livelovelaugh22

I feel as if they look at me in such a way, as their tone of voice changes when they're discussing the pay scales of the competing hospitals. And I also love the variety of situations that I have encountered at my teaching hospital, as they've helped me become a better nursing student. :)

Before anyone becomes overly concerned, I still care about my patients and my job. However, what I do not care about is that __________ Hospital pays their staff a little more for the same job. I love my current employer, despite its imperfections, and my patients are just wonderful. I cannot stand it when fellow nursing students look at me as if I am a three-eyed monster because I'd rather stay at the teaching hospital that I've grown to love. I also do not care for coworkers who treat their position like a joke, but that is their problem, not mine. As long as they don't harm a patient, we will continue to peacefully coexist. That is all, my friends.

I should've elaborated (it's a long story)! I was gifted a Littmann Classic III, which has wonderful sound quality, but leaves something to be desired because I am hard of hearing. I can hear everything with the Classic III, but heart sounds are more muffled than I'd like them to be. Hence the reason why I began to consider purchasing the Cardiology IV. Luckily, my family is wonderful and they purchased it for me (total surprise). I will use the Littmann Cardiology IV the most, as it has superior sound quality. The Classic III and MDF stethoscopes are my back-ups, which will be kept at home. My mother bought me the MDF at a yard sale, but it would be my last resort stethoscope, as the sound quality is poor compared to my Littmann Classic III. In all honesty, I never intended to own three stethoscopes at once, it just happened. You should be fine with one, just remember to always keep it on your person. Littmann stethoscopes are hot stuff! I start nursing school in a few weeks, so I haven't used the stethoscopes in a hospital setting yet-just on my family members and myself.

I have a Littmann Classic III, a Littmann Cardiology IV (it's currently being shipped to me), and a MDF stethoscope. It is not necessary to have a backup, as hospitals have disposable stethoscopes that are used for isolation patients. At my hospital, there is a newer surgical progressive care unit that has bright orange Littmann Classic III stethoscopes affixed to the walls (with an extension cord, of course). Disposable stethoscopes are also used in our isolation rooms in other units. You shouldn't worry about losing your stethoscope as long as you have it on your person at all times. It may be wise to have a label and/or other unique item on your stethoscope.

I hope by this point that you have either... A) put your foot down and insisted that you will only operate within your scope B) are searching for alternate employment C) quit D) A&B E) All of the above

Oh dear... I understand that she is a child, but there is no recovery from brain death. I'm so glad that I know my loved one's wishes, because no matter how much it hurts, I'd rather allow them to die with dignity than be subjected to unnecessary procedures.

It sounds like you need to stand your ground with this CNA. I understand that she is the only CNA for 18 patients (your management needs to work on getting 1-2 additional staff to assist her), but there is justifiable reason why she should be going against policy. I surmise that the RNs on your unit do most of the care for the patients--vitals, Is and Os, turns, etc--on top of your normal duties. Hence, the reason why she has no right to put patients at risk for skin breakdown. At my hospital, we use the Covidien dri-flo pads, as they are excellent at wicking the moisture away from patients (and disposable). I hate to say this, but it seems that a patient's incontinence will go unnoticed for an extended period of time if one chooses to use briefs. Why? Unfortunately, staff get busy and "forget" that the patient may have went in the brief. The brief does nothing to wick the moisture away from the patient's skin, thus leading to incontinence-associated dermatitis and skin breakdown. If it were her family member experiencing the skin breakdown, she would probably be livid if someone chose to use the brief for the sake of convenience. Management also needs to address her problems with following directions and professionalism. I would never behave in such an asinine manner around my patients and nurses. It seems like you and your fellow nurses are understanding of her patient load and do what you can to help. Perhaps a write-up (and some photos of IAD and associated sequelae) might shake some sense into her. :) Addendum: I have had 10-12 patients at a time, with vitals, Is and Os, orthostatic vitals, and more, but I always found time to follow the evidence-based practices (which are hospital policy, mind you), because I don't want my patients to suffer (nor do I want to be unemployed). When there's a will, there's a way. ***To emphasize what I said at the beginning... your management should NOT have 1 CNA to 18 ICU patients. The end.***

I think you should heed the advice of the previous commenters and get the he** out of dodge! Staying at this facility is endangering your future.

Forgive me if this isn't a perfect answer, but this is how I deal with workplace gossip. My mantra is "if they don't pay my bills, then their words don't affect me". Well, this is what I told a coworker yesterday after she complained that another NA might have been talking about her. As long as your patients are being taken care of, then you have nothing to worry about. I would try to ignore the gossip. Other than that, I have no other helpful advice to give you. However, if enough time has elapsed since you being hired, then you should look into applying for another job. A toxic work environment like that is not salvageable. I have had the misfortune of observing toxic units within my own hospital. The nurses and nursing assistants seem to be pitted against one another and the patients ultimately suffer. However, because I am in the float pool, I am not subjected to the endless suffering. I wish you the best of luck.

I do not think that you're overreacting. That CNA's behavior was very inappropriate. To the poster that insinuated that only the resident's dignity would be injured, well... you're wrong. If someone is able to be safely walked to the restroom or bedside commode, then why make them go in a brief? When patients sit in their excrement for extended periods of time, they are more likely to develop incontinence-associated dermatitis and/or skin breakdown leading to a pressure ulcer. I bet that unprofessional CNA wouldn't want that to happen to their family member, so why do that to their patient?! I don't understand people. You'll make an awesome nurse someday.

I would like to thank everyone for their helpful feedback. Since last week, I have had a different outlook about my job. I try to obtain vitals early, no matter what, because I want my patient's care to be the best possible. I am also spending less time giving report, and I am able to overlook my rude coworkers. Even though I've had 2 people insist on me giving them the report sheet to read, versus allowing me to give any verbal report, I didn't take offense to it.

And when do you think it's okay to pair up the difficult patient with the RN from the float pool? Although I am just a nursing assistant, I am in the float pool. Some floor NAs are jealous of float NAs (they think our wages are higher, but they're not!) and they insist that we take on their difficult patient assignments. Also, if we're sitting with a violent patient, some floor NAs think it's acceptable to not coordinate break times with us. Everyone should work as a team to ensure the continued safety and care of complicated patients. Let's not forget to mention that the safety of staff should always be maintained.

You're right. Forgive me for not understanding your point the first time (it's been a long day for me). Now when I think about it, I tend to be long-winded when I give report. I routinely place too much on my shoulders and think that the patient is still my responsibility once I clock out. For now on, I will try to give more concise reports. I know I have it in me :). Labeling my coworkers is wrong, and so are my micro aggressions. I need to realize that some of them are stuck in their ways and move on with my life, as I will never be happy if I don't. But I was never trying to undermine the importance of nursing assistants-my own profession. I know that we play an integral role in our patients' well-being. I just don't want to do that all of my life. We are underappreciated and sometimes overworked. However, I feel bad about complaining about this aspect of CNA life to a CRNA, as I know that you have to work under much higher pressure than I; plus, I'm sure that you also have days in which you feel underappreciated. Ironically, I wish to become a CRNA someday. I will try to "go with the flow" more often at work and trust that my coworkers are doing their part. I will allow the RN to redirect the aide if needed. Regarding the tardy coworkers, I will be more firm with them and speak to management if the behavior persists. To be honest, I had become accustomed to being mistreated at my former jobs and failed to realize that pointing things out could be considered rude. I guess my smile makes me seem more condescending, but that's not my intention. When I worked in a research lab, I was physically assaulted and berated by my lab manager. When I worked at my college, I was embarrassed in front of my coworkers by a supervisor, and much more. I guess what I'm trying to say is that I was used to much worse behavior, hence the reason why I thought I was being "nice". And thank you for empathizing with my mother's situation. Whenever I take care of someone with a complicated medical history (like my mother's), I unfortunately become WAY overprotective and envision bad things happening if I neglect any little thing. If I see a code, my heart drops and I envision my mother on the stretcher, fighting for her life. I need to detach myself from my personal life. Nowadays, my mother asks me if I think that I have chosen the right profession. Honestly, I don't envision myself doing anything else, but this job is so emotionally demanding. Thank you kindly, Livelovelaugh22

I definitely agree that I am somewhat a control freak. I wouldn't say that I'm always policing people though, because although I may remark on what should've been done, I don't take it upon myself to chastise people. As you said, I am not in a managerial position. When I gave the examples for my report, I almost always stick to the pertinent information (I read everything off my report sheet to the oncoming sitter/NA). The reason why I gave "misc. info" as an example is because I didn't want to risk disclosing PHI on the Internet. My goal is never to waste anyone's time or bolster my ego. I just want to leave work knowing that my patient(s) are taken care of. Oftentimes, sitters don't bother to read the report sheets (let alone reference them) and they act as if they didn't just spend 8 or 12 hours with them. I also interact with everyone with a smile and I keep the snarky comments to myself, although it's hard at times. I try to seem like an easygoing individual, because if I show everyone how uptight I am, then I probably wouldn't have any work friends lol. I should also add that I not only checked care activities, but verified with the sitter that the patient hadn't been turned for three hours. I was very nice about it, but this patient was extremely emaciated and weak, and was unable to reposition themselves without significant assistance. When I first got this job, we were always told to speak up. I realize that I might be a PITA at times, but I'm reluctant to report anyone. I just provide occasional feedback and I'm kind about it. If I were to make a mistake (which I have), I would expect to receive constructive criticism. My particular ways didn't arise because of an inflated ego. I have witnessed my mother suffer from the effects of serious chronic illnesses, and viewed the nonchalant attitudes of some health care providers that resulted in (nearly) grave consequences for her. I just want to give everyone a shot at wellness. Perhaps I care too much .

Hello everyone, I hope this post finds you all well. I am a nurse aide and soon-to-be 1st semester nursing student. Although I am a nurse aide, I am a floater and usually spend most of my time as a sitter (while still performing NA duties). Although I love my job, my patients, and the vast majority of my coworkers, sometimes I become frustrated. Obviously, many of my patients couldn't prevent becoming ill. Nonetheless, I never pass judgment on those whose illness arose from self-neglect, as I imagine how I would like my loved one to be treated, regardless of their situation. Most of my coworkers are lovely individuals. They are dependable, attentive to their patients' needs, and exhibit a high degree of professionalism. Nonetheless, I am growing tired of NAs arriving late. Leisurely walking in with a Starbucks coffee 5 minutes after I was *technically* supposed to clock out does nothing to soothe my nerves. I understand that life happens, and I am a very understanding person. However, I don't see how it's difficult to be slightly early (or on time) for patient hand-off/report AND get your coffee. Please understand that I may have either had a heavy patient load or sat with a sundowning patient who threatened to kill me while constantly being incontinent of stool/urine, hence the reason why I WANT TO GO HOME ON TIME. Sorry about having all caps :). Also, let's not forget about the aides who look dumbfounded to as why I haven't done the 10 p.m vitals on a stable patient. Duh... I'm leaving at 10, so their you're responsibility! Don't misunderstand me though, if a patient is critical or their vital signs have wild fluctuations, I will do those vitals on time, even if that means doing another shift's vitals. I would never want a patient to miss out on needed treatment. With that being said, you are perfectly capable of looking up from your iPhone and doing Mr. So and So's vitals (especially since I dutifully took his vitals, charted ADLs, Is and Os, ensured his safety/cleanliness/nutrition, and so much more, w/o any attitude)! I understand that sitting is boring, but why do you insist on being lazy, inattentive, and breaking hospital policy for your own leisure?! Before anyone attacks me about this, here is our policy on this issue. A nurse aide who is leaving at 6 a.m. is not expected to complete the 6 a.m. vitals for that group, as they have end-of-shift duties that must be completed. Likewise, a NA/sitter leaving at 4p isn't expected to do the 4p vitals for that patient. Of course, if the RN requests an extra set of vitals, I will do them right away, no questions asked. Ultimately, if I were to disobey the RN and somehow delay the care of a patient, my a** would be grass. Let me not forget to mention the ultra-lazy/borderline neglectful NAs NA: "I don't take the vitals unless the nurse tells me to!" (chit chats with buddies) Me: "But you know that they're q4!" *Checks care activities* Me: "Um... why haven't you turned this patient in 3 hours?" (me to sitter) *Checks vitals* Me: "You realize that their vitals were due 6 hours ago, right?" Sitter: "I bet they're not diabetic, they're just paranoid about their blood sugar!" Me: *checks EHR* "Um... they take humalog." Nurse: "Oh crap! Accucheck them!" And, lastly... *The types of people who receive report* THE INQUISITIVE employee (my favorite) Me: "Blah blah blah blah, misc. info, misc. info, important info (x10-20) blabbity blah blah blah. Any questions?" Them: "Yes, I was wondering..." or *listens intently* The "I HATE MY JOB, JUST SHUT UP AND LEAVE" employee Me: "So, this is what went on, this is what you should watch out for--" Them: *cuts me off multiple times* "Okay, okay, okay." (with an attitude) The "why are you giving me such a detailed report, you're JUST a nurse aide" employee Me: "Blah blah blah, important info, blah blah blah." Them: "Why are you so detailed? It's not like you're a nurse." (laughs) My inner thoughts: No offense, but it's not like I want to remain a nurse aide for the remainder of my life. NAs and RNs go hand-in-hand, but I will expand my opportunities and become a RN someday. Why don't you want a comprehensive report? You rushing me is just making me forget important things. Don't you want the best information possible in order to give your patient excellent care? Thank you everyone for reading this lengthy rant. I hope no one hurls any stones at me for being too uptight. I realize that I may give off an uptight "vibe," but it's for a good reason. I treat my coworkers like family, but I cannot condone laziness, as it risks impairing the health and safety of my patients.