Trying to avoid undesirable CNA duties

allnurses Guide · Jul 31, 2010

My comment was not intended to mean that any individual person was not being "real" and I read all the posts before yours that made the same points you did. I don't disagree with any of it except as a reason a CNA has no right to know what type of infection a patient has.

It's great that you can be 100% alert to every detail of all situations 100% of the time. My point about "human nature" is that most people are not all that, all the time. It's "human nature" to become more easily distracted when tired, overwhelmed and stressed. I will admit it here for everyone! I am not perfect! My attention wanders sometimes when I need to think about 40 things at once!

It is "human nature" to heed more carefully information that stands out from the norm. I don't think there has been a CNA here who has said they are indifferent, even if gowns, etc are outside the door. Why do you think that is? Their powers of concentration as a group just aren't up to snuff?

In my comment I addressed the issue of a pos test after contact with staff and carefully said, "if the nurse knows, so should the CNA". Why would you not want them to know? If it's an issue of the patient's privacy and dignity, I guess we'll have to disagree because I don't think of CNAs as separate, but part of nursing.

caroladybelle, BSN, RN · Jul 31, 2010

It is "human nature" to heed more carefully information that stands out from the norm. I don't think there has been a CNA here who has said they are indifferent, even if gowns, etc are outside the door. Why do you think that is? Their powers of concentration as a group just aren't up to snuff?
In my comment I addressed the issue of a pos test after contact with staff and carefully said, "if the nurse knows, so should the CNA". Why would you not want them to know? If it's an issue of the patient's privacy and dignity, I guess we'll have to disagree because I don't think of CNAs as separate, but part of nursing.

I did not refer in my post to CNAs, LPNs or RNs.

I referred to care givers. Which involves all of us.

I did not say that I did not want CNAs to know - in fact if you read my post, I said that we do indeed inform other members of the healthcare team.

I include MDs, LPNs, RNs, CNAs, NAs, PCTs as members of the care giving team.

Do you for some reason exclude them? If you do exclude then it is you that is creating the offense.

But is there an absolute reason to know?

However, strictly speaking...one does not necessarily need to know the specific disease for proper isolation precautions, merely that those precautions are in place... unless it affects the care that one gives is specifically affected, beyond what the posted precautions cover. And in most cases, that mean that most caregivers of all types won't need to to know.

In my facility (where we do tell NAs), the pts nurse may know, because they may be waiting for cultures to clear or need to monitor the number of negative stools/cultures and days apart, so to collect the specimens at appropriate intervals to get the pt off isolation. In other places the MD regulates that.

But knowing the specific disorder does not change the overall care, that is instituted by the contact precautions posted.

Do I get tired or hurried? Of course! Does that change my care? Of course!

But does it change my care for one or two "particular pts" vs the whole group? No, it doesn't, because I know that virtually any of my pts could be carrying the exact same thing that "those pts" that I know about, has. And it is shortsighted to ever think or behave otherwise.

Do you really want to know how many people have HIV, that have it for years on end, and until a certain lymphoma shows up, never have been tested? Do you know how few facilities screen routinely for MRSA/VRE/C'Diff? It is mind boggling.

allnurses Guide · Jul 31, 2010

Carolladybelle- you jumped into an ongoing discussion about CNAs. My last few posts were a back and for with a CNA here in this CNA thread on this CNA Forum. Not surprisingly, I assumed we were still talking about CNAs. You read my comment about blood-borne infections as if the topic we were talking about was blood-borne infections when the actual talk was about the quasi-caste system many CNAs feel. See below:

QUOTE=orange juice;4439358]girtent- I dont remember where I saw you posted but CNA's DO know the diseases pts have or at least they do in CA and in several states I know of. Even thou you use standard precautions for everyone it is always important to know if patient X has MRSA, PNA or whatever. If the hospital you will work in doesnt tell their CNA's that I wouldnt want to be a patient or an employee there. If they dont tell you at report, always ask

QUOTE=ctmed; They also say with universal precautions, the CNA should not need to know, which is just...insulting. Basically, it is "go away and start wiping" or "Don't you have something to do." It reminds me of an old fast food adage: "Do not question. Time enough to lean, Time enough to clean" mentality.
CNAs DO have the right to know. Some of us have families, too.

Nowhere did I even mention offense or taking offense to anything. You took offense. And you also falsely interpreted my post to mean that we were singling out anyone for any different behavior whatsoever! Being alert is not a behavior! I appears to me as if you are linking discrimination of AIDS patients into this somehow. As if the idea that a nurse would handle a contaminated needle in exactly the same manner as one from a 2 year old?? And if, God forbid she was more careful that is tantamount to discrimination? You are reading far too much into this exhange.

Satori77, ADN · Jul 31, 2010

There are facilities that ban nursing assistants from knowing the patient's diseases and looking at their charts. I don't think it's right, but they do.

Wow, I am a newbie and had no idea! I just finished my clinical rotation, and all the CNA's knew everything wrong with their residents, and they would tell me what was going on with each one. I can't imagine working at a place where you didn't know. How can you take care of them? How can you protect yourself? I applied for a job where I did my clinicals. Management and nurses are so good to the staff, and the staff are wonderful to the residents. Seems like a great place to work. I would never work at a place where the CNA's are not given the respect they deserve and just treated like butt wipers. That is beyond insulting.

caroladybelle, BSN, RN · Jul 31, 2010

Carolladybelle- you jumped into an ongoing discussion about CNAs. My last few posts were a back and for with a CNA here in this CNA thread on this CNA Forum. Not surprisingly, I assumed we were still talking about CNAs. You read my comment about blood-borne infections as if the topic we were talking about was blood-borne infections when the actual talk was about the quasi-caste system many CNAs feel. See below:
Nowhere did I even mention offense or taking offense to anything. You took offense. And you also falsely interpreted my post to mean that we were singling out anyone for any different behavior whatsoever! Being alert is not a behavior! I appears to me as if you are linking discrimination of AIDS patients into this somehow. As if the idea that a nurse would handle a contaminated needle in exactly the same manner as one from a 2 year old?? And if, God forbid she was more careful that is tantamount to discrimination? You are reading far too much into this exhange.

I did not "jump" into a thread....I have been participating all a long. And I believe that the OP really did not discuss a "caste" system - they addressed not wanting to handle urine or stool and thinking that when they graduate and become an RN that they will not have to deal with that.. During the course of the thread, they clarified that their worry was about "picking up something". I have been discussing the reason that should be an erroneous fear.

The OP has also clarified that they want constructive answers to these questions. Thus, the "caste" issue has nothing to do with the purpose of the thread nor is it a constructive discussion of the OP's issue.

I have mentioned bloodbourne diseases as an example of utilizing universal precautions, of HIV is one. I have not mentioned AIDs (HIV does not equal AIDs) or any discrimination. And yes, I treat a needle from a 2 year old just as I do a 35 year old IV drug user. It is the only prudent way to safely conduct oneself.

You referenced being "only human". I repeat if one is being human (occasionally tired, cranky, making errors, stressed etc), you are that way equally with ALL pts, because ALL have the potential to bring something adverse to the table.

allnurses Guide · Jul 31, 2010

You continue to not understand what I was saying with regard to my last few posts with ctmed and satori77 and their concerns so I will leave it be. After 17 pages, a thread spawns side conversations at times. I'm really not sure what you think I was actually saying with this, but if anyone else reading this wonders, I'm not making excuses for anyone about anything, or saying the bar should be lowered because you are tired. I'm all about the good and the better, nothing else. I'm out of this discussion.

nurseinthemaking2010 · Jul 31, 2010

I am not trying to be mean but... Why be a nurse? Poop is life, you will be helping people take care of their life. And I have been on a mental health floor and I saw much worse then poop. And I was just visiting. I am taking my CNA and doing my homeowrk while I type. I know poop is coming my way. I am a mother of 2 young children so I know how poop smells and how foul it gets and a child and it just get bigger on adults. But if we won't do it who will. I want to go to sleep at night knowing I helped someone make their day a bit better. Even if it means getting the crap of their rears. Just a side note there is vomit, poop, blood everywhere. And someone needs to clean it up. I mean why go into it if you are not going to do all into it. And I can tell you the pay for a CNA is crap no pun there. 10 an hr... I can tell you I am not getting into this for the money. Although I do plan to go onto a higher form of nursing. I know the crap is coming. I am goved up and ready to play ball! You should too!

nurseinthemaking2010 · Jul 31, 2010

I just have one more thing to say. What is wrong with CNA work. Are you saying that you are better then a CNA? It just seems rude to ask if you really want to be a nurse. Poop is poop is poop. Take pride in your eduation and your job. That is the entire thing about being a nurse, helping people when they need it the most. And if you are no longer able to wipe then we need people in this world who are going to do it. And not to be raude again but I think ya ****** a lot of nurses off by asking this question. I may not be a nurse yet but it ****** me off! Just watch out it may come back to bite you. Karma man it can get ya good.This is just my :twocents: !

ctmed · Jul 31, 2010

The 'caste' issue is also relevant to any CNA discussion. Especially discussions where you talk about some of the duties that many people wish they could eventually get out of. Like it or not, Nursing culture is soaked in it. NPs and Doctors are gods, RNs/LPNs are the middle, and CNAs, dietary, and environmental are your expendables. Every industry has the "bottom" job that they put on newer folks in the field. ie: IT has answering phones to customers for no money and reading 'scripts'. Retail has the guys that constantly have to go around refolding clothes that careless customers throw everywhere, etc.

Whenever you talk about duties.. is there a chance to learn more or do more? Or are some tasks being hogged by higher staff and the rest delegated? Is there any chance to get better tasks? That is what the OP was getting at.

Let's say you work for famous New OrleansTV Chef Emeril LaGasse. With no experience, he would probably put you washing dishes. Once you prove you are a hard worker, show up on time, and are a team player, you eventually get to do cooler things. Eventually, you can become a Chef as well after many years.

With CNA, your only option is to change areas/ job. There is no upward mobility unless you are in the few places that uses CNAs as supervisors. You cannot move higher. Doing the cooler things requires requires a hard to get degree which program in many places is like 2 jobs and boot camp rolled into one. Some can not do this because of real life issues.

Us guys and gals that have been in this, remember, you have A LOT of folks that are flooding in from fields like accounting, IT, business management, paralegal, and education because of no jobs. Nursing is the only two year degree that promises a middle class lifestyle, somewhat better job opportunities, no age discrimination, and respectable work. Some get CNA because it is a quick way to get to work. It is easy to understand how someone who is CNA could feel that way sometimes. Who here does not want better?

I am glad the OP brought this up.

nurseinthemaking2010 · Aug 1, 2010

And that is where I start to take it personal. Most people know going into CNA class that you have scut work. I knew this at least and so do most of my class mates. We are from all walks of life and the large majority are not there for the paycheck. We are there to help, I have heard it so much this week I am getting sick of it.

But anyway... If you know what you are getting into why do it. Yes I know that some may not be able to do the 2 year degree for the RN and some may even have a hard time with the one year LPN. I do plan to go and at least get my LPN. I really want to go higher but I need to see how life is going. I am young so I know I have the drive and energy. And my children have proven to me that they can keep up with the crazy pace and are loving it.

I think my point is why go into a field knowing the poop is coming your way wether you want it or not. But they you can also go into a specialty. Where poop is not there. But you are going to have to deal with it at some point. You need to get threw clinicals, and I know in NY in my area even regular nursing students have a few clinicals at a nursing home. But when you are done with school there is drug rehab. But don't think it doesn't get messy there. Like many have said it is just one of the uglier sides of nursing. And if you heart is not all in it why do it! There are people out there like me who have been trying for 6 years to find a good CNA class and the funding to take it. And it you don't want to be there you are taking a spot for someone who really does.

CrazierThanYou · Aug 1, 2010

I am not trying to be mean but... Why be a nurse? Poop is life, you will be helping people take care of their life. And I have been on a mental health floor and I saw much worse then poop. And I was just visiting. I am taking my CNA and doing my homeowrk while I type. I know poop is coming my way. I am a mother of 2 young children so I know how poop smells and how foul it gets and a child and it just get bigger on adults. But if we won't do it who will. I want to go to sleep at night knowing I helped someone make their day a bit better. Even if it means getting the crap of their rears. Just a side note there is vomit, poop, blood everywhere. And someone needs to clean it up. I mean why go into it if you are not going to do all into it. And I can tell you the pay for a CNA is crap no pun there. 10 an hr... I can tell you I am not getting into this for the money. Although I do plan to go onto a higher form of nursing. I know the crap is coming. I am goved up and ready to play ball! You should too!

This is a bit off topic but your post reminded me of my first day in CNA class. It was my 3rd time taking it so I had no illusions but our local CC has a CNA instructor who is a classic example of a failure at being a nurse; fired from every job, etc. So, she has a real chip on her shoulder and is a nightmare all the way around. Anyway, the first day of class, she announces "Just so everyone in here is aware, you WILL WIPE A$$". After a moment of silence, the woman next to me says "WELL SIGN ME UP!" It was hilarious but really, at least we had no illusions. While at clinical, there were some students from the HOSA program at the local high school doing their clinicals. One girl burst into tears and screamed "No one told me I would have to deal with poop!" and ran from the room. That girl evidently had some illusions...

Anyway, to all those who are career CNA's and loving it, my hat is off to you! And I don't mean any offense. I am a CNA and I start working on my RN in 18 days. I do like my job and I have liked my CNA jobs in the past but I just can't picture myself doing it forever. So, kudos to all of you! :yeah:

nurseinthemaking2010 · Aug 1, 2010

This is where I am having trouble personally. The only reason I don't want to move up in the nursing field is because CNAs have the most interaction with the pts. And that is the one thing I am looking foward to the most. CNAs are so underpaid. I have to put my children threw college so I need to move up on the ladder.

And this is what my teacher told the class. "We all have to start at the bottom and if you want work your way to the top. But don't get into this field if you have a problem with body fluids and solids for that matter."

And one more thing... How do you think the people you are cleaning up feel? They can no longer give themselves basic care. And if you have the mind set of this is gross I am not going to do this and I want to find a way to get out of the nasty things. Then (this is just my opinion) you should not be in the nursing field. We need nurses that care and want to do your job not do it for the money. I know I have gotten a few nurses that were there just for a paycheck and I did not get the help or care that was needed. IE. My son has epilepcy (sp) and the doc put him on keppra and insisted on upping the dose to the point where he was hitting everyone, and he is 4. And he might be little but he can hit hard. To the point where he got me off guard and knocked me clear on my face. And I had my 5 yo daughter with us. I yanked the call bell off the wall to get some help and all the nurse did was just watch. I needed help with either my son or take my daughter out of the room so she doesn't get hurt. Well long story short... It took me screaming for another nurse to help me hold him down so we could get some meds in him to counter act all the keppra. And my poor daughter is hiding in a corner crying and me in teas from pain and just being upset. While the first nurse was just standing in the door. And no I did not go down to the ER to get checked out. I just delt with the goose egg on my head and slep with an ice pack that night. I was not leaving my son's side after that.

So moral of the story you really need to be in this 100% if you want to be anything in the nursing world. If you don't things will get ugly fast.

Update on my son... He is 4 no longer on a violent rampage but still very off the wall. But nothing we cannot handle and he loves every nurse he sees. Lol the one that help him down scared him. But didn't hurt him!