hands as we turned her around and sat her in her recliner and it worked well....I was not even going to go to the supervisor because it seems that in the end the DON does not really want to hear it (unless it is an abuse situation) They just want the status quo-and other times I have had this kind of problem I have had MY professional manner called into question-and have been told to not be as "friendly" The charge nurse works 12 hour shifts-by 7 am she has all of her routine paperwork done and has much more time to help out on the floor then the other nurse and I do-and she does do more but we all 3 do ALOT.It's a dementia unit and we have all stepped in and taken over a shower when a resident was escalating-we toilet,feed,etc........A few of the cna's have the attitude that if they try once then tough luck-they are done...So-I went to the supe-I had to....She promptly went to the DON and the cNA was called to the office and down there for quite awhile-In the meantime she had told me to counsel everyone about the careplans and this resident in particular...Of course-another cna (she is a borderline-nut) had to start and make it all about her and her problem with one of our horny old men and switching assignments,etc...I abruptly told her that we were not going to talk about anyone else's situation at that time and wound up the meeting...At the end of the day they were all at the back of the unit b*tching about me...I did shut her down in front of everyone but I feel that I was taking control BACK because her and another cna were trying to monopolize the conversation and saying things like they were told in training that they don't HAVE to take care of anyone that they feel "Uncomfortable" with...NOw -all of the cna's that have a problem with this woman are black and she is white.I have seen them often show favoritism towards the black resident and be less then kind to the demented troublesome white ones.....I KNOW that when I get back I am going to be in that office and chastized-it will end up being MY FAULT somehow...I told the cna during the episode the rationale for what we were doing-I told him all about the many approaches we were trying and why it was important for ME to witness her behavior and document it so we can get her medicated if we need to...The cna that gave me lip yesterday "I ain't getting her azz out of that bed" Told me to make up a note for the chart after I insisted WE (her and I) try to get her up...Per the doc's direct orders-he noticed she was in bed one late morning and the charge nurse told him of the difficulty we are having and he ordered us to get her up(within reason-If I see her ripping and tearing and am concermed for her safety and the staff's she will stay in-but I'll have good documentation on it for the Doc when he reams my azz....and the family when they find her in bed AGAIN or when I call them to notify them of ANOTHER skin tear.....I CAN'T keep working like this-my health is starting to show it-I can not deal with the tension and stress...It gets to me to the point that I am almost afraid to tell ANYONE to do ANYTHING because they see it's OK to be insubordinant to me and a few of them like to get under my skin and get me rattled so they are looking for the chance to get lippy.....I am SO angry and upset and SAD...I want to get along and I want these residents to get the care they deserve.If I am the sourc of the problem I need off of that unit because it is not good for the residents to be around the screaming and yelling....And it's always ME-when I am in charge-I get attitude...I have been in th office with a few of them (one was let go for admitted abuse) and the DON backs me usually and always in front of them-after they leave I come under attack and I hate it and dread it...I don't seem to have any problems asking anyone esle to do anything on other floors.....I HATE TODAY
  12. by   PhePhe
    Stand your ground! Please don't fold. You are doing what you are supposed to be doing. Grab the job description and sit down with the supervisor as a witness and ask the aide just what she is REFUSING to do in conjuction with that patient. Also hint to your manager that you have had it with not being supported and for now on you will document all refusals when patients are not gotten out of bed. You can't fight city hall! This place sounds like one where the NAs think they are going to boss you around. You may have to start looking for another job. Or ask for a transfer. When will nurse managers realize that it is this kind of non-support that drives a nurse to quit!! I feel for you honey. Again, stand your ground. They are challenging you. I know you can come up with a workable solution.
    Gettin an AZZ out of bed, indeed! How unprofessional.
  13. by   Brita01
    It sounds like that whole heap of troublemakers needs to be scrapped. But since that is very unlikely to happen, you might want to start looking at the job ads. There are too many available positions out there for you to continue at a job where you're being stressed out like this. The job is stressful enough without having to constantly fight with the nursing assistants and management. There's only so much you can do before you have to stop beating your head against a brick wall and move on. Good luck to you.