Tips on being more assertive and managing nurses aides

Jules A, MSN · Jul 11, 2008

It will be great to see the pointers others can offer because I swear sometimes dealing with employees is the hardest part of our job. I would take it slow because like you said you are young, inexperienced and they are older and have experience at that facility. It is uncalled for but unfortunately they are posturing. What I did when I was new and how I continue to work is by being super nice to everyone and very helpful. It speaks volumes if a nurse is willing to do whatever needs to be done. We have all heard about the nurse that wanders around for 20 minutes to find a Tech to put a patient on a bed pan. Believe it or not that actually happened to me as a student! I was pulling meds from the pixus and the nurse came to find me and then had the nerve to tell me to hurry up. Can you imagine? :madface:

Anyway I would ease your way in slowly. Let them know that you need and appreciate their experience and input as you learn the ropes. Imo showing that you are human goes a long way and having them in your corner is priceless. Bottom line is that yes you are the nurse and their supervisor but stepping in gently is how I would proceed. Good luck and it does get easier.

pagandeva2000, LPN · Jul 12, 2008

LPNs can supervise and delegate to CNAs. I can't really offer any suggestions per se, because where I work, the RNs are the delegators, and in fact, there are more RNs than LPNs in our facility. I have received some resistance, though, mainly because most of the aides where I work used to be my peers until I became an LPN.

I would certainly take JulesA's suggestions, because it is easier to gain their confidence when they see that nothing is beneath you regarding patient care. What I would like to add is when you do delegate, do not ask but say "I need such and such to be done". Sometimes, asking gives them the impression that they have an option to say no. Telling them leaves no room for that, and if they say no to a direct order, then, they are, in fact, being insubordinate. I had to do that until I got to know the good workers versus the lazy ones. The good ones, yes, I may say "Do me a favor, get those vital signs for me, please?" because I got to know them, and have faith that they will do, and if not, will tell me why.

Good luck, and I do know how you feel.

Jules A, MSN · Jul 12, 2008

Great advice Pagandeva2000, about not "asking" but "telling" the ones you know are going to give you a hard time! There is a tech at my job that I still can't ask anything because she will find an excuse as to why she can't. Unfortunately I have to say "when you are finished with abc please do xyz" because of course "when you get time" will be never, lol. Truth as I see it is that she is just lazy its not about me personally. Most our techs are awesome though. :)

bluegeegoo2, LPN · Jul 13, 2008

I will pitch in and toilet someone, help dress, wipe butts, and whatever I can do for my aides. Lord knows they do a lot for me! At first, I couldn't get an aide to look at me cross-eyed, much less do what I asked. However, after awhile, they saw that I would help them even if I was busy, and they have learned to respect me and mostly do what I need them to do. Also, I will stop what I'm doing and give them my full attention when they are trying to tell me about an issue with a pt. That shows I respect their observations and value their opinion. While I may have their med hx wrapped up, they know better than anyone on the floor what is normal for their people, and know when something is wrong, and we'd be smart as nurses to pay attention. Ask them questions about their people. When they feel valued they are more likely to come to you with changes in status, as well as do what you ask. I have learned quite a bit from some of the aides I have worked with. Some of them have vast stores of knowledge in healthcare, and can help us be better nurses.

MicStar · Jul 13, 2008

questions from an Oz Nurse, how may levels of nurses and nurses aids are there in america? who reports to who ( i got a general idea ), what does CNA & LVN stand for?

CT Pixie, BSN, RN · Jul 13, 2008

questions from an Oz Nurse, how may levels of nurses and nurses aids are there in america? who reports to who ( i got a general idea ), what does CNA & LVN stand for?

There is only one level nurses aids that I know of.

CNA stands for Certified Nurses Assistant/Aid

LVN/LPN stands for Licensed Vocational Nurse/Licensed Practical Nurse (exact same kind of nurse. Two states in America call these nurses LVN's and the other 48 call them LPN's. I think its California and Texas that call them LVN's)

The CNA reports to the LVN/LPN and the RN

there are several levles of nurses. The LVN/LNP, RN (with either a diploma, an associates, or a bachelors degree) there are other levels with more edcation but someone with more knowledge would have to explain above the RN with a bachelors level.

MelodyRNurse · Jul 13, 2008

They start to do what you ask when they realize they don't have a choice because you will not put up with it otherwise. It is difficult when your young and they know you've just started out. Thats a hard place to be. Remember you are their supervisor and you have the ability to give verbal warnings, written warnings, or whatever your protocol is for insubordination. If your unsure of when it is appropriate, ask for some help from your supervisor.