What would you have said to this CNA

[zofran]

I was almost done posting this but it went away? Sorry if it comes up twice???

Anyway, I am an RN on a busy day shift med-surg/onc floor. The other day it was crazy. It was about 1400 and I had not eaten or peed. I was starting to feel a bit sick. I told the HUC that I was not feeling well and that I was going to take a quick break to pee and eat something real quick. I told her to tell the CNA I was working with that I was not feeling good, would be back quickly, and to give her this note.

The note said - Take temp in 502 and get water for 507. Thanks

Well when I got back, the CNA working with me was livid. She demanded to talk to me in private. She says (and I quote) "I am not your N-word" (but she says the word if ya know what I mean) "You can't just leave me notes and expect me to do what you say"

I was just so shocked! First that she would use the N word (we are both white) and second, that she seemed to not care that I had to get off the floor for just a few min.

So I end up apologizing to HER, explaining why I left the note, and telling her how bad I had to take a quick break. She really didn't care, didn't even give the water or take the temp, and just talked trash about me for the rest of the shift. I heard her later telling the other cna's that 'she put me in my place"

this type of behavior is so dishearting for me, We should ALL be there to support eachother and the patients. What would you guys have done?

[Virgo_RN, BSN, RN]

Post #124 on page 13, folks.

[firefox828]

Hmmm... she got FIRED!!! Thanks for the link, VirgoRN.

[humblecirculator]

I suppose I prefer a closed-loop communication process when delegating (face to face and receive immediate feedback if there are any questions)...I look at written orders from NPs and MDs a bit different...but still, you are correct in that the bottom line is that patient care was compromised (thankfully without negative outcomes) - this situation would be a good root cause analysis...

[dlnyhan]

If I were in your shoes, you should have ask to have another neutral party present to act as a mediator. This would help prevent any harsh words to be said during a heated arguement. I myself work as a CNA, and have issues with nurses, that when we work together we do not mesh well. I took apropriate measures and spoke with the charge nurse and any and all issues have been worked thru.

I find it amusing how many nurses rely on the backs and legs of the CNA to do their jobs. Yes, a CNA is there to help the nurse in their task, however they also have a task list to acomplish with many more patients and nurses asking them to do their mindless task. I can now only imagine how many nurses reading this are seathing and angry, believing that is our job. But I have also worked with many nurses, some who are even much older. And they seem to be able to do their jobs, as well as, take care of the mindless task.

Please remember we are all adults when working together. Maybe before you write her up, ask her why she was so angry with the note. She is NOT a subordinate, she is your coworker. Find a mediator, and try to work thru any and all issues. Now if something like this were to happen again, take a trip to your managers office to find out what your next course of action should be.

[picuman, BSN, RN]

Well ....easy write her up. Maybe? just maybe she will think twice next time. times are tough jobs are hard to come by. maybe someone should remind Her of those facts. And you are a terrific example of what we RNs do and donot do. Cheers!

[jollydogg_RN, ADN, BSN]

If I were in your shoes, you should have ask to have another neutral party present to act as a mediator. This would help prevent any harsh words to be said during a heated arguement. I myself work as a CNA, and have issues with nurses, that when we work together we do not mesh well. I took apropriate measures and spoke with the charge nurse and any and all issues have been worked thru.

I find it amusing how many nurses rely on the backs and legs of the CNA to do their jobs. Yes, a CNA is there to help the nurse in their task, however they also have a task list to acomplish with many more patients and nurses asking them to do their mindless task. I can now only imagine how many nurses reading this are seathing and angry, believing that is our job. But I have also worked with many nurses, some who are even much older. And they seem to be able to do their jobs, as well as, take care of the mindless task.

Please remember we are all adults when working together. Maybe before you write her up, ask her why she was so angry with the note. She is NOT a subordinate, she is your coworker. Find a mediator, and try to work thru any and all issues. Now if something like this were to happen again, take a trip to your managers office to find out what your next course of action should be.

I took a few minutes and thought of a way to respond to this. Here it goes, will try my best.

You talk of CNA doing the "mindless" tasks. Well, I'm extremely sorry you feel this way, but the tasks are not mindless so to speak. They are the basic levels of patient care. Sorry, but the reality is that with more education comes more responsibility. If you are tired of nurses asking you to do "mindless" tasks, then maybe you should go further with your education? Or look into another field? The reality is that your "mindless" tasks help promote patient well-being and play an integral role in patient recovery and satisfaction. We ALL have a job to do, whether it be get ice for, fill a water pitcher, turn the patient, give a med, or perform a procedure. As a nurse, sometimes we wouldn't be able to get things done if all of the other "mindless" tasks weren't done.

Your argument would bear weight if the situation was different. For example... if the situation was when the nurse came back from the floor, and the CNA said "Excuse me, can I talk to you in private?" Said nurse and CNA are now in private... "I don't appreciate how you gave me that note like that. I asked you to help me turn Mr Johnson earlier, because he is obese. You said no. But now you give me a note telling me to do this. I need more help from you on your end on certain issues I cant tackle by myself"

NOW your argument might bear some weight. But if the CNA replied like the OP said? Using derogatory language? When the RN used a PERFECTLY acceptable way of delegating tasks, which btw, IS the RNs responsbility?

You are right on one issue. She is your coworker. Not your subordinate. But guess who gets the flack when all of these "mindless" tasks do not get accomplished? That's right, itn most cases and scenarios its usually the RN. Because the RN is the person responsible for the patient care. Sure, you have a task lisk and more patients, but guess who gets grilled if something from YOUR task list doesnt get done? Thats right.... the RN. So yes, we have that responsbility.

So yes, we rely on the CNA to do some legwork sometimes because of the greater responsibility we undertake for the patient. Sorry, but thats just reality. If the RN is unwilling to help the CNA on certain issues, thats a different issue altogether. But this was nothing out of the ordinary, and anyone saying that CNA is justified needs to take a second look.

We arent seething angry, we're trying to explain to you the reality of the situation.

[Virgo_RN, BSN, RN]

If I were in your shoes, you should have ask to have another neutral party present to act as a mediator. This would help prevent any harsh words to be said during a heated arguement. I myself work as a CNA, and have issues with nurses, that when we work together we do not mesh well. I took apropriate measures and spoke with the charge nurse and any and all issues have been worked thru.

I find it amusing how many nurses rely on the backs and legs of the CNA to do their jobs. Yes, a CNA is there to help the nurse in their task, however they also have a task list to acomplish with many more patients and nurses asking them to do their mindless task. I can now only imagine how many nurses reading this are seathing and angry, believing that is our job. But I have also worked with many nurses, some who are even much older. And they seem to be able to do their jobs, as well as, take care of the mindless task.

Please remember we are all adults when working together. Maybe before you write her up, ask her why she was so angry with the note. She is NOT a subordinate, she is your coworker. Find a mediator, and try to work thru any and all issues. Now if something like this were to happen again, take a trip to your managers office to find out what your next course of action should be.

Hmmm, so many things to comment on here.

First, in my hospital, while it is true that the CNAs have a list of tasks to accomplish, performing patient care activities as delegated by the RN/LPN is one of the items on that list of tasks, so yes, if you were a CNA in my hospital, it most certainly would be your job to take direction from the nurse.

Second, yes, I agree we are all adults, but where I disagree with you is that the RN in this scenario is in any way, shape, or form, responsible for the way the CNA reacted to the note. As an adult, the CNA is responsible for how she responds.

It is attitudes like yours that is causing me to leave floor nursing. Not the patients, not the demands, not the backbreaking work, not the inhuman levels of stress, not the ever increasing piles of paperwork, not the incessantly ringing phone I am required to carry, but the attitudes of the CNAs. The ones who huff and puff every stinkin time you ask them nicely using the words "please and thank you" to do a single thing. Or, instead of outright refusing to do something you ask, they just don't do it, and when you follow up on it, have some weak or lame excuse for not doing it. And when you go to management for guidance, they say to report any CNA who refuses to do as you ask since that is insubordination, yet they never outright refuse. They just huff and puff or quietly avoid, and so are never held accountable by management for their behavior. Our unit has a reputation for having the worst CNAs in the entire hospital, and because of it, nurses hate floating here. Our unit is hemorrhaging good nurses because of it. And so, by extension, patient care and patient safety are compromised because of the CNAs. I'm sure the CNAs on my unit (soon to be ex-unit) would wholeheartedly agree with your post.

[jollydogg_RN, ADN, BSN]

Hmmm, so many things to comment on here.

First, in my hospital, while it is true that the CNAs have a list of tasks to accomplish, performing patient care activities as delegated by the RN/LPN is one of the items on that list of tasks, so yes, if you were a CNA in my hospital, it most certainly would be your job to take direction from the nurse.

Second, yes, I agree we are all adults, but where I disagree with you is that the RN in this scenario is in any way, shape, or form, responsible for the way the CNA reacted to the note. As an adult, the CNA is responsible for how she responds.

It is attitudes like yours that is causing me to leave floor nursing. Not the patients, not the demands, not the backbreaking work, not the inhuman levels of stress, not the ever increasing piles of paperwork, not the incessantly ringing phone I am required to carry, but the attitudes of the CNAs. The ones who huff and puff every stinkin time you ask them nicely using the words "please and thank you" to do a single thing. Or, instead of outright refusing to do something you ask, they just don't do it, and when you follow up on it, have some weak or lame excuse for not doing it. And when you go to management for guidance, they say to report any CNA who refuses to do as you ask since that is insubordination, yet they never outright refuse. They just huff and puff or quietly avoid, and so are never held accountable by management for their behavior. Our unit has a reputation for having the worst CNAs in the entire hospital, and because of it, nurses hate floating here. Our unit is hemorrhaging good nurses because of it. And so, by extension, patient care and patient safety are compromised because of the CNAs. I'm sure the CNAs on my unit (soon to be ex-unit) would wholeheartedly agree with your post.

I agree. Hopefully my first year in Med/Surg goes smooth (well, as smooth as can be expected for a new grads first year on a med/surg floor) so I can get into an ICU or trauma unit here in Nashville. Seriously, I'm already starting to see the stuff we have stacked on our plates as a floor nurse is ridiculous. :uhoh21:

[Virgo_RN, BSN, RN]

Well, if it helps any, our Med/Surg floor has the best CNAs. I am thrilled whenever one of them floats to our floor. They have their act together and do their job well. Maybe you'll have a good experience!

[lamazeteacher]

i'm a tech for almost 3-years & can't figure out why cnas are problamatic? it says on our badge Nurse Assisttant. last time i remember , the english part of that means you help the nurse. that idiot needs to be fired

She was, (fired) as I read somewhere earlier in this thread........ I think it's interesting to see the agreement with your post, by CNAs as well as others.

[jollydogg_RN, ADN, BSN]

Well, if it helps any, our Med/Surg floor has the best CNAs. I am thrilled whenever one of them floats to our floor. They have their act together and do their job well. Maybe you'll have a good experience!

well, ive only had positive experience with our CNAs so far. the majority of them have been working on the floor for 5+ years, so it must be good. i think ive only heard one of the newer nurses ever have a complaint about one of the CNAs, and I can kinda see where she gets it from. But other than that, no one has anything bad to say about our CNAs.... which is a great thing! =)

[meluhn]

If I were in your shoes, you should have ask to have another neutral party present to act as a mediator. This would help prevent any harsh words to be said during a heated arguement. I myself work as a CNA, and have issues with nurses, that when we work together we do not mesh well. I took apropriate measures and spoke with the charge nurse and any and all issues have been worked thru.

I find it amusing how many nurses rely on the backs and legs of the CNA to do their jobs. Yes, a CNA is there to help the nurse in their task, however they also have a task list to acomplish with many more patients and nurses asking them to do their mindless task. I can now only imagine how many nurses reading this are seathing and angry, believing that is our job. But I have also worked with many nurses, some who are even much older. And they seem to be able to do their jobs, as well as, take care of the mindless task.

Please remember we are all adults when working together. Maybe before you write her up, ask her why she was so angry with the note. She is NOT a subordinate, she is your coworker. Find a mediator, and try to work thru any and all issues. Now if something like this were to happen again, take a trip to your managers office to find out what your next course of action should be.

I disagree, the cna is subordinate to the nurse. She should do the tasks that are delegated by the RN, we are coworkers but their is a chain of command. This CNA should have been written up immediately. No one should be yelling at anyone in the workplace. Respect is a 2 way street.