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What an RN should never ask of a CNA

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Any nurse worth their weight in water knows, understand, values and appreciates the function and role every CNA plays in the delivery of our patient care. And yet, I still see RN’s treating their CNA team member horribly.

Here is the best piece of advice I can give to any RN out there when delegating to their CNA team members:

Never delegate out of sheer personal convenience

Too many times I have seen/heard/witnessed an RN/LPN delegate a task to a CNA simply because it was inconvenient for them. We all know the stories and the urban legends of CNAs always doing the dirty work (bed baths & bedpans to name a few), while the RN/LPN walks away. I have seen them answer a call bell, learn that they need to get their hands dirty. They walk back out of the room and call/delegate the task. There are actually individuals out there that believe that once they are licensed, they don’t need to get their hands dirty???

I’m here to publicly apologize to any CNA reading this. Contrary to popular belief, this is not the norm, nor is it acceptable to most of us currently practicing! I still strongly believe that the most important assessment skills can be learned from getting my hands dirty. I learned that from a CNA!

The professional rapport you have with your CNA can make or break your career. I make it a point to strengthen that relationship, because when the going gets tough and the you-know-what hits the fan, my fellow CNAs are often times the ones that keep me afloat.

What goes around comes around folks. If you cannot make the time to get your hands dirty, the CNA will not have the time to keep you from ‘drowning’ in your time of need. It really is that simple. It’s called teamwork.

A nurses’ aide (Certified Nurses Aid – CNA) is the unsung hero of the nursing world. When someone asks what you do, never simply say “I’m just the aide.” When we speak of bedside care and we refer to the ‘team effort’ this part of the team is probably the most under-appreciated, yet most needed team member. They are the silent majority. When they are doing what they do best, you sometimes (more often than we like to admit) forget they are there. But, when they are absent it turns your whole world upside down. Thank you for all that you do!

By the way, this post was inspired by a previous Scrubs post: Top 10 things you’ll need in your CNA survival kit. Be sure to take a look.

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Sean Dent

Sean Dent is a second-degree nurse who has worked in telemetry, orthopedics, surgical services, oncology and at times as a travel nurse. He is a CCRN certified critical care nurse where he's worked in cardiac, surgical as well as trauma intensive care nursing. After five years practicing as an RN, Sean pursued and attained his Masters of Science in Nursing. Sean currently practices as a Board Certified Acute Care Nurse Practitioner (ACNP-BC) in a Shock Trauma urban teaching hospital. He has been in healthcare for almost 20 years. He originally received a bachelor's degree in Exercise and Sport Science where he worked as a Certified Athletic Trainer (ATC).
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83 Responses to What an RN should never ask of a CNA

  1. John

    The best nurses I know started their healthcare careers as CNA’s. I was a “NA” before the “C” was required, I remember the treatment we got. My CNA’s are my most valuable tool!

    • Sean Dent Scrubs Blogger

      @John, I was never an aide (CNA), but I agree with your concept absolutely.

    • Teresa

      Thank you so much for writing this. I am a CNA in nursing school and I am often insulted by the way im treated by most of the floor nurses. Ive been yelled at in front of patients for not being in two places at once while the nurse sat and gossipped at the station! I vow as a nurse I will treat my CNAs like gold..because they are a very important part of patient care!

      • Sean Dent Scrubs Blogger

        @Teresa Hang in there! So glad you understand the value of the CNAs.

  2. I had this LPN stick her head in a room as I had just come back from showering an obese patient and was drenched in sweat and water tell me to be sure to put powder under her fat rolls. She spent more time telling me what powder to use and where to put it then to actually take the 10 seconds to do it herself. She also wanted to change the sme person’s sacral bandage after a brief change but since I could not safely change the person’s brief myself I asked for her assistance. She pondered helping me but left and said she would just do it when I had found another cna (who was busy with her own hall mind you).

    • Sean Dent Scrubs Blogger

      @anon Thanks for sharing your story. So sorry.

    • carmenroxasalmero LVN

      I worked as an LVN wound care nurse and I couldn’t have done my job without the assistance of the CNAs. I also learned to turn patients by myself because I never felt that finishing my job was more important than any CNA’s and having them stop what they were doing just so they could help me finish my job first. God bless the CNAs!

  3. Evelyn

    I am in complete agreement. I could not do what I do without them. A good CNA is worth their weight in gold. I also was an NA then an LVN before I became an RN.

  4. Alana RN

    I was a CNA, LPN and now an RN and my nurses’s aids are my eyes and ears. They see and hear things before I do sometimes without them my job is twice as hard. Don’t ask an aid to do something you aren’t willing to do yourself. God bless all CNA’s. :))

  5. Alana RN

    I was a CNA, LPN and now and RN and my CNA’s are my eyes and ears. They see and hear things most times before I do and without them my job would be twice as hard. Don’t ever ask a CNA to do something you aren’t willing to do yourself. Just saying…

  6. colleen miller cna

    thank you for supporting us cna’s .almost all of us including myself pride ourself’s in the work we do.

  7. Kim

    I greatly appreciate and thank you for writing about CNA’s and the work we do! Too many times I have witnessed RNs who do not understand that we are here to “enable” you to do your jobs more efficiently, not to make it “easier”……..there’s a difference between the two. I hope more will read what you have written and incorporate it into their daily functions!

    • Sean Dent Scrubs Blogger

      @Kim You are very welcome. “are here to “enable” you to do your jobs more efficiently, not to make it “easier” – well said!

  8. suzi

    I have seen many an RN treat LPN’s this way too!

    As a matter of fact, it is the main reason I am working from LPN to RN now.
    I am tired of Rn’s treating me like dirt and having to prove their “power”. I hope to set a good example when I get my RN & all my former
    CNA’s said they would be glad to work for me.

    • Sean Dent Scrubs Blogger

      @Suzi as a current RN I look forward to you starting your new role! Hang in there! And thank you.

    • sjfantini

      Remember, they don’t work for you but with you.

  9. annonymous

    @sean- thank you for your compassion. Sadly my experince as a cna at the ltc location aforementioned has convinced me that I will not be a floor nurse (I love the elderly). There was so much negativity amongst the staff, a SERIOUS lack of management, and frankly just a depressing environment because most of the residents got the bare minimum treatment. It’s a shame too because I really love the elderly and was really looking forward to improvong the resident’s quality of lives. Also in my clincal experiences I feel like floor nursing is chaotic, disorganized, fatally flawed, and… Hostile. After I have my RN I will probably just continue my education and eventually work in administration or policy.

    • kjkamk RN

      I can tell you that not all places are like that and there are some places who give quality and quantity of care to their patients. I have worked in negative environments and we turned it around as the staff. I heard a lecturer challenge a group of college freshman who were complaining about the government, their city, their state, etc. “They suck!” She turned it around on them and said “Maybe YOU suck!” All depends on your perspective.

      • orlyroseCNA_SVN

        I currently work at a convalescent hospital I like my job. I don’t like my bosses there are some charge nurses I don’t particularly care for. I plan to go for my rn after my lvn and I just keep thinking about how I won’t have to get treated like crap by my bosses. The rn’s at my work are super nice thankfully. But that job is highly underpaid and we get thrown under the bus so much (had a patient throw me under when I did nothing wrong) I’m amazed at how hard cna’s work for that. I’m going to love my cna’s when I’m an rn and lvn. GOOOOOO CNA’S <3!!!!!!!

    • zlatajagoda CNA

      They need your compassion. Please don’t let some negative nellies push you to administration if that’s not your true passion. The elderly get the short end of the stick so often.

  10. Sean Dent Scrubs Blogger

    @anon I’m sorry to hear about your negative experiences. I CAN tell you that we make our own experiences with each step in our career. I hope you find what you are looking for. Best of luck.

  11. Abby Student

    I wonder why cna s get paid so little for doing more work than anyone else? I was a cna in a ltc and got laid off at the beginning of the recession. I had been the last one hired. I had to move states so that I would be able to start my two years of certification over. I still have not found a job. The only one job that I was offered was for $7 an hour. That’s less than minimum wage and they were only offering me six hours a week. I am in school for my rn, just started, and I have tio take odd-jobs just to slip by. My certification is expiring in a month and then I’ll have nothing

  12. Nurse Rene RN

    Great article Sean!
    I, too, started out as a “Nurses’ Aide’ and worked my way through a 2-yr. RN program. The one thing I would add is: Never Ask Someone to do What You Are Not Willing to do Yourself!
    Honestly, I have, on quite few occasions picked keeping my unit’s CNA OVER an RN who did not know the ‘territory’.
    A good experienced CNA is invaluable to the rest of us!

    • kare44

      You shouldn’t have to ‘pick’ one or the other…that to me is unprofessional behavior. In units where there’s an unspoken culture or ‘territory’ and you either fit in or you don’t are detrimental and completely unfair to the person being ostracized…I’ve seen experienced nurses and others display that behavior and I’ve lost a lot of respect for the gossipy kind of people that pick on the select few that are different. That energy could be spent helping the person acclimate or actually having the maturity to keep them informed of how they can improve

  13. Candace Student

    Thank you so much for this post!
    There are so many times that I dread going into work because I just know my busy day will only be worsened by a nurse who is too afraid of hard work.
    I am very thankful to be an aide and when I finally graduate nursing school I will appreciate and respect every CNA I work with.

  14. trinak88 CNA

    As a CNA, we can pretty much tell if our nurse has been an aide or not. I had one nurse tell me that “it was not in her job description to be nice to the aides or to make their jobs easier.” Needless to say everyone hates her, and she is always wondering why she cant find anyone to help her do her work.

  15. Linda D RN

    Sean,
    I could not agree with you more. I spent a great deal of my nursing career teaching nursing assistant courses. The folks who come to this job are not looking for a huge paycheck. They care for patients out of personal love and kindness, and choose this area of nursing because they honestly care about people. My advice to all nurses is to embrace these angels, and NEVER ask them to do anything that you (nurse) would not be willing to push up your sleeves and do yourself. They can be your most wonderful asset, or your biggest adversary. You choose!

    • kjkamk RN

      Absolutely. Never ask someone to do what you would not do.

  16. tloomisrn RN

    When I worked in the hospital, our CNA’s were the backbone of our team. I would have never survived some of my shifts without their help and dedication to our patients.

  17. estela40 LVN

    I have had the privilege of having the best CNAs, but they respond best when you treat them as human being. many are just lazy but still respond if you let them know what is expected of them during your shift.

  18. kjkamk RN

    TRUE. It sounds like you also worked on the other side of the equation, as did I. I literally have heard people say “I’m an RN, that’s not my job.” to which I reply – “Yes it is! Did you not read your job description? ‘and ANY other duties as assigned.'”

  19. DanidelionRN RN

    I think that while an RN should not be just avoiding helping people because it’s CNA work… CNAs should also not assume that a nurse who delegates something to them, is doing so for that reason, either. I have worked as a CNA, and now I am an RN, and on occasion, when I have been walking down the hallway on my way to attend to something, I will poke my head in where someone’s call light was on, to see what they needed, and then flag down an aid, if they needed to be toileted, etc; because while CNAs do a lot of work, and I can do parts of their job…. they cannot do mine. At the end of the day, I am responsible for a lot more dimensions of care than the CNAs under me are, and making sure that my patients get their meds and their treatments, and their new orders processed and their families notified of important changes, etc, is more important than me doing part of the CNA’s job, unless I have free time to help them, and am not otherwise occupied. I’ve been a CNA, and I know what it’s like- and that’s why I also know that it’s not impossible work. I’ll help if an aide asks directly, but often, I stay late charting in the first place, because i didn’t even have time to sit to chart during my shift- so no, I don’t have time to do what I delegated to you.

    • kare44

      Thank you for voicing the truth!!! These comments about ‘don’t do what you’re not willing to do yourself’ is not the problem. It’s a time issue. I’ll see people sitting at the station giving me attitude every time I ask for help or disappear because they don’t want to work. I guess I’m at fault in the sense that I expect my co-workers to work as hard as I do and I am always running around. Just because an rn is living in the pt’s room doesn’t mean they have the time to complete every task. The same can be said for a cna. Of course, there’s always the amazing outliers- RNs and cnas who have the energy to work hard

  20. kmillersocal

    Thank you for taking the time out to write this! I was an NA in the late 80’s, a CNA in the early 90’s. I took an 18 year break from nursing for many reasons of which one was the way I was treated. Now I am an LVN and start school again in the Fall for my RN.

    Just out of personal observations, some of the best nurses started as NA/CNA’s.

    I think LVN/RN’s can all agree that we would be lost without the strength and compassionate care provided to our patients by of our CNA’s.

    Hugs to all CNA’s xxxxx

  21. Nurse Rene RN

    WOW, Sean! You hit a Grand Slam with this one! Congrats!

  22. shellystemm

    I have CNA,Rn’s & LPN’s working in my home and had an LPN look at the CNA and snap her fingers said clean up on isle 5. I was horrified she had said that to the person that has more hands on with me and spends 6hrs./ day with me to her 45 min / day. I made it very clear that she was no better than my CNA!!! You all are very valueable to me and my care. THANK YOU!!!

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  24. emt88 Student

    I appreciate this article being posted. I am not a CNA- I am an EMT Intermediate. I essentially have all the qualifications of a Paramedic except there are several cardiac medications I cannot give.. however, I am enrolled in Nursing school and working in a local Trauma/ER as a Patient Care Tech. The majority of the nurses treat the tech like they are ignorant. I have many times brought to the attention of the primary nurse a significant vital sign change or change in mentation of a patient, only to be looked at like I am inappropriately overstepping a boundary by advocating in the patients best interest. I have witnessed a nurse chart a respiratory rate of “18” for an adult patient who I witnessed breathing close to “38” times a minute- when I asked her about it she went on to give me education on how DKA patients often breath fast… This is something I already knew and the unwanted advice did nothing to clear up the question of why she was falsely documenting a vital sign on a patient who was – as she said – in DKA and hyperventilating. The majority of the other ER techs are phlebotomist or CNAs that are cross trained to start IVs, draw blood, perform EKGs etc and I see them getting treated worse than me. I have seen even the strongest nurses trick these other techs into doing things that clinically should not be delegated- because the nurse didn’t want to get up and quit texting on her phone. I agree with other CNAs who have posted- this gives me an exact indication of the type of RN I never want to be. It is sadly a large majority of the nursing staff, not just one or two and not just one one shift. It is unacceptable and I wish more nurses were aware and recognized this as an issue. Some of us have clinical background- I am licensed on an ambulance to assess, treat, medicate, diagnose, intubate and trasnport any patient of any age – trauma or medical. I have worked more codes in the past 8 years than some veteran RNS have in their entire career. It has been a very eye opening experience to see how I am treated and I appreciate the rare oppourtunity I have to see it from this position so that I can have even more respect for the CNAs when I become an RN. Because, like many nurses mentioned on here- when the going gets tough- the CNA is who keeps you afloat and typically knows what you need before you know you need it!!! Thank you for posting this issue!

    • nwrn

      As an RN, I loved my CNA’s and ER techs. They were team players and I could not have been a strong PCU nurse without them. I often bought them lattes from our coffee stand, and whenever appropriate I would openly acknowledge their contributions. Give credit where credit is due, CNA’s are worth their weight in gold. Our strongest CNA’s often got my “Go to nursing school!” lecture!

  25. Judy Smith

    I worked as a CNA in a hospital, but quit my job because I was treated like crap by 3 of the nurses I worked under. Have my own business taking care of people in their homes and going to school to get my nursing degree. I wil never treat my CNA’s the way I was treated.

  26. lizguy

    As a three yr CAN in my pre-core, I appreciate the chatizement of not “just the aide”. I. Have had the priveledge of working with 30< vetran nurses who wouldn't tolerate me calling myself "just the aide"
    I also have worked with rookie nurses who had the education, but the fear of being hands on. There is a huge difference between the nurse who says they know what to do, and the nurse who walks away having done it. :)

  27. lphillips0027

    I appreciate all aides whether NA’s or CNA’s. I was NA for 3 years prior to becoming an RN and being appreciated went a long way! Thank you’d go even further! So for all the aides out there. THANK YOU!

  28. Pattimelt

    My daughter is a CNA on a bone marrow transplant floor. She works hard and loves her patients and her nurses and they love her. However, it is hard to make a living being a cna. She has been with this hospital since March 2011 and got her first raise in August 2012 and it was 13 cents an hour even though her review was excellent. She was crushed because she loves what she does and loves the one on one patient care. It is sad that the jobs that are so important pay so little. I told her she needs to go to nursing school but she said the nurses do lots of paperwork and do not get to spend as much time with the patients. They are on the phone with the doctors and such. She was crushed. Thank you cnas for all you do! Where would hospitals be without you!

  29. jetalynne RN

    After working in a nursing home on a division where I could have up to 28 patients, I really understood how important my CNAs were! Often times my division would be short an aide and I would be left with 2 CNAs and myself, along with the Med Tech who was busy passing meds on 2 divisions…not once did I ever just sit around and delegate simple tasks that I could do myself to my aides! Every aide I worked with thanked me for helping them with stuff, and always told me how none of the other nurses would even dare to help with some of the simplest things! I was just appalled! I have only been a nurse for about a year now, but never will I just leave my CNAs hanging, I couldn’t do my job without them!

  30. kreinarn APN

    I started my career as a CNA, then went on to be a SN in both the floor and ICU environment. I remember thinking that when I graduated I never wanted to be treated the way I was treated or be thought of as lazy. I got my RN in 2009 and have worked as at 2 different locations at an ICU. One was a step down/ ICU unit in one with an acute side and a subside. Out of the 7 CNAs in that hospital unit only 2 helped out. One actually would verbally abuse both nurses and patients but due to the union they were a part of nothing could be done I was told. While one of my patients arrested and I was at this bedside on the subside that night, my other patient called several times only to have the calls hung up. As a result this patient called 911 and managed to fall attempting to get the bedpan. All the while, the CNA was reading for school at the nurses’ station and I was pushing meds in another room slowly coding my other patient. I filed a complaint and soon after left the job. I felt it was unsafe to have no help. In my current job, I experience the same situation. I bathe my own patients, QC my glucometers, stock my supplies and linen, call for environmental services when needed, and get my own EKGs and lab draws. There is only one CNA on our unit that will actually help. Most of the time the charge nurse will help with turns or we ask each other out of fear that we will a) get verbally abused b) it will not get done. I guess my point is that it happens in both spectrums depending on where you work. My experience the last 4 years with CNAs has been negative to say the least.

  31. melodyrhyme2005

    I have read most of the comments posted and agree, Just like the RN is the eyes and ears of the MD, CNA’s are the eyes and ears of us RN”s and are at the foundation of good patient care. I am a pretty new RN and have been working in a LTC facility for the past 10 months. Taking care of 20 to 23 patients sometimes makes you feel like only a pill pusher, allowing you not as much time to do the vital assessments as you would like. I do try and help out my CNA’s when I have the time. (and sometimes when I dont because the resident is in immideate danger – which makes for those “crazy shifts” that all nurses just LOVE…) On VERY rare occasions am I able to take the two 15 minute breaks and sometimes do not get my 30 minute dinner break because I would rather see my family rather than stay 1 hour or an hour and a half after my shift ends ( especially when my shifts supposed to end at 10 pm at night and my stop time is at 1130pm at night, with a daughter that gets up at 0630). This is part of the RN world that many do not think about. Sometimes it feels like the paperwork never ends and those 8 to 12 patients you have to write a narritive on ( usually a paragragh and a half to two paragraphs, if you REALLY want to CYOB from legal liability) are never going to get done. Or the 3 lab draws, 10 head to toe assessments/10 Vital Signs, and the 5 skin assessments you have to get done before you med pass for 20 to 23 residents( Including the 6 residents with Accu Checks and coverage) starts 2 hours into your shift. Then starts the 2 hour med pass , which this WILL take you 2 hours if you are very dilligent about your pass, with those 6 resident you give insulin to. This is half of my 8 hour shift. Then you MAY get an hour of calmness to start charting on your residents, which take approximately 8 minutes a piece if you go into the specificity you are supposed to on why they need our care, what assessment, intervention and evaluations you did to help that resident( Indispensible for getting reimbursed for care from private pay/medicaid for resident care). Easily an hour and 1/2 work of paperwork. Then another med pass starts and if you work 2-10 that means another 23 people to pass pills on, which may take an hour and a half if your lucky with another round of 6 accu checks and coverage.By the time your done with this workload, you have an hour and a half to fit in your 30 dinner and to finish charting on 4 – 6 more residents. Leaving you approximately 15 to 20 minutes in the shift as “down time”….of course, you havent cleaned off your med cart, restocked it or replaced meds and write down on a pharmacy reorder sheet which meds you need….damn, there goes another 15 minutes….This countdown doesnt even include when you have an admit, someone falls, or someone needs immideate intervention which can happen at any moment on ANY shift. Helping aides is important,but I hope they remember in turn an RN”s usual schedule and what all he/she HAS to complete during thier shift for the team that only they can do as an RN and come in under the dreaded OVERTIME for the company. Sometimes RN’s feel undervalued and scathed upon because we HAVE to delegate those things that a CNA can help us with….myself and the other 2 to 4 nurses on the floor are the only ones who can complete our assessment or provide the interventions needed by the patient….and they have their own patients as well. In my point of view its not really about how much nurses help out their CNA’s, but how much the TEAM is willing to lean on eachother to get the things done that need to be done. Just remember the RN has ALOT on her plate as well and is under ALOT of pressure.

  32. Steve_RN RN

    I appreciate our CNA’s greatly, they are awesome, efficient and keep our unit rocking!

  33. bailsto LPN

    I was a CNA and I am now a LPN I value my CNA’s and they know it….they are totally under appreciated and a much valued part of the team…thank you for all you do

  34. amatherwin RN

    I am an RN but I don’t treat my CNA/LNA that way. They are an important part of the patient care team and I do appreciate them.

  35. judontmesswithme

    I work in nursing homes and I love CNAs. I just wanted to voice my appreciation for them. I also worked at a hospital and appreciated my Patient Care Technicians!

  36. jennren

    I’m really glad to see so many nurses really appreciate their CNA’s. I’m working as a CNA while going to VN school and plan to continue on to RN. I’ve heard many nursing students say they want to be a nurse so they don’t have to do the dirty work. I have been quick to remind them they don’t want to become the nurse we CNA’s hate to work with. Ultimately the patients are the ones that suffer when the nursing staff doesn’t work as a team.

  37. Amused66

    I’m sorry to say, but as far as LTC is concerned your words fall on deaf ears. I’ve worked in several different LTC facilities,and it was always the same attitude with different surroundings. In fact the overall degrading treatment of CNA’s led me to further my education. I’m a PCT and a CPT, and I left LTC to work in CCU at a nearby hospital. I’ll never forget my days working in LTC, and I appreciate the fact that we work as a team in CCU. The worst floors at the hospital don’t compare the utter lack of human compassion I experienced in LTC. We were treated as lesser human beings not worthy of any dignity whatsoever. The only thing worse than the treatment we received, on a daily basis, was the pay. I’ll never understand why CNA’s continue to subject themselves to such belittling standards when they could earn just as much (with some once of respect) anywhere else. I truly feel sorry for them, because they have the most difficult and demanding job. I’ll never forget what a supervising nurse said to us one day. The nurse was explaining a major change on our unit and one of the CNA’s said, “well I think,” and the nurse cut her off and said, “you’re not paid to think!” Personally, I’d like to believe we’re all capable of thinking and contributing to the better care of our patients. I always said if I became a nurse I would never treat CNA’s, PCA’s as below myself. I went back to college and in my second year pre-nursing I was diagnosed with Rheumatoid Arthritis. I was high honors and had to drop A&P (medical leave) with a 98 average :( It’s life, but I’m thankful for the support from the wonderful nurses in CCU, because we are a team!

    • mikafr28

      I’m a cna working at a nursing home… It’s one of the worse jobs ever. We are underpaid and overworked!!! Administration doesn’t care about quality or quantity so they underpay us and leave us to work the halls by ourselves. I feel they show us how what they think of us with how they treat us. We are treated like we are the bottom of the barrel, lowest of the low from residents family, residents themselves, housekeeping, dietary, and nurses. Yes majority of us love our residents but sometimes that’s not enough to keep doing your job and doing it well. A lot of us are ashamed to even say that we are CNA’s because they look at us like we are uneducated fools….depressing

  38. Marybeary

    Have they been to the hospitals in Upstate ny LOL that happens so much

  39. madyxo

    This may sound horrible to some, but I feel it justifies part of the stigma of nurses vs cna. Being someone who went straight for their RN, I do not understand what a day in the life of a cna as simply just a cna is like. But I can tell you what I am taught in school, which no cna would fully understand unless they completely go through nursing school for their RN. RN’s are TAUGHT to delegate tasks and use their LPNs and CNAs…and don’t get mad at me for saying that, just simply read a text book or the NCLEX itself. So I believe that was already instilled in an RN coming onto the floor. Am I saying I agree with overworking or mistreating a CNA..NO..but if a CNA does not understand how we’ve been taught to think and that a huge part of our schooling is managing and delegating tasks…then they see it as being “that” nurse.

  40. Jennnnnifer

    This is a very sore subject in my experience, so I’m going to put in my 2 cents. I agree that a good cna is worth their weight in gold, but I’ve met very few good cnas in my 14 years of nursing thus far. Most cnas are lazy, mouthy, and worthless. I have witnessed more neglect than I care to mention but im going to share my stories(which most of you im sure can relate to). I have caught cnas putting depends on residents before dinner and leave them on till 930pm and strip them off them right before shift change….this way they dont have to change any beds all evening…no regard for the residents comfort or skin integrity….afterall, they dont have to do the documentation, notifications, and treatment for a wound. They are too busy to change a bed but have time for their multiple smoke breaks. Then there are the residents that are difficult to feed or are slow to eat…cnas often try to rush these people and if they arent successful, they just take them back to their room….so they can get them in bed so they can go on break…afterall, they dont have to notify the doctor, family, and nutritionalist of their weight loss. We all know of difficult, unruly residents….the ones that are a nightmare to deal with in the middle of the night….if they are asleep, you know the cna isnt going to change them in the middle of the night because then how would they be able to sit at the nurses station all night gossiping with the other cna or take their smoke breaks. Ive caught cnas rigging call lights to not work when pressed by a needy resident. Another good one….not turning on a residents bed alarm because they move around in bed too much causing the alatm to sound frequently…afterall,they dont have to do the incident form, call the doctor and family, do the transfer paperwork if they are injured, and tranfer them to the hospital….BUT if the alarm goes off too often, they may have to sit with that resident and miss a smoke break. I could go on all day but I think ive made my point. I was never a cna but im not afraid to clean up a soiled resident, give a shower, feed residents, sit and do a one on one so cnas can check on others, etc. I dont mind helping IF I have time, but when 6am rolls around and I have meds to finish or charting to do, will the cna be there helping? NOPE. I once had a difficult cna that later went to nursing school….a couple months after she began working as a nurse, she called me and simply said “I get it now”. Until you have walked in a nurses shoes, you have NO clue what it is we do. I am currently taking a break from nursing, not because of my patients, notbecause of the stress, but because im burnt out on crappy cnas. To get my respect, they have to earn it…..and few have ever done so. One last thing, I have reported cnas for all the things I spoke about….but there is a shortage of cnas, so to the clueless administration, a warm body is better than nobody.

    • TGayle CNA

      Wow, Never walked in our shoes. when there 15 to 1 CNA or more with bad rounds no team work no help rushed times for everything, plus what the RN needs done Vit. and ect. that they need by a certain time, I have seen a lot of what u said. sorry it’s there, but how do u see an 6-2 CNA doing: vit. 1st rounds, 1st meal, documentation, showers, 2nd rounds, bed changes, vit., 2nd meal, documentation, 3rd rounds, stock, empty barrels, then last log documentation. and the call lights are going off you have to pass water, ice, snacks, take persons out for smoking. All by 2P.M. for next shift? I in hopes you did not forget anything that can get you wrote up from by 2nd shift. And all the time being yelled at and belittled. Most CNA’s don’t get lunch, u know the good ones that work till their backs hurt so much. sometimes all that CNA get is that five minute smoke vs. that 30 min lunch. I said this because for 4yrs I worked like that, trying to make it right, it was a few of us but no matter how hard we worked there were complaints. till one day I could do no more. I get it you all have paperwork and meds. I get it I always have. But do you all get 15 16 or 17 patients to one CNA plus showers meals ect. do you all get it. I think we all understand for sure that everyone sees their job over demanding but if everyone could find two ways to help each other each shift I feel it would lead to far better understanding. There are 6 RN’s I would do anything for no matter what because they get it.

    • eawatson

      As an aide, I have witnessed as much abuse and neglect of residents by nurses as I have of other aides abusing and neglecting residents. It’s a tough world out there, and the only way to provide quality care is to work as a team. It’s an unfortunate reality. I’ve also been in the situation of reporting aides and nurses to administration to see no results…to that, I suggest moving on to a positive environment that fosters a harmonious and appropriate work place with no b.s. They do exist, I promise.

    • katykate

      Yes, it is a two way street and I’m glad that you expressed your side and I agree
      However, some CNA’s do work hard and try to help the patients.
      But, as you said, it is far to few who do their best.
      And now having a family member dying in a SNF I can tell you that I”m very stressed from seeing how careless they are with my dad – from not having the call light in reach, to not having the bed low and not having the bed alarm on.
      But then some will be great with giving him a bath and bringing him food.
      Some just don’t care about safety issues and neither do the RN’s, the D.O.N. nor the administrator.
      I can tell you that this is the most horrible experience of my life and my dad has had some falls due to neglect.
      Then, if he falls and get back on medicare the corporation get double the money.
      Talk about perverse incentives.

  41. K8graceg

    Ok, I get what you are saying here. And if you ask anyone I work with they would tell you that I’m the first to volunteer to help and I almost never say no to a CNA when they ask me to help. I try to always approach this situation by saying “Hey, can you help me clean up so and so?” But here’s the thing. I typically have 4-5 patients, and that is a ton of work. I pass meds about every. 2 hours. Then I have alll the other treatments and respiratory needs of my patients. Not to mention extensive wound care. I work 12 hour shifts, which typically turn into 13 hour shifts. I run from the second I get there, till the second in leave. I have at least 10 pages to chart on each patient. So, while you condemn a nurse for not helping you with your job, I want to remind you that you can’t do mine. While I stay late almost every single night, rest assured that I have never seen a CNA stay late. Now if you are talking about a Nurse telling the CNA to clean someone up and then standing around doing nothing, I agree that is totally wrong. But I see this attitude all the time, like its never ok for a nurse to say I can’t, I’m busy. But like I said, how can you expect me to always help you with your job, when you can never do mine? I feel I have the right to say this, because I usually always try to help. But the next time you get mad at a nurse for not being able to help, please consider what else is on her plate. How late is she going to have to stay tonight, while you go home on time? Just sayin………..

  42. TGayle CNA

    Glad to have read this today, I have been an CNA for 10yrs. and just here some months ago due to very poor treatment of a states CNA’s I decided to go to school to become and RN, although it’s hard I have been pushing through my 1st semester (at it’s end). I saw this then I remembered what pushed me to school, RN’s that care, listen, and work with their counter parts is what I want to become. I have loved being a CNA all these yrs. until I moved to this state I left another path that I went to school for, because I found peace in this, it made me happy and I felt good about what I was doing and It helped me to grow into the person I am today, full of love, zest for life, and compassion. I have learned things from my work and care for patients that I couldn’t have learned any other place. So thank you for that excerpt it means the world to me.

  43. RN_Enigma

    I learned very early on as a student nurse to treat CNAs w/ respect. They often know more about a resident/patient than you do b/c they often have more interaction w/ them.

    I find that especially true now that I’m a nurse in long-term care. I consider my CNA co-workers as valuable team-mates & resources. My CNAs have been working far longer than I have in long-term care, so I include them when I’m trying to decide what course of action to take when treating my residents. Because I include them, I’ve learned a lot. And I’m not above taking residents to the bathroom or cleaning them up, or even changing soiled briefs in bed. I don’t mind getting my hands dirty at all…except w/ mucus. I can’t handle mucus. LOL I love my CNAs. :)

    • OregonCNA

      Thank you for calling CNAs your co-workers. That means a great deal to me and I’m sure to many other CNAs. Often times we are not thought of as co-workers, just someone to do the dirty work. I understand all the paperwork, medications, treatments and everything else you do that I’m not trained to do, that’s why I try my best to ask other CNAs for help before I ask an RN. But there are times when it’s not possible. I help out the RNs I work with as much as I possibly can because I know how overworked they are too. So being called a co-worker does more to a relationship than you might think.

  44. rnjen123

    As charge nurse on a midnight shift I can’t tell you how many of our CNA give me a hard time when they actually have to work. When you have to ask them to get up from Facebook watch out. How dare I give them an admit they were too busy eating and gossiping. And asking them to help out in a room that’s not theirs, again watch out.
    My favorite was walking up on a NCA complaining loudly to others that I wouldn’t give my patient pain medication. Well lets see her BP was 80/40. They can’t do my job. And to say rn’s don’t get their hands dirty is plain stupid. I’ve NEVER seen a NCA stay late although I stay late almost every shift. So no I don’t have time to do their job. Saying that I will and do help; always. But I’m not doing their job. I work on an extremely busy unit and we’re short rn’s. I never see an rn sitting but the NCA have plenty of time.
    Now we do have some good NCA’s and I never question them. If they say their busy I know they are and just do it myself.
    for me to analyze the latest set of blood work is way more important than helping clean up a patient. The rn’s on our floor always help one another even if its NOT their patient. The NCA’S need to do this too.

    • amtjim

      I have had an RN walk into a bathroom as I was doing a bowel program and hand me a piece of paper that said “our patient in room ### has had a bm and needs to be changed” After the second time in the same week he did this to me, we had words and he now takes care of the issue himself.

      • katykate

        I’m confused! I thought that you are getting paid to assist the R.N.
        And if another patient is next in line to be assisted than what is wrong with that.

  45. lorlor21

    I have been an RN for several years, I believe in treating everyone the way you would like to be treated. I respect my CNA’s and they respect me. I started my healthcare profession s a CNA which makes me understand the battles of a CNA. I do understand that there are some RN’s who are infected with the RN-itis and the LPN-itis; they think they earn the right to throw their power around. I want to tell them that without. Good conscientious aid they cannot complete their work efficiently. However, on the other hand, we do have some sorry aids out there who refuse to take directions and perform sloppy work. This makes it bad for all the hardworking aids out there. Keep your heads up high and continue to take pride in what you do, YOU ROCK.

  46. runningnurse

    I believe that ALL LPNs and RNs should be CNAs first. It shows the value of teamwork, how hard NAs work, how to treat others.
    Walk a mile in their shoes……….really. I couldn’t do it without my CNAs!!

  47. moe

    Have been a CNA for 20 years, and have worked with every type of nurse there is. I can almost always accurately tell the RN’s who started as CNA’s vs those who did not. I am constantly asked in the hospital, “Are you going to go back to school to get your RN?” My answer is no, I LOVE my job as a CNA. Am so very thankful for the nurses and doctors that recognize the butt busting work I do, and treat me as an equal, not as a minion! Nurses need to know we as CNA’s can make your life so much easier if we are treated with the respect we deserve, and we will give you that respect in return. I will respect you either way, but it makes it a lot easier to do when I am treated like a human being!!

  48. starswilldiex

    Thank you for this. Many RNs do not appreciate CNAs. Especially found this to be true in working LTC. Working in a hospital the RNs were much more helpful & appreciative. In the LTC I work in, it depends but many do not. I’ve noticed it a lot more since my injury in 2011 and being on light duty. Before I just was so busy it didn’t matter. Honestly the culture needs to change and that needs to happen at each and every facility. I think it also wouldn’t hurt to have a continuing education credit about the issue or even make it a part of the RN program.

  49. katykate

    R.N.’s and LVN’s, of course need to be polite and respectful but most are too busy doing their tasks to take care of everything and that is why their are CNA’s to help them.
    And CNA’s have been treated badly I’m sure but they still need to take care of the patients and to be sure that all safety precautions are in place such as bed in low position, call light in reach, and , if needed, that the bed alarm is on or the floor mat alarm etc.

  50. toricoco

    Thank you for this article, it is so very true. I have been a C.N.A for over 6 years now and I can say that I have worked with a lot of nurses that would rather walk around the unit looking for you than give a patient water…. with that said I have met some Amazon nurses that would bend over back words to help their aids and I would do anything for them. My problems with how C.N.A ‘s ate treated are not mainly the nurses to be honest its the pay and our patient ratio. For one we are higher educated than a highschool diploma so why is it that everywhere seems to want to pay us minimum or a dollar over minimum wage. It is not something you can live on and I don’t understand why there is such a pay gap. Hospitals Here pay $9/ hour $11 if you don’t take benefits how does anyone think that’s acceptable especially when we usually have between 12-25 patients. We get thrown up on,messed on, wet , dirty, you name it and if were doing our job right we don’t always have time to even sit for lunch. The funny thing is I love what I do and how I get to spend more one on one time with my patients, I don’t want to be a nurse but because of how they pay us and treat us it is very difficult to make C.N.A and actual career only a stepping stone.

  51. flubz

    I have been a CNA since my first semester of nursing school. I have been very fortunate to work with fantastic nurses who value me and my coworkers as their first line of defense. They respect us and give us all the information we need to care for our patients. There are a couple of them who look down on us, but the good ones more than make up for it.

    The floor I work on is a rather small geri-psych unit. I know as a recent grad, I probably won’t find a job in a place like this. But, I really hope that wherever I end up, I have CNA’s like me and my coworkers. We really love our patients and we work hard to care for them. And our nursing staff is always available to help us out if we need an extra set of hands.

    When I become a licensed nurse, I will never leave my CNA’s to flounder. I know what it feels like to be overwhelmed with patients as a CNA, and I never want to make someone else feel that way. There is nothing worse than needing help and not having anyone available to help you. Like many of you have said, you have to worry about yourself as well as the patient. I’m not even a nurse yet and my back and knees are already messed up.

    As a current CNA and soon to be RN, I know how valuable our team members are.

  52. Mb1870

    I have been a cna for 20 years now, and ltc facilities are the worst for treating staff poorly. I remember when an lpn would walk from rm 130 to rm 101 just to tell me rm 130 needed a glass of water, while my gloves are dirty giving a shower. Ive done this long enough now If a nrs rn lpn or a house super comes looking for me to do something like putting a pt on the toilet or get ice or empty a fc from a room they just exited I will respond in kind ” you just came out of there and its not in your scope of practice to do it?” if you have to hunt me down trust me im not setting at the nrs station talking Im busy w/pt care. When nrs’ finally adopt the attitude that primary care is in their scope of practice It will start getting better for pt and cna team work makes things go so much smoother….after all they are all our pts.

  53. Granny RN RN

    For me, the 2nd Rule of Nursing has always been: Never ask anyone to do something that you would not do.

    I have, on many occasions when given the choice, elected to keep my CNA (who was able to anticipate and come close to reading my mind better than most RNs!) rather than ‘trade’ her for a floor nurse who was not critical care competent, could not take ‘vents’ or ‘drips’ and just would not be as effective as my ‘regular’ CNA.

    I started as a Nurses’ Aide-with a pink dress uniform, beige pantyhose and white Clinic shoes. I still have the highest respect for good Nursing Assistants.

  54. Ole walrus

    When I went to nursing school, about half of the class were cna before. During our first clinicals I could not have made it without their help and experience. I had no clue! My long retired nurse mother told me that cna were like Sargents in the army, the eyes and ears for the officers, and that I should listen to them. They were resources that should not be wasted. At my first job in ltc , I loved my aides and they took great care of both the pt and me the poor first year nurse…..

  55. Craziest Ever

    Thankfully I’m in a position where i as a CNA tell CNAs and Nurses what to do. Its amazing how much a nurse forgets that a CNA remembers and vice versa. I believe that CNAs are a great part of the Interdisciplinary team. They get the patient clean, moving and feeling better. Often times, patients get tired of medication reminders and criticism on their diets. They often seek companionship and a friend who isn’t all about clinical.