You can help me when you have time

It would have upset me, and I would have said "An incontinent pt takes priority over VS. I need your help and will meet you there in 2 minutes."

If she didn't show up, or gave any more lip, the unit manager would be getting a phone call the next shift.

Sounds like her response was very condescending. You did the right thing by caring for your patient, but I would address the issue with your manager. Could be she was having a bad night if she usually does good work. Could also be she just needs a little instruction on prioritizing, etc.

I agree with Tazzi. You are the nurse. You don't take orders from her. I know it's hard when you're first starting out , but it's something you will run into more than once. Nip it in the bud!

It would have upset me, and I would have said "An incontinent pt takes priority over VS. I need your help and will meet you there in 2 minutes."

If she didn't show up, or gave any more lip, the unit manager would be getting a phone call the next shift.

Tazzi is a little more generous than I am. I'd still have made a formal complaint about her behavior whether she changed her mind and helped me or not.

While we are all grateful for the assistance that CNAs and techs give us,

NO WAY am I going to allow a nonlicensed person to dictate patient care prioritization.

Sounds like a task oriented person.Great workers in their comfort zone but ask them to deviate from this and they just can't cope!I had one the other night. I needed help with a combative resident,the carer was making a bed,I needed the help NOW but she was determined to make that bed first!Sometimes it just needs pointing out, forcibly, what the priority is!

And sometimes it is good to look at the situation from the other guys point of view. I do agree that patient should have been cleaned up. If the aide had 25 patients to do vital signs on, that will take a long time. She has probably had nurses getting on her before for not having them done in a timely manner. The more interruptions, the more untimely. Does the aide usually take good care of the patients or is slacking her usual? We are all busy but if you cleaned that patient once and the aides did it the other multiple times that day the patient was incontinent then maybe you just have to look at it as your contribution to good patient care.

We are all busy but if you cleaned that patient once and the aides did it the other multiple times that day the patient was incontinent then maybe you just have to look at it as your contribution to good patient care.

I had been there the previous 12 hours, and was working over. I had not once that day asked for help until then, b/c her grandaughter was in the room who is an RN but she had to go to work. The tech had just arrived for the pm shift. I am not the type of nurse that asks aides to do my work.

And if she had one or two left, I would not have thought much of it. But, someone whose bottom is raw does not need to lay in diarrhea for an hour and I think all the nurses would agree.

Like I said, I have spent a lot of time as a tech, and I can see this from her view point. I have been in that situtation reversed many times. And I know from those experiences I would not have acted that way.

It would have upset me, and I would have said "An incontinent pt takes priority over VS. I need your help and will meet you there in 2 minutes."

If she didn't show up, or gave any more lip, the unit manager would be getting a phone call the next shift.

Right on!

We had a bunch of call in for nights tonight (a bugs been jumping around). I agreed to stay until 11pm until another nurse was able to come in. Right after shift change a patient's daughter called me to tell me her mom had a BM. She is on tube feedings, so she has frequent dairrhea. Her bottom is getting a little raw, and I'm scared she's going to develop an ulcer from the diarrhea, and basic status. I have never worked with the cna they have on nights, but everyone razes about how great she is. She had just started vital signs. I called her and said "I know you just started vs, and I'm sorry, but I need..."and that's as far as I got. She replied "look, if you are calling me about 222, I know and forget it. I am going to finish my vital signs. When I have the time, I will let you know so you can help me.". :angryfire

So, here's way it p.o'ed me

1. I spent years as a tech. I wasn't asking her to do anything I would not have been willing to do. Techs have menioned to me that I don't ask for help enough.

2. I am responsible for that patient, as well as 5 more. If their needs are not met, it is my liscence, not yours. So I need your help to care for them, not the other way around. (I just wish I had a tape of how she emphasized that statement, and the attitude she used)

3. I prefer my patients not lay in crap while you do vital signs on 25 patients.

Long story short, I cleaned her myself. I was difficult, since she fights, but she was cleaned. My question, am I getting upset over nothing just because I am a little tired...or would this situation have upset you guys?

I dealt with something just the opposite at my new job. I was carrying linens, etc. into a patient's room. The CNA stops me and says, (with attitude), "You don't need to take that in there, I already have some there, so you can put those back." I said, "Oh, well he'll have some for tomorrow (forgetting how much I myself hate extra linens in the rooms)." Then I told her that I was going to help him bathe. She proceeds to tell me, "I don't know what they told you that I do around here, but..." Then she pulls out some wadded up paper and begins to tell me her "routine", all the while referencing this piece of paper. I told her that I was just doing my job. She insisted that I not help this man bathe, because she was going to. I would think that a little help would be appreciated, but I guess not. I proceeded to do it anyway, then it was like she was in a race to get things done faster than me. What a nutjob. I thought to myself, "Where did they find this fool..."

I think you have every right to be P.O.'d. I would also have reported it to the supervisor. You were not asking her to do anything out of her scope of practice, and she didnt even give you the chance. You sound like the nurse that would have surely helped the assistance, since the pt was not a one person job. Sometimes its and Us vs. Them mentality. Dont her bully you.

If you are not going to report it now, let it go for now. However, you need to nip it in the butt, if there is a next time. There is no need for it. We are a team and need to get the job done for the pt. my

sounds like she has been bluffing her way for quite a while. I would document and be sure to tell her in the future that delegation is not in her job description.

Who knows if this CNA had a bad moment already, or if she is really as good as they were saying? I know this one male CNA that received an employee of the year report, but working on his floor, you see him sitting on his rump, the RN doing admissions and discharges, and the LPN is instructed to 'hurry up and give medications' to 25 rehab patients so that she can 'then do patient care'. I was shocked to hear this, because I thought that this CNA was the greatest thing since sliced bread, according to the award given to him. But, he does nothing. I understand that he intimidates many of the RNs, but, hey, what is his job? I would not want to have the LPN rush through her med pass and possibly make a mistake, while a CNA is dictating what he will or will not do.

I think that I would let this one go, but the next time it happens, speak to the CNA. But, for sure, I would watch the interactions between the CNAs and the other nurses and supervisors before I speak...I have seen CNAs do things that are dead wrong, but receive more support from the nursing supervisors than the nurses do. You need to know this, I believe before you speak...it will let you know how you have to approach the subject. I remember once, on the med-surg unit at my hospital, the CNAs reported to the supervisor that the nurses were not answering call lights (don't know if this is true, I was not there), and one of them is a 'favorite child' of a higher-upper. The nursing supervisor told the two CNAs to watch a one to one and and made the nurses do patient care. The CNAs laughed at the nurses all night long.

Also, (I am desperately trying to give the CNA a bit of credit), what if she is being threatened and harassed that certain things are not done the way that they wish (even if it is unreasonable or impossible)? Maybe she snapped because of that? Who knows? Of course, delegation is not within their scope, we know that. But I also know that many times, people who should not do just the opposite.