Struggling as a Nurse Aide

Virgo_RN, BSN, RN · Dec 21, 2009

It sounds like there is a problem of low morale on this unit. Most likely, this is due to things beyond your control, so the chances that you can singlehandedly turn this around are slim to none.

As far as workload, nothing in your post sounds out of the ordinary. In my experience, everyone works hard, not just the aides, and not just the nurses.

Be very careful about assuming that all the nurses are doing is "giving meds and starting IVs" (though those are important tasks that the nurses are expected to complete). As you progress through nursing school you will see that there is far more to nursing care than you may be aware of now. Many nursing students still remain unprepared for the demands of nursing care when they hit the floor as new grads. It's called "Reality Shock", when you realize just how different, just how demanding being the nurse really is. You will experience this when you graduate and start that first nursing job, and you will be amazed at what you weren't aware of when you were an aide.

My advice is to avoid burning bridges, especially in light of how scarce jobs are right now. Go to work, do your best, and work on developing a thicker skin when it comes to your coworkers. Be polite, do your job to the best of your abilities, and focus on doing well in school.

allnurses Guide · Dec 21, 2009

Very rough estimate because I don't know the particulars 6 Nursing School classes= 1 hour per each= 6 hrs. x 3 days= 18 hrs+ 2 hrs each for homework (cause that's what they told me to do, mileage may differ)= 30 hrs + 24 hrs for job= 54 hrs + preceptor 8hrs = 62 hrs

Are you used to working this way? Some people apparently like it, but for the most part this is courting disaster on many fronts. You seem already to be on the brink what with worrying and being exhausted, etc.

Where is some give in this? Do you have to work? Can you spread your classes out more? I know some hospital staffs are just clique-y jerks, but being stressed out of your mind changes your viewpoint, even if just a little.

You mentioned you thought maybe it was racism. I am in no way saying it isn't there, but I'm wondering why that was considered a possibility rather than chalking it up as a bunch of rude mean-spirited b-----

GoalsInTransition · Dec 21, 2009

Hi there,

I junt want to tell you that I can empathize with your situation. I once worked as a CNA in a skilled nursing facility and the staff were the unfriendly, unhelpful bunch you have described at your hospital. I was also working another job and going to school full time back then, so I also empathize with feeling overwhelmed.

True, it would be wonderful to have a pleasant supportive environment at work, but this may not happen. As much as it may suck, maybe sticking it out is your best option. It will definitely toughen you up to get through this on your own, as hard as it is. I wish I had stuck it out in my situation, but I just jumped ship instead of "conquering" the tough spot I was in.

I know your time is stretched right now, but try to fit in some fun- family time, shopping, friends, sports, church-- whatever you can do off the job to relax and to feel better about yourself. it really will pay off, even if you never make a single friend on the job.

I hope things will get better for you- hang in there!

Stacy

SuesquatchRN, BSN, RN · Dec 21, 2009

islandgrl, is there ANY way you can survive financially without this job? You are spread too thin.

locolorenzo22, BSN, RN · Dec 21, 2009

although that I agree you are spread too thin...I suspect that perhaps you may be sending off signals that somehow relate to you coming across as rude to the floor staff as well. You mention that you are at a run...and that ALL the duties seem to have been relegated to nursing aides. Well, that's part of being a aide...you generally do have more duties you're responsible for....but the nurses have their own job to do.

I'm not saying they shouldn't answer lights or help check in on patients, but often they may have 3-12 other things going on with all their other patients and be having to admit patients, etc....

You don't mention what shift you work, what your duties are, what you are doing when patients are on their lights and you answer them(are you just "I'll go get the nurse" or "I've let your nurse know, I'll let them know again, is there anything else I can do for you while you wait?"...makes a world of difference. Is it a matter of time on the shift, organization, you feel constantly behind, etc? let us know, and we can also help give you tips on how to get through this. also, how old are you? generally, sometimes, age plays a role in how you relate to others.

a valuable piece of advice that I remember from my tech days that I still use is that I CHOOSE what attitude I come to work with....I can choose to be grumpy, POd about work that was left for me or admits to come or tasks still to do....or I can choose to be friendly, knowledgeable, plan my time, get my work done ASAP, and then I can be free to assist the aides with whatever needs to be done...I have given baths early for the aides when I was all caught up, and things needed to be done. Not above doing whatever needs to be done. But that is a choice you have to make. Refuse to let others dictate what you do.

let us know those answers, we can help!

islandgrl001 · Dec 23, 2009

I really appreciate everyone's response. It gave me a lot to think about. I do think I am spread too thin. With that being said I think I need to find my way out of this spot, as a poster suggested, rather then jump ship. I really need the money and the experience. Plus I am overly sensitive and really need to build a thick skin which I think may be the hidden value I take away from this difficult experience.

I think it's my burnout/stress talking when I say all the nurses do is give meds/start IVs. I did ask to shadow a nurse for a shift on my floor so that I could see the reality of what they do. I got a really good perspective from that experience. While they are not on a dead run all day like the nurse aides are they still have a lot more indepth critical thinking work to do with each patient. While I am jealous of their 4 patient workload to my 11plus patient work load I have to laugh that my stress and anger is going to the nurses when that's what I am going to be in 9 months. I guess the frustration has to go somewhere. I will say that a nurse friend of mine found it really crazy that the nurses on my floor never ever give baths, transfer patients, do I&O's, etc. And just the other day I had an experience that I think highlights just how hands off some of the nurses on my floor can be. I was struggling with really low blood sugar the other day and just needed to drink some juice to bring it back up and on my way to the nurse's lounge one of the nurses grabbed me and insisted that i help her patient that instant get into and out of the shower. I didn't deal with the situation well but I felt so frustrated that a nurse couldn't gather the necessary towels herself and walk the patient to the shower when she was already in the room, but felt the need to summons me to do it instead. In the time it took her to find me she could have done it herself. I found that really frustrating and a tad ridiculous.

I do think that I am sending off signals to the staff that probably comes off as rude when it's stress. I really need to work on that but don't know how. The truth of it is is that the only two days I have off from school are spent at the hospital so I walk in pretty tired and exacerbated to begin with. Its hard to paint on a smile and keep up the good attitude halfway through a shift when the inevitable you-know-what hits the fan and I am now miserable and just trying to get through my shift.

I think I take things too personally. I do think that there are some people on my floor that aren't as open to accepting me because of my race but I think it's probably more of the signals that I am giving off then overt racism. I have experienced some verbal disrespect from one or two of the nurses but from what I hear that isn't uncommon. It's just a bit of a wake up call to an idealistic nursing student. I thought nurses and nurse aides were supportive of each other. It's too bad to see how much, and to what extent, that isn't always the case.

Again, I really appreciate the advice. It's helpful to get a different perspective from my own. I will continue to reflect on my experiences and hopefully I can find further meaning and some positive resolutions to my struggles as a nurse aide.

islandgrl001 · Dec 23, 2009

PS-Locolorenzo:

My Duties: My ususal day consists of taking vitals on 11+patients every four hours. Hourly personal rounding on each room. Frequent vitals for the many patients on spinal anesthesia for ortho surgery. Setting up their trays for breakfast/lunch. Am care. Record I&O's. Bed baths and showers and linen changes for all of these patients, every day shift. Make sure the venodynes are on and working. Refill the icemans and make sure they're on and working. Empty the Foley's. Empty drains and wound vacs. Basic wound care. Turning. Refill the icewaters. Schedule wheelchair transportation throughout the day for all of the patients that are receiving PT. Get these patients dressed in PT clothing and make sure that the transporter comes and takes them to thier PT appointments on time throughout the day. Help intake all Post-Op patients (set up the machines and do all the vitals on post-ops) and help with discharges. Answer ALL call lights for all of my 11plus patients. The call lights are constant on my floor mostly because it's post-op ortho and there's a lot of pain issues. A good majority of the patients need a lot of assistance with bedpans, getting on a commode, or getting to the bathroom. Also I have done some patient education and talking with family members. Then I chart which is the best part of my day because if I'm lucky I can find a seat and sit down for the first time.

I am in my late twenties. I think sometimes I act a little immature in nursing for my age because I did a career change and this was such a jump for me. I am use to writing grants and being burried in an office and sometimes I feel so unsure of myself at the hospital so I am in a kind of constant anxiety level that I think can come off as immaturity. I think most people outside of the hospital would say that I am mature for my age. But admitably, in the hospital I revert to my teenage years and just get big eyes and act like I am really suppose to know how to transfer a double hip fracture by myself? So yes, I need any help/suggestions you have to give to me to help me relate to others and relieve anxiety in the hospital.

Whenever I answer call lights I usually resolve the issue myself unless its a pain med request or they want to speak to the doctor. A lot of the time its for pain meds and a lot of the time it's simple things like they need more water, want tea, they need to go to the bathroom and need help getting up, etc.

But I'm just exhausted thinking about it and dreading my next shift which isn't good, and is not at all the way I want to be. I am sure many of us have seen the overly frazzled nurse you wouldn't want working on you and I never want to become that but clearly I'm on my way.

allnurses Guide · Dec 23, 2009

It's perfectly normal to have the big eyes and the anxiety when confronted with something totally new!! If you didn't feel that way it would be weird!

I wish I knew why groups of people push a new person out in the cold. I wish I could say that was unusual in nursing, but unfortunately it's pretty common. Sometimes younger nurses will ostracize an older nurse, older nurses a younger nurse-- it's just wrong whatever the reason. I would also hope that if you could share with them all you have on your plate, they would understand your being edgy sometimes!!

I suppose the best way to look at it right now is that it's temporary, you are busting your buns for your career goal, and I for one admire you, 'cause they might be leading me by the hand to the Happy Farm if I had a workload like that.! :bugeyes:

Best wishes to you as you continue the path to your nursing career!

Virgo_RN, BSN, RN · Dec 23, 2009

It sounds to me like you are approaching this with a lot of maturity and insight, and because of that, I think you will only be successful.

It does sound like you have a lot on your plate as an aide, and hopefully, at least some of the nurses do jump in and help out. For example, I don't think it's too much to ask for a nurse to at least start the process of helping the patient to the shower, then asking you nicely to pick up where they left off. The exception would be if the nurse is needed elsewhere for something more critical, but it seems that you are able to understand that, unlike a lot of the aides I worked with in the past. This is what makes teamwork, is everyone being willing to pitch in and help out when they can.

Good luck to you in your schooling! You sound like you will be a great nurse!

locolorenzo22, BSN, RN · Dec 23, 2009

Wow....you do have a LOT of things on your plate. Let me say I understand...I work ortho/neuro/detox and did my CNA for 3 years while I was in school. So, let me get some of these duties understood....for the vitals:do you use a machine or a manual BP? I've found that a manual solves problems because then you don't have to repeat them when the nurses ask about the bp....any abnormals, just go report them right then, because then you don't have to go back or remember later....

for the post ops, do you have vital machines that automatically take bp/pulse at least? I understand the spinal monitoring, I do it too. Tray setups? do you mean that on top of everything else you have to take trays into patients and make sure everythings ok? I would say that really that belongs with dietary, and only if they REALLY need help should it fall to you.

Icemans? are those the little cooler ice pack things? Empty drains and wound vacs? basic wound care? some of that stuff should be back on the nurses....i.e. it may also be out of your scope of practice, I would check your practice act. here in IL, CNAs cannot do dressing changes, wound cleaning, etc.....

Icewater wise, do you have liners for each pitcher that you could just fill all of them at a central location and take them to each room, or just pitchers? If the latter, then collect all the pitchers at a point for 15-20 minutes, fill them, and take them back to patients.

The w/c transportation can't help ya with.

Really, education is good, but you have to be careful there....know what you're REALLY talking about, and then make it as short as possib le, friendly, but to the point.

One of the easiest ways to relate to someone is thinking about "how would I want to be treated if I was him/her?" I joke, talk, educate, and push patients. sometimes I have a grumpy gus, and just give meds, do what has to be done and leave them alone. It takes a good six months to really understand what's going on....and you just go in, do what you can and forget about it.

the call light issue I have a MAJOR issue with...I firmly believe it's a team...nures have to answer lights same as techs...it really helps out a bit...positioning...if you are having a issue simply say "well, I have x/y/and z to do...I can get to that boost in a few minutes or I've got a lot going on...can you get someone else to help you for a minute?" good luck, feel free to post back here about how it's going...

NENE RN · Jan 8, 2010

I understand your frustration as a nurse aide. I don't feel as though we get respect for the job that we do. On top of everything that you do I am required to do lab draws and EKGs. I have had nurses try to interrupt other nurses while they are giving instructions to me. I know what kind of day I am going to have by the nurses that I am assigned to. Keep you head up. I started my nursing program recently but I went to causual because becoming a nurse is more important than being stressed out about work as an aide. It is also suprising to me that they hired new RNs for aides because that is a no no where I work. You can be highered as RN and assigned to work as an aide for the night. Just Keep Your Head up..ps. I understand "just passing meds" comment.