Nurse's aides are running the the floor.

JDZ344 · Mar 30, 2011

Exactly. On my floor, all of our CNAs/techs like to think they're entitled to much more information than they actually are. A couple of them go so far as to look up labs (and attempt to explain the non-wdl ones to nursing students.. that gave me a laugh after a long night) and read the H&P and progress notes.

In our facilities, NAs are allowed to read and document in the nursing notes. I only document when instructed to, though (example- if a patient falls and I am the only witness then I have to state what happened and then the RN writes her assessment afterwards). Looking up labs- I have a passcode for the system, but I rarely use it unless an RN wants me to log on and look up for them.

samirish · Mar 30, 2011

I have worked as a CNA for 3 years. I am now in school doing the prereqs for the nursing program and I fully intend to join the RN program next fall.

For the most part, when I worked, the nurses didnt bother me at all. I did my job and they did theirs. I did have a nurse say to me a few times " Mr. Smith needs some attention". I would go look in on Mr. Smith and sure enough, he would be lying there in a huge foul mess. Now, could the nurse have cleaned him up instead of coming to find me? I guess, but I never really thought about that. She has her own job to do and its not my business what she's doing. While its everyone's job to help the patients, I dont think its the nurses primary job to clean up a patient when they already have a cna assigned to them. When I am a RN, I fully expect cooperation if I ask a cna to give "Mrs. Jones" some attention when I have other duties to attend to.

tiroka03, LPN · Mar 30, 2011

When you are willing to put up the cost of education, and the time and scarficies to attend school. When you are willing to spend hour upon hour studying and practicing an endless list of procedures and lists of knowledge, then you have the right to say you are on the same level. If you think that a one time 3-4 week CNA class equates to nursing school, and CEU's due every other year, your fundamently mistaken.

I would like to see how many CNA's who think nurses are dumb to try to pass state boards. I can tell you I have seen countless CNA's go to school, and earn their degree. Then I have seen those very same ones, struggle for all they are worth to do the job, they earlier said was so easy.

I think it is because we do our jobs so well, and look at ease doing it, that CNAs think we are totally relaxed and just enjoying ourselves.

My first job as a nurse, we had no CNA's. I worked on a 20 bed med/surg unit. Two nurses at night. We did two sets of vitals on every pt every night. We passed meds, turned and cleaned pts. Before we left, every single one of those twenty pts had a shower or a bedbath. They were in a chair dressed, and hair done. Their bed was completly stripped and remade. Then we gave them their breakfast before we left. Until I see a CNA who could do that, minus the drugs and the dressing changes and the charting, I don't really buy into the misconception (putting that nicely), that CNA's are too busy. Because for years, I did more than I see CNA's do, plus the nurse aspect of it all.

So, do you CNA's do two sets of vitals on all of your pts? Do they bath and shower every single one of them every morning? Do they strip and remake every single bed?

I found it much easier to work as a two nurse unit. We got much more accomplished, just the two of us, then I do now with 3 to 4 CNA's. Why is that?

mandy1026 · Mar 30, 2011

Thanks. My thoughts exactly.

mandy1026 · Mar 30, 2011

Good for you. A team player is a team player no matter what title you hold.

JDZ344 · Mar 30, 2011

So, do you CNA's do two sets of vitals on all of your pts? Do they bath and shower every single one of them every morning? Do they strip and remake every single bed?
I found it much easier to work as a two nurse unit. We got much more accomplished, just the two of us, then I do now with 3 to 4 CNA's. Why is that?

I do 2-6 sets of vitals per patient, per day, and 2-4 at night. On day shift we strip and re-make every bed and bath every patient as well as a million other things.

kristak10 · Mar 30, 2011

I can see this from both points of view. CNA's are valued members of the health care team. I don't agree that anyone could perform their duties. It definitely takes a patient, caring person to be a CNA. I have worked with awful, and wonderful CNAs....just as I have worked with awful and wonderful Nurses. On the other side, CNAs don't always know what it is that nurses do. There is a lot more to nursing than meets the eye. A CNA may tell the Nurse that patient A needs pain medication...while patient B, C, D, E all have important issues that need to be addressed. If the nurse does not immediately meet patient A's needs it probably means the nurse has something more pressing to deal with, not that she is lazy,uncaring, slow because she thinks the patients is a drug seeker, etc. That may not always be the case, but more times than not it is. I would never walk into another patient's room with narcotics or blood. It is interesting how facilities are so concerned about medication errors, and errors in general, but implement policies like this...seems counter productive to me.

CCL RN, RN · Mar 30, 2011

.
My first job as a nurse, we had no CNA's.

I was a PCT for 14+years prior to becoming an RN.

I work in an all RN ICU, and in the cath lab, there are no techs/CNAs. Just RTs/RNs.

I prefer it that way, I wish we would go back to primary nursing. I would rather do it myself then rely on somebody else. In the ICU I am doing Q1 hr VS (at a minimum, sometimes q15min), all ADLs, bathing, call lights, monitor teching, and sometimes unit clerking. I don't need a CNA.

When I was a tech, I thought nurses were lazy too, and that I "ran the show". I thought that I did the majority of the work. Boy, how embarrassing. Seriously, I was so wrong. And seriously I am still embarrassed.

On floors where the nurse has so much to do, CNAs are necessary. But ADLs, call lights, and VS are not the crux of the pt care duties.

And CNAs can think, but they cannot critically think about the same things that we do. They just cannot understand until they become nurses. It's kinda like when people who have no kids criticize mothers. Until you've live it, you can't understand what we do.

Somedays, I would LOVE to go back to the days of being a tech where I didn't have to worry the way I do as an RN. Sometimes they offer us to float to the tele floor and act as a PCT. I ALWAYS volunteer. It's a much needed break from nursing. And when I do that, all my pts are bathed, fed, up, and beds made.

Primary nursing is something we should all strive to do, I wish we could implement this. Can you imagine an all RN med surg floor? Fantastic.

caliotter3 · Mar 30, 2011

I have worked as a CNA for 3 years. I am now in school doing the prereqs for the nursing program and I fully intend to join the RN program next fall.
For the most part, when I worked, the nurses didnt bother me at all. I did my job and they did theirs. I did have a nurse say to me a few times " Mr. Smith needs some attention". I would go look in on Mr. Smith and sure enough, he would be lying there in a huge foul mess. Now, could the nurse have cleaned him up instead of coming to find me? I guess, but I never really thought about that. She has her own job to do and its not my business what she's doing. While its everyone's job to help the patients, I dont think its the nurses primary job to clean up a patient when they already have a cna assigned to them. When I am a RN, I fully expect cooperation if I ask a cna to give "Mrs. Jones" some attention when I have other duties to attend to.

One time our DON fired an RN who cleaned up a resident's puddle of diarrhea instead of summoning a CNA to do the task. That is the difference between CNA tasks and RN tasks. Not many CNAs get fired because they did an RNs task instead of summoning an RN to do it.

dizzyray822 · Mar 30, 2011

As a student i observed this that happened with this patient that was going into surgery later that day due to a broken hip from a fall she had the day before and she really wanted to be washed up before surgery so Nurse called the PCT and let her know. Well, while we were in the room giving meds the PCT came in and set the basin filled with water and soap on the bedside table and left. The patient washed her face and brushed her teeth and called the Nurse to see if the PCT was coming back to help with the rest as she was in too much pain to do it herself. The nurse called the PCT and said that the patient was ready for her so we saw her go in the room and come out just a minute or two later. A little later the Nurse asked the patient how her bath was and she said she didn't get one...that the PCT just emptied the basin and left the room. Since the PCT had given the Nurse attitude that morning already the Nurse let the charge nurse know what was going on. I offered to bath the patient but the nurse said that since this has been an on-going problem that the charge nurse needed to know. Well, after being told to do so the PCT went back into the room to clean the patient. About an hour later we went to see that patient again and the nurse asked if she had been cleaned yet. This was so sad to me as the patient said "she came back and stood here and handed me the wash cloth for me to do it myself." "I had a hard time reaching some areas but I'm somewhat clean." This was upsetting to me. I know that we should promote independence and I know how some patients can be but this was not the case here. This patient has a fractured hip and was in a lot of pain and was by no means demanding. She was actually worried later about the PCT getting in trouble. I mean, seriously, if you cant treat the patients with respect and compassion then you need to find a different job. This is something that will be hard for me to deal with as a nurse. This nurse was saying too that its like at times you just want to jump in there and do it yourself but if you did that everytime a PCT wasn't doing their job then you would never be able to leave for the day. Meanwhile throughout the day I saw the PCT took her lunch and breaks and chatted with her friends.

That being said as a student I've also met amazing PCTs that I learned a lot from and made me feel more comfortable with patients. And I've met nurses that I wonldnt want near me ever. So I guess it depends on your facility but you'll have good workers and lazy workers regardless of their position everywhere.

JDZ344 · Mar 30, 2011

One time our DON fired an RN who cleaned up a resident's puddle of diarrhea instead of summoning a CNA to do the task. That is the difference between CNA tasks and RN tasks. Not many CNAs get fired because they did an RNs task instead of summoning an RN to do it.

I have never worked anywhere where an RN would be fired for that. That is part of an RN's job.

enchantmentdis, BSN, RN · Mar 30, 2011

Because of precisely the problems with CNAs and management the OP described is the number one reason why i preferred primary care over a mixed floor, and eventually left acute care altogether. I would rather have 4 patients and do all the care for them instead of have extra bodies sitting around the nurse's station, enjoying watching me bust my butt, while they chat in Spanish or Tagolog, or ebonics. And how dare they interrupt and put in their two cents while i am talking to the doctor. The doctors look at them like they are nuts. Sad to say, i have found the majority of CNAs to need lots, tons of help, in fact doing their jobs. I tell you it is just like working with babies, they have to be watched all the time, and have to be told how to do everything. If a blood pressure is high or low in one arm, i can't believe these folks need to be told to check it in the other arm before coming to me first. Just seeing them roll their eyes at me makes me cringe. Funny, long before i attended nursing school i was a cna at a large hospital and was able to get ALL of my baths, toileting, feedings done with all of my patients and never once asked an RN or LVN for assistance. The licensed staff appreciated it and because of that i was invited into their conversations, etc. I felt honored. I knew i was there to do my own work, not to constantly beg nurses for help. What i did when i needed help turning pts, etc was ask another aide for help. I wouldn't dream of bothering a licensed staff to do my job for me. I saw how incredibly busy the nurses were and how much responsibility they had. Nowadays the CNAs seem to enjoy gawking at the licensed staff as they carry on their duties, and are very bold when nurses ask them to do their own cna work. Yet they are annoyed that the doctors and ancillaries don't pay them much attention. Why should they receive attention-- the doctors and ancillaries are very busy are well aware that the cna has no responsibility or power and are taking up breathing space and aren't doing their work. As i have stated before: IF I WANTED TO BE A CNA I WOULD HAVE STAYED ONE AND IF THE CNA IS JEALOUS OF THE LVN AND RN BECAUSE THEY MAKE MORE MONEY GET OFF YOUR BUTT AND GO BACK TO SCHOOL. DON'T BLAME US FOR NOT BEING INTERESTED IN DOING YOUR JOB FOR YOU!!!