Another thing I've noticed is that the patient can get so used to the nurse doing everything, that when the CNA happens to come into the room, they don't ask the CNA for anything, nor do they use their call bell, but instead, will wait for the nurse to come back and make all of their requests then.
You couldn't be more correct with this statement. It even gets to the point sometimes when the pt will say... I ask my assistant but she never does anything or forgets.. I know since you are the nurse you will get it done....
And sometimes a patient needing pain meds or paging a doctor has priority over changing a gown. And even if we could have done it, as soon as we are in the middle of changing a brief or walking someone to the bathroom that doctor will call back, it never fails.
But sometimes Earle58, when a CNA knows you help them they take advantage of it.
I have clashed with aides many times in LTC. I take them aside and discuss the issues and it's right back to work. I was an aide back in the day, and I know the job is stressful, but I had respect for the residents and did my job. I always tell the aides that we are there for one reason, and that is to take care of the residents. After a little talk it's usually back to business as usual and no more problems, at least for the rest of the evening. :wink2:
If you don't belittle them, and tell them you appreciate their work and make them feel part of the team, they seem to have a different look on things. It's important we ALL get along for the residents sake
I'm a CNA in LTC and I can't believe these stories. No one sleeps or disappears off the floor at random without telling anyone at my job. We can't go on the computers and I don't think anyone fakes vitals either! Some people text on their phones at the CNA station or stretch their 10 minute breaks to 15, but I think that's about it. And we don't always get our breaks or leave on time. We scramble to get the paperwork done because the nurses need it an hour before our shift ends.
As for all the clashing between nurses and aides, I have to say it's not always either one's fault, but here's my perspective as an aide. There are CNAs that are good, bad, and in-between, and sometimes 2 people just don't click for whatever reason, which is okay, but both sides need to be diplomatic. If ,as nurses, you look at it like you're all employees with different job descriptions and you don't look down your nose at the aides, and the CNAs don't have an inferiority complex about the nurses, then they're more likely to feel better about their jobs, and do them well, just like if the aides do their best, the nurses are way less stressed out. A lot of the nurses at my facility are pretty nice, and as CNAs we tend to help them out as much as we legally can. We do all the vitals, empty foleys, do I&O, because we're supposed to. We hold people's limbs up or roll them over so the nurse has both hands to do a treatment, and at night we coax the difficult ones out of bed and sit with them so the meds can be given quickly and without a fight. If a nurse puts someone on a bedpan, that's fantastic, but if she doesn't have time because she's busy doing her med pass and says, "Hey I was just in So-and-so's room and they want the bedpan" I don't think it's a big deal. I realize that we each have a job to do and that the med pass is more important than bedpan duty, which anyone can do.
But if it's one of the nurses we have that acts snotty and passive-aggressive towards us, still hasn't bothered to learn my name, and wastes 5 minutes on the floor going into all the rooms to interrupt me while I'm caring for a resident to tell me that I need to go put So-and-so in the bedpan immediately (and acting like I did something wrong- and no, the resident didn't ring the bell, so how would I know?), well... geez. I'll do it without an attitude, but when she's working, I'll be almost unconsciously avoiding her the whole shift because she makes me feel so uncomfortable. It's the same for all the other aides. You don't have to kiss our ass, but I think it really does affect our work when we are treated like crap. I force myself not to take it personally because I don't think anyone likes working for her, and I know that I do my job well and shouldn't feel down for the whole night because I think someone picked on me.
On a side note, I hate being singled out by nurses! I've gotten snapped at a few times, and usually I can tell it's not personal- she's just stressed out. But there is this one nurse who yells at me whenever she gets the chance (which thankfully is not often because I hardly work under her), over minor things that everyone does, or stuff that I didn't even do. I'm so easily intimidated I always freeze. I don't know how to act around her, esp when she yells at me. She lets the CNAs who have been there a long time, who she's buddy-buddy with, do whatever they want, and then she gives me hell for it. i don't know how to deal with her. She makes me so insecure.
As RN's I belive we would need to make a difference.
Maybe we can ask our manager/director to try different things?
Incentive reward programs for aides/unit clerks.
I had to laugh about the incentive rewards. We have that at my hospital. I have three cards, count them three! I'm not trying to give myself a slap on the back but I know I work hard. I care about the patients and put time and effort in my work. There was this other PCA that was ridiculous she was always sitting at the nurses station. I could have five new admits and her butt wouldn't move from that chair to lend a hand. Well I opened the locker we shared one day and her cards what looked like 40 of them fell all over the floor. I couldn't help but wonder how exactly did she receive so many cards, was it the way she sits at the computer or talks on her cell phone? Blah oh and by the way we can buy things with those cards. I figure by the time I'm 62 I will have earned enough cards to buy a magnet lol!
I work with vg CNAs. My unit is set up that you either get with the program or you will find yourself out the door. I work a busy M/S unit and not doing your just job isn't tolerated. I'm lucky to work in a team environment where everyone is respected for what they do.
leslie :-D
11,191 Posts
if i truly have the time, i'll do it.
it's all about priorities.
i'll get a pt on the bedpan, but will hunt down the cna to get him off.
i'll empty a foley bag and jot down the output.
a fingerstick takes a second.
i will do a partial linen change for a pt who has vomited.
when the aides know i help out, it does indeed, become more of a collaborative effort.
leslie