What to do about tech refusing to get VS?

I have had this situation with an aide before. I simply set them down at the nurse's station with the other night shift nurses and told them I would have none of it. The aide said, " I'll just quit." To which I replied, " Go ahead. It makes no difference to me, because you are replaceable." (You also have to take into consideration that the night shift has worked more nights without an aide than they have with one) The aide didn't quit and she didn't get the picture either. The night shift nurses made her life a living hell. The nurses read the CNA job description and there was a line in it about cleaning the unit.She was not allowed to sit down or take a break except for her 15 minute break per shift and her supper break for which the nurses timed them to the exact minute. If she was a minute late, she was wrote up. After a week of her cleaning the counters, walls, and equipment of our unit, the night shift nurses had no trouble with her again and the unit never sparkled as much as it did. I know it seems mean, but sometimes as a charge nurse you have to do what you have to do. There is no room in our profession for back talking, lazy people(CNA, LPN, or RN) who can care less about giving patient care and is only there to get a paycheck.

Schroeder

At my job I have been told that if a CNA has a "bad attitude" towards the nurse that the nurse should send her home immediately. He said nurses don't have to put up with any bad attitudes from the CNA's at any time.

At my job I have been told that if a CNA has a "bad attitude" towards the nurse that the nurse should send her home immediately. He said nurses don't have to put up with any bad attitudes from the CNA's at any time.

I'm finishing nursing school this spring and work as an aide on a very busy unit. Nursing is a second career for me so I've been around the block a few times.

I am constantly amazed at the fact that I can work my butt off helping to care for the nurses' patients, but yet very few nurses care to help me. It doesn't matter what I'm doing, the nurse (one of seven on the floor) wants me NOW, regardless of where I am or what I am doing. Healthcare is a team effort folks, and respect is a two way street. If you find that your CNAs have attitude, perhaps you should examine your own before pointing a finger.

Classicaldreams

Well, you won't believe this! I did charge today and we were so busy that I ended up taking 2 patients myself. Sarah happened to have those 2 rooms. She was in those rooms taking VS before I ever had a chance to get in the room. She was so pleasant, asked if there was anything else I needed her to do. I was in total awe. I was told that she had her yearly evaluation on Friday. I'm assuming that something was said. I couldn't believe it! I hope that is the last chapter in this book. Thanks to everyone for letting me vent.

That's great news!!! At my LTC most of the CNA's work hard and do a great job!!! I don't know why but it seems that at every job there is always one CNA who want to make the nurse miserable and will do so unless they are written up or someone has a talk with them. I have lots of respect for most of my CNA's because they do work their butt's off and I am happy to help them out when I can. :)

Well, you won't believe this! I did charge today and we were so busy that I ended up taking 2 patients myself. Sarah happened to have those 2 rooms. She was in those rooms taking VS before I ever had a chance to get in the room. She was so pleasant, asked if there was anything else I needed her to do. I was in total awe. I was told that she had her yearly evaluation on Friday. I'm assuming that something was said. I couldn't believe it! I hope that is the last chapter in this book. Thanks to everyone for letting me vent.

Well, let's hope that this new attitude doesn't last until Friday is over, but I don't know...

You know, you sound like you are a very fair nurse-- for crying out loud, you prefaced your anecdote with "Sara is a very good PCT."

You did nothing wrong by asking her to get vitals and I would be very frustrated by the fact that the tech seems to operate with impunity. New nurse manager needed, perhaps?

What some aides just do not understand is that sometimes we can do their jobs (meaning all the tasks that are delegable to them), but they can never do our jobs. If we are doing the stuff that should be delegated to them, then we are not getting to the non delegable tasks. Admissions are a lot of work for RNs! Especially outside admits.

And yes, I often do aide jobs. I will ALWAYS empty a urinal, I often take trays away, I will get vitals sometimes (and a lot more often than not blood vitals), and other sundry tasks. Hey, guess what: I always get out later than any aide.

It sounds like you help out whenever she can (and probably sometimes when you really don't have the time.) This aide is taking advantage of you. She knows it too.

sometimes we can do their jobs (meaning all the tasks that are delegable to them), but they can never do our jobs. If we are doing the stuff that should be delegated to them, then we are not getting to the non delegable tasks. Admissions are a lot of work for RNs! Especially outside admits.

Thanks, I never thought of it in that way but you are absolutely right. I like my nurse manager but I do think she is way too linient!

I'm glad something was said in her yearly eval...and I hope she does not slide back into bad habits. Keep up the good work Dutchgirl...it is not 'bad' of us to expect others to do their jobs. CNA's who think they can mouth off to the people they were hired to 'assist' (its in their title even) need to be dealt with.

I had a float CNA come to my unit once (I was in charge at the desk) She had a bad attitude from the start...loudly complaining she had to come, didn't like our unit, proceeded to tell me how I should run the unit. I quietly told her ' You may go home now'. then picked up the phone and told the supervisor I had an insubordinate CNA and she needed to be sent home, I would rather do her job AND mine rather than put up with her nonsense. And (in front of her) I told the supe a written complaint about her behavior would be sent to her manager AND HR. She was totally cowed, left the floor only to return later with the supervisor to apologize. I made it clear I would have preferred she be sent home, that the complaint forms would still be filed, and if she did not do her job to my nurses' satisfaction, this would also be dealt with.

What is wrong today is people don't want to do their jobs, do not want to work as a team, and bad managers/charge people don't insist this happen. OK rant over now...LOL!

I'm glad something was said in her yearly eval...and I hope she does not slide back into bad habits. Keep up the good work Dutchgirl...it is not 'bad' of us to expect others to do their jobs. CNA's who think they can mouth off to the people they were hired to 'assist' (its in their title even) need to be dealt with.

I had a float CNA come to my unit once (I was in charge at the desk) She had a bad attitude from the start...loudly complaining she had to come, didn't like our unit, proceeded to tell me how I should run the unit. I quietly told her ' You may go home now'. then picked up the phone and told the supervisor I had an insubordinate CNA and she needed to be sent home, I would rather do her job AND mine rather than put up with her nonsense. And (in front of her) I told the supe a written complaint about her behavior would be sent to her manager AND HR. She was totally cowed, left the floor only to return later with the supervisor to apologize. I made it clear I would have preferred she be sent home, that the complaint forms would still be filed, and if she did not do her job to my nurses' satisfaction, this would also be dealt with.

What is wrong today is people don't want to do their jobs, do not want to work as a team, and bad managers/charge people don't insist this happen. OK rant over now...LOL!

Way to go!

Just wondering. In a LTC facility, what would you consider an ideal CNA? Do you mind questions?

Just wondering. In a LTC facility, what would you consider an ideal CNA? Do you mind questions

Happy to help. You don't have to work LTC to know what a great CNA is.

Get the vitals first thing. (The nurses can't give certain meds without knowing what they are.) Report anything that's out of normal so the patient can be treated quickly. Had one patient who wanted to walk to the BR. She stood up and nearly collapsed. Her BP was 44/20 and she needed immediate treatment.

Keep patients from falling. Falls constitute huge threats to patient's lives in LTC. If you know a patient is confused and might fall, keep that patient where he/she can be eyeballed frequently, not hidden away in some room somewhere. Use alarms, use distraction, use floor beds, whatever it takes to keep that patient safe.

Keep the patients clean, dry and repositioned frequently. This includes reporting any areas of skin that you might note that are non-blanching red. If a patient has an immobile hand, don't let it dangle; put a pillow under it to keep it from swelling. Prevent skin-to-skin contact. Keep the heels "floated"--that is, put a pillow under the legs so that the heels dangle off the pillow and don't touch the mattress. Check the heels for reddening and report any problems. Check the skin folds at the groin, under the arms, under the breasts for reddening. If a patient wears O2, look at the ears where the tubing sits for redness or open areas.

Encourage food and fluid intake. Elderly folks do better with smaller portions more frequently throught the day, which is why snacks are important. Please tell the nurse if anyone seems to have any runny nose, cough, pocketing of food, or difficulty swallowing while you are watching/feeding them in the dining room. These are all signs that the patient could be aspirating. Be alert to the confused patients and know what their diets and liquid consistencies are. Does it seem like someone has a hard time with certain consistencies? Maybe they'd eat better with a puree diet, for instance. Stay alert when on dining room duty. You might save a life. One confused resident was left alone in the dining room after breakfast and managed to get hold of a breakfast sausage, which he tried to eat, couldn't, and choked to death on. That was so unnecessary! All that needed to be done was to make sure one person stayed in the dining room while the other patients were transported back to their rooms.

Keep the head of the bed up for all tube feeders, again so they don't aspirate. Aspiration pneumonia is avoidable. It's also not pretty to see. The patient's temp goes up to about 104 in a matter of hours. And yes, they can and do die from this. So please have the nurse turn the pump off for a couple of minutes before you change and reposition a tube feeder.

Report any unusual behavior of the patients. Often, increasing confusion can signal a UTI. Drooping on one side can signal a stroke. Lethargy and confusion can signal a dangerously low blood sugar. If a patient complains that they have chest pain or shortness of breath, get help fast. If you notice sudden swelling in someone's extremities, do the same. Both shortness of breath and/or swelling in the extremities can signal an emergent CHF.

A great CNA, in other words, is alert to prevent problems and actively anticipates the health care needs of patients and cooperates with the nursing staff to keep the patients in the best health they can achieve.