Why do nurses delegate with a power trip?

Nurses Relations

Published

So I started as a CNA and worked my way up, minus LPN. I now find myself with a BSN and a blur of my days as an aide.

I recall feeling underappreciated and lower than dirt. I remember being "told" to complete tasks and not asked.

Once I became an RN, I left LTC and thought I would never look back. I am an ER nurse. As a social experiment, I decided to work PRN in a LTC facility.

Let me just say WOW! Nurses are constantly jumping down the aides throats, for EVERYTHING! Please do no say "CNAs are lazy,.worthless, uneducated and conferntational". Please do.not say that these things are not said behing the CNAs back. They are! You smile in their face and talk about their incompetence, when their backs are turned.

The techs in the ER are not micromanaged, they are trusted to complete tasks. They do EKGs, blood draws, insert IVs,.splint as well as straight cath. I have watched the techs execute CPR and save lives! Our team work is outstanding. They are part of the medical staff. Although they cannot present themselves as nurses to the patients we all refer to them as "technical nurses"

We do not have the ability to write them up, we do not have the ability to reprimand in ANY way. That is up to the ANM and NM ONLY. We educate them if they need help understanding certain tasks. In the same respect I have been educated by them as well.

They do not just do slave work,.they do valuable work and they do it proficantly. They are respected as knowledgeable co workers, not monkey workers.

I have worked in other parts of the hospital and every other type of nursing field. LTC seems to be the only place I see that. I want opinions on why this is. Also, if CNAs were called PCTs (not nursing assistance, essentially nurses B****) as well as allowing them on the job training, to have a little more responsibility, that "real" nurses see as more than just crap work (pun intended). Lastly, not allowing every LPN, RN to write them up. Do you believe.this would make for an easier, more respectful (between every title) atmosphere.

One of my nursing instructors did address the topic of saying "My aide." Her point was that it had a servile connotation, and we shouldn't say "my aide." They are the patient's, not the nurse's. No argument there.

.

This tickled me to read. When I was a CNA I would run to the schedule at start of shift to see whose aid I would be that day. If it was Ms. Eleanor or Ms. Sharon I worked "I'm Ms. Eleanors/Sharons aid today" into the conversation as much as I could. They were talented know it all nurses who actually knew it all and I was proud to be on their team. Furthermore, whats wrong with having a servants heart ? Serving someone else doesn't make you less than them. Maybe it means you are secure enough in your own value to not let a position or title define your worth. I was a nurses aid who aided her nurses. Problem where ?

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
I NEVER said they are called "technical nurses". I was throwing out an idea.

The techs in the ER are not micromanaged, they are trusted to complete tasks. They do EKGs, blood draws, insert IVs,.splint as well as straight cath. I have watched the techs execute CPR and save lives! Our team work is outstanding. They are part of the medical staff. Although they cannot present themselves as nurses to the patients we all refer to them as "technical nurses".

Yeah, actually you did.

Specializes in Med-Surg, Emergency.

I rarely find myself needing to delegate but the CNAs on my floor are excellent. I also make sure they know that if they are going to give a bath they should come find me so I can take a look at the patient's skin at that time and assist them as much as I can. On the rare occasion I have to ask a CNA to do something more than once, yeah, I get a bit testy when I'm running around passing q2 pain meds and they're sitting around playing on their phone and speak to certain of them more firmly than others.

I'm sure one of them thinks I'm a mega-b***h because I was in the middle of my med pass and a patient asked for a sandwich. The patient couldn't feed herself so I asked the CNA to assist her. She said "yeah, yeah, in a minute" and continued to play on her phone. Of course I got firm and said it needed to be done now!

I respect every one of the CNAs on my floor and tell them when I have free time on my shift to help them, and they all know that if they call my phone or a patient calls out and I'm sitting charting I will get off my butt and do it myself. I've never worked as a CNA and told several of them that I wish I had because I can't do their job half as well as they can, and I've even asked one to walk me through something (I literally never put a patient on a bedpan until I was an RN, not for lack of effort on my part, but for lack of opportunity at clinical sites). Night shift on my unit functions as a team, and I love that. But when I was in school, my fundamentals teachers drilled into us that we are not "above" doing any task.

That being said, I do have a coworker who told a CNA that it was outside of her (the RN's) scope of practice to change linens....but that's a whole other story.

Once again, I.will say, I am speaking of my position in LTC. I am putting my notice in, the first of next week. It was a social experiment, as I previously stated. I had forgotten how I sometimes felt as an aide. I thought my daughter was being a cry baby, so to speak.

I agree, some CNAs have an attitude. Some nurses have attitudes as well. Those that have been nurses longer than I have, believe they know the right way due to experience. Those that have been nurses, for lesser amount of time, believe they know the NEW "right way".

Which takes back to my original point. Things need to change, to create better teamwork. Work would be easier, life would be easier.

With that being said, I wouldn't leave the ED for anything in the world.

You took that out of context. We call them that amongst ourselves. E.g., "Patient Care Tech, my ass, she's the technical nurse". This was actually said a few months ago, after a seasoned nurse, new to the ER, froze during a code and the tech began CPR, ultimately saving a life.

Specializes in Emergency & Trauma/Adult ICU.

You seem defensive ... and your posts have now migrated all over the place. You work in an ER, but your stories are about an LTC. You're putting in your notice ... somewhere? Your daughter? I dunno.

And your stories don't ring true. ER techs, particularly those with an EMT or paramedic education don't refer to themselves or each other as "technical nurses". They just don't. To explain why would encompass a long explanation of education, workplace/professional culture, historical context, etc. And you're an ER nurse who believes that ER techs get an EKG ... on a whim? You've somehow missed the concept of protocols? Not quite buying it.

Yes, yes ... maybe you work in a *uniquely* special ER.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
Those of you that say I am wrong about who is working under whos credentials, in my hospital, have NO idea. Tell me how, the few techs that work in the front of the er, are suppose to be monitored by the nurses, while we are in the back? When a tech, based on his/her jusdgement, decides someone needs an ekg, they execute said ekg, print and take to the Dr. I have nothing to do with this.

What I am saying, all boils down to this. If I have to delegate I don't want that person as my teammate. Side note, none of the hospitals in my area hire LPNs as nurses, they are techs as well.

Not one person said that the CNA's work under your license. In fact, those of us who mentioned it at all were pretty clear that nobody works under our license. Not sure why you aren't getting that. But, regardless, we are ultimately responsible for those patients assigned to us and that includes the care rendered by the CNA's.

Your techs in the "front" are not using their "judgement" to get EKG's. They have been trained that if a patient complains of A, B or C then they are to get one. This is called a protocol.

Your distaste for delegation leads me to believe you don't really understand what it is. As the RN you are supposed to have the big picture when it comes to your patients as a whole. At any given time you should be able to prioritize their needs based on your education and training as a nurse. This education and training goes way beyond what a CNA or even one of your techs has. So if you your CNA is getting started on vitals but you know Mr. Brown's blood sugar has been all over the place you use your skills to prioritize and ask the CNA to get a FSBG first before doing her vitals rounds because you know clinically it's more important. That is delegation and team playing because you are including the CNA in the plan of care and trusting her to do an important task while you attend to other things. In this case delegation is appropriate and positive.

Now if your CNA is playing Candy Crush Saga on her phone and you have to tell her to do her job that's an entirely different story. This is not delegation this is babysitting and you would be right to decline her as a teammate.

Read what I have written. I AM AN ER NURSE. My daughter is 17 and works PRN as an aide. SHE IS TREATED LIKE CRAP! I started working at an LTC facility as an experiment. My experiment is over, they are getting my notice next week.

The techs in my hospital are , CNAs, EMT, Corpsman, LPN and paramedics. They ALL hold the same title.

YES EVERY SINGLE NURSE AND SOME P.As And DRs will call them technical nurses. It is an inside term. *** is so hard to understand. I am so glad NONE of my co-workers are such defensive babies. Wow!

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
You took that out of context. We call them that amongst ourselves. E.g., "Patient Care Tech, my ass, she's the technical nurse". This was actually said a few months ago, after a seasoned nurse, new to the ER, froze during a code and the tech began CPR, ultimately saving a life.

No I didn't. I directly quoted you and used the entire paragraph. You're back-pedaling.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
Read what I have written. I AM AN ER NURSE. My daughter is 17 and works PRN as an aide. SHE IS TREATED LIKE CRAP! I started working at an LTC facility as an experiment. My experiment is over, they are getting my notice next week.

The techs in my hospital are , CNAs, EMT, Corpsman, LPN and paramedics. They ALL hold the same title.

YES EVERY SINGLE NURSE AND SOME P.As And DRs will call them technical nurses. It is an inside term. *** is so hard to understand. I am so glad NONE of my co-workers are such defensive babies. Wow!

Excuse me?! We're defensive?! Who is using foul language and all caps which is the Internet version of screaming? I'm sorry but you are the one who is throwing a tantrum. The rest of us have been pretty polite. We just disagree with you and you don't like it.

FlyingScot.

Okay, I agree with your perspective. I have delegated in this manor in LTC. Which is something I am not use.to. I am an ER nurse. Nothing is planned out. We ALL FALL into place, without a word being said.

Now as far as the EKG thing. I will give an example. Some techs to exactly by policy. Everyone over 16 with chest pains, everyone over 30 with pain from waist up. Anyone with numbness, tingling etc..EKG. A senior tech will recognize a patient as a frequent flyer, with non controlled panic disorder, same symptoms as a MI or TIA. Hospital policy would say EKG. She uses her judgement and decides her time is better spent elsewhere.

This was all just food for thought. Carry on as you please. I am done.

Yes it's pissing me off that everyone is telling ME what happens at MY ER.

Last story. I had a nurse tell me a story, which happens to her friend. Her friend is a nurse, she pissed off an aide. The aide was a vindictive bihh. She took some of her personal xanax, placed it in the jacket (which was on the back of her chair) of said nurse. The aide then went to the ADON, told her she seen the Nurse pocket a parients Xanax. Guess who got this nurse out of possibly losing her license? Another CNA.

+ Add a Comment