Nurses behavior towards CNA's?

Nursing Students CNA/MA

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So i have a question; the other day I was having a pretty hectic shift. I had a total of eight patients, three of them were brand new admits that were just coming onto the floor. I also was told to move two of my patients to other rooms because they needed to move an unstable patient closer to the nurses station. That meant moving four different beds, plus the patient's belongings. I had to get my admit kits for two of the patients that had arrived, when the third one arrived. The nurse was in there with the patient, doing her assessment on him. She asked me to take his blood pressure, but I also had to check three of my patients sugars before they ate their dinners. The nurse got upset that I didn't check his BP when she had asked. I went in there and took it, while she was in the room with me. Isn't that something that she could have done, seeing that I was busy running around like a chicken with my head cut off? It's like she didn't even care that I was busy, she just wanted to tell me what to do, and for me to do it when she had asked. She then asked me to recheck his BP at a later time. During the time she had asked me to recheck his BP, he needed to use the bathroom. He was in there for a minute, and when he was finished, he needed my help, so I helped him clean up. While I was doing that, I noticed a stage II/III sore on his bottom. I asked him if the nurse had assessed his bottom when she was doing her assessment and he told me no. I told him that I was going to get her so she could look at his bottom and that I was also going to come back and get his BP. When I saw her, she asked me what his BP was and I told her that he was using the bathroom during the time she had asked me to take it. I told her that he had a sore on his bottom that I wanted her to check out and she then said that she wasn't trying to be mean, but when she tells me to check a BP, it needs to be done at that moment. I checked it, and she checked his sore. After that, we didn't end up talking to each other the rest of the shift.

Does she have that right to speak to me like that? Basically like I was her little slave and that I needed to do what she told me to do at that moment? I've never had any of the other nurses speak to me like that, and actually I've had nurses do something for me because they knew I was busy. It's like she just didn't want to do it. What is a CNA's/PCA's/MA's right when it comes to nurses talking down to them? I always do what my nurses ask of me, but I won't lie, there have been a few times where I have forgot something, but had always remembered a little bit later. These were things as small as bring the patient a blanket, or some new socks. Is there a way to handle these situations? Especially since I feel like she completely missed a big part of her assessment, which was the skin assessment, and if it wasn't for the fact that I had helped him in the bathroom, I would have never found that sore.

Specializes in Emergency, LTC.

I've had similar happen during a shift. Usually when I'm in the middle of something and a nurse calls to delegate another task I say something along the lines of "ok, I'll do that as soon as I'm done with ___", at which point they either say "okay, thank you" or "I actually need this done right away" and that's how I know which task is a priority to them. As the nurse, they're far more competent in assessing/prioritizing and I respect that and learn from it.

In my book, it's all about respect. The entire floor team needs good communication and respect for one another. Those teams are the ones that work well together, thrive and have better patient outcomes.

Brush it off and just ask which task they'd like done first next time. It'll save you a lot of grief :)

ask which task they'd like done first next time. It'll save you a lot of grief :)
this, THIS RIGHT HERE. Oh my gosh, it was a hard lesson to learn at first, but seriously, when you're stuck in a mire of a huge workload and sudden demands get put on you, I find this to be the easiest, er, most efficient way to communicate.

Just like I tell my patients I'll be back in X amount of minutes, I like to find out priority level on things...because let's face it, you never get asked to do something when it's convenient. ;)

Nurses like that are the worst!!! I would just try and stand up for myself (like I've done in the past) and told her that you cannot do everything she asks right when she asks it. If she wants it done on HER time she should do it herself. It's not your fault she failed to do her job properly.

That nurse absolutely did her job properly. Part of her job is prioritizing, deciding what needs to get done and when. It is absolutely the nurse's job and right to tell an assistant (respectfully) to stop immediately what they are doing and help the nurse if the nurse assessed the situation as such.

Your statement is a perfect example of the difference between a CNA who is task oriented, and a nurse, trained to critically think, assess a situation and implement an action.

I'm not saying CNAs don't have critical thinking skills, but they don't have the medical knowledge to fully use it within their job scope. I just told my husband today of a relatively new assistant who is awesome at detecting things and reporting it. She has assessment skills that would make her a perfect candidate to further hone those skills in nursing school.

However....big however....Last night she did not report very abnormal vitals to me within an appropriate time. She was extremely busy and thinking in a task oriented manner.

I personally make very sure to always show my appreciation for the CNAs. But I also let them know (in a teaching manner) when they messed up and what to do next time. (Like the CNA waiting too long to report vitals to me.

Well I agree with most of what you said. I was a Cna for 3 years and I'm half way through my last semester of practicum so I do actually get to see what nurses do. Significantly more then I thought as I am never done on time. However I am going to have to disagree with the part where you said cnas can't prioritize. I think nurses fail to understand that the pt load for cnas are always at least double if not triple or quadruple that of a nurse. Often nurses tend to think the aid is their own personal assistant and don't realize there may be 5-6 other nurses asking them to do tasks as well. This can greatly compound the problem. Communication is absolutely vital in our jobs. Once that's in place there is no stopping you.

Specializes in ICU Stepdown.

But, as a nurse, is it hard to let an aide know that something needs to be done right away for -this reason-? Or to at least state that it is important/top priority? Because in our heads, we are doing our jobs and are focused on OUR jobs. Just as nurses aren't going to prioritize an aides requests because they're too busy focusing on THEIR job...

Specializes in ICU Stepdown.
Well I agree with most of what you said. I was a Cna for 3 years and I'm half way through my last semester of practicum so I do actually get to see what nurses do. Significantly more then I thought as I am never done on time. However I am going to have to disagree with the part where you said cnas can't prioritize. I think nurses fail to understand that the pt load for cnas are always at least double if not triple or quadruple that of a nurse. Often nurses tend to think the aid is their own personal assistant and don't realize there may be 5-6 other nurses asking them to do tasks as well. This can greatly compound the problem. Communication is absolutely vital in our jobs. Once that's in place there is no stopping you.

Thank you! And there are many times where I have forgotten to even get vitals at the request of a nurse... We have residents/patients talking in our ears, requesting countless things and really their requests are top priority in my CNA mind. So I'm going to forget to do something or not think to do it right away because this person needs this or this person wants to go to bed and this person still needs their bath... For a nurse to tell me that I'm not good at prioritizing...why don't you do what I'm doing?

Every nurse I've seen that has done an aide's work doesn't do very well.

This nurse sounds like she is on a power trip. Remind her that you are her coworker and not her slave. She shouldn't be talking to you like that. Yes she wanted you to check his BP but when a patient needs to use the restroom badly and you say "let me check your BP first" the patient would not be happy. You did the right thing bringing him to the bathroom. Try to be civil but if she keeps it up I think something will need to be said to the supervisor. Working in a toxic environment is not healthy for anyone, it will burn you out quick. Keep up with the good work. You do a lot as a CNA and sometimes the nurse doesn't understand how much you have going on too. Good luck!

Well I agree with most of what you said. I was a Cna for 3 years and I'm half way through my last semester of practicum so I do actually get to see what nurses do. Significantly more then I thought as I am never done on time. However I am going to have to disagree with the part where you said cnas can't prioritize. I think nurses fail to understand that the pt load for cnas are always at least double if not triple or quadruple that of a nurse. Often nurses tend to think the aid is their own personal assistant and don't realize there may be 5-6 other nurses asking them to do tasks as well. This can greatly compound the problem. Communication is absolutely vital in our jobs. Once that's in place there is no stopping you.

I was a CNA for 5 years before becoming a nurse. A CNA of course can prioritize their job duties. However, ultimately, it is the nurse's job to prioritize because the nurse has the entire picture.

The CNA does not. I know what they need to do. They do not know what I need to do.

If I'm asking a CNA to drop something that was on his/her top priority list, I ask what they were doing so that I can decide which is more important at the time. What I need done at that moment vs. what the CNA was about to do. I decide. That's my job.

Many times I hear what they say they are doing, and I say, ok. That trumps what I need done right now. Either way, it's my choice as the nurse.

Specializes in ICU Stepdown.
I was a CNA for 5 years before becoming a nurse. A CNA of course can prioritize their job duties. However, ultimately, it is the nurse's job to prioritize because the nurse has the entire picture.

The CNA does not. I know what they need to do. They do not know what I need to do.

If I'm asking a CNA to drop something that was on his/her top priority list, I ask what they were doing so that I can decide which is more important at the time. What I need done at that moment vs. what the CNA was about to do. I decide. That's my job.

Many times I hear what they say they are doing, and I say, ok. That trumps what I need done right now. Either way, it's my choice as the nurse.

And I suppose it's the patient's choice to curse the CNA out and tell them that they don't care what the nurse needs, they need to go to the bathroom 😊

Specializes in ICU Stepdown.

I wonder how nurses survive places where they don't employ CNAs... I don't even mean to be passive aggressive, I am truly curious.

I'm pretty new to a sub acute rehab facility. Many of the patients, specifically being there for PT, are none weight wearing and require total assist. This of course means that it takes a good chunk of time toiletting a patient.

So at the end of shift today while giving report, 4 of us nurses were at the nurse's station when one of our ADONs came to us with an inservice sheet saying they have received a LOT of complaints lately that nurses, particularly one (I'm pretty sure it was me) are answering call lights and saying that a CNA will be with them after they are finished with what they are currently doing.

The sheet we had to sign stated that we are all nurses, and that we all know how to toilette patients.

Well....we were PISSED and all of us spoke up. However, we had our different reasons for being upset. I was upset because our facility strongly emphasizes never passing a call light un-answered. So I always knock and much of the time, yes, I let them know a CNA will be with them. That is after already having toilette 3 patients, knowing the CNA is working his/her butt off too. But I can only spend so much time toiletting patients! A CNA pointed made a good point today that MY work has a legal time limit. I'm always always cutting it extremely close BECAUSE I'm also answering call lights, or a situation occurs. (2 of my patients both had BPs over 200 at the same time the other day at the exact same time a post op patient spiked a fever. LOTS of time spent contacting the doctor, entering new antihypertensive orders, administering the meds, checking and rechecking the BPs during a good 6 hour period. I eventually sent one to the ER.

ANYway, the other nurses were in an uproar saying that the CNAs were lazy and aren't answering call lights. That irritated me. Yes, there are a few CNAs like that. But that for the most part is not the problem. The problem is ridiculous CNA to patient ratios and unrealistic expectations of patients.

My point of this long post, lol, was to stick up for CNAs agreeing that many nurses don't realize how busy the CNAs are.

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