I started working at an LTC facility a month ago and it's a very rough job. Just even being here for a month, the turnover rate is ridiculous and so many CNAs are quitting. One thing I noticed though is the nurses don't help out with anything. I'm currently in nursing school and I'm in complete shock at how it's the first time I've seen some nurses not even bother to answer a call bell, delegate tasks to CNAs while they were just in the room, sitting at the desk just chatting and not bothering to help a patient who is right in front of you asking for help. I might just be a bit naive but is this usually how it goes in LTC facilities? I just couldn't do that as a nurse. Plus along with the fact each CNA has 10-11 patients to themselves who they have to get up, groom, bathe, dress, feed, etc. in a matter of 4.5 hours. I'm just in shock and disgust...especially since they are elderly. I'm actually looking for another job right now because the environment at this LTC s just toxic. I don't even call them nurses. All I see them do is pass medication, chart, and have their daily social chit chat. I can't even ask a nurse to help me transfer a patient to a chair....=/ We have had CNAs who would call out their shift and instead of the nurses even just taking one patient each, all of us get an extra 3 patients added to our workload. Am I in the wrong for thinking this is not right? I seriously feel I can't even properly give adequate care to the patients because if I don't get everyone done in time, I get yelled at and have to stay over my shift. I just...can't believe how multiple call bells would be going off...and none of the nurses would move.....Like you can't put someone on a bedpan or just change their pants? You make them wait....Oh but when state is around.......
Also do you think it would look bad if I do find a job after two months of working there and just give my two week notice for leave?
This sounds terrible! I hope you found a better facility. I haven't work in a medical center yet. However, this does not sound like an environment you would want to be in for too long. Are you still working there?
I've been a cna and a nurse. When I worked in ltc as a nurse I helped out the cnas when I could but, 90% of the time it just wasn't possible. I'd answer a call light if I knew the person probably wanted a med, a drink or something that was quick and easy to do. Anything other than that I'd leave up to the cnas. Even though we may be sitting at the nurses station doesn't mean we aren't working, a lot of our job is paper work and I can chart and chit chat at the same time. We also have to do things other than charting so, even if we aren't in the charts we my have to test the glucometer, write shift reports, put in supply charges for billing, file faxed Dr's order's etc. 100% of my time sitting at the nurses station was spent working. I know that some nurses never help but, in my experience most do if and when we can. I know also that some cnas think that we don't do anything just because we are sitting but, what they don't understand is that when they get to go home at shift change we are there another hour or so finishing up our charting that we didn't get to because we put so and so on the bed pan or helped get so and so dressed earlier in the shift. As for the nurses taking on patients for cna duties when you have a call in, that's never happened anywhere I've worked. If a nurse calls in a cna can't take on some of her patients. I had 55 patients a night I would have never got to leave work if I had 3-4 added on that I had to get dressed in the morning or feed breakfast. Hopefully things will look up for you. Things always seem to run smoother when everyone pitches in and helps each other out when possible.
So you guys are telling me that a nurse who is just sitting at the nurses station doing nothing should call other cnas to answer a call bell that is right in front them when the cnas are mid bath or mid feeding a patient? Even if they just need a bed pan or some water etc.
Well, chances are that the nurse is not just sitting at the desk "doing nothing". There is a LOT going on at that desk, charting, reviewing, reports and things you can't even fathom. I work rehab and do everything I can to help the CNA's I have and for the most part they appreciate it. It goes both ways though: I've asked a CNA before how a resident transfers so that I know and I can help. Her response? It's in the PIW binder, you can look that up yourself. If I'm in the supply room getting something I need for my med cart, I'll grab a few sleeves of cups for the kitchenette since I'm in there anyway. One response I got?: Are you doing my job because you're assuming I can't? Sometimes people make it super difficult to help them out and then it seems those are the first to complain that no one ever does! I'm NOT saying the OP is like this, but it is food for thought...
When I worked in LTC the RNs rarely did CNA stuff. That was just the way it worked. They had their job and we had ours. It never really bothered me.
In a hospital its a different story though, and RNs that don't help out with the CNA type stuff are incredibly annoying to me. In a nursing home the RNs will have like 20 or 30 patients. In a hospital an RN might just have 2 or 3, so as far as I'm concerned there's no excuse for them not answering call lights and doing things like toileting people or anything else patient care related. Not to mention its a heck of a lot easier for them to keep track of I/O on their 2 or 3 people than it is for us to do it all for 15.
RNs that don't help out with the CNA type stuff are incredibly annoying to me.
In a nursing home the RNs will have like 20 or 30 patients. In a hospital an RN might just have 2 or 3, so as far as I'm concerned there's no excuse for them not answering call lights and doing things like toileting people or anything else patient care related.
Not to mention its a heck of a lot easier for them to keep track of I/O on their 2 or 3 people than it is for us to do it all for 15.
Yikes, I am sure none of those RNs want to "annoy" you!
I have a few questions for you:
1. Do you think there is an acuity level difference between in-patient level patient and a resident in a nursing home?
2. Do you think maybe there really are some "excuses"/valid reasons why an RN managing 3 sick patients might not be able to answer every call bell and rely instead on their assistant or the patient-care tech to do some patient care and/or assisting tasks?
3. Are you really "tracking" their I&Os or are you just measuring and documenting while the RN is doing the tracking, assessing it, and creating/modifying the plan for it?
I do think most nurses try and pitch in. If the nurses at your facility don't then find a new facility. There are times when nurses can't do some tasks hence the need for assistants and techs.
There are going to be people who do the bare minimum where ever you work, regardless of their title. When I worked in LTC other CNAs would hide in patients bathrooms so they wouldn't have to help get people up for dinner. I've also had nurses spend 5-10 minutes looking for me because a patient needs a bedpan instead of taking the 30 seconds to slide it under them. However, I think the problem is that a lot of CNAS think that when the nurse is sitting at the desk they aren't doing anything, they don't realize all the behind the scenes type work that happens every day. You gotta keep in mind that RNs in LTC have over 40 patients with a ridiculous amount of meds each, plus all the charting that needs to get done..Chances are they're not just sitting around.
I'm really lucky, the nurses I work with are the best. I'm the only aide for 13 (total care) pts, if six or seven call lights are going off the nurses jump in and answer. They know I can only be in once place at once lol. And I understand if they have multiple high acuity patients, an admission, etc and totally swamped they're not going to be able to answer all the call lights. We all work hard and do the best we can. I've found that when I offer to help my coworkers with anything they need (extra sets of vitals, weights, emptying drains/bags, whatever limited stuff I can do), they're more willing to lend a hand when I'm overwhelmed.
When I worked in LTC the RNs rarely did CNA stuff. That was just the way it worked. They had their job and we had ours. It never really bothered me. In a hospital its a different story though and RNs that don't help out with the CNA type stuff are incredibly annoying to me. In a nursing home the RNs will have like 20 or 30 patients. In a hospital an RN might just have 2 or 3, so as far as I'm concerned there's no excuse for them not answering call lights and doing things like toileting people or anything else patient care related. Not to mention its a heck of a lot easier for them to keep track of I/O on their 2 or 3 people than it is for us to do it all for 15.[/quote']
They may have only two or three, but those may be very ill and/or complicated. A sick patient in a hospital requires a lot more attention than a stable one in LTC. We don't have CNAs where I work. I have 4-5 acutely ill patients for whom I provide total care. On days when I have someone who is very ill, I simply don't have time to do all I would like and still care for those who need the scope of care an RN can provide. They get toileted because there is no one else, the ones who need it get peri care but likely not a full good wash, and I'm likely staying past my shift to finish my documentation. So, on days like that if I had a CNA working with me, you bet I'm leaving them to do the tasks they can do so I can focus on what I need to as an RN.
That said, I know there are days when my patients are stable and everything gets done. If I had a CNA with me for sure I would do some of the care, too. This type of shift there isn't an excuse for not helping.
However, like others have said, be aware that there is often much more going on than the CNA knows. Not because they are not intelligent, but because without actually being a nurse, they can't know everything an RN's day involves.
In my ICU the techs really don't do anything without the nurse present or without checking with us but they are a HUGE help for baths and turns. A while back I had a patient who was on his call button to go to the bathroom and the tech came and told me, I asked him to please go help him - and he did but made a comment about it. I was in another room with 4 other nurses and two doctors, I'm sure that without knowing what was going it looked like I had time to go help him onto the bedpan but I was checking off a cooler of blood to start mass transfusion. Tech or not there was no way I could make it over to another room.
It's always possible you have lazy nurses, but our role is very different. There is a LOT of stuff that must be done before I leave, and management wants me out on time (haha). But when I ask one of our techs to make sure one of my patients gets turned every 2 hours, it's not because I'm lazy, it's because my other patient is so sick I'm not able to leave the room much.
The RNs at my job sometimes (OK, most of the time to be honest) don't have time to toilet the people they are assigned to or do their I and Os because they are too busy in the ER to help us. The hospital I work at is very small; nurses are not assigned by department unless it's OR day. They have to split their time between their assigned patients and ER patients.
I know how u feel i worked ltc for a month and a half n most of the nurses never helped but there were.a few that helped if needed... Now in in a alf n tge nurse usually helps out....
NLOPEZBR
11 Posts
This sounds terrible! I hope you found a better facility. I haven't work in a medical center yet. However, this does not sound like an environment you would want to be in for too long. Are you still working there?