Nurse's aides are running the the floor.

Five&Two Will Do · Mar 30, 2011

Wow that sounds like the kinda floor I would not like. CNA's are often overworked and short staffed too. I know this from personal experience. I also know that lots of RN's are too good to clean a patient or help with the care. I love the ICU cause I do all of it for les patients. When I need helo there are other RN's there. We only hae a telemetry tech that is a cna and no lpn... Makes it pretty simple :)

R*Star*RN, BSN, RN · Mar 30, 2011

I have been in the situation you are describing. To be honest I'm glad that the facility I work in is primary care nursing. I have 3-4 patients on night shift and days gets 2-3 patients. Charge has no patients so she can help out as needed. The only CNAs or LPNs in the hospital are floats for 1:1 sitters or Rehab.

Five&Two Will Do · Mar 30, 2011

I have been in the situation you are describing. To be honest I'm glad that the facility I work in is primary care nursing. I have 3-4 patients on night shift and days gets 2-3 patients. Charge has no patients so she can help out as needed. The only CNAs or LPNs in the hospital are floats for 1:1 sitters or Rehab.

I think that primary care is the best model for nursing. Others may not agree, but I like knowing everything that is going on with my patients. I worked on a tele floor before that use team nursing. I had to rely upon medication nurses (not always LPN) to make the proper decisions about giving meds. They usually were relying upon VS taken by a CNA. It goes on and on. Too much room for miscommunication or someting being forgotten. Very scary to me

JoMark06 · Mar 30, 2011

Primary care nursing can work with the right RN:Patient ratios. The facility I just left did primary care nursing for the most part. When you have 3 RNs to 19 patients it is near impossible to get everything done for everyone. And in my opinion, that situation just is not safe! My current facility does "team" nursing. We have 23 beds, 2 techs and 5-6 nurses (depending on census). I typically have 4 pts a night with potential to have 5 if needed (but that doesn't happen often). With this set up, I am able to spend more time with my patients. I do as much as I can to help out my techs to include toileting, hygiene care, ambulation in addition to my duties of assessments, passing meds, checking off orders, etc.

Five&Two Will Do · Mar 30, 2011

Primary care nursing can work with the right RN:Patient ratios. The facility I just left did primary care nursing for the most part. When you have 3 RNs to 19 patients it is near impossible to get everything done for everyone. And in my opinion, that situation just is not safe! My current facility does "team" nursing. We have 23 beds, 2 techs and 5-6 nurses (depending on census). I typically have 4 pts a night with potential to have 5 if needed (but that doesn't happen often). With this set up, I am able to spend more time with my patients. I do as much as I can to help out my techs to include toileting, hygiene care, ambulation in addition to my duties of assessments, passing meds, checking off orders, etc.

This sounds like a good setup. When I worked on the floor, the team nursing would allow for me to have responsibility for 8 patients. Some of them were quite sick and should probably have been on a stepdown unit, but they do not have that in this VA. Sounds like you stay busy which certainly makes the night go faster:up:

backatit2 · Mar 30, 2011

it's funny that i saw this thread because i was just thinking about how frustrated i was after working with the laziest LPN i've ever seen in my life today (i'm a CNA/nursing student).

she came and hunted me down at least 5 times today to get me to do things that would've taken her less time to DO than she spent looking for me to get me to do them, u know? one example - a patient (whose room she was in, and whose room she went back to after finding me) needed a CLEAN "hat" put in her toilet to measure urine. it would've taken her less time to grab a clean hat from the supply room and stick it in there than it took for her to find me, tell me about it, and walk back to the room. another time - a patient had an EMPTY urinal sitting on his bedside table and she wanted it moved. seriously, think about walking by a room and seeing a urinal in a place you think is "inappropriate" and how long it would take to move it RIGHT THEN and how long it would take to find someone else, interrupt what they're doing, and ask them to go move it.

i think these CNA/RN wars come from simply being jaded. there are certain nurses who i will go out of my way to help (because they help me) and by help me i mean they do what they're SUPPOSED to do. then, there are nurses who i wouldn't get in a hurry for if they were on fire because they do stupid crap like hunt me down to get a cup of ice when they could've stood by a fridge and waited for some to freeze in the time they spent finding me to get some.

unfortunately, the nurses who aren't lazy get screwed by policies like the one you described because the ones who ARE lazy abuse the CNAs so badly. yes, CNA's are there to ASSIST, but MANY nurses take advantage of that and won't do certain things (like answer lights or help a patient to the bathroom) EVER -even if they aren't busy - because "that's the CNA's job." but you better believe the nurses won't hesitate to ask us to mess with the IV pumps to help THEM which is actually out of our scope.

it would be so, so nice if people would get over themselves and just do everything they could possibly do to help the patient instead of looking for someone else to put the work off on. a spill? why clean it up when you can call housekeeping? bathroom? why take them when you can get someone else to? food? why go to the cafeteria when you can get a nastier version brought up by dietary? it's ridiculous and it makes me sick.

mandy1026 · Mar 30, 2011

This conversation is discussed all the time. I work the night shift and have been working the night shift for many years. Most cna's have the same response about the nurses not helping them. i have seen cna's sleep until five in the morning and then complain they are behind time and want help from nurses. Bottom line if everyone does what they are supposed to without pointing fingers we would not be having this conversation.

emt123277 · Mar 30, 2011

That's fine, and they are overworked and abused by some other staff but here it is anyway:

I can train anyone to answer a call bell, toilet a pt, get pts in and out of bed, peri-care, and fetch water. When they can assess, teach, hang blood, perform IVP med passes, or generally critically think then we can have this argument but until that time... I think I hear a call bell. So take care of that while I chart on the vasoactive drips, IABP, and PAWP... you know the things that I've been to busy doing to help you ambulate Mrs. Jones.

Five&Two Will Do · Mar 30, 2011

This conversation is discussed all the time. I work the night shift and have been working the night shift for many years. Most cna's have the same response about the nurses not helping them. i have seen cna's sleep until five in the morning and then complain they are behind time and want help from nurses. Bottom line if everyone does what they are supposed to without pointing fingers we would not be having this conversation.

Everyone does not have the work ethic it takes to be a Nurse or CNA. The healthcare "team" is what takes care of the patient. We should not point fingers. Nicely put by you:yeah:

morte, LPN, LVN · Mar 30, 2011

Hi everyone! This is my very first post...(after being a follower/reader of posts for a while!) I am a fairly new grad and have worked on a hectic med surg floor for about 7 months. Everyday is filled with the struggles of being a new nurse: time management, prioritizing, handling emergencies, making sure pts receive the correct medication ON TIME, & putting out fires in every direction with unhappy pts/family members/doctors. The list goes on and on. I truly feel like I am doing the best I can (and trust me I am my own worst critic.) I always make sure all my pts needs are met before I chart/take a break. Most shifts I miss my lunch and am lucky if I am able to use the restroom! This being said, there seems to be a new motto on my floor.."The RNs are lazy and think they are too good to do the CNA's job." We just had a staff meeting (with all CNAs, LPNs, and RNs), which, in a nutshell, bashed the RNs ONLY for not answering call lights, leaving pts dirty, and refusing to toilet them. My manager was ALL ABOUT this, nodding her head and agreeing with the cnas who were complaining. She's now put into place a rule that no nurse can walk past a call light, beeping iv pump ect. and if it is witnessed one can get written up. Doesn't matter if I am on my way, narcotics in hand, to medicate a pt, or en route to hang blood, I have to not only answer the call light, but meet that pts need, meaning taking away care from my own pts. I completely understand the need for call lights, and that it could be something very important. Truth is though, that each nurse is only one person, has their own huge pt load and the cnas are there for a reason...to assist the nurses! Now I can only truly speak for myself but I know my fellow RNs on the floor are for the most part on the same page. We actually do spend a huge amount of our shifts doing cna work! I toilet pts, empty ready to burst foleys, I never leave a pt dirty unless it is to get a cna to help me clean then up. I had a pt who definately needed two people to help clean him up, boost and turn him. I asked a cna to help me (very politely) and all I got was eye rolling. She even said "I have too many pts and don't have time." And walked away. So I had to get another RN to help me. The part that infuriates me most is that said cna, (and honestly most of the others ones) can be seen talking on their cellphone, hiding in various spots on the floor, and they NEVER miss a break or lunch, and in fact take extended lunches! Most of the RNs including myself have gone to our manager recounting this behavior and NOTHING gets done. It is to the point now where its just a waste of time to complain and I just suck it up, keep my mouth shut, and do my job. Does this sound familiar to some of you or is this something unique to my floor? I in no way think I am above doing to basics of caring for my pt and I hope I am not coming off that way. I am just sick of running around like an idiot all shift! Am I wrong for thinking every worker should be accountable for completing their job responsibilities? On my unit, however, it seems to just be up to the RNs to do everything!!

Get the new policy in writing, esp the part that bolded. Then send it to risk management. It is not acceptable to bring meds/blood into another patients room.

allnurses Guide · Mar 30, 2011

I have been in the situation you are describing. To be honest I'm glad that the facility I work in is primary care nursing. I have 3-4 patients on night shift and days gets 2-3 patients. Charge has no patients so she can help out as needed. The only CNAs or LPNs in the hospital are floats for 1:1 sitters or Rehab.

I thought this model had become extinct! When I started we used the primary care nurse model and everyone was all about rejecting the Team Concept as "assembly line nursing". Now it is back with a vengeance - I don't recall seeing this much animosity between RNs, LPNs/LVNs and CNAs. It seems to have devolved into a de facto caste system.