1 reply to this topic

[lcraigbsn]

hi. i need some help. Will be starting a project for a clinical ladder program. having trouble narrowing down a topic. i look at the problems we have on our unit and am just curious if others have same: such as CTA/CNA not reporting vital signs to nurses, or complaingin of not wanting to do work etc. we also have a communication problem btwn shifts. any suggestions? thanks

[lberghood]

hi. i need some help. Will be starting a project for a clinical ladder program. having trouble narrowing down a topic. i look at the problems we have on our unit and am just curious if others have same: such as CTA/CNA not reporting vital signs to nurses, or complaingin of not wanting to do work etc. we also have a communication problem btwn shifts. any suggestions? thanks

Hi we have a lot of the same issues where i work and i am working on improving communications and accountability so anything that you come up with would aslo help me. One of the timgs that we did with the Vital Signs was to place parameters to report to the charge nurse directly on our preprinted vital sign sheets. You would think that this would be common sense but it does not appear that it is and in order to improve this area and hold the cna's accountable i have found that i as a charge nurse have to directly ask and check the vital signs and when i found that someone did not report significant changes and/or abnormal vital signs i have to go to them and ask them why and explain the importance of this to them. Some of them really do not know or are intimidated to "bother" the charge nurse because she is "busy" I have found that although it is a slow process change can happen but only if we are aware of the need for it and willing to invest the extra few minutes and all improve our communication skills. Placing blame and punishing the CNAs does not work and you will be met with even more resisitance and passive aggressive behavior. If everybody really is to work together as a team it is of the utmost importance to establish an environment where mutual trust and respect can flourish and this seems to have to come from the top down. We can not expect this of our CNAs if they do not see it happening with the charge nurses and the management. Health care can be a difficult stressful and intimidating field where people are not given aknowledgement and recognition for what they do well but are disciplined and told all of the time what they are doing wrong and this makes for a fearful secretive environment with a lot of resentment and gossip. If the staff feels that they are appreciated and valued they are more likely to be open to suggestions and even take a newfound pride in their work. Let's face it. Our CNAs are our front-line of defense and without them we would not be able to do what we do. Let's give credit where credit is due and remember that these people, for the most part, work hard and have less advantages or education than we do and they may not have developed basic skills such as communication or problem solving.. I think it is very important that we make sure that they clearly know their roles and what is expected of them and work with them to help them to develop these skills and not just treat them as dispensable unlicensed custodial personnell. When all of the above has failed and we have truly tried, sometimes a "bad apple is just a bad apple" and then it is time to start to document and start the paper trail. If we wait too long then one bad apple can spoil the rest and have a devastating effect on the morale of the staff and staff gets the message that it is okay to not do your job and there are no consequences and the motivated conscientious staff learn bad habits. Just my thoughts on the subject this is a topic close to my heart as this is what i am curently working on in my new position as the 11-7 "patient care coordinator"(glorified name for shift supervisor)