Nurse's aides are running the the floor.

[sprout2010]

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!!

[enchantmentdis, BSN, RN]

Oh MY!..So now CNA's can't think critically?

Right. They either don't want to, can't, or won't do it.

[enchantmentdis, BSN, RN]

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.

You are the bomb EMT and VERY brave! I'm sure you will be flamed, but who cares. So well said, i'm rolling on the floor laughing and need to change my underwear! This is the BEST post i've ever read!..... "I think i hear a call bell"......Tell it like it is! Fetch that water, do that peri-care. Amen. LOLOLOLOLOLOLOLOLOLOOOOL! :yeah::lol2::heartbeat:heartbeat:heartbeat:idea::idea::clown:

[joanna73, BSN, RN]

I've worked with some awesome CNA's, and some that should be fired. For the ones often complaining about their nurses: Come and talk when you have finished your training and passed the nursing exam. Those CNAs really have no business thinking that they know it all, because they don't. And to those CNAs who are always willing to help, and work as a team...thanks :) You're gold!

[JDZ344]

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!!!

Wow, you have a nice attitude towards CNA's. I bet they just LOVE working with you. And, as an aside, what does it matter which language they are speaking? If they are not working, they are not working, regardless of which language they are having their side conversations in!

That superior education you have gives you the knowledge to know to check the other arms. Some CNAs may not know this. Just be grateful they came to you at all- quite a few don't!

[newway]

You are the bomb EMT and VERY brave! I'm sure you will be flamed, but who cares. So well said, i'm rolling on the floor laughing and need to change my underwear! This is the BEST post i've ever read!..... "I think i hear a call bell"......Tell it like it is! Fetch that water, do that peri-care. Amen. LOLOLOLOLOLOLOLOLOLOOOOL! :yeah::lol2::heartbeat:heartbeat:heartbeat:idea::idea::clown:

Wow how sad you two think so little of your co-workers. Are there lazy CNA's yes , but there are probably just as many lazy RNs as well. Thankfully where I work we get a little more responsibility such as EKG's, vitals, blood draws, accuechecks, and specimen collection. Of course I am sure in your mind they could teach a monkey to do that as well. Respect is a two way street, if you are not giving it out don't expect too much back. We can make or break your job, and from what I have seen not all nurses are the brightest crayon in the box iether. As far as not being able to think, I guess I could act dumb when I notice a change in a patient's condition and not tell the RN. Its not my job right?

[enchantmentdis, BSN, RN]

Wow, you have a nice attitude towards CNA's. I bet they just LOVE working for you. And, as an aside, what does it matter which language they are speaking? If they are not working, they are not working, regardless of which language they are having their side conversations in!

That superior education you have? Gives you the knowledge to know to check the other arms. Some CNAs may not know this. Just be grateful they came to you at all- quite a few don't!

The CNAs i've worked with have enjoyed having me around because they said, "wow, you help out a lot". They just have no idea what i really think, because i keep my attitude in check while i am at work. This forum is a safe place which allows people to vent. And i appreciate that. Language matters if you don't understand what they are saying, and especially if the doctors have complained about it and have asked the nurse to stop them from doing it. It's America--it's common courtesy to speak English while working in America's hospitals.

[CCL RN, RN]

I LOVE THIS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

You do? Because it made the poster look insecure and petty.

And it immediately weakened any argument she/he was 'trying' to defend...

[enchantmentdis, BSN, RN]

Wow how sad you two think so little of your co-workers. Are there lazy CNA's yes , but there are probably just as many lazy RNs as well. Thankfully where I work we get a little more responsibility such as EKG's, vitals, blood draws, accuechecks, and specimen collection. Of course I am sure in your mind they could teach a monkey to do that as well. Respect is a two way street, if you are not giving it out don't expect too much back. We can make or break your job, and from what I have seen not all nurses are the brightest crayon in the box iether. As far as not being able to think, I guess I could act dumb when I notice a change in a patient's condition and not tell the RN. Its not my job right?

If CNAs are doing ekgs, vitals , blood draws, etc then they need promotions, better pay, and a title change. How are they able to do all their bathes and feedings while doing accuchecks? No cna has ever made or broken my job. I worked 15 years in acute care before leaving and did it all, but generally prefer primary care where there are no cnas. CNAs are being phased out in favor of primary care in many hospitals. Pts seem to want the licensed staff in their room more nowadays. It's not so bad if the RN has four patients---she can do all the baths and all the technical stuff, too. Fewer bodies taking up space and less animosity between licensed and unlicensed staff. Like i said in a previous post, cnas have enjoyed working with me because i did do lots of baths, etc and they appreciated the help. Also, it is nice to freely express my opinions on this forum, even if some are angry with my posts. It's called freedom of speech.

[lalalalexi]

This has clearly turned into a CNA vs RN debate, and each side is going to think they are right. I think the people with the most valid points though, are those that have worked as a CNA and are now a nurse. They know both sides of the coin. I worked as a tech before I became and RN, and while I knew the nurses were busy, I really underestimated how much they do and how busy they really are. I would sometimes get frustrated that a nurse would call me to get someone off the bedpan/bring someone icechips etc when it seemed she had the time to do it herself. Like someone else on here said, I feel embarrassed now that I ever thought that!

I work on the same floor as a nurse that I did while I was a tech, and I find myself apologizing sometimes when I ask the tech to do something I know I could do myself but just have something more urgent to take care of. Like I'll say "I'm sorry, I know you probably think I could get so and so off the bedpan myself, but I'm really busy doing xyz right now". Sometimes I hate that I do this, but then at least they know I'm not just being bossy and lazy. I will always help out a tech if I have time.

But I will tell you this...the hardest I've worked so far has been as a nurse. I never clocked out late as a tech, I almost always got my lunch break, always got all my charting done and could just leave work at work. As a nurse, sometimes I'm not sitting down to do my charting until the techs are clocking out, I've missed lunch and not even noticed more times than I can count, and I often go home and think about my patients, think about what I could have done better and worry if I made the right call.

But I will just say it again, until you've done both jobs, you really don't know. I worked hard as a tech. It IS a hard, important job. But boy was I surprised when I became an RN. Are there lazy, bossy nurses out there? Yes of course. But next time you CNAs roll your eyes or complain about a nurse not helping out as much as you'd like, give them the benefit of the doubt! Chances are they are busting their butt and you just don't realize it.

[TheCareerStudent]

Wow this is a good post OP. I would say that everyone should strive to work together, however one thing I learned a long time ago in the military:

Rank has it's privileges.

If CNA's do not want to do their tasks and duties go to college and become an RN. An RN, in my mind, worked their butt off in school and Earned the right to due higher level tasks. While we should all help out the team when the team needs it, it should be remembered that in a normal setting there are Indians and there are Chiefs.

[DogWmn]

Wow is all I can say, I so glad I no longer work in the hospital environment. I graduated in '72 and my first job was at a small rural regional hospital that had team nursing. I worked on the Ortho floor that was pretty busy, back then we had some fairly long term patients with traction etc. along with surgical ortho.

We had team nursing and no cna/techs only RN's and LPN's and I loved it, we did have a ward clerk and there were "aids" who delived laundry, meal trays, stocked the fridge etc but no patient contact. We had plenty of staff, the shift super would come around to make sure every one got their lunch break, we had a float pool of experienced RN's and LPN's to help when the patient population went up during a shift or help cover for lunch breaks. We even had two wards one female and one male along with 2 bedroom suites and a couple of singles up front by the nurses station.

The noob LPNs did patient care to learn the ropes, the experienced LPN's with advanced pharm courses either passed meds (1 per team) or took on a high acuity patient or 2 (my fave). We had 1-3 RN's per floor depending on patient census, their responsibilities were to start IV's (LPN's weren't allowed back then) hang blood and give IV meds, supervise the the team, assist with admits, doc orders and round with the docs. The team assignments were always flexible depending or staffing and patient census, no one ever got stuck with too much work and if someone got buried we all pitched in, when we went on break we gave mini report to those remaining (including RN's) to cover patients. I don't ever remember an us vs them, RN vs LPN thing, we each proudly worked with in our scope of practice.

I guess I'm really greatful I can look back on my hospital nursing experience with fondness and such a fun happy experience...don't get me wrong we did work our butts off, but it was a rare day we didn't all get our lunch break. Vary rarely did anyone stay over because we all pitched in to make sure EVERYONE got out on time, I even remember a few times the shift supervisor pitched in when we'd get buried with admits from emergency surgery! I even remember working along side her one time as she helped me get ready for two striker bed patients, get them set up, etc. A true team effort through out the hospital it was great:up:

[JDZ344]

If CNAs are doing ekgs, vitals , blood draws, etc then they need promotions, better pay, and a title change. How are they able to do all their bathes and feedings while doing accuchecks? No cna has ever made or broken my job. I worked 15 years in acute care before leaving and did it all, but generally prefer primary care where there are no cnas. CNAs are being phased out in favor of primary care in many hospitals. Pts seem to want the licensed staff in their room more nowadays. It's not so bad if the RN has four patients---she can do all the baths and all the technical stuff, too. Fewer bodies taking up space and less animosity between licensed and unlicensed staff. Like i said in a previous post, cnas have enjoyed working with me because i did do lots of baths, etc and they appreciated the help. Also, it is nice to freely express my opinions on this forum, even if some are angry with my posts. It's called freedom of speech.

now I've read a few more of your posts I'm not angry any more- but you really did make it sound like you were generalising all NAs in a post further up. Probably the way I was reading it. I'm sorry you've met some awful NA's.