more comments on the nurse aide topic

[debbie_ann_tx]

i have just been watching the aids and reading the comments on the topic of aids. some really good points have been made. what i see at work is there is a very thin line between being friends with the aids and not being friends. they do play favorites but i believe the biggest key comment that was made was to "help them to help you". i truely believe that they are the nurses backbone when it comes to good hygiene and skin care to the patients. not to mention care for the resp system just by simply turning the patient. I find at my job if i do a bath before they ever get out to the floor then they can see that i do care about them and their job. i still find it difficult to have to be after some of them to do what they should not have to be told to do.. no one reminds me that it is time to do my meds or ask me if i have done my charting.......... keep the comments coming.

[kbit]

The aide situation is one of the reasons I left the nursing home. Our unit had 40 patients. Most of the time on the 3 to 11 shift we had 3 aides. They were great at patient care but didn't really understand the meaning of it or have any compassion. They knew that they had to feed and bathe the patients but if someone had to go to the bathroom an additional time then they would get ticked. That was just one example. They were also always fighting amongst themselves. This one couldn't/wouldn't work with this one or that one. They would want me to help with this or that. If I had time I would have loved to but my patients were very demanding and had a lot of medical stuff going on. Lots of diabetics and g-tubes.

I also worked in acute care for elders at night (11 to 7). I loved my aide there. She was compassionate but totally overworked. It seems like that is what they do to the good ones. We had 40 beds, 3 or 4 nurses and that one tech. She busted her butt and did a great job. I don't think anyone really acknowledged it either. They were always quick to point fingers if she didn't put extra wash clothes in so and so's room even though we had a code and someone vomiting all night. I guess it is dog eat dog with the techs sometimes too.

[frances18]

I work at a small rural hospital in Kansas. I must say the aides we have on the noc shift and the day shift are awesome. Some of them know more of what is going on c the pt than their nurse. We have the few that are lazy et you have to stay on top of them but for the most part they are all Great..
But, I think the aides are like anyone else, they want to be tx c respect. If they see you are willing to help them et don't talk down to them it makes things a lot smoother. We have a few nurses that will be in the pt room et see a full urinal et call down to the station to have the aide come et empty it. I don't agree with that. They are my pt's too and ultimately their care is my responsibility. It's supposed to be about team work. Not I'm the RN and your the Aide, I'm too good to empty a urinal. The Aides know that we have more training et they respect that, at least the ones where I work do.

[mattsmom]

With the push towards primary care (in acute care facilities) I have not seen many CNA's around, although when I trained back in the 70's we learned how to do team nursing. Back then the CNA's were excellent...they were knowledgeable team players and we all worked well together. Our work environment was set up for team nursing, with solid expectations around the aide role. Today I see too many poor quality aides...by that I mean they are not the right kind of temperment and don't work as part of a team. Often facilities don't have the leadership set up to keep the working environment positive for all the staff.

I've done some agency shifts in LTC's where the CNA's had created a horrid toxic environment where nurses could not do their jobs. These type places couldn't keep a nurse and I could see why instantly. The CNA's had been allowed to run the show. Goes back to poor leadership. When management supports the CNA's and allows laziness and bad behavior, well I'm sure ya'll have encountered this if you've been nurses as long as me...LOL! its really hard to change a place once its become toxic as described above. I've simply had to leave..unable to stand the work environment, unable to effect it positively.

That said, the hospital I work at now occasionally gives us a CNA on days and they are very good; because the expectations are high for their aides and a culture exists that supports excellence.

[faviola]

Having aides can be a great thing..but unfortunately not all aides are very helpful..i have experienced times where i have an aide..and well they are no where to be found..so i learned to not rely on them even if they are there...but when good ones come along..they are great help to have around!

[kimmiejs]

Where I work they are considering going back to primary care nursing. There might be an aide on the floor to take vital signs and help answer the phones when the unit secretary is swamped. I would much rather have 3 patients (4 tops) and be responsible for all of their care. When my old unit tried this years ago the patient satisfaction and nurse satisfaction scores went through the roof. Over all it was a great experience for all involved

[BigRedNurse]

Where I work they are considering going back to primary care nursing. There might be an aide on the floor to take vital signs and help answer the phones when the unit secretary is swamped. I would much rather have 3 patients (4 tops) and be responsible for all of their care. When my old unit tried this years ago the patient satisfaction and nurse satisfaction scores went through the roof. Over all it was a great experience for all involved

If, indeed we do go back to working minus aides, I doubt very much whether we will only have 3-4 patients each. At the last hospital where I worrked (11p-7a) it was not at all unusual to have 8-10 patients each on med-surg. I believe that it's all about the almighty dollar. But I sure hope that you're right, cuz it looks like the aides are on their way out (sadly).

[kimmiejs]

If, indeed we do go back to working minus aides, I doubt very much whether we will only have 3-4 patients each. At the last hospital where I worrked (11p-7a) it was not at all unusual to have 8-10 patients each on med-surg. I believe that it's all about the almighty dollar. But I sure hope that you're right, cuz it looks like the aides are on their way out (sadly).

When we first reopened our surgical unit we did primary care nursing. This worked well. We had the highest patient satisfaction and employee satisfaction levels in years. Originally when they reopened the unit we were to have only a small patient census. When our patient census exceeded the number administration was expecting we had to resort back to having larger patient loads and using CNAs. I do know that administration is seriously looking back into having primary care nursing with the smaller nurseatient ratio again.

Remember patients that feel like they are being cared for will return and so will their family members, friends, neighbors, coworkers etc... When a person receives really crappy care at a hospital they make sure everyone knows about their experience. When a patient receives mediocre care they tell no one. When a patients receives care that surpassed his or her level of expectation everyone hears about it. I would like to think this fact has hospital administration listening to what their customers... patients, doctors, nurses, the general public, etc... having been trying to get them to listen to for a while now