I've read several threads over time, and I "hear" from both the RN's AND the CNA's that CNA's are there to "help the RN." I am a little lost on this one, I can see in a way what it means, but IMO, EVERYONE is there to help the patients, yes? I think the worst portrayal of this attitude is when CNA's (and NO, definitely not all of them) feel that the RN should kiss their feet for any thing that they do "for them," and should just suck up a poor attitude by that person, because it would be "worse" without them there. It goes the other way, too.
From my perspective, having been a CNA for 5 years before becoming an RN seven years ago, is that no one is REALLY "more" important than the other. We just have different roles. Of course I appreciate working with a good CNA (and I am fortunate, I work with very good ones!) but I don't necessarily think of them as "doing me a favor" when they bathe a patient or answer a light. That's their job. It's mine, too, so I will do both of those things when time permits me. To me, one is doing me a favor when they are working with a different RN and have a patient assignment, but will help me with my blood sugars when I'm working alone, if they have time. THAT'S above and beyond. If they're ON my team, it's not a "favor" to me for them to get sugars....it's an expectation. Now, if I'm going in to a room anyway, I WILL often enough get it myself, I have no problem sharing those tasks. I don't think I'm doing THEM a favor, either, by sharing the baths...we're a team. I do give plenty of "thank you's" when they do their job efficiently and thoroughly, as well. I don't really see anything as strictly theirs to do. If I had a day where I couldn't help with the basic patient care as much as I'd like to/usually do, I will explain to them WHY I had to stick to what are strictly my RN duties (more new orders than usual, a patient having complications, etc).
Anyway. Just my two cents. Any thoughts on this? I would think relations between RN's and UAP would be better overall if EVERYONE took responibiility not only for their jobs, but for all of the patient's care. As soon as an RN OR a CNA feels like the CNA is there just to help the RN, and that any of the work they complete is a favor to them, it gets hard to get ANYTHING done the right way.
Hope this made sense. I've read it several times now, so I just wanted to get that out.
I'm seeing some very naieve, idealistic, defiant, hostile and arrogant remarks from non-nurses and those who's experience with nursing consists of watching soap operas.
If YOU are not there to assist the nurse, then YOU need to have YOUR title and job description changed. Period.
I personally get tired of having these girls spit in my face when I ask them to do something. Most of them are great. And I have never asked anyone to clean up a mess I made or requested anything unreasonable. But don't stand there when I ask you to help someone to the bathroom and tell me you are about to go on break or do something else.
As for this you-have-to-earn-my-respect deal, take a step back and look at yourselves. What makes you think you deserve any respect?
:twocents:HAVE YOU EVER BEEN A NURSES ASSISTANT? OBVIOUSLY NOT!!! The work that them girls do on a daily basis is just that WORK!!!!! Been there done that got the t-shirt, I know what I'm talking about. However there is always a bad apple in the bunch, but I'm not talking about them right now. As for respect it takes some to get some!
:twocents:HAVE YOU EVER BEEN A NURSES ASSISTANT? OBVIOUSLY NOT!!! The work that them girls do on a daily basis is just that WORK!!!!! Been there done that got the t-shirt, I know what I'm talking about. However there is always a bad apple in the bunch, but I'm not talking about them right now. As for respect it takes some to get some!
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Passionate subject for sure. Remember, we can debate the issues without attacking one another. If you feel hot, walk away and try posting later when you feel better. And shouting (all in capital letters) generally turns people off, as do attacks. You cannot get your point across when you do this.
Please cool down so the thread does not have to be locked. Thanks.
I think that this discussion has gotten awfully tense and that your feelings have been hurt. I'm sorry for that.
The vast majority of aides are fabulous, as are most nurses. However, here and there one does get an aide who really oversteps her boundaries, and here and there one finds nurses who are dismissive of everyone "below" them. I've had RN's be really snarky to me because I'm and LPN, and I've seen LPN's be snarky to CNA's because they aren't licensed. And I've had SNA's who were flat-out insubordinate and rude. I will never forget asking someone three times to put a resident who wanted to go to bed and look at me and sneet, "You ain't charge." When I reported this I was told that I was the problem. The aide was later fired for being abusive to residents, which I had repeatedly reported. I had an RN I worked with who would allow the aides to keep residents from their rooms, in which they had the right to be, because they would do things like hid poopy briefs in their drawers. Well, that's why they were with us. Because they were demented. I made the aide who was upsetting her back off, knelt down to her level, and asked, Mary, am I mean? The aide AND RN both looked as if they had been slapped, as well they should have. I soothed the resident, and the RN apologized, and admitted that I was right. We do not mistreat patients because it is easier for us.
That said, they recetly cut an aide from a floor with 42 very disabled residents. Not one is capable of ADL's independently, only about 3 on the nit are still ambulatory, and there are now 5 aides doing what was the work of 6 for 42 lost souls. They are overwhelmed. By the same token, each resident is on at least 10 meds, all more than once a day, so the nurses are up to their eyeballs, too.
I will never forget the aide who came to me and said, "Jim's leg looks bad." Well, I might not be an RN, nor was she, but I took one looks and said, "You're right. That ain't right." It was an obvious phlebitis, and I was very grateful to Sherry for picking up on it. The doc came down to send him directly to the bigger hospital in the area and an RN from the ED started in on me on the phone on how could we get away with not having an RN on the unit, as if we were all unskilled, brain-dead chimpanzees without a clue.
I guess my point is that we are ALL overwhelmed and short-handed. Our patients are older, sicker, and more helpless, reimbursement rates don't come close to reflecting that, and everyone on the nursing team, in which I, at least, include the aides, has a great deal of responsibility with next to no authority. And instead of working together we bicker like a bunch of school girls.
Again, I blame management for thinking that dumb things like cutting an aide is a good idea, that we need to accept ever more debilitated and demted residents, and that we don't work together.
If I ask for help with toileting someone that's important. Dignity is important. The offenses I found most often, from nurses and aides alike, were against patient dignity because priorities were screwed up.
I once had my co-LPN report me for refusing to DRAG a resident into the geri-chair because she didn't give a damn that it upset him her was care-planned for it and she literally would not give me time to lock up the med cart so I could walk with him for five minutes.
I don't get it. Instead of backing one another up we rip each other to shreds.
And yes, there are nurses who will state that they didn't go to school to wipe butts. They ought to get out of nursing, because keeping patients clean, safe, and care for is the very crux of our profession. But when we really don't have time to do it it's because an emergent situation is arising or a more pressing task that the aide can't perform needs doing.
I remember one morning at shift change (I was nocs) the aide and I were up to our elbows in a hideous code brown plus puke. The other aide was off having a well-deserved break - 3 of us for 42 nocs. When my relief came in she loudly announced that I hadn't cleaned the suction container for our trach res. To everyone.
It's a business that looks to throw each ther under the bus instead of work together. And management promotes that, and feeds it, and likes it.
And you helped me make a decision today. I vowed a long time ago that when I became an RN and I might be one - took the boards yesterday - that I would not change my user name to reflect that. But I am relly proud of what I've accomplished and was tying with the idea of adding the RN. I've decided against it. Over the past few days I have been reading incredibly knowledgeable posts from people and then saw that they were aides and I don't want my knowledge judged on the letters after my name. I'll let it stand on its own.
Ignore the posts that upset you. I know precisely what you're feeling now, because I've felt it, too. FUMING at what some people on the internet who don't know you and have never worked with you believe. Let it go.
That is exactly right. This is only an internet forum, and words and intentions for those words are so easy to misconstrue it isn't even funny.
No one knows what kind of nurses we are to work with, nor what kinds of aides are making comments we may misconstrue because we perceived a tone from reading the post that reminded us of a bad experience we had which caused us to react.
No, dont let yourself get too upset over this. It's just a lively debate, like that show "Crossfire." You'd think those guys are going to start throwing punches, sometimes. My favorite episode ever is the one with John Lofton and Frank Zappa about censorship, lol.
I think that some of these posts have turned into "us" vs. "them" and they don't have to be.
For every example of an aide who gave me a hard time I have another of a nurse who helped enable the attitudes.
What is a mystery to me is that some of you nurses have worked with no lousy nurses who contributed to your problems, and some of you aides have never met a lazy-butt aide.
And no one is acknowledging that the problem lies in being short even when fully staffed.
And I get sick of nurses telling me how I'm worthless and not worth anything and I'm so much lower than them because I'm not a nurse. And then demanding I get there vital signs right away when mr. so and so needs to go to the bathroom right now as well and mrs. b wants ice water.
.
Not taking up for anyone, but, sometimes knowing the patient's vital signs is much more important that ice water or going to the bathroom.
It all boils down to respect and most of the cna's I've worked with do their job very well and left little room for me to have to tell them or ask them to do anything extra.
There has been a time or two that I felt like I was having to BEG and be ULTRA NICE to a tech just for her to do what she was suppose to do everyday. At that point, I went to the nurse manager and informed her of the situation. It was taken care of.
I think that there are a LOT of misunderstanding here. I think we all become so engrossed in our own roles. Here is what I think should happen and I think it should be a YEARLY requirement. I think if you are a nurse you should have to shadow an aide for a day and be a resident/patient for a day. If you are an aide you should have to shadow a nurse for a day and be a resdident for a day. I think that this would hit people with a DUH they don't work harder than I do. They work just as hard, in a different way. Being a resident you would KNOW what it's like. To have to wait and wait and wait. And maybe in your daily roles you'd jump a little faster for the resident because you remember waiting hours and hours. Part of the problem is when you are an aide you aren't really taught what the nurses job is. I've been an aide for 4 years now and I still don't have the full idea because number 1 I'm not a nurse...yet number 2 I've NEVER shadowed a nurse EVER. A nurse learns in nursing school what an aide does and I believe they actually have to do it for the first little bit in clinicals. But we forget. We forget what it's like being the other person. That's just my idea and I KNOW it will NEVER happen.
That we are a team and need to work as one is agreed upon, and a bit of a given, IMO. My point is that the role of the CNA in that team is not one of having an independent practice, and that the CNA is there both to assist the patient *and* to assist the nurse; those two functions are not mutually exclusive.
As far as staffing levels having an impact on this, I can see that in places where the staffing matrix is ridiculously short of adequate. However, where I work, it seems to boil down to work habits the majority of the time. When we're well staffed, and I go into my rooms to do my med pass and every single water pitcher is bone dry, while the CNA is sitting out there checking their personal email or balancing their checkbook, it's about work habits, not staffing. When I'm busy admitting a new patient and the CNA is repeatedly walking past another room, commenting on the smell, but does not think to go in and check the BSC for stool, it's about work habits, not staffing. When I ask the CNA to get patient A a snack, but the CNA is too busy informing me that patient B needs a sleeping pill and that the one he took the other night didn't work, so the CNA thinks I need to call the doctor to get an order for a different sleeping pill, then proceeds to dig through another patient's chart to find out why she is not on a diabetic diet, while patient A is still sitting there starving and yes, I am physically capable of getting a snack, but I can't ask the CNA to do the admission med rec, which needs to be done NOW because the doctor is here writing orders, so I'm asking the CNA to get a snack.....sigh....it's about work habits, not staffing levels.
SmilingBluEyes
20,964 Posts
I second that, Sharrie! Thanks.