Difficulty with a CNA - page 3

I am an RN and I view myself and my CNA as team. Most of the time it works out... I treat the CNAs with respect. At the beginning of the shift I go over our patients with the CNA and at that time... Read More

  1. by   Diva Nurse Dani
    I can say that as a new nurse, an ex-cna, and an ex-unit secretary...you have som great team members, and then you have the select few who SUCK!! And those are the ones who make it hard for everyone...RN's, CNA's, and Secretaries alike!!:trout:
    I agree that to pull the individual aside and deal with the situation is a great move. Pouncing on them like snoopy with linus is a better one! :lol_hitti
    We have one who, well when she works with one male charge nurse, she is more concerned with his needs than anyone elses. Trying to get her to do anything for ANYONE is like knocking down a building with a tonka truck!! And trying to talk to her...she always gets frustrated and makes it not even worth the effort. It seems only the new nurses have spoken to the team leader about it and I can't understand that at all!!! I mean, what, are we supposed to continue to work around her just to get thru the night??? :angryfire I THINK NOT!!!! If that were the case, We would work somewhere where there are no CNA's!!! Or better yet, maybe they should just hand over their checks...We did the work!!!
    Sorry...venting from my own insanity!
    Any-hoo....The good (or even outstanding) CNA's , so let us not forget them when faced with the evil spawn with CNA tags!!!
    I am thankful for the RN's and CNA's that I work with, and though there are nights like tonight, I would never dream of being anywhere but here (for now LOL)
    Hang in there...it has to get better than this!!!
  2. by   chenoaspirit
    Yeah, you need to stick to facts and report them, but you still have to find a way to deal with them yourself. Reporting them alone wont take care of the problem, or it wont at my facility. Hopefully at yours it will. And still, they will know you reported them and there will be issues with them because of it. There WILL be some type of confrontation unfortunately. But it has to be done.
    Last edit by chenoaspirit on Dec 26, '06 : Reason: forgot something
  3. by   Marie_LPN, RN
    I can say that as a new nurse, an ex-cna, and an ex-unit secretary...you have som great team members, and then you have the select few who SUCK!! And those are the ones who make it hard for everyone...RN's, CNA's, and Secretaries alike!!
    Have to agree with this. I left one job because of the 'iron fist' that someone ruled 30 CNAs with an iron fist, all because ONE (not me) was the problem.
  4. by   TrudyRN
    Quote from evans_c1
    I notice you are 24? Well, I am 23 an a new RN..I have the same problem but only with a few of the aides. I think they feel threatened and jealous that the "new and young nurses" are telling them what to do...well most of the time it is just ridiculous to try to ask some of them to do something.
    I took the issue to my nurse manager and she has done nothing about it...so what I do is if I need a BP, foley emptied, someone repositioned, whatever..I just do it myself. It might take you an hour to find them and then talk them into doing what it is you want..just do it yourself..atleast that is what I do. It usually is a task that will only take 2-3 minutes anyways.
    mostly...there is no teamwork haha. I get a lot more done with the RN/LPN helping me than what meI could ever get from an aide. I guess in the end we are the liscenced personnel anyways.
    I don't see anything funny about it.
  5. by   TrudyRN
    Quote from chenoaspirit
    There are 2 CNA's on my floor who are the same way. A patient (3 month old) was running a temp of almost 102 at vitals. I gave Tylenol. Next vital check, she skipped the baby, knowing it NEEDED to be done. Whenever I use the call light to call out for help turning an obese patient, she wont come. I leave the room to find her, she is sitting at the nurses desk chatting! One night I had a combative patient who needed an IV re-started, all I needed was the CNA to hold his arm so I could start it, she threw things down and yelled at me. We proceeded to the room, I was trying to ignore her, but she then got beside the patients bed and started yelling at me again. I had been trying to get someone to help me start this IV for 4 hours! I was FURIOUS! There are other CNA's who work with me as a team, and I appreciate them. But I HATE working with the lazy ones. I used to just do it myself, but if I am going to to their job and mine both, then they dont need to be there. So you will get to the point that you will get sick of it and deal with it. It is hard to deal with people like that, there will be a huge confrontation, but in the end it has to be done. The patients need it to be done. I hate it that you are going through this, it makes your job ALOT harder and longer.
    She was sitting at the desk, she yelled at you, she threw things. And you didn't write her up? Did you at least talk to her and find out what was going through her mind? She also deserved to be told that you have need of her help and have certain expectations and that it is for the patients, not for any other reason.
  6. by   TrudyRN
    Quote from NurseWi_JennJenn
    I am an RN and I view myself and my CNA as team. Most of the time it works out... I treat the CNAs with respect. At the beginning of the shift I go over our patients with the CNA and at that time delegate appropriate tasks. I usually don't have a problem, like I said.

    K back to me... I'm an easy-going nurse that has a very good sense of humor, I'm also not as good with confrontation as I should...but I start losing my sense of humor when I have to ask a certain CNA to get a BP like 5 times or if there is a scheduled task like rechecking a temperatiure or discontinuing a foley... and I ask if she has those scheduled task results... no I didn't do it. Or how about at the beginning of the shift, I tell her so and so needs to be repositioned every 2 hours and that I will help her if there isn't another CNA available. What is it that she doesn't get? I am not delegating things that are difficult or that she hasn't done a million times.

    I feel like I'm constantly going over her work and either doing it since she didn't, or redoing things... She CONSTANTLY is saying "Why, I normally do it so-so way or only once a shift for vitals" to everything. I've tried to be nice about it, but I'm to the point where I want to say, "Well this is what I need done, and if it isn't, there will be problems." Of course I'm too chicken with confrontation...

    I guess the point to this is, how do you deal with a nursing assistant (or even other coworkers) that deliberately does not do what I ask them to do??

    Thanks in advance (o and I'm working on this communication problem of mine by reading a book)

    Thanks...Jenn
    Jenn, ask her point blank - Do you plan to do these assignments?

    Go from there, based on her response.

    No, it's not easy but you have to find your backbone. I feel your pain but you, I, all of us, have to deal with this. Ironic - they have no trouble bulldozing us yet we are reluctant to confront them. We just need to get over it.
  7. by   chadash
    scuse me, checking my avatar
  8. by   Shiggles!
    I share your aggravation like I'm sure others do. I am a traveling nurse, but every assignment I give it my all, and I find myself not a very confrontational or assertive person at times until I am pushed to my maximum. I think sometimes it would be easier to decrease the amount of patients and do primary care. I find that some of them really just don't care or have a clue. I had a diabetic, the CNA took the blood sugar after they ate, and said Oh look, see how high their sugar is. I took a deep breath, and explained to them why the sugar was high and the importance of taking before they eat. I don't think I should have to do this! Even when I explain reasons and rationale's for why these things need to be done. I pulled my manager aside and explained my aggravation because my job is twice as busy and hard for cleaning up the mess. He told me, I don't know these things happen unless you tell me. The manager seems supportive so far. He told me that I could leave annonymous notes on specific staff and the actual problem that occured. In which I have done so, because their are specific CNA's that keep committing the same offense. He also told me that some CNA's have been there for a long time and don't feel like they need to do certain things. God forbid, I don't want to rock the boat, because all I need to do is make one of them mad and nothing will get done. I don't know if this helped you but I feel a lot better now that I have vented.
    P.S. for every one that makes you lose your patience their is another one who shines. I just wish I worked with that one all of the time.
  9. by   chadash
    Inservices explaining the rationale behind CNA tasks would be so helpful. I know I have acted ignorantly on my job, not because I don't care, but because I don't know.
    What would be basic and obvious to a nurse could be an enigma to a CNA.
    Also, most of our RNs have up to four patients, which seems safe and reasonable because of the complexities of their job. But I may have ten or even more, and a lot of flux throughout the day: I may have nailed my assignment, and be floated to another department suddenly. If I were a rocket scientist, I doubt I would be working as a CNA. These circumstances are ripe for blunders: high patient load, lack of education, and inconsistant assignments.
    I am not excusing NAs with bad attitudes, I am only explaining how mistakes are bound to happen.
  10. by   Shiggles!
    I here you, but I am afraid it's going to get worse with the "nursing shortage"... Hopefully not. The travel assignment that I am on now, has me floating after 8 hrs, to different units throughout the hospital daily, even to the hospital down the road because they are sister hospitals. Things have calmed down since I switched to day shift, but each day I was working with a different CNA. It was very hard, because I got no continuity with them. A lot of them made me feel like an outsider no matter how nice I tried to be. Did you say you take care of up to 10 patients on days? If so that is crazy, even if you are on nights......
  11. by   dmarie (GA)
    I'm a student nurse. I was assigned a patient during clinicals recently. Her chart indicated that her vitals and BP, which was taken just an hour before by the Tech., was within normal range. When I went to assess her myself, her BP was 185/100 with bounding pulse and temp. of 101.3.

    I found the RN talking and laughing with the attractive male Tech. I explained my assessment, and the RN blew me off and seemed annoyed that I --- the student --- would even comment on anything. The Tech. looked at me and then quickly downcast his eyes, as if he was guilty.

    This really opened my eyes because I naively thought the Techs. actually did their jobs and that the RN's were sincerely concerned about the patients and obtaining accurate vitals. I realized this isn't always the case.
  12. by   P_RN
    SO what happened with the patient with the ↑ BP and pulse? Did you get your instructor or charge nurse involved? Vitals can shoot up though not usually that rapidly. If it took say 45 minutes to get all the vitals and then they were charted at the one time, then your lady could actually have been stewing for as long as and hour or two before you caught it. SO what happened ????
    Last edit by P_RN on Dec 31, '06
  13. by   chadash
    Quote from nursesconnect
    I here you, but I am afraid it's going to get worse with the "nursing shortage"... Hopefully not. The travel assignment that I am on now, has me floating after 8 hrs, to different units throughout the hospital daily, even to the hospital down the road because they are sister hospitals. Things have calmed down since I switched to day shift, but each day I was working with a different CNA. It was very hard, because I got no continuity with them. A lot of them made me feel like an outsider no matter how nice I tried to be. Did you say you take care of up to 10 patients on days? If so that is crazy, even if you are on nights......
    Yep, as many as ten when there are staffing issues, more typically 8 {this is on day shift (hospital)}. Of course, I have alot less responsibility than you as nurses. But, if I could have a 4 patient assignment, wow, my folks would be shining, happy, watered and monitored. That would be ideal. I had only five the other day, and though I was not oriented to the unit, and they were scattered a bit, it was great. Then I had to pick up 4 new ones at 3, and made some mistakes. It would be great to have continuity in my assignment, and also stick with one nurse at a time. I could get to know what kind of help she needs and expects.

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