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 know you weren't addressing me, cherrybreeze, but my response has to do with the concept that the CNA is not there to assist the nurse, but rather, for the patients. I disagree vehemently with this sentiment. The CNA is there for both.
I've worked with CNAs that behaved as if they had their own practice. The ones who go on break without informing the nurses or finding another CNA to cover their lights. Their attitude is "the nurses can answer their lights.". These are the same ones who don't do the Turn Q2s, but rather, wait for the nurses to come find them and ask for help turning the patient. I could go on and on. But basically, they've got it in their head that they're there for the patient, so they decide what is important that they focus on for each patient, which is often in conflict with what the licensed nurse views as the priority for that patient. They make decisions independently of the nurse, and overstep their bounds by doing patient teaching. In effect, the patients get substandard care and the nurses are overworked, while the CNAs walk around as if they have an independent practice.
It is part of the role of RNs to supervise and delegate work to unlicensed assistants. It is not about having power over a person, it is about getting work done with help from others. The licensed nurse is the one responsible for the overall care of the patient and in organizing/directing that care as appropriate.
I think delegation is such a complex task. I am not a nurse yet, but I can see how it can be difficult to find a balance between what should be delegated, what to do yourself, and not over-or under- delegating. The majority of nurses I have worked with have been excellent leaders who have role modeled the kind of nurse I want to be.
CNAs are responsible for performing tasks that are assigned to them, but also knowing what they can & can't do (scope of practice) and refusing to do a task if they don't feel competent. It would not be appropriate to use the excuse "but the nurse told me to.." if they know a task is out of their scope.
As for attitude between CNAs and RNs, I think it comes down to respecting and being considerate of each other. Let's let go of the stereotypes of "power trip nurses" and "lazy CNAs" who tend to be the exception rather than the rule.
Just wanted to say, I had a good time reading all the post written for this thread. I really don't have an opinion on the topic, although since i was an aide and am now an RN, i just found the thread and posts very interesting.
Well........ i do have one thing to say lol b/c on my unit I am both the aide and the RN, and I like it that way. The only time we have an aide on our unit is if we have 4 pts a piece. I laugh at our co-workers (aides), (laugh at in a good way) when they float to our floor, b/c they love it, b/c we are so used to not working with an aide, that we just automatically do all the pt care. But then they get tickled at us, b/c we thank them so much for floating to help us b/c the extra set if hands do help. Needless to say we work well together when our co-workers do float down to help out
I think this has been posted, but respects for your co-workers goes a long way. I respect everyone I work with from the nurses, to the aides, to the housekeepers, and anytime I need anything i know they all got my back, just as i got theirs and will help the nurses & aides with anything they need, and yeah it might put me behind on occassion, but that's cool, b/c I am there for pt care, not just my pt care and to me that is what it is all about, good oh teamwork:up:
Anyway I guess my post really did not have a point:loveya:, but again it is an interesting thread to read.
SuesquatchRN, BSN, RN
10,263 Posts
I think she was trying to.
And thanks!
:)