What if CNA won't work?

chadash · Jan 30, 2006

I did try often however to give my aides kind words and thank them for jobs well done.

Let me tell you, when nurses take the time to say something encouraging, it can make all the difference. :balloons: Thanks drifternurse!

chadash · Jan 31, 2006

update on this, incase someone has some advice.
I took her urine again, still Positive for leukocytes and nitrites. Asked her if she passed the info on to her agency nurse via the agency nursing assistant, and she send her nursing assistant said she "doesnt do that kind of thing" and said she would just have to tell the nurse herself when she sees her next week for her regular visit.
Are positive nitrites and leukocytes not always significant? It went all the way to the darkest color within seconds of dipping. She just hasn't been herself lately, and had a serious hospitalized UTI in the past year,
Thanks!

WEll, as usual, I am in deep do do...

to review: I work private duty as a nursing assistant, and about ten days ago I noticed the patient, who has a cath, urine smelled differently and that sometimes the pad under her had a little urine on it. She had no obvious symptoms, but I got some reagent strips that test for nitrites and WBCs and it came out positive. My patient has another NA and a RN who visit from a home health agency. So I left a report for the NA who was to be there the next morning to pass this on to her RN.

Well, she did not, so I tested the next time I came, 4 days later, still positive, so I left another note for the NA and stressed with the patient to encourage her to call her nurse. The NA, who came the next day, called the nurse. When I came back my next working day ( I work only tues and thurs) the nurse had not yet responded. I was still concerned, but figured the nurse new alot more than I did, so maybe this was not really important. When I came last thursday, my patient said she was not feeling well, so I tested again, still positive. I left another note for the NA, stressing my concern. The patients son was home that day, so I explained to him my concern.

Well, I come in this morning, and my lady is sick in bed, never got a response from the nurse, so the family took her to the doctor Sat. and she does have a UTI.

Well the agency nurse shows up while I am there today, and questions her about her symptoms, why anyone tested etc.

The nurse blamed me for not calling her directly ( I do not work for the agency) and said that was why she had ignored her NA's report about the nitrites and WBCs. Said for all she knew this was not significant because she did not know who I was. She said no lasting harm done, but that the patient had to suffer because of this. She said she was going to report to the doctor why this happened.

The last thing I wanted was to have my patient suffer! She had seen the nurse during this interval once, but the nurses said the urine looked good and dilute. Frankly, it did to me too. I just could smell the difference. And I am a worry wart!

Ugh!

FrustratedLPN · Mar 27, 2006

If nothing else, these threads keep you from feeling like you're all alone on the front lines!!!!

CNA's that won't work? Hmmm, working a 7p to 7a shift with CNA's that work Baylor on weekends is interesting to say the least. I am fortunate to have several of the hardest working, most caring CNA's I have ever worked with in 16 years as a nurse, but also have some of the laziest bunch on weekends. For the most part the weekend crew are all enrolled in nursing school, and use the weekend job simply as a "stop gap" on their way.

To my way of thinking, if you can't do a CNA job well, why should anyone believe you, as a nurse, will be any better? Whatever your task, do it to the best of your ability. I've also seen some CNA's that have completed nursing school, yet failed their state board.. talk about arrogant!!! They think somehow they're above the other CNA's on the floor, talk with disrespect to their co-workers and supervisors, refuse to do what's asked of them. Yet, it's all smiled at by the male unit manager, and the male staffing coordinator. Let's not forget the Male charge nurse that relieves me in the mornings and just happened to be in this CNA's nursing class!!!!

Yes, write up the cna's that aren't doing their job. Yes, it makes for a difficult situation because you'll have these same cna's that you have to work with day in and day out. Usually, I will do a staff education form first.. for ALL staff that I supervise, whether it be a reminder on how often rounds are to be complete, the use of cell phones in the building, answering call lights, ALL residents are YOUR residents, etc. Once they read and sign it, you have verification they were aware of the rules and what is expected.

I have worked in LTC facilities where we were told... "it's easy to replace nurses.. cna's are hard to find". What kind of atmosphere is that? Also, cna's have union representation in some states, nurses had none.

If for one day, every LPN/RN working in LTC stayed home to protest the conditions under which they have to function daily, and management nurses had to work the floor.... interesting thought?

chadash · Mar 27, 2006

If nothing else, these threads keep you from feeling like you're all alone on the front lines!!!!
CNA's that won't work? Hmmm, working a 7p to 7a shift with CNA's that work Baylor on weekends is interesting to say the least. I am fortunate to have several of the hardest working, most caring CNA's I have ever worked with in 16 years as a nurse, but also have some of the laziest bunch on weekends. For the most part the weekend crew are all enrolled in nursing school, and use the weekend job simply as a "stop gap" on their way.
To my way of thinking, if you can't do a CNA job well, why should anyone believe you, as a nurse, will be any better? Whatever your task, do it to the best of your ability. I've also seen some CNA's that have completed nursing school, yet failed their state board.. talk about arrogant!!! They think somehow they're above the other CNA's on the floor, talk with disrespect to their co-workers and supervisors, refuse to do what's asked of them. Yet, it's all smiled at by the male unit manager, and the male staffing coordinator. Let's not forget the Male charge nurse that relieves me in the mornings and just happened to be in this CNA's nursing class!!!!
Yes, write up the cna's that aren't doing their job. Yes, it makes for a difficult situation because you'll have these same cna's that you have to work with day in and day out. Usually, I will do a staff education form first.. for ALL staff that I supervise, whether it be a reminder on how often rounds are to be complete, the use of cell phones in the building, answering call lights, ALL residents are YOUR residents, etc. Once they read and sign it, you have verification they were aware of the rules and what is expected.
I have worked in LTC facilities where we were told... "it's easy to replace nurses.. cna's are hard to find". What kind of atmosphere is that? Also, cna's have union representation in some states, nurses had none.
If for one day, every LPN/RN working in LTC stayed home to protest the conditions under which they have to function daily, and management nurses had to work the floor.... interesting thought?

It does seem that the whole system needs revamping. The state's have Department's of Nursing. When are they going to make some meaningful changes in how this works?

My theory has always been, better pay for nurses in LTC (why make it a hardship on those who have made the effort to get a very demanding education?), much better CNA/pt ratios. As far as CNA's are concerned, if you want to keep the ones that care, who really want to do it for ever, you have to make it possible for them to do their jobs well:there just has to be enough time and resources to complete task well. I really believe that management and the state have a real issue with physics, you know, that whole space time continuim thingey. Thus, the issue of multiple tasks, that require a nonneqotiable amount of time with multiple patients, that equal more time than is in a day.

The CNA's that sit on their behinds while a pts diaper is dripping wet: I don't care how hard it is to replace a CNA, that person could be replaced by my sister's pug.

Jedi_Iatros · Apr 2, 2006

My CNAs don't mess around and they better not. Why? Because I'll sick the local ombudsman or the residents families on them if I found out that they are doing less than proper care (like turning pts Q2-3 hours). When the RN's or management aren't around, I'm the boss. I had to put a CNA in her place just this past week and things got a little heated and we both had a talking to by the higher ups (I don't care...when I'm right, I'm freaking right!) I don't tolerate aides lying to me or being insubordinate. You people shouldn't either. :nono:

meintheUSA · Apr 2, 2006

in our long term facility, we have a hand-full of slackers... thank goodness we are all on the same page on my unit (safety, health and well-being of residents first). i have seen what one "slacker" can do to a unit. they mustbe stopped... as another cna, i would report it first to my lpn, then if not result, my shift supervisor rn, then go to the don.. i have been in management, and learned along time ago, if you are looking over your shoulder, are you really doing a good job when the management comes around? i have seen 11-7 people sleep and cover for each other... (they are not working with us anymore, fired).... we work for the residents, and they must come first... i give an hour's worth of work for each hour i am paid.... i can sleep when i go home and take pride in my work. .... you must be an avdvocate for the elderly, as a cna, lpn, rn, or don...

firstaiddave907 · Apr 3, 2006

i know what you mean i was a CNA for a while and some of the peopple you worked with were lazy and that made me mad because there getting paid to do nothing at all and just to sit around and if some one walked by they just pretended to do something now i am going to college and i dont have to worry about it anymore. i agree with you chadash how would the nurseing assistant feel if they had wet brefis on i woulndt like it one bit.

chadash · Apr 3, 2006

i know what you mean i was a CNA for a while and some of the peopple you worked with were lazy and that made me mad because there getting paid to do nothing at all and just to sit around and if some one walked by they just pretended to do something now i am going to college and i dont have to worry about it anymore. i agree with you chadash how would the nurseing assistant feel if they had wet brefis on i woulndt like it one bit.

Good for you! You will never regret getting that college education!

meintheUSA · Apr 3, 2006

after replying to this forum, i worked that night. the first thing i did was to tell the other cna's on my unit just how much i enjoyed working with them... i was really sincere. we worked end of month change over and daylight savings fri and sat 11-7, lots of extra to do with only 7 hrs on sat night to do it in... needless to say, i had two of the most calmest, most enjoyable work nights of my cna career... the praise was passed on, and even the rn supervisor that night seemed calmer and happier. don't forget to sing your praises when due.... thanks for letting me share this...

born to nurse · Apr 3, 2006

I agree with most of the above replies. Now IMHO, you cannot possibly expect the CNA to do their job, unless all of the nurses do their jobs. Many do not take care of their own duties, and pay absolutely no attention to the aides. Consistent supervision is the key. As someone also said, you must have back up from management, which is rare. I hate to disappoint you, but when push comes to shove, management will most always side with the CNA, and you look like the meanie

GLORIAmunchkin72 · Apr 3, 2006

The laziest CNA I ever worked with: She wheeled "her" residents from DR to "designated" area and said: "I'm going to break". I said: "You what???!!" I haven't seen her back since that one and only time.

Hello. I've had something on my mind for a while and I was wondering if anyone here could give me some input. I will be (God willing) an LPN in three months. I intend to work in long term care upon graduation. I have been working as a CNA for some time now and have come across other CNAs who couldn't care less about their work and are guilty of flat out neglect and abuse. Y'all certainly know what I'm talking about so I don't need to list examples (a CNA working 11-7 who makes his first round at 0530 would be a good one). I know this doesn't apply to all or even to most CNAs but I've seen enough of these types to make me worried about how to handle it when (if) I become an LPN. Is it possible for an LPN to get into legal trouble and even be barred from nursing if neglect by an aid on his/her shift is proven? How can you possibly keep up with 30 something residents being clean, dry, repositioned, etc. as well as pass meds, do treatments, and chart? Today I worked with an aid who sat and watched basketball while her resident's brief was falling to her knees. The nurse mentioned it to the aid and her response was that the resident belonged to another aid (not true) so the poor woman just stayed like that till shift change. If you had been this nurse what would you have done? How do y'all handle this type of thing? I dont want to be a hard a** but I more than that dont want to loose my liscense! Thanks for any responses.

PeachPie · Apr 5, 2006

I agree with most of the above replies. Now IMHO, you cannot possibly expect the CNA to do their job, unless all of the nurses do their jobs. Many do not take care of their own duties, and pay absolutely no attention to the aides. Consistent supervision is the key. As someone also said, you must have back up from management, which is rare. I hate to disappoint you, but when push comes to shove, management will most always side with the CNA, and you look like the meanie

Dang, where do you work? Everywhere I've worked, they've sided with the nurses, even if we were blamed for a resident's violent episode.