RN - CNA working relationship

ocb_dave_ocb, LPN · Sep 25, 2008

Of course we all know RNs have a lot more responsibility than CNAs, but I feel that "CNA jobs" are not below the RNs duties. Even if I am in the middle of morning med pass, I can spare three minutes to help someone to the bathroom or get them a pitcher of water. I'll make the aide aware that we need a specimen, but I'll get it myself if I happen to be there at the right time. And I can even set up a lunch tray.

That is most likely d/t your "newness" I was the same way after I became licensed.. Now im an LPN with 28 pt's daily.... That 3 minutes of your time starts adding up after you help say 5 - 6 people, that is 15 - 18 minutes.. Now you have 2 hours to pass your pills.. Your hour before and your hour after.. In my case with 28 pt's if I spend 5 minutes with each person whilel giving their pills im already over by 20 minutes, seeing it will take me 140 minutes for 28 pt's... now add your 15 - 18 for helping 5 - 6 people and you are already 38 minutes out of your time frame..

I have to space my time adequately there are some that you can get in and get out quicker, but when you have 3 or 4 pt's with 2 or 3 different types of eye gtts or inhalers.. Well there you go, more time, 5 minutes in between each...

So if you want to add that your going to be an hour out of your time frame.. Better not let state come in and catch that they will have a CVA....

Don't get me wrong I will wipe tails with the best of them AFTER im done with my med pass.. I don't hesitate a bit if they ask me to help them do something.. W/C - bed transfer, or help them on the BSC or BR... I do answer the call lights while the aides are doing rounds.. But now if im charting and my aides aren't doing rounds they get all of the lights etc.

Hope this helps you out some... Not trying to sound "Smart" but it is alot different with all the responsiblity..

Tippy-ta-ta · Sep 25, 2008

I'm a CNA and I worked with alot of RN's mostly in the hosp. When i worked on the floor some of the RN's would help you out alot and do alot for there patients. Of course the hosp I worked at the nurses did total care on there patients, there were no med nurses or trreatment nurses. Whether they were LPN or Rn they were reponsible for doing the treatments and giving the meds to all there patients. So if they were in there doing an assesment, giving meds at the same time and the patient needed a bed bath or the bed pan then they would usually do it themselves rather than go looking for the CNA. When I worked in the ICU it was pretty much the same way, with the exception of some RN's who had a severe case of RNitis. They would hunt you down to go get an IV pool at the other end of the hall from which they just came. and spent more time looking for the CNA than the time it would have taken to do the "CNA" job there self. And it's not that the CNA could not be found or hiding, We are just as busy with our own tasks and the other nurses hunting us down. Too many nurses who have never been a CNA think CNA's are lazy, when we are not. I have seen nurses sit at the nurses station on the phone talking to there boyfriend/friends..ect while there patient's lights are going off and there wanting there meds cause they haven't gotten them yet. There are just as many lazy nurses as there are lazy CNA's and it just makes the job harder for those of us that actually do like our work

mpccrn, BSN, RN · Sep 25, 2008

i've been an rn for 30 years in critical care. it's only in the last 10 years that cna's even came into the units. i've always had a work ethic that makes the patient come first. i don't put much stock into titles. in my eyes an rn can do anything a cna can do and a good cna can make an rn aware of problems that she can further evaluate......maybe that's why i get along well with the cna's i work with. they respect me and my time, i respect them and the hard work they do.....we're part of the same team, we get along, we have some fun and we all walk out at the end of the shift. :smokin:

PiPhi2004 · Sep 25, 2008

While many RNs dont feel they are 'above' CNA duties, you really have to learn how to delegate tasks. There will be times where you dont have the time to spare to do something another person can do. AS PPs have said, those 15 minutes add up. Now, if I were passing meds and a pt said they had to use the bedpan while they were getting those meds, I would get it for them no problem, but if I had a pt down the hall who needed it I would delegate. If you aren't busy, you should always take that time to do any duties you can, related to either title. Working ICU, we have CNAs on during the days and that is all. If we have only one patient we are responsible for all the CNA duties. If we have 2 pts we help with the bath. I constantly do those duties because (unless a pt is crashing) I almost always have the time, plus assessing skin is extremely important and the best times are during a bath or using the bedpan. I have never come in contact with a nurse who thought she was above these duties, as they would've been gone a long time ago!

I do get attitudes from CNAs sometimes, but I tend to just smile and continue to treat them as any other staff member, and I always say something like "thanks, you're a lifesaver." or "I wouldnt be able to get through today without you." If they do something for me that I really didnt have time to do. A good attitude usually rubs off on people. We are a team, there really isnt an us vs. them mentality in our unit, and I like it like that.

Farmer Jane · Sep 25, 2008

Of course we all know RNs have a lot more responsibility than CNAs, but I feel that "CNA jobs" are not below the RNs duties. Even if I am in the middle of morning med pass, I can spare three minutes to help someone to the bathroom or get them a pitcher of water. I'll make the aide aware that we need a specimen, but I'll get it myself if I happen to be there at the right time. And I can even set up a lunch tray.

Good for you. I've been an RN for 5 years and this is still my philosophy.

Tippy-ta-ta · Sep 25, 2008

A good attitude usually rubs off on people. We are a team, there really isnt an us vs. them mentality in our unit, and I like it like that

I agree

ocb_dave_ocb, LPN · Sep 26, 2008

I watched a "House" Re-run last night.. There were 3-4 docs standing around and the pt. had an incontinent episode.. House says " what is that smell, pulls up the sheet and says WOAH.. Let me find a nurse..."

I thought that was kinda funny... Had to watch it I guess

*EDIT*

In this same episode he put down a Medic.. They brought in another pt. on a gurney... House stopped him in the middle of the hall and started looking at him. The medic said Dr. you need to get him in. he has lost 3 units of blood.. House said something like "if you wanted to play Dr. you should have tried harder in school"

I like House, Scrubs, and Greys Anatomy.. But man House can really be hard on people.

TheCommuter, BSN, RN · Sep 26, 2008

I watched a "House" Re-run last night.. There were 3-4 docs standing around and the pt. had an incontinent episode.. House says " what is that smell, pulls up the sheet and says WOAH.. Let me find a nurse..."
I thought that was kinda funny... Had to watch it I guess

I don't watch "House" for this very reason. Many primetime television shows that are set in hospitals have the gnawing tendency to belittle nurses.

Virgo_RN, BSN, RN · Sep 26, 2008

As others have mentioned, it can be important for the RN/LPN to be able to delegate in order to keep their head above water. There is a line, though, between appropriate delegation and over-reliance on the CNA. Sometimes you can tell that the RN/LPN just doesn't want to get their hands dirty, but other times, I think it's easy for a CNA to make that assumption simply because they do not comprehend all that the RN/LPN has on their plate.

Myself, I'm not "above" providing basic care for my patients, but I do have to prioritize. Sure it only takes a few minutes to fill that empty water pitcher or fetch a warm blanket, but all of those "few minutes" can really add up. I usually just go ahead and do those things, but if I'm sinking, I might have the pt. put on their call light and ask the CNA. I'm sure that does not look good to the CNA who knows that I was "just in there" and "could have done it myself" while I was just there, but those "few minutes" it would have taken to toilet the pt, help them soak their dentures, help them with their HS care, bring them warm blankets, etc., is a few minutes that I need to go check on my pt. on a dilt. gtt. or who has a sheath in their groin.

I'm sorry if I sound harsh, or like one of "those" nurses, but I cannot ask the CNA to assess a groin site or titrate a gtt. Therefore, if I have a million things going on at once, I have to delegate what I can.

It really is all about teamwork and patient safety. I do not unneccessarily ask the CNAs to do anything that I can just do. But when I do ask them to do things, I wish they would give me the benefit of the doubt that it's not because I think I'm above it, it's because I need the help.