Nursing Assistant Getting the Run Around

[CheshirePlate]

I'm currently a male nursing assistant working in a hospital facility among an all female staff. I have dreams about becoming a nurse and just got accepted into a Master's Program (which I'm terrified to mention at this point).

To sell myself on this problem: I'm a happy person. Seriously, I'm a contagious smiler who worked at the hospital as a transporter for 6 months prior to starting as a CNA. I know more than half of the clinical staff of the entire building and I have received positive feedback from multiple departments as well as multiple commendations from my patients. I've even been offered a position in a video-marketing campaign for one of the hospital's initiatives.

I was originally hired into the department that I currently work for with the purpose of improving the reputation of the facility in comparison to the rest of the hospital. After working as a CNA for the past 2 months I've started losing that desire to smile. I still love working with my patients, but I feel like I'm getting judged for not being at the nurse's station and dumped on with responsibilities as "ancillary support". I have a problem with saying no to the RN's I work with and so I get heavily derailed with tasks when it comes to collecting vitals/blood sugar checks. *For the record, pericare is awesome and I have no problem with patients requesting help. I DO currently have problems with nurses that sit at computers and chart while telling me to go do X with patient Z. Do nurses always chart medications for four patients throughout their shifts?

I feel like I'm pulling loose ends for 3 nurses by the end of the day;

tonight I was told that the staff thinks that I have difficulty prioritizing my goals which often leads to me seeming frazzled and distressed at the end of the shift.

I've been told that nurses eat their young, but what is this! Team work should not be the result of delegating tasks and then talking about coupons at grocery stores with other nurses!

I'm meeting with my hiring manager tomorrow to talk about scheduling with my immediate supervisor. Professionalism prevents me from saying names in the office.

If I have problems focusing, what should my greatest priorities be as a CNA?

[pamelalayn]

A hospital video is hardly a "position". I think you're looking into the importance and magnitude of it and magnifying it by 1,000.

Many workers are in it and not for any grand reason. I also do not see your placement in that department as some master plan by the hospital to save it's reputation. Now being a N.A. is much different than being a transporter. It's very demanding exhausting and poorly compensated ($). It takes quite a while to get the hang of things. Much longer than many other positions. You stated you feel like you are delegated to all day. Well you very much are, you are the nurse assistant. Now you have stated that the nurses shouldn't take all day to chart meds on 4 patients. Well, they are not just charting meds. You'll find that out for yourself if you ever become a registered nurse. I'm not saying there aren't some lazy nurses or other staff out there, where there's good theres bad. I think after a while you'll do well, it takes time.

[Bringonthenight]

Unfortunately a lot of nurses feel that "basic cares" are CNA work. Also delegation is apart of nursing, though I do feel your frustration.

[balatro]

I generally lack respect for nurses who didn't climb their way up the totem pole by starting out as a CNA (or something similiar).

It's not because Susy Q. fresh out of college with her BSN, having never worked a day in a hospital, LTC, etc in her life (or even a job to begin with) can't be a good nurse -- a decent number of them are. However from my experience working in hospitals and LTCs (before I began the process of becoming a CNA - I've worked in transporting, PCA, and as a "spotter"), there's a large number of nurses who don't truly understand what it is that a CNA does/is responsible for and all too often the RN finds certain work beneath them.

I've seen far too many nurses who will be in a resident's room doing their thing, the resident says he needs to go the restroom or has had a BM and the nurse, despite being available, walks out to find a CNA instead only to do this:

RN: I need you to give bed baths to 56, 54, 53, and 51.

CNA: Yes ma'am

RN: I also need manual vitals on 48, 47, 44, and 32.

CNA: Okay

RN: And 57 and 58 have either had a BM or need to.

Moments later, said nurse is spotted checking FB on the computer at the nurse's station, texting someone, and/or watching TV in the resident lounge.

Yes, I understand the above delegations are CNA duties, however there's still an issue of being a team and helping each other out -- especially when you pile tasks onto a CNA who's probably looking at managing the care of 15+ residents while said RN is watching Pretty Little Liars.

Anyway, /rantoff -- just my experience from when my grandparents were in a LTC, my father in a hospital, and my own experience working in hospitals and LTCs -- CNAs who become RNs are almost always (98%ish) the better RNs because they're not afraid to get their gloves dirty.

[WhichWayIsUp?]

I am a little put off by the comments that the nurses in this scenarios delegated tasks then went to do non-nursing tasks. In my hospital that would last about one time and then the nurse would be in the nurse manager's office with the HR rep and being told when to expect their final check. Just not going to happen!

On the other hand, I see red when a PCT/MA/NA says "shouldn't we all be a team player?" That seems to work really well when the NA wants your help but does nothing to help the RN meet all the obligations thrown at them.

Let me be real clear. I don't think PCT/MA/NA understand how they got to where they are today. We went from a Team nursing care delivery system to a Primary Care nursing delivery system to a Task nursing delivery system. Nursing has been reduced from a Profession to a Trade. This situation was created by for profit companies injecting the profit motive into health care instead of the care motive.

In the days of the Team model (70s) there were only NAs (nursing assistants). Their role was to provide the basic necessities of care including filling ice pitchers, serving trays, feeding, emptying urinals, bedpans and BSCs, bathing and changing beds. Then overnight Primary care into play and all the NAs were gone! The ratio of RN to patient was never to be more than 1 to 5 and the nurse would do everything. Nurses left the profession and we had a major nursing shortage (80s). Then hospitals decided to make more money and figured out they needed "nurse extenders" also known now as Patient Care Technicians. The nurse practice act was violated and all of a sudden these super NAs were trained to put in foleys, do Accucks, start IVs in some facilities and other skilled tasks. Now nurses are thinking less critically with a higher nurse to patient ratio and much, much sicker patients. Forget holistic practice. Now it is a matter of how many tasks can you perform in one 12 hour shift and can you chart it at leas 3 different ways. The ANA is expecting a loss of 25% of the current nursing workforce at the bedside when the economy turns around.

So let me clarify PCT expectations: take the vital signs on rounds. While you are in the room empty the urinal or the BSC, offer the patient the bedpan if necessary and take them off. Fill up the ice pitcher. Get them something to drink from the diet kitchen if they want it. Empty the foley and record it on the I&O sheet. Give the bath if needed. Do the Accuck. Call me the out of range results on any test or vital sign. If you need help to clean up a patient or turn the patient then let me know. And while you are doing these things I will be taking off orders, giving meds every hour, calling the doctor, assessing the patient for changes, filling out Influenza and Pneumonia screens, doing core measures sheets, learning how to use the new RX for DVT Prevention, attending the training on the new pump, attending the meeting on the upcoming JACHO review, learning how to use the new defibrillator, trending outcomes, reviewing patient satisfaction scores and learning how to use the new computer system update.

Yes, I am your team member. We are here to help each other help the patient. But always remember, you are an extension of me, you are doing the things I would do myself if some hospital CFO would let me. But they want me to take my 3rd admission of the day before I can discharge my other patients. I have walked in your shoes, you can't walk in mine.