I have a tech at work who I'll call Sarah. She is a really good tech. The problem is that she has an attitude with me. I have reported her at least twice and nothing ever gets done. It goes like this:
I always get my own admission VS, post-op, post cath, and blood VS. I very rarely ask a tech to do anything for me. They know what they are supposed to do and they do it. Yesterday I had a new patient that the physician had sent up from his office, he wasn't even allowed to stop at admitting, dx: viral meningitis. He was 80 years old and I was told that his temp was 103 and that I was to immediately start an IV, order labs, give IV Phenergan, get VS, etc, etc..... At the same time I had another admit come up from the ER. I asked Sarah to get the vital signs on the first patient while I was starting the IV. She brought the dinemapp in the room and said "since you're in here you can get them" I said no Sarah get the VS, she said " do you want me to show you how to operate the equipment, is that the problem?" and she promptly left the room. I was not only furious but embarassed in front of the patients family. I told my assistant nurse manager and she didn't say much.
This is the 3rd such similar incident with this CNT in about 3 months time. I have spoken to her directly also with no results. Any suggestions? What I'm thinking about is asking for a confrontation in the nurse managers office.
I would like to tell her that I think she does a good job but do not appreciate her reluctance to do something that I ask her to do because I only ask when it's really needed. I would like to tell her that she needs a refresher on what her job description entails. Should I mention that I am her superior, well that's not the word I want to use but you know, I'm over her, in charge......?
I want to tell her that if she wants to give the orders that she should go to school and get her nursing license. Thanks for any advice you can offer. We both work tomorrow and I'll let you know how it goes. Thanks.
She brought the dinemapp in the room and said "you can get them". "No Sarah, I can't please get the vital signs" she said "well if it's a matter that you don't know how then let me teach you".
This gets me. In the time it took for this conversation to take place, Sarah could have gotten the vitals, which the nurse gets the historys, med, and IV. It would have been different if Sarah was busy doing something else.
this is exactly what i was trying to say. i know how busy it is when there is a patient to admit, i see it everyday, so i know the nurse would have had time to take vitals.
and to the poster who ,made a comment about one needle in one arm and bp cuff in another, how else would it have been done??? especially if the nurse was to start the iv immediately. My point is that teamwork is working together, not trying to make someone do something that you are perfectly capable of doing. and another thing that bothered me was the conversation between Sarah and Dutchgirl, i dont think the nurse had any right to respond by saying "no, get the vitals". it's always nice to ask someone to do something for you and not demand it! Again not taking up for Sarah, because her actions were not completly right either
I had to take a deep breath before responding. Dutchgirl should not have to ask Sarah to do Sarah's job. Isn't Sarah supposed to be getting vitals? I would have been livid if I were dutchgirl and I would have reported her immediately and had the doctor sign the report since he was there. Bottom line is Sarah should have been doing her job and no one would have had to "demand" she do anything. A nurse should not have to beg an aide to help. It is her job. She is getting paid to help the nurse, whether she likes it or not.
Well not to get of the topic but .. I do agree that what "Shara" is doing is worng . I think you just need to move on with the rest of you day . There most be other aids on the floor . So keep talking to your nurse manger and keep complaining .
But to say the words " if she doesn't do what i tell her " Well I'll tell you were iam coming from .. I've been a PCT on a med/surg floor for two years while in nursing school . BELIVE IT OR NOT IT IS POSSIBLE TO ADMIT SOMEONE AND START AN IV AND DO VS AT THE SAME TIME . Mabye it will take you 5 mins but you know it was done right and you don't have to spend 10 mins tracking done the aid that probley dosn't like you for the main reason that you don't respect her .
REMEMBER THAT IN NURSING SCHOOL YOU WERE TAUGHT ALD'S , VS , AND BASIC CARE BEFORE IV DRUGS AND OTHER STUFF , ALSO REMEBER WHEN CALL LIGHTS ARE GOING OFF ITS FOR A REASON ITS BEACUSE SOMEONE NEEDS YOU !! ISN'T THAT WHY YOU WENT INTO NURSING !! ALSO A CNA WORKS UNDER LIS. SO THE LESS YOU DO THE MORE ROOM FOR ERROR !!
Jennie EMT , CNA, NURSING STUDENT
I'm not sure if you're replying to me alone or not...lol..
I've worked with and without CNA's on the floor..of course I'm capable of taking vs,answering lights,giving pt care..all of which I do..cna or not...but isn't it soooooo much better to work together? I'm not the nurse who says 'that's not my pt' or sits on my orifice while others are working...and yes I DO remember why I went into nursing..and it wasn't to do EVERYTHING...guess I'm not supernurse and need a little help sometimes ~peace~
You keep saying she is such a great CNA...I don't see how neglecting the needs of the patient because she is po'd with you makes her a great CNA.
(I am a CNA, so I am not biased in favor of nurses. You sound like you are trying to do your job and it is reasonable to ask for assistance from a tech!)
this is exactly what i was trying to say. i know how busy it is when there is a patient to admit, i see it everyday, so i know the nurse would have had time to take vitals.
and to the poster who ,made a comment about one needle in one arm and bp cuff in another, how else would it have been done??? especially if the nurse was to start the iv immediately. My point is that teamwork is working together, not trying to make someone do something that you are perfectly capable of doing. and another thing that bothered me was the conversation between Sarah and Dutchgirl, i dont think the nurse had any right to respond by saying "no, get the vitals". it's always nice to ask someone to do something for you and not demand it! Again not taking up for Sarah, because her actions were not completly right either
yes, the nurse DID have the right to respond "get the vitals". In a Nurse job description and scope of practice, a nurse may, can and must delegate tasks to assistive personnel. And it is also the nurse's responsibility to follow up and ensure that the task was performed. I read the post, the poster initially asked the tech to get the vitals, when the tech refused, then she told the tech to do it.
yes, the nurse DID have the right to respond "get the vitals". In a Nurse job description and scope of practice, a nurse may, can and must delegate tasks to assistive personnel. And it is also the nurse's responsibility to follow up and ensure that the task was performed. I read the post, the poster initially asked the tech to get the vitals, when the tech refused, then she told the tech to do it.
i stilll dont agree that she had the right to say "no get the vitals" it would have been much more appropriate to ignore Sarah's behavior, be professional and not talk disspectful to another co-worker in front of a patient (because two wrongs dont make a right), get the vitals, continue with the admission, then i would follow up with my nurse manager about my complaint. i am completly against any kind of unproffessional attitudes around patients, i would never do what sarah did or the nurse... thats just me!
I was a CNA for about 4 years off and on before I went to school for my LPN(LPN for years with a variety of experience)...when I was the CNA..I didn't understand why a nurse couldn't do VS or something else..when I became a nurse I saw a whole new perspective...lol
I will admit I was passive aggressive with the nurses mostly the nurses that insisted I stop what I was doing, do what they needed so they could sit at the desk and visit...still happens as an LPN with RN's...
The thing is understanding doesn't exist for CNA;s maybe when I am an RN I will understand too however when she walks in your shoes she will get it...now lets look at this situation...
Ok the nurse had 2 admits coming one in rather critical care...while she was attempting to be supportive of her patient and of her doctor she attempted to delegate a task a person had time for....
Lets say she did the VS..well that is about a minute to hook up the machine to the patient...as long as no clothes or other things are in the way then it is more time...then she starts the dynamap...that takes about a minute to process too...then she has to look at the machine and record the VS..that may take a minute too...so she spent 3 minutes of time for one task...during that 3 minutes she could have had the IV started with the phenagran going...had other verbal orders of the doctor noted and begin her patient assessment but now she has to spend 3 additional minutes thus taking precious time from the patient...now if it was me...i would personally want the VS taken before giving any medication...just as a precaution so ya I would want a CNA to do it, I would expect it because they are trained, qualified for, and there to assist the LPN/RN in whatever role that the nurse see's fit as long as it is in the CNA's scope of practice and job description.
A CNA is there to support the nurses MA-LPN-RN...an MA to support an LPN-RN, an LPN to support RN/MD...an RN to support the MD.
Now a doctor is capable of taking VS and starting IV's or listening to LS or whatever it maybe does that mean because he/she can that a nurse shouldn't...Would a CNA/MA/LPN/RN dream of telling a MD to do something he/she is able to do for them? No..that is the thing, each level in nursing is there to support the next level that is what we are all trained for that is what we all get paid for...
This CNA should have shut her mouth and did her job, after all isn't she to support the nurse...
To the nurse in school, go work a year in Med/Surg then tell me what you think, cause it took me about 6months to a year to think damn I was dumb now I finally get what a nurse does....A CNA doesn't always see what a nurse has to do, they don't understand the mind grueling it involves, the multi tasking, the application of knowledge to real situations, the ability to perform invasive procedures...IV insertion, Catheter insertion, DRSG changes, NG insertion...sometimes a nurse needs help...an RN may need to do a NG insertion so she asked the qualified LPN to do a catheter insertion...these tasks involve more than just the task...that is the difference a CNA/MA are taught the task however they are not taught the implications behind the task from the good to the bad from what is right and what goes wrong.
You can teach anyone how to do a task but can you teach them the why, the right, the wrong, and the dangerous. A nurse maybe sitting at a desk but what is she doing...charting or reading fun stuff, most likely she is charting!!!
I am sorry CNA's till you walk in a nurse's shoes don't shoot your mouth off about what you don't know, I was there I was a CNA that didn't get it...heck I get it now...lol Don't tell me nurses don't get your job, ya maybe some don't get the repition the demands a nurse puts on you...but you know they teach us your job so we understand it, but they go beyond to give us the knowledge behind that job...
Ok that is enough ranting for now...lol
Dutchgirl, stick to your guns...and document everything...you were in the right...eventually the NM will address the issue with the CNA...her is a thought for you...what she did to you is insubordination!!! Plain and simple, most places a person can get fired for that!!!
To everyone, be understanding and be good communicators...cause communication is what makes a team!!!
i stilll dont agree that she had the right to say "no get the vitals" it would have been much more appropriate to ignore Sarah's behavior, be professional and not talk disspectful to another co-worker in front of a patient (because two wrongs dont make a right), get the vitals, continue with the admission, then i would follow up with my nurse manager about my complaint. i am completly against any kind of unproffessional attitudes around patients, i would never do what sarah did or the nurse... thats just me!
No, there is nothing "unprofessional" about asking a CNA to get VS in front of a patient.
The VS NEEDED TO BE DONE, and the nurse obviously had no time to get them, with her hands already full with 2 admissions - the CNA should have got them without having to be reminded.
WHY do CNAs think they are there, if not to get VS or whatever else needs to be done?
The nurse was BUSY. She didn't have time to do it.
Not to MENTION the fact that the VS needed to be done from a policy and procedure viewpoint, AND because the nurse needs to know what the vital signs are!
If would NOT be "professional" to stay silent and somehow try to get them yourself, because you're working with a surly CNA with an attitude.
She can get over it - the nurse is RESPONSIBLE for the patient's welfare and that includes getting their needs met - in this case, vital signs.
It was entirely appropriate to ask the CNA to get them in front of the patient.
To stay silent and "try" to get them yourself would be unprofessional, IMO, because you would be compromising PATIENT CARE then!
I'm not sure if you're replying to me alone or not...lol..
I've worked with and without CNA's on the floor..of course I'm capable of taking vs,answering lights,giving pt care..all of which I do..cna or not...but isn't it soooooo much better to work together? I'm not the nurse who says 'that's not my pt' or sits on my orifice while others are working...and yes I DO remember why I went into nursing..and it wasn't to do EVERYTHING...guess I'm not supernurse and need a little help sometimes ~peace~
I understand what your saying . I've had too many bad experiance with nurses that for whatever reason belived that there were god and i was the **** they walked on . I've had nurses not answer call bells which burn my ***, beacuse people have falling because then need to use the bathroom ande iam the only aid on the floor with 21 total care pts . Well i made it clear one night that I WORK UNDER YOUR LIS. THAT THEY ARE STILL RESPONABLE FOR THE PT. AND WHEN THAT PT FALLS BEACUSE YOU WENT TO FIND ME INSTED OF TAKING 5 MINS TO WALK SOMEONE TO THE BATHROOM THEN THATS YOUR *** NOT MINE . This type of things have made me a little bitter . It reminds me of how iam not going to be when i finsh school .
it would have been much more appropriate to ignore Sarah's behavior, be professional and not talk disspectful to another co-worker in front of a patient (because two wrongs dont make a right), i am completly against any kind of unproffessional attitudes around patients, i would never do what sarah did or the nurse... thats just me!
Me unprofessional? Hardly......it was "no please Sarah get the vitals" and that is not disrespectul. I simply asked her to do her job to which she refused. I did do the vitals after starting the IV and giving the phenergan. There were no "2" wrongs, only "1". I reported her to my nurse manager whom told me she would take care of it and who has given me the same song and dance before with no change in Sarah. The next time I have an issue with Sarah I will take it up with her in an empty room with someone there as a witness.
Thank You Underwatergirl & Sunstreak for your support! It's greatly appreciated and I appreciate everyone who has voiced their support. It's hard enough to do your job well without needless frustration to deal with.
Look, I am a nursing assistant, and I would expect you to lay down the law if I acted that way. Your aide needs to be told why she is there: to give the best care possible to her patients, and to assist the nurses in any way that falls into the limits of her training. Unfortunately, this created an uncomfortable atmosphere for the pt and family who were already under enough stress.
this is exactly what i was trying to say. i know how busy it is when there is a patient to admit, i see it everyday, so i know the nurse would have had time to take vitals.
and to the poster who ,made a comment about one needle in one arm and bp cuff in another, how else would it have been done??? especially if the nurse was to start the iv immediately. My point is that teamwork is working together, not trying to make someone do something that you are perfectly capable of doing. and another thing that bothered me was the conversation between Sarah and Dutchgirl, i dont think the nurse had any right to respond by saying "no, get the vitals". it's always nice to ask someone to do something for you and not demand it! Again not taking up for Sarah, because her actions were not completly right either
I am a CN.A. the aide should have taken the Vs Immediately. She could have had them done while the nurse was preparing her equipment to start the IV. I think the nurse in this instance showed great control. I don't care if the CNA had issues with the nurse or not. The aides first concern should have been the pt. In reacting to her own needs in the situation the aide put the pt.s second. The attitude exhibited in this situation by the aide makes the perfect case for why the nurse is the nurse and the aide is the aide. If you want to be treated with respect and as a professional ( no matter what the letters after your name) you have to act like one. The nurse knew she had two admits one of which sounded to me to meet possible serious medical criteria. She wasn't just starting an IV, she was in her mind organizing what she had to do to meet the best immediate needs for her pt's . I say to the nurse: Great job. To the aide I say: Grow up
Marie_LPN, RN, LPN, RN
12,126 Posts
This gets me. In the time it took for this conversation to take place, Sarah could have gotten the vitals, which the nurse gets the historys, med, and IV. It would have been different if Sarah was busy doing something else.