Nurse being above emptying a foley catheter bag??!!

[LPNfurever]

I am a new grad lpn who thankfully found a job at a LTC facility. On occasion I also work as an aid; one afternoon, I had asked the nurse if she had emptied a foley catheter bag as it contained very little in it. She looked at me as if I were crazy and said "Oh, I dont do that" in a tone that was arrogant. She walked away from me as I stood there with my mouth open dumbstruck. I dont consider myself above anything that involves pt care.

[MAISY, RN-ER, BSN, RN]

I understand the band thing, but it could've been any request. Let's face it....the right person has to be hired for the right job....plain and simple. They pay us to work regardless of our positions, my point is that everyone should be responsible for a "good day" at work and do their jobs. Additionally, priorities can be very different and I think the shift's goals and needs should be discussed at the onset, not later..... with understanding of all what the expectations for the shift are. That's what good teams do...

*As for people sitting around....if I am not sitting around, I don't expect to see anyone working as part of my team sitting around. If so I have no problem calling them on it and ensuring that they don't work with me again! Kudos are deserved when earned....as are disciplines-we have become a world where everyone is great because they think they are. NEWS FLASH! It ain't so! Hard work earns deserved praise.....slackers need to do something else (regardless of position).

M

[nursemike, ASN, RN]

my comment about re-banding a pt was strictly for correct identification of the pt,,,did not mean to make this a nurse vs cna thing...

Thanks. I didn't mean to make it a cna vs. nurse thing, either, only to say that we do sometimes delegate things we are perfectly capable of doing, with legitimate reasons. And I gotta admit, it was not best practice to let the patient go without a band, even for a few minutes. However, one of our aides' duties at change of shift is to go around the rooms and verify that each patient has a correct band, and the aide I asked would be doing that in a few minutes. She had no problem with the request, but the bysitter (too lazy to be a bystander) needed to put his two cents in. Not surprisingly, he was one of those who was more than happy to let the nurses do their jobs and his too, and the only good thing I can say for him is that he isn't there any more.

That said, I'm lucky to work with a good bunch of aides. A few bad examples have passed through our unit, but there are some who make me look like a better nurse than I am, and I don't hesitate to tell them so. Still, I do get the feeling, sometimes, that even the best don't fully understand what a nurse does in a typical shift. Neither did I, before I became a nurse. Which, of course, doesn't apply at all to the OP. It was just something I felt like mentioning.

[SuesquatchRN, BSN, RN]

Good grief. I just can't stand stuff like what I'm reading here. I remember a nurse that I used to work with treated the aides like servants. If she was in the room with a patient and the patient needed a bedpan or urinal, she would go find the aide and ask them to do it. I was like ***? You can't do it? If you aren't doing something else, there's no reason you can't put a patient on the bedpan!

I'm in a position in a place like this now. NONE of the nurses, except me, will do this stuff. I will not call an aide away from what they are dping if I am right there or not busy.

However, I now have one aide who will sit there while bells ring and look at me.

Help!

[Virgo_RN, BSN, RN]

I'm in a position in a place like this now. NONE of the nurses, except me, will do this stuff. I will not call an aide away from what they are dping if I am right there or not busy.

However, I now have one aide who will sit there while bells ring and look at me.

Help!

She's sitting there looking at you because she knows you will go answer the call bells. This is why *some* (not all) nurses do not get into the habit of doing "CNA" tasks, because they know *some* (not all) CNAs will take advantage. This can sometimes (not always) lead to conflict among the nurses as well, as in "Nurse X answers call bells and toilets residents, so all the nurses should do it too.", without regard to the nursing duties that prevent the nurses from being available to do these things. The other nurses can start looking at Nurse X in a bad light, because now the aides are expecting them to drop whatever they're doing to "help out".

While some people decry the delineation of duties between nurse and aide as an example of how NOT to work as a "team", the positive in it is that it gives clear structure and protocol and a clear idea of areas of responsibility.

When I was a CNA in LTC, none of the nurses, even the nicest ones that I liked, ever answered a call light or toileted a resident. Ever. They had their responsibilities and I had mine. Because I knew those lights were my responsibility, and keeping those residents clean and dry was my responsibility, there was no confusion over who should be doing what.

When I went to acute care as a CNA, things changed. I noticed the nurses answering call lights, toileting patients, and a whole host of other things that I was used to taking full responsibility for. The other CNAs who had been there for some time had a tendency to shirk many of their duties, under the assumption that "the nurse can do it" (I'm not talking about the CNA being busy or tied up with something, but just not wanting to go into a room, knowing the nurse would have to go in there sooner or later, etc.).

There was a lot more tension between CNAs and nurses in the second scenario than the first. In the first scenario, everyone knew their roles and what they would be held accountable for, resulting in greater "teamwork". In the second, the lines were so blurred that it was always a matter of interpretation, resulting in less "teamwork".

Really, it was so bad that even something as small as refilling a water pitcher, getting a warm blanket, getting a snack, helping the patient to the toilet, the aide would just say "Oh, the nurse can do that. S/he has to go in there to do her/his assessment anyway.", leaving the patient with no water, cold, hungry, needing to pee, and the nurse having to go get water, a warm blanket, a snack, and toilet the patient before starting her/his assessment. No joke. Even the first set of vitals at the beginning of the shift, the CNAs would say "The nurse should do them. It's part of her/his assessment.".

I'm not saying you shouldn't help residents with ADLs if you are there and the aide is busy. The resident's safety comes first. But, if you have responsibilities that you are being held accountable for, and the ADL can wait a few minutes, then the aide is perfectly capable of doing it. I would just ask this particular aide to please go answer those call lights. Say something like "Could you please go answer those lights? Thank you.". Say it nicely, but firmly. I might even stop doing any ADLs (unless it is a safety issue, of course) when that particular CNA is on duty, just to break her/him of the habit of thinking you will do it.

[SuesquatchRN, BSN, RN]

The resident's safety comes first. But, if you have responsibilities that you are being held accountable for, and the ADL can wait a few minutes, then the aide is perfectly capable of doing it.

Thanks, Virgo.

It is when it's either a safety issue - alert but high fall risk and completely disoriented with a personal alarm going - or an rehab resident who is 90 and still continent needing to pee when the aides are doing rounds.

It's only one aide who is becoming a problem. And I am hearing about the other nurses, but they SHOULD be watching out for patient safety and I frankly know some would call an aide before intercept the guy about to crack his head like a canteloupe. It's a loooong hall and it's hard to always hear the alarms if you aren't there.