Pet Peeve

Nurses Medications

Published

This is random but I just wanted to get this off my chest. First, before a CNA gets offended, I have to say I love CNAs. I was a CNA myself, and it is hard, under appreciated work. My pet peeve? I work in a LTC/SNF. The aides are constantly saying with an attitude "he needs a prn."

It's not the aides job to tell me what med to give and when. I simply want to hear what observations they made of the resident, then I, the nurse, will assess the resident and decide what action I feel is best to take. I remember one specific time, a CNA told me her resident needed her "prn." This resident had no psychotropic meds. The CNA snottily said "well the doctor needs to know he needs one." No, the doctor needs to know my assessment, and he/she can decide from there the best course of action to take. Many types of sedatives are contraindicated in the elderly especially combined with their diagnoses, which could cause an adverse reaction or even make the resident more agitated.

I just want to hear from the CNA what he/she observed, and I will take it from there. I've only experienced this at one place, so once again, no offense to CNAs. Just a handful at my facility.

I see CNAs as my 2nd set of eyes. They are a wonderful asset to the nursing team. Not all of them are good or bad. , but that's with everyone you work with. I appreciate the info they report to me and as a result , I go and assess the patient . If they recommend a treatment , I listen . If I don't agree or it cannot be done. , I communicate and educate them why. I respect them and I expect the same from them . I get along with all of them at work , I always make them feel welcomed and appreciated.

Specializes in Transitional Nursing.
AGAIN...I too was a CNA. And damn proud of it. I saw decline in the patient much earlier than the nurse would. One of many any examples was when I walked onto shift at 7 am (sitter at the time.) The patient was "sleeping." This was NOT normal for her. Her O2 was 91 (way below HER norm. She reacted in no way when I took her BP. Unusual for her. I tried to arouse her while calling out for help. Rapid response came...she had a new brain hemorrhage. So once again, I value what they bring to the table. I was one of them.

And AGAIN....I have stated repeatedly that I appreciate CNAs, value their opinion and most of them, their judgment.

I think so much of the defensiveness lies in that individual. It's narcissistic thinking, making everything about you. "You" in general.

Sorry if I made it seem like that was directed at you, Sleepy. Really, only the first part was, and It was just a thought. I mostly composed my reply due to some of the comments I've seen indicating that CNAs should be seen and not heard, etc. Sorry I wasn't clear. :-)

I totally get what you're saying, and I see why you were annoyed.

Sorry if I made it seem like that was directed at you, Sleepy. Really, only the first part was, and It was just a thought. I mostly composed my reply due to some of the comments I've seen indicating that CNAs should be seen and not heard, etc. Sorry I wasn't clear. :-)

I totally get what you're saying, and I see why you were annoyed.

Lol, gotcha. Thanks

Just making an observation but I was wondering that when you call a Doctor do you not make recommendations for care? I only ask this because after assessing/working with a pt and you notice something don't you call the doctor and say " Hey I noticed this, would you like me to order this....ect?"

In effect isn't this what your CNA's are doing with you?" I notice pt is doing this, you might want to do this?" or " So and so is hurting, they need a pain pill"

If it is not an appropriate intervention at the time all you have to say to your CNA is something like "Thanks, I will go and check on them and see what we can come up with for a plan of action." or you could go into technical aspect of pharmacological meds and interactions and why that might not be a good idea.

I guess my point is I am not above anyone recommending any kind of intervention about a pt be it CNA, Respiratory, or even family. If it is not feasible or not safe it is a teaching moment. If it is part of their orders and the pt warrants it after I asses the situation, I'll do it or call for an order, no big deal.

Now if this is an attitude issue as in the CNA is saying it disrespectfully then that is a conversation you need to have privately with them and expectations you have for working together. You teach people how to treat you.

I was the original poster here. I had created a new account to my current one bc it had been a while, and I couldn't recall my username, and I no longer had access to my email to obtain my log in info. I came across a post with my previous username SleeepyRN, and have been having fun going back and reading my posts from when I was a new grad.

Some make me cringe at my opinions at the time and at how I worded something; some make me smile remembering the very early days.

I remember this instance very well. I should have made myself more clear. I remember in that specific facility, a good handful of CNAs, probably more, would not simply recommend a medication be given. They snarled it, huffy and puffy, judgingly, as if we nurses weren't doing our jobs. THAT was my issue. Not the fact that they were suggesting an intervention. But that they were being snotty.

As far as recommending interventions to a Dr. or NP, that is within our scope of practice. It is not within the CNAs scope to do the same. That being said, if a CNA came to me and described a patient's behavior with no attitude given and asked if the pt would benefit from a drug, I would have zero problem with that. I would thank the CNA and say let's go see. I would assess the pt, and proceed from there.

P.s. Man, some of my posts are embarrassing. I had years earlier had yet another username while in nursing school. I hate to admit this, but I was one of those students who strongly felt that it WAS a nurse's job to help train nursing students in clinicals. And I said so on this site. Ohhhh naive naive Orion. Lol.

But this is fun reading through these and seeing how much I've grown.

...I came across a post with my previous username SleeepyRN, and have been having fun going back and reading my posts from when I was a new grad... Some make me cringe at my opinions at the time and at how I worded something; some make me smile remembering the very early days... P.s. Man, some of my posts are embarrassing. Ohhhh naive naive Orion. Lol.

Bwahaha! I was just reading through some of mine. Some I just glanced at and said "nope!" because I just couldn't deal with the cringe :bag:

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