Problems with CNAs and Jeopardizing Nursing License

chadash · Mar 28, 2008

I am a nurse's aide, but if I were a nurse, I definitely would get my own post op vitals. All four. And also, I would check the door chart with routine and q4 vitals and not depend on the NA to report (though they should)....I just would want to see it for sure.

That is probably one good reason I would not be a nurse: I'd drive myself crazy with this!

That aside, sometimes nursing assistants know what to do, but they don't know why it is important for them to do these things in a certain way. The NA that reported the vital sign when she got it, BUT put it in the record with the same time she did all her other "8:00 vital signs", might not have connected the dots. Getting the job done is her goal, and she knows the patient is alright because you addressed it , and documenting is just one more thing to do in a very busy day. Some of the most attentive, caring NAs I know are awful at documenting, and some of the most useless ones are meticulous at recording everything they do (or maybe did?). Take some time and stress the importance of accurate times in the record, and how it needs to be consistent with your response. Ask her if she needs some help.

twinkerrs · Mar 28, 2008

I've worked with such computer systems too. But I've had situations where CNAs would take all VS, then put them all in the computer, and not tell me about abnormal VS. After numerous times of checking to see if VS were in the computer yet, I'd find out 2-3+ hours after the time the CNA recorded VS were taken that I needed to address abn VS. There's no proof of when - or if - you were informed of abn VS, or when you found out about them through the computer. I've also had CNAs take VS on an admit, and then not tell me what they were or record them in the computer for 5+ hours! And then have an attitude when I repeatedly tried to obtain that info. So where's our protection for our nursing licenses if something happens when the CNA didn't tell you timely about abn VS or record VS timely?

If you needed the vitals, wouldnt it have been easier to just go take them after all of the time you had spent trying to get them from the computer and the cna? Not trying to be ugly, but if you act like you are too good to do them yourself the cna is not going to work well with you, its just the way it goes.

vegasmedic · Mar 28, 2008

:nuke:just a quick note. what would be the use of a CNA if nurses have to go back and double check their work. Maybe there should be a more thorough schooling and not a silly 6 week course. vitals are important and with nurses having to work on sooo many patients at once, the cna being accurate is very important to the proper tx of patients. plan and simple. there is no excuse for improper vital taking and being lazy whether you are a nurse of a CNA. :nono:

chadash · Mar 28, 2008

I agree with the last post: the six week education is so so inadequate. It barely covers the "what" and totally neglects the "why".

It leaves the NA to find out for themselves, research topics, and frankly learn a lot through mistakes.

I know that all nurses is not the place for NAs, but this has been an incredible source of information.

It scares me though, what I do not know as an aide.

sherrytzu · Mar 29, 2008

what's the use of have nursing assistant's if they are not assisting the nurses? It is that simple to me.

medsurgrnco, BSN, RN · Mar 29, 2008

For the good CNAs posting to this thread, please don't take the comments personally about CNAs that are challenging for RNs. Both good CNAs and RNs are extremely busy during shifts. I have often done work that could be done by a CNA because it was simpler to do it myself than to hunt down the CNA or deal with their attitude when being asked to do something. RNs often work overtime to get everything done, but I've rarely seen a CNA do that.

grannyNan · Apr 3, 2008

What people really want, RNs, LPNs and CNAs alike, is for those who are performing below the standard to grow up and act responsible. No matter how much education you give a person it is ultimately their choice as to how they will act in any given situation. CNAs are a valuable member of the team but we all have to work as a team.

pagandeva2000, LPN · Apr 4, 2008

:nuke:just a quick note. what would be the use of a CNA if nurses have to go back and double check their work. Maybe there should be a more thorough schooling and not a silly 6 week course. vitals are important and with nurses having to work on sooo many patients at once, the cna being accurate is very important to the proper tx of patients. plan and simple. there is no excuse for improper vital taking and being lazy whether you are a nurse of a CNA.

I agree with the last post: the six week education is so so inadequate. It barely covers the "what" and totally neglects the "why".
It leaves the NA to find out for themselves, research topics, and frankly learn a lot through mistakes.
I know that all nurses is not the place for NAs, but this has been an incredible source of information.
It scares me though, what I do not know as an aide.

What people really want, RNs, LPNs and CNAs alike, is for those who are performing below the standard to grow up and act responsible. No matter how much education you give a person it is ultimately their choice as to how they will act in any given situation. CNAs are a valuable member of the team but we all have to work as a team.

I do agree that a nurse should be able to depend on a CNA to perform accurate vital signs on stable patients with predictable outcomes (not a crashing patient or post op, etc...this is what they are trained to do, and we have too many patients or too much pulling at us, sometimes, to act on each and every patient that some CNAs blatently refuse to do. What is the sense of hiring anyone, may it be a housekeeper, CNA or a nurse if they are not performing the job they are paid to do. It is the responsibility of the nurse, ultimately, what happens because we are essentially delegating a part of our jobs to another person to perform, but are accountable for the outcome.

What is missing is explaining to the CNAs during their training is the IMPACT of not performing accurate vital signs on a patient and reporting to the nurse on a timely basis. And, this can be emphasized again when they are hired. There is nothing wrong with explaining WHY this has to be done. I think that this can be done in a 6 week period if it is re-enforced in each setting and during their clinicals. And, they should be made to feel to be a valuable member of the health care team.