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.
We'll see I'm in a weird spot because as an extern I'm not a Cna anymore, yet not quite a nurse either. At least not for another couple of months. However, Let me muddy the water a bit. It's not always that cut and dry. On my hospital floor we are a 42 bed med surg unit. You may have 1-2 pcas (cnas). There are 7 nurses to share the pcas. Now you are also sharing those same Pcas with at least 4 physical therapists. So now there is really 11-12 sharing 2 aids. These Aids can also be called upon by respiratory therapists here. Now your up to 15ish sharing 1-2 aids. All trying to delegate. You as a floor nurse will not be able to dictate YOUR priorities to that aid all the time. It just doesn't always work that way. Now ltc is a different animal but some floors in hospitals it just simply can't be done
In our hospital, nursing orders and doctors' order trump all other orders, no matter what. We officially report to the RNs on duty, not PT or respiratory. The RNs have had go arounds with PT over us putting a patient back into bed for skin assessments or wound dressings or taking the patient to the bath tub because they needed a bath *that bad* when PT wanted them in a chair. Admission vitals *always* take priority over other things; if it is an acute admit, they obviously are sick and those vitals are a critical piece in getting them well. An abnormally high temp needs to be dealt with immediately, just as a high BP or pulse, or low POX or pulse needs to be recorded right away. The attending or on call provider needs that information immediately and expects it immediately. Taking vitals does not take that long, either, so to me, it's a no brainer.
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...
We shouldn't have to fully explain our rationale for prioritization to the aide. Ex: My patient's bp has been high throughout entire shift. I've been giving hydralazine. I need last BP check to see if I need to send him to the ER.
BUT, I need to be in another room dealing with the same situation.
True story. Happened the other night.
So I needed my aide to get the BP for me. It was to be the last check before the Dr said, that's it, send him out. Let's say the CNA needs to shower a pt. The pt has been waiting all day
Important? Of course. But of course I'm going to tell the aide to get the BP first. I dont need to get into the hx of the entire shift of calls to the MD and orders for hydralazine. I hate to sound harsh, but it's a "because I said so" kind of situation. Said respectfully of course.
Nurse: I need to have Mr. Jones BP checked.
CNA: Ok, I'm about to shower Mrs. Woods. Shes been waiting all day. I'll do it after.
Nurse: I understand. However, this takes priority at the moment.
We shouldn't have to fully explain our rationale for prioritization to the aide. Ex: My patient's bp has been high throughout entire shift. I've been giving hydralazine. I need last BP check to see if I need to send him to the ER.
BUT, I need to be in another room dealing with the same situation.
True story. Happened the other night.
So I needed my aide to get the BP for me. It was to be the last check before the Dr said, that's it, send him out. Let's say the CNA needs to shower a pt. The pt has been waiting all day
Important? Of course. But of course I'm going to tell the aide to get the BP first. I dont need to get into the hx of the entire shift of calls to the MD and orders for hydralazine. I hate to sound harsh, but it's a "because I said so" kind of situation. Said respectfully of course.
Nurse: I need to have Mr. Jones BP checked.
CNA: Ok, I'm about to shower Mrs. Woods. Shes been waiting all day. I'll do it after.
Nurse: I understand. However, this takes priority at the moment.
The shower will have to wait.
Thank you. I will be in room number xyz.
End of story.
Clearly getting a BP should be done before a shower if a nurse asks for it to be done. But the situation is that a patient has to go to the bathroom and the CNA chooses to take them to the bathroom before taking the same resident's BP. IRL, if I were the CNA I would ask the patient "we really need to do your BP, are you able to wait a couple minutes before going to the bathroom?" And I go from there. But it just sounds stupid for an aide to give someone a shower before getting someone else's BP. MY overall problem and the reason why I'm bitter about the entire thread is that the nurses I have worked with are rude and try and tell me how to do my job. I have gotten into it with a nurse because a resident had her light on 5 million times asking about her pain meds and each time I would tell the nurse and she eventually says "well I don't want to talk to so and so right now." She didn't talk to her to begin with. If someone's call light is continuously going off and I tell them that the nurse is busy each time there's a point where the nurse needs to go in there and say something to the resident because I have nothing to say about her pain med. The same nurse says "well I've never been a CNA so I don't know what to do" pretty much saying she can't answer a freaking call light. Nurses coming to me saying that this person needs to go to bed then two minutes later says someone else needs to go to bed. NURSE, I know what I'm doing, you've never been a CNA while I've been one for a year now. I know who is sore but I don't have a clone that I can tell to go out this person down while I put someone else down. Oh, and thanks for telling me that so and so has a dinner tray in their room when dinner just ended about 15 minutes ago and I have more important things to do than go take someone's tray out their room.
We shouldn't have to fully explain our rationale for prioritization to the aide. Ex: My patient's bp has been high throughout entire shift. I've been giving hydralazine. I need last BP check to see if I need to send him to the ER.
BUT, I need to be in another room dealing with the same situation.
True story. Happened the other night.
So I needed my aide to get the BP for me. It was to be the last check before the Dr said, that's it, send him out. Let's say the CNA needs to shower a pt. The pt has been waiting all day
Important? Of course. But of course I'm going to tell the aide to get the BP first. I dont need to get into the hx of the entire shift of calls to the MD and orders for hydralazine. I hate to sound harsh, but it's a "because I said so" kind of situation. Said respectfully of course.
Nurse: I need to have Mr. Jones BP checked.
CNA: Ok, I'm about to shower Mrs. Woods. Shes been waiting all day. I'll do it after.
Nurse: I understand. However, this takes priority at the moment.
The shower will have to wait.
Thank you. I will be in room number xyz.
End of story.
I hear you, but wouldn't it go better if it went down like this:
Nurse: Please check Mr. Jones BP for me, I think We might need to send him out to ER
This conveys urgency and let's her know it's a priority, because something might be wrong, not a priority because I said so.
Clearly getting a BP should be done before a shower if a nurse asks for it to be done. But the situation is that a patient has to go to the bathroom and the CNA chooses to take them to the bathroom before taking the same resident's BP. IRL, if I were the CNA I would ask the patient "we really need to do your BP, are you able to wait a couple minutes before going to the bathroom?" And I go from there. But it just sounds stupid for an aide to give someone a shower before getting someone else's BP. MY overall problem and the reason why I'm bitter about the entire thread is that the nurses I have worked with are rude and try and tell me how to do my job. I have gotten into it with a nurse because a resident had her light on 5 million times asking about her pain meds and each time I would tell the nurse and she eventually says "well I don't want to talk to so and so right now." She didn't talk to her to begin with. If someone's call light is continuously going off and I tell them that the nurse is busy each time there's a point where the nurse needs to go in there and say something to the resident because I have nothing to say about her pain med. The same nurse says "well I've never been a CNA so I don't know what to do" pretty much saying she can't answer a freaking call light. Nurses coming to me saying that this person needs to go to bed then two minutes later says someone else needs to go to bed. NURSE, I know what I'm doing, you've never been a CNA while I've been one for a year now. I know who is sore but I don't have a clone that I can tell to go out this person down while I put someone else down. Oh, and thanks for telling me that so and so has a dinner tray in their room when dinner just ended about 15 minutes ago and I have more important things to do than go take someone's tray out their room.
There's my frustration .
The example is valid. In that given situation, the patient is not being admitted but has already been admitted and is not hemodynamically stable. And, I have worked with CNAs who would do the bath first, then the BP. They are people who cannot prioritize or manage time, and they lack all common sense.
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 😊
Right, because I don't get cursed out either when I prioritize who I will see first.
Clearly getting a BP should be done before a shower if a nurse asks for it to be done. But the situation is that a patient has to go to the bathroom and the CNA chooses to take them to the bathroom before taking the same resident's BP. IRL, if I were the CNA I would ask the patient "we really need to do your BP, are you able to wait a couple minutes before going to the bathroom?" And I go from there. But it just sounds stupid for an aide to give someone a shower before getting someone else's BP. MY overall problem and the reason why I'm bitter about the entire thread is that the nurses I have worked with are rude and try and tell me how to do my job. I have gotten into it with a nurse because a resident had her light on 5 million times asking about her pain meds and each time I would tell the nurse and she eventually says "well I don't want to talk to so and so right now." She didn't talk to her to begin with. If someone's call light is continuously going off and I tell them that the nurse is busy each time there's a point where the nurse needs to go in there and say something to the resident because I have nothing to say about her pain med. The same nurse says "well I've never been a CNA so I don't know what to do" pretty much saying she can't answer a freaking call light. Nurses coming to me saying that this person needs to go to bed then two minutes later says someone else needs to go to bed. NURSE, I know what I'm doing, you've never been a CNA while I've been one for a year now. I know who is sore but I don't have a clone that I can tell to go out this person down while I put someone else down. Oh, and thanks for telling me that so and so has a dinner tray in their room when dinner just ended about 15 minutes ago and I have more important things to do than go take someone's tray out their room.
There's my frustration .
Yeah, unfortunately, there are rude nurses who let the stress build up and then take it out on the CNAs. You shouldn't have to put up with that, and you should take it up with management at that point.
Never having been a CNA is no excuse for a nurse. First semester is learning ADLs and basic patient care. All throughout nursing school, nursing students still perform direct patient care while in clinicals on top of higher level nursing care. If a nurse is saying she doesn't know how to do basic care, it is her duty to go to management and say I need to shadow a CNA for a few days. Because it is unacceptable and irresponsible for a nurse to say she doesn't know how to do it and leave it at that.
I have absolutely gone into patients rooms and told them I will be with them shortly. It is not the CNAs job to continue going into that patient's room and have to apologize and get cursed at for the nurse.
I'm sorry there are nurses who take advantage of CNAs. I truly do get it. I was there myself.
Yeah, unfortunately, there are rude nurses who let the stress build up and then take it out on the CNAs. You shouldn't have to put up with that, and you should take it up with management at that point.
Never having been a CNA is no excuse for a nurse. First semester is learning ADLs and basic patient care. All throughout nursing school, nursing students still perform direct patient care while in clinicals on top of higher level nursing care. If a nurse is saying she doesn't know how to do basic care, it is her duty to go to management and say I need to shadow a CNA for a few days. Because it is unacceptable and irresponsible for a nurse to say she doesn't know how to do it and leave it at that.
I have absolutely gone into patients rooms and told them I will be with them shortly. It is not the CNAs job to continue going into that patient's room and have to apologize and get cursed at for the nurse.
I'm sorry there are nurses who take advantage of CNAs. I truly do get it. I was there myself.
I worked with a nurse once who told me that she got her LPN so she didn't have to do direct patient care, e.g. ADLs, toileting, etc., after I had a call light on for 15 minutes because I couldn't get a resident off the toilet. There was something seriously wrong with the resident and she needed to see what was going on and I needed help because the resident had gone from 1 assist to 2 assist in a matter of a hour. I had much less respect for her after that. I might have been a brand new CNA at the time but I knew the resident was not doing well.
She would also turn on a resident's call light for one of us to toilet a resident rather than take the resident herself even though she had plenty of time to do it due to low census. She even balked at helping move residents up in bed. She recently interviewed for a position at my current employer but they didn't hire her. I was secretly glad because we absolutely need the help of every nurse on the floor sometimes due to staff to patient ratio and combined duties and she would not have been a team player.
And that is ultimately what this boils down to: Being a team player. Vital signs don't take very long, or at least they don't for me. I can get 5-6 sets in less than 20 minutes. Even manual BPs don't take me long unless a patient has a faint pulse or extremely low BPs. If a nurse asks for something be done and it's at admission, it should be done right then because I know you as the RN may be on the phone with a provider getting orders or verifying orders and you don't have the time to do it.
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.
Back in the 70s and early 80s hospitals did away with aides (no certification back then). It was called primary care. Granted, acuities weren't quite as high, but staffing ratios were still 5-6 per nurse. So, in addition to meds, assessments, Doctor rounds and phone calls, we did ALL the personal care-bed baths, showers, toileting, fetching food and blankets.
We did it. And we did it in 8 hours, not 12. Was it a good use of our time? Nope. That's why they eventually brought aides back.
That part where you say we shouldn't have to explain ourselves to Cnas. Technically this is true. I just really hope you don't actually say that. I've never had an RN say something even remotely close to that to me and after I graduate I wouldnt say it either.
Kystudentrn
63 Posts
We'll see I'm in a weird spot because as an extern I'm not a Cna anymore, yet not quite a nurse either. At least not for another couple of months. However, Let me muddy the water a bit. It's not always that cut and dry. On my hospital floor we are a 42 bed med surg unit. You may have 1-2 pcas (cnas). There are 7 nurses to share the pcas. Now you are also sharing those same Pcas with at least 4 physical therapists. So now there is really 11-12 sharing 2 aids. These Aids can also be called upon by respiratory therapists here. Now your up to 15ish sharing 1-2 aids. All trying to delegate. You as a floor nurse will not be able to dictate YOUR priorities to that aid all the time. It just doesn't always work that way. Now ltc is a different animal but some floors in hospitals it just simply can't be done