When to delegate to CNAs?

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by Alexx_xox Alexx_xox Member

Has 1 years experience.

You are reading page 2 of When to delegate to CNAs?. If you want to start from the beginning Go to First Page.

Leader25, ASN, BSN, RN

Specializes in NICU. Has 39 years experience. 1,295 Posts

you said:"I learned how to make an occupied bed, how to bathe a patient without leaving them a sopping, soggy mess, making a dressing change neatly and efficiently, how to set up dinner trays and feed patients and about 1001 other things from the NAs at my first job"

I am just curious ,how come you did not learn this while in nursing school?How did you pass clinicals?.

Leader25, ASN, BSN, RN

Specializes in NICU. Has 39 years experience. 1,295 Posts

The CNA has a job description,look at it and see what the requirements are,I really enjoy working with them and once in awhile I can get a grumpy one to turn around.

Most of the time it is How one asks or requests the work to be done.I am not a pushover but I do make an effort to recognize their effort and even help out as needed.They do not know about all that stuff on your plate or a bad assignment.During holidays i always make an effort to show my "appreciation". These people are the salt of the earth and will have your back many times.

I did not know this as a new grad it took trial and error and doing it MY way.Treat others as you would like to be treated.

guest2117

guest2117

33 Posts

My last job was on a cardiac floor. Our floor techs were required to have CNA licenses, and I'm not sure anyone really knew why the hospital used the term tech vs CNA. Anyway, we had two techs at night, and they had a pretty organized routine on what needed to be done during the shift:

-Routine VS, blood sugars, patient weights

-Assisting the RN in getting admissions/transfers: Getting pt's VS/Ht/Wt, hooking pt up to cardiac monitor, making sure pt had admit supplies (toiletries, non skid socks, appropriate bracelets indicating fall risk etc, ice water)

-Around midnight techs would ask RNs if we had any AM procedures/NPOs, and they would place NPO sign on door

-Techs would prep patients going for surgery/procedures in AM (shaving/bathing with hibiclens/making sure patient was only wearing gown/socks)

-With last round of VS, the batteries in cardiac monitors would be changed, linen bags would be changed, ice water refilled

Ultimately in my mind, it is the responsibility of BOTH the tech and the nurse to make sure these things are done on top of making sure patient's call lights are answered, patient's are assisted to the toilet, snacks and drinks are brought to the patient, patients get bathed/linens changed.

If a patient needed a bed bath/linen change, I always tried to make it a point to be in that room helping the tech. Each nurse had 6 patients, and if it was a crazy start to the shift I would coordinate with the techs and let them know which of my patients I could grab VS or blood sugars on. I know the techs always appreciated how involved I was in helping out. Any time I needed anything from a tech they were always willing to help out. Gosh, to be honest, I preferred working with my fellow techs than a couple of RNs on that unit... lol.

Bottom line: It's a team effort!

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience. 16 Articles; 7,358 Posts

you said:"I learned how to make an occupied bed, how to bathe a patient without leaving them a sopping, soggy mess, making a dressing change neatly and efficiently, how to set up dinner trays and feed patients and about 1001 other things from the NAs at my first job"

I am just curious ,how come you did not learn this while in nursing school?How did you pass clinicals?.

I don't think that's what they teach in nursing school these days.

Leader25, ASN, BSN, RN

Specializes in NICU. Has 39 years experience. 1,295 Posts

Ahhh ok thank you for the information.

ellisjl, BSN, RN

Specializes in MedSurg, ICU. Has 1 years experience. 14 Posts

I work in a different environment from you; two CNAs split patients on a 26 bed floor. They do HARD work, and I honestly don't see how they do it as well as they do with so few complaints.

As as far as any advice from me goes... just be reasonable and respectful when delegating. If you can and have the time, do it yourself. If you can't do it because you don't know how, don't ask them to do it and walk away. Ask them to show you how. Be a team player. If they request lift help, for god's sake please help them because no one should do that alone and also because you'll need lift help soon enough.

Also, biggest advice: never, ever make the mistake of thinking that being a nurse makes you smarter than a CNA. On my floor, one of the ladies really saved my patient's and my own ass one day by noticing her foley bag had the same amount of urine in it that it did when she glanced at it that morning. I couldn't be absolutely sure (bc I didnt chart it/nurses on my floor aren't required to keep I/Os without an order, even with a foley) but I really thought I'd seen more in the bag just a couple hours before. Turns out the sitter emptied it and didn't want to tell us bc she thought she would somehow be "in trouble" for it. Phew.

cjcsoon2bnp, MSN, RN, NP

Specializes in Emergency Nursing. 8 Articles; 1,156 Posts

Knock off the grateful stuff. The CNA role exists only.. to ASSIST you.

You will not be asking for help, you will be directing patient care.

I seriously hope that this is a joke.

When I was an ER nurse I had no problem delegating tasks to CNAs and I certainly wasn't a pushover but I also learned that asking for help and showing a little humility from the get-go made a lot fewer conflicts and very seldom did I have to tell a CNA to stop goofing off to help me. The same could not be said for some of my RN coworkers who "delegated" everything possible to the CNAs but couldn't be bothered to help another nurse out when a critical situation came up.

Delegation needs to be used for delivering the best care and using the team in its most efficient capacity. Another user said it best, delegation shouldn't be done only out of convenience.

Example, the other day I was in the ED doing my re-assessment of a patient (I was the NP caring for the patient) and I knew I needed a temp. recheck before discharging the patient. I saw a thermometer sitting right outside of the room and it only made sense for me to grab it and take the temp. I walked by the patient's nurse and asked if they didn't mind entering the temp. into the EMR flowsheet for me (because only CNAs and RNs can do that) and the nurse was appreciative that I had done the temp. recheck. By your logic I should have walked past the thermometer, found the nurse and delegated him/her to recheck the patients temp. and then notify me of what it was.

Would that be appropriate delegation? Technically, sure it is.

Is that within their scope of practice as the RN? Absolutely.

Isn't it easier for me as the provider to delegate this task and then go about my business? Probably, but sometimes it's about being a good team player and showing that everyone can help out with no task being beneath anyone.

Do I run around doing this sort of thing all the time? Obviously no because it's not efficient. But when I do, people remember it and try to go the extra mile to help me in return. Just a thought...

!Chris :specs:

TruvyNurse

TruvyNurse

354 Posts

I was a CNA before I was a nurse and I had some awful nurses. I told myself I'd never ever take my CNAs for granted. I make sure my CNAs know they are appreciated. I won't ask them to do anything I won't do. I always offer to help if I can. I only ask them to do me favors if I'm too busy to do it myself.