Yes, yes, yes. Thank you for making your point candidly. We are all subordinates to somebody aren't we? Sure, I understand - where else can one go to vent about nursing issues. You are right. I'm just an idealist at heart. I am lucky in that I work with a very good team, and I know my place in the scheme of things. I look up to the nurses I work with as good role models. Sure, there are some techs that I would like to personally choke:angryfire, as I would like to choke the people who hire them! You have no idea how much I worry and care about the patients. More often than not, my nurses tell me to sit down and quit doing so much! I do the best I can to do my job right the first time and never have to be called aside by anyone. Some of my nurses have thrown things at me just to see if they could "catch me", but I know they have done it with good intentions. I take pride on being the right arm for my nurses and helping them get the job done by the end of our shift. They are my brothers and my sisters, and my mentors.
hello everyone, i just finish reading everyone take on aides running the floor, and for the most part yes, very hot subject! i'm an aide now waiting to go to nursing school this fall. i have been a aide off and on since 1987. the floor i work on now, i do mostly everything the rn does expect pass out medicine and write nursing notes, ex: trach, suctioning, vs, baths etc... you name it the aides do it also. now for me, it all okay to do what i was hire to do since this will help me to become a better rn i'm all for the work. but, and this is a very big but.. it's all in how your rn ask you to do something. and over the years, most not all rn's talks to aides like we are their children,( and i'm 20yrs or more older then most of them ) or they talk about us as if though we were not there. you all know there is a shortage of rn's so an aide would get fired way before a nurse. most, not all rn's love the word delegate, i hate to hear the word. most aides that are lazy usually have been working the same unit for years and are friends with the boss or other rn's that been there for years also. my floor is a critical floor, so our nurses were given a raise for critical care, the aides got nothing, and only one nurse spoke up on our behalf. i have seen aides that become nurses change, i have seen young new nurses and nurses that never had to do aide work or did it for a short time as a nurse intern, look down on aides. yes, we would like to make more money we have homes, kids, and bills too. but, no that is still no excuse to mistreat the patients. i don't know what nursing school teaches, but most rn's i have work with recently seem to have this air about them. as, long as the aide do everything they are told to do w/o any disagreements everything is fine. but let that aide have a mind, or a voice, now the aide is label as lazy. now all rn's are not like this i have work with some that i love and would go to the end with them, but the ones who make sure i know my place as a aide is beneath them, i do my work because that's what i was hire to do, nothing more but still nothing less for them. we all deserve respect, no matter what title is behind our names. we all must do what we were hire to do but, also help each other out from time to time. when we walk out the door from our jobs no one cares if you are a aide or a nurse, as long as you are a loving human being.
i'm sorry but you couldn't possibly do everything the rn does. she has to assess, pass meds, care coordination, assess, assess....of course the rn can do everything the aide can but the aide can not do everthing the rn can.
The aides are there to do the dirty work. That is their job.
We are hired to do meds, paperwork, dressings, supervision, talk with doctors, pharmacists, assessments of patients.
We cannot be doing both our own work and the work of the aides. There just aren't enough hours in the day. If we do their work, we still have our own to do, as they cannot legally or by virtue of education do it.
Repeat - they are hired to bathe, dress, turn, clean, feed, and transfer patients. It is hard physical work. It's what they were hired for. Sure, we can help them. They can only be one place at a time. So can we, though.
I don't agree with the aides being there just for the "dirty work" I am out cleaning and bathing and turning my pts as the charge nurse. Everyone is supposed to work as a team and if you go in with that attitude then your going to get one back. I heard a lvn nursing student complaining about going to clean up a pt. She said "I am here to do nursing not a cna class." I immediately corrected her. I have figured out if I ask someone to take care of something that I get an attitude for I will track them down later and explain why it needed done right then. Alot of aides and even lvn's don't realize what you do as an RN. I can speak from experience cause I was like that until I was halfway thru RN school. Let them know what is expected of them. Tell them why. THey don't know cause they haven't had the education.....
I don't agree with the aides being there just for the "dirty work" I am out cleaning and bathing and turning my pts as the charge nurse. Everyone is supposed to work as a team and if you go in with that attitude then your going to get one back. I heard a lvn nursing student complaining about going to clean up a pt. She said "I am here to do nursing not a cna class." I immediately corrected her. I have figured out if I ask someone to take care of something that I get an attitude for I will track them down later and explain why it needed done right then. Alot of aides and even lvn's don't realize what you do as an RN. I can speak from experience cause I was like that until I was halfway thru RN school. Let them know what is expected of them. Tell them why. THey don't know cause they haven't had the education.....
I don't think anyone here is saying that they aren't willing and able to do the "dirty work", but that it is sometimes impossible to do it. When I worked the day shift, I had 20 LTC respiratory patients to pass meds to (some with g-tubes), do treatments on (drsgs and trach care) and document on. If they day went well, I could possible squeeze out of work on time. Meanwhile the CNA's are usually done and in the back lounge for an hour or so - they always leave on time and they always get their breaks. The LPNs on my floor rotate between med nurse and patient care assignments. When we do patient care assigments we are also expected to do any treatments on the patient - which makes sense - be we are also out on time on those days. When passing meds, if I had a chance and could help turn or spot someone I would, but unfortunately the CNAs could not in turn help me out.
Now on night shift it is a whole other ball of wax. We are the only unit where the nurses help the aides on rounds - 2am and 5am. So while I'm passing meds from 11-1:30, I expect the CNAs to answer lights and assist the resident. Not ask me "can you check to see what so and so wants" or can't you just get them on the bedpan", or actually not be available because they are on the phone for an hour or visiting someone on another unit. Same thing at 6am. I'm in the middle of passing meds, doing bgs and getting vs with some documentation still to do. I will help them turn someone or pull them up, but they need to ready, not make me wait 10 minutes while they get ready. I will also give a bedpan if I know the CNAs are busy giving patient care.
Bottom line, I help when I can, but I can't do their job and mine - there just isn't enough time in the day.
I'm Sorry but you couldn't possibly do everything the RN does. She has to assess, pass meds, care coordination, assess, assess....Of course the RN can do everything the aide can but the aide can not do everthing the RN can.
Hello, No you are right the Aide does not do everything that the RN has to do, I believe I did give a couple of examples. But yes we do assess the patient. Each time you walk into a patient room ( in which the Aide is usually the first one ) you notice changes if any about your patient Ex: are they still alive, did they fall out the bed, do they seem upset today, things of that nature we look at also in order to tell the RN.
Hello, No you are right the Aide does not do everything that the RN has to do, I believe I did give a couple of examples. But yes we do assess the patient. Each time you walk into a patient room ( in which the Aide is usually the first one ) you notice changes if any about your patient Ex: are they still alive, did they fall out the bed, do they seem upset today, things of that nature we look at also in order to tell the RN.
absolutely.
i so value any input the aides have.
if one tells me that something is off about a pt, i make it a point to see that pt asap.
I was a tech at my prn job not to long ago (like 3 mon.!), so when I am the charge nurse it can feel a little weird. Lucky for me though, the techs and LPN's I work with are great, we work together wonderfully as a team and everyone knows their job and does it without me having to ride their backs all night. I work on a psych unit though, and personally, I feel that teamwork is better on psych floors vs. your typical medical floor. There isn't the same emphasis placed on hierarchy.
There is one tech where I work that drives me crazy sometimes. She's a really hard worker but she always wants to be helping out with nursing duties and therefore ends up leaving the floor with no one watching it.
The other night she was the only tech and I was in the nurses station (it's separate from the rest of the unit and sealed in by glass walls) and she came up there and started printing out paperwork for the next day (normally my job but something that she knows how to do). The next thing I know I'm getting all the drinks and cigarettes, and I'm out in the milieu helping people to the bathroom and showing them where to do laundry. Suddenly I realize, She's up there doing my job and I'm back here doing hers.
So basically I swallowed a big girl pill, and went up there and told her I appreciated that she was trying to help but there were phone calls that I had to make and it would be more helpful of her to stay out in the milieu with the patients. She was mad, and it sucked having her mad at me, but sooner or later she'll get over it and I had to do what I had to do.
I try to be as helpful to the tech's and pitch in where I can, and while I can do all of the techs job, there are parts of my job that only I can do and if I spend my whole night doing the tech's work then nobody is doing mine.
That was one of the hardest lessons to learn post nursing school. Sometimes you just have to delegate (whether they like it or not).
I asked a health care assistant to help me sit a patient up and she said 'why can't she do it?' pointing to an RN who was doing iv drugs. I smiled sweetly and said 'Because I'm asking you' lots of muttering went on but she did it. Trouble is this girl is idle and management won't deal with her. Constant aggravation everytime she is asked to do anything, prefers to sit on her bottom if possible. The only one I ever had bother with.
as far as ideas to encourage aides to do their job i have a few.
1) pay them more. i dont do payroll so that is easy for me to say, but i think if we raise the bar and make being a cna a more desirable job, we will get better applicants. as a tech, i can't agree more especially for the ltc setting. i work in acute care and make almost what a new lpn makes but i stayed away from ltc and one of the reasons is they paid almost $3.00 per hour less than what i make now.
2) respect them --treat them as an extension of your self. ask them their opinion and then listen to it. i have seen nurses dismiss what an aide has to say, do that enough and the aide will stop reporting changes to you. this is a two way street. i agree that we deserve respect but you deserve the same, if not more, respect.
3) we have staff meetings that are mainly geared towards the nursing staff, the aides should have aide staff meetings. many aides have great suggestions, they just need to be heard. yes!!!!!!!!!!!
4) offer incentives or rewards for exemplary performance, maybe cafeteria dollars, or even something silly like a star pin to wear on their name badge. some small token that shows we appreciate them.
5) get rid of the ones that drag the others down, we as a staff should not tolerate rude behavior. if an aide is not doing their job and a new aide is hired and sees that "old" aide is not working nearly as hard, yet is getting the same $$, do you think new aide is going to bust her butt? no, they will soon see they can get away with not doing as much and still collect the same pay check for half the work. we just went through this. the whole staff complained for months about this one particular person. it's amazing how one person who doesn't do their job can bring down the whole floor. we were all miserable working with this person but it seemed like it took management forever to realize it. our nursing manager even came down on this person twice, this person had a no call/no show, and management didn't do anything about it until it was too late and morale was already in the toilet. if the new aide is going to try to slide by like the older one....that new aide is probably not the right person for the job in the first place.
another suggestion i have and this i am sure no one but the aides will like, dont make them work holidays. let them have holidays off and have just an rn staff on those days. lets face it, they make at least 1/2 if not a 1/3 of what a nurse makes and the good ones work just as hard as the nurses do. i would be willing to bet if a facility treated their aides with respect and gave them perks such as holidays off and other incentive programs, we would retain the good aides and qualified cnas would be beating down our doors to get a job. i disagree with this one. the point of all of us working together is so we act as a team. if the aides/techs don't have to work holidays because they already work hard where is the teamwork in that one? techs and rn's should have the same work requirements because we are all in this together. splitting things up like that is just going to cause animosity between the two and break down whatever teamwork was there before.
since i am not in management, i can not make those changes. but i can provide the respect part of the above suggestions.
Do you ever clash with your aides? yes...the lazy ones...who don't want to do what I ask them...instead they would rather sass me
What about? Anything that involves work
Who "wins"? Most of the time I do
Do you have friendships among your subordinate staff? What about with other coworkers? I do not believe that work is a place to make friends...that can get messy to involve your personal life with work and vice versa. I do have a relationship with a couple of my coworkers...one was my former boss.
Have you ever had an aide tell you she's refusing your direction to do this or that? Have you ever called your supervisor for back up? What happened? Yes, alot of times the supervisor will talk to them and it gets twisted around and I end up being the "bad guy" so I've learned to keep my mouth shut and just deal with it.
How did you cope with it? Were you made to feel at fault somehow? See above.
Are you in a long term setting or acute care with quick patient turnover? LTC
Is your staff pretty stable or do you have a frequent load of new staff who don't really know the job yet? Our staff is far from stable...we use alot of staff mostly CNA's and one Med Aide from a travel agency...alot of times we get the same ones and they act like they don't have to do stuff that you ask or do things the way they should be because they know they won't be in trouble...they also call in a lot, but my boss keeps a record of that and if they call in 3 times in a month she'll have a talk with them and their agency and not have them come back for a while...it's rather interesting...I have my best days when I have all or most of my staff that works for my facility.
I sure hope she got a good long write up. And I hope management backs you up. If she doesn't want to do her job, then she shouldn't be there. And there could be some pt. neglect issues going on that need to be checked into.
This nurse is now one of the house supervisors. Go figure:confused:
I have worked at a number of facilites (both LTC and acute) in which the aides run the units, mgmt knows and does nothing, and nursing complaints fall on deaf ears. This is pretty common in health care.
This has also been a major factor in why I have quit a number of jobs.
Regardless of how it looks, the aides tend to run the floors.
I remember being able to get my work done and out on time when we didn't have the aides. They increased our workload with aides because they were supposed to be doing the less technical part. What I find is that I have to keep doing what they deliberately ignore and it all adds up by the end of the day. They leave on time, I'm over trying to do the part of my job that they can't.....charting.
They fuss that we can do their job, but they can't do ours. The problem is that EVERY department thinks the nurse can do something and the nurse gets stuck with so many tasks so that they can go home on time. We can't say anything. We can't complain. We can't get rid of any task that got dumped on us.
I have noticed for a long time now that techs no longer empty urinals or the pans in the toilet. I have also noticed that for some reason patients seem to think the only one that can is the nurse. They will never ask the tech to dump it but will wait for a nurse to ask.
I also noticed that most techs don't rinse urine and stool from pans. I don't understand that one. I have even had patients tell me that no one does that when I do rinse it.
Turning patients....don't know where that training went but it is a thing of the past. Making sure they have water....that's gone too. Vitals are optional and weights are only obtained when they are missed enough that someone says something.
Oh ya, cups and other helpful items.....no longer being stocked. Little by little they do less and less. Stock is short, patients have full urinals...no water, no food, their draw sheets are up at the top of the bed, incontinent pads up their backs, rooms are a mess, patients are lying on IV lines and call lights. I don't get it. I'm so ready to go back to primary care.
Ya, it takes more time to find the tech so I do it myself, do it myself, do it myself. I always feel that something is wrong when I see techs strolling around with arms folded, sitting on the internet or sitting with their legs crossed and nurses are running around. What happened? We literally get kicked down further and further and further below everyone. If the tech isn't happy, it's a nurses fault. Patient unhappy, nurses fault. Doctor ticked off, nurses fault. Something not done, nurses fault.
I would like to see a survey on nurses general health.
I have found babysitting other adults is not very rewarding. I would like to assume that as an adult you know there is work that needs to be done, vital signs are not optional and yes....you can empty the urine too. And, would you put your mother on a pan stained with feces or urine?
Nurses aren't the only ones that pay for the imbalance. The hard working techs and patients pay too. I always feel so ashamed when a patient asks me to empty their urine. It's like I might as well count on it not being done by the techs so I can not be embarassed.
bollweevil
386 Posts
I wish we worked together. God bless you.