19 years as an RN, never had the need to write up anyone. Briefly, very busy med-surg-ortho unit, doubled in size and tripled in space in 3 months, with of course minimal planning staff wise. Short everyday, Charge on care everyday. The usual.All of us stressed out. CNAS work only weekends,from nursing home. One, always had a major chip/attitude problem, but worked hard, wanted to learn; went out of my way several times to help, workload wise, explain other complaints, etc, etc. 2 weeks ago, dared to ask tell her what 4 hourly VS i needed. Major huff, did them though. Then after constant complaints from my pts, re baths, water (for gods sake), i asked her, in the break room would she change a pt and do a water round. The answer was no, she was charting, she had her own routine. Talked to Charge, who talked to her, response, she didn't like my tone. Result she comes yelling at me at the hallway, patients in earshot etc. Walked away; again talked to charge. Fast forward to 2 weeks. 3 cnas schedule (27 pts); one announces shes "light duty"; so she gets to do vitals accuchecks. At 1200 the charge asks her to do an accucheck, she refuses, back hurts; so they send her home; she goes to the supervisor to complain. Yep, will get paid and do zip. Meanwhile both CNA's are now giving me the "treatment". I called to ask if she could give a pt, post op x 4, miserable, in pain, a bath as he was asking. She stomps into the room hands on hips and demands to know what I want. I tell her. "im busy" and off she goes. I get to apologise to the guy. she gets to him eventually. I ask much later in the day about my VS, thats the cna they sent homes pts. This i s 4pm, she went at 1100. I state that fact she walks away after telling me about" my tone". SArguement at station. Today, my I got a baseline set of vitals, my 4 hourlsI did, Fair enough, 13 pts ok. I also did my own accucheck,baths bed changes, when my lights were on they were "busy". Final straw was the original pt; I walked in to do his VS to hear her asking him "did I scream at her? did I do anything wrong". He apoloized to me for asking for anything. Sorry, got typing and venting I guess. Bottom line. Going to talk to the manager, do a formal write up and any tips on what to put in leave out?Hate to play this high school crap, but after 19 years, is it too much to ask for a little respect? I work hard, do more than most nurses as far as physical care goes (in fact my charges advice today was that was my "problem"). Yes, I get irritated when people don't do their jobs and make mine harder.Sorry I don't feel I should have to beg for people to do their jobs. or my tone isn't right when I am working without a break for 14 hours and dealing with DVT/PE that got missed in 3 days, irritable and non cooperative docs . pts. Question is, with all of the above I want to keep this effective and professional. Mad as I am, in front of the pt, we work together. I do my job, you at least try and do yours.

I would document everything. Every little time they fail to do their job, make a written note of the date, time and what they failed to do. These people are not able to be rationally spoken to. Get your evidence together and see if any other nurses have had similar problems and ask them to do the same. These people do not deserve to have the privilege of caring for the sick.

I don't think writing these CNA's up is going to help, but I'd still do it so it's on record. Are the other nurses having the same problems with these CNA's? How long has this been going on?

I've worked as a CNA for 5 years on med surg and yes, I have politely told a nurse who asked me to give the new admit a bath that I had more pressing things to do but that I would add it to my list. I carry a post it note with things that need to be done so I don't forget anything. I feel horrible for that pt who thought that he did something wrong when all he wanted was a bath. It's amazing how many times after finishing a bath that I hear "thank you for taking the time, I feel soooo much better." She should have apologized not you.

I would recommend a unit meeting. I hope you have a good NM who is willing to stick up for you. Is there some internal conflict btw management and them? I guess it doesn't matter because no matter how little they get paid they have NO right to treat others this way. We're in this business to take care of people when they're at their worse. If you don't like it, work at McDonald's.

Thanks for your responses; yes another nurse has the same issues; she is very passive and works till 10pm every shift. I know there underpaid, overworked, but so are we. Yep, I know you have calls from room to room, I hear them paged. When I dont, I kick in. When I see them reading emails, skuling down the syairs for another smoke break, yapping on cellphones,I have a problem.

Continue to document. Address the offender(s) in writing as you find necessary. Whether or not you get any backing from above, doing this unwelcome supervisory part of your job will document your job performance should you be called to task at any time.

Consider this extra work documentation and counseling a necessary part of covering your "license", even if it seems non-productive. You may not be able to change the world, but this documentation needs to be in place in the unfortunate event that something tragic happens, and the mgmt team attempts to burn you. It's up to you how much effort you want to put into trying to effect change or deal with this or even keep this job. Make certain that you protect yourself as best you can while you are there. Good luck.

Thanks for your responses; yes another nurse has the same issues; she is very passive and works till 10pm every shift. I know there underpaid, overworked, but so are we. Yep, I know you have calls from room to room, I hear them paged. When I dont, I kick in. When I see them reading emails, skuling down the syairs for another smoke break, yapping on cellphones,I have a problem.

Does your facility have a personnel policy? By us, these infractions are definitely grounds for disciplinary action and eventual termination.