Difficulty with a CNA

  1. 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
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  2. 109 Comments

  3. by   nursesaideBen
    Bottom line is you're the nurse, she's the aide, it's your responsiblity to stand up and flat out tell her that she needs to start listening to what you tell her to do. If you ask her for a b/p on a patient you're not just asking for the heck of it, you need it for a reason. Probably the reason she's been able to slide by with doing the bare minimum is because no one wants to confront her but it has to be done, because ultimately it's the patient's who suffer. I can understand your fear of confrontation but as long as you do it tactfully and to the point you'll be fine best of luck to you with this and Happy Holidays :Santa5:
  4. by   SCRN1
    Quote from nursesaideBen
    Bottom line is you're the nurse, she's the aide, it's your responsiblity to stand up and flat out tell her that she needs to start listening to what you tell her to do. If you ask her for a b/p on a patient you're not just asking for the heck of it, you need it for a reason. Probably the reason she's been able to slide by with doing the bare minimum is because no one wants to confront her but it has to be done, because ultimately it's the patient's who suffer. I can understand your fear of confrontation but as long as you do it tactfully and to the point you'll be fine best of luck to you with this and Happy Holidays :Santa5:
    DITTO!

    Actually, I'm beginning to think they lied to us in nursing school about delegating tasks. The tech you're speaking of is not the only one who is like that. I have seen too many in the hospitals I've worked in who fit that same description. But I have also worked with some who are there to actually do the work they were hired to do and I am very thankful for them.

    Last night, a tech said she was hurting. I asked her where and she said all over. I told her she's to young for that and asked what she did to hurt herself all over. She glared at me and said, "from all the work I have to do for you nurses who don't do anything but walk in a room to see a patient and then get to sit on your butts playing on the computer". I too have no patience for that kind of attitude so I said, "EXCUSE ME! But I feel the need now to let you know that is NOT how it is. I do my fair share of lifting patients, turning patients, stooping to empty foleys, help patients to the bathroom, put them on bed pans, and all the other things you do, PLUS many things that you do NOT do nor CAN do. I rarely call you for help or ask you to do anything for me. Most of the time, I go to the lab to pick up blood myself and take specimens to the lab. So, don't try to complain to me that I'm not doing anything physically. Also, that sitting on your butt, playing on the computer? It's called charting, 24 hour chart checks, looking up labs and all the other things that my job REQUIRES me to do and is in no way something I would choose to do if I were sitting down to play." I guess she didn't expect she would get that kind of earfull, LOL. But for the rest of the night, she was very pleasant and coming to me to ask if she could do anything to help. I guess she thought about it and realized I never really do ask her for anything and thought maybe she'd better straighten up.
    Last edit by SCRN1 on Dec 23, '06 : Reason: typo
  5. by   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.
  6. by   GardenDove
    This is a common problem. There is a CNA who comes to mind that does the same. There's no cure for it, you just have to get bossy. Just keep bossing her around, don't let up on her. It's a pain, I like it better now that I work in CCU and don't have to work with CNAs as much. Some are great but a few you have to babysit.
  7. by   nurse4nurse
    As a CNA myself (for now) I see both sides of the fence, I see some nurses the DO sit and play (yes ...play) on the computer,I see other CNA's be lazy,and I do see the young new nurses (not to many)that don't want to get their hands dirty.

    I am a CNA that works on a med/surg floor, I am going to school part time which is borderline to fulltime, and work fulltime, with 5 kids. Lots of work for us and well as the nurse.

    We work as a team, on most occasions, unless we have other nurses float to our floor. I do my job as best I can, on rare occasions do I not get a patients BP due to the Dr,or other hold ups going on the the room. I sometimes forget because I am doing something else with another patient,but THANKS to my nurse ,she kindly reminds me .

    I do work with other CNA's that have the nurses take the BP, go hide ,sit on the phone and BS. Hey I like to do that too,there is a time and place for everything.

    For(some of) the new nurses, there are times when I have been in a room and had a new nurse or a float nurse go look for me for 3-5 min to tell me a pt. needs to go to the bathroom, HAHA, by the time I get there I have to do another bed change and whatever else. So, hey sometimes they need to take the time out to do it themselves. I had a bad experience with a new nurse, but all is well now that she is a TEAM member. There is another new nurse that she still can't get it, wears a face mask all the time, and just silly stuff,it's to funny sometimes,now she has decide to work for a DR office.

    I say do away with any none working person,lol, CNA,RN,LVN whatever the case may be. Pt. come first, hey hospitals are bought out all the time, no money , due to pt.care and sometimes other reasons.

    GOD BLESS us all, hug a vet and GOD BLESS our TROOPS!

    Joe Ann n TX
  8. by   antihippie
    As a tech I can totally commiserate with the original poster, lazy CNAs drive those of us who do work hard just as nuts as they do the nurses. It not only makes the rest of us look like crap but it makes for more work for the rest of us when the RNs start looking to us to help them with patients that aren't ours when they can't find their CNA or give up on asking them for help. Though I can't speak for all decent tech's I know that I hate lazy workers as much as anyone and wish that there was an easy way to be rid of these people instead of the current system that seems to view any warm body filling a billet as a plus.
  9. by   meownsmile
    There is a cure for it. SCRN 1 has the ticket. Nicely pull them aside, let them vent ,, then give it to them straight. Pull no punches and let them know exactly what YOU have to do in your shift, plus everything SHE askes you to help HER with. I had this problem when i first came back to my present job with my RN, it took exactly one discussion to get this girl to change her attitude.
    Very frank, in private i told her that if there was a problem with anything that i was asking her to do, to let me know and i would explain what it was i needed, and if there was still a problem we would discuss it in the NM office with her but i would guarentee that SHE (the CNA) wouldnt like the outcome of that discussion. Never had another problem with her questioning or not doing what i had asked her to do.
  10. by   classicdame
    This is one thing that could be covered in a staff meeting when CNA's, techs, clerks and nurses are present. Justwhat are the expectations of the CNA? Is there a written job description to exhibit? If so,then YOU are not the bad guy, you are just trying to clear things up. Persevere.
  11. by   gitterbug
    Most CNA's do a good job. The ones who don't need to be weeded out. I have dealt with many who are great, others just are a waste to their unit.
    I never like to see anyone lose their job, but some just need to be pushed
    into another line of work.
  12. by   puggymae
    Nip it in the bud! When you see something not done correctly you need to confront the CNA right then - and have them redo it (and redo it, and redo it) until you are satisfied. If it happens more than a couple of times I would start writing them up. I had a CNA tell me once "I have been here 15 years, you've been here 15 minutes and YOU are NOT my boss." Come to find out lots of people had issues with her for years, and when I started documenting her sloppy, lazy care she was fired within a month. A good CNA is worth their weight in gold and I appreciate and love all the great ones I have worked with over the years, but it only takes one bad one to make your work day go to hell in a hand basket.
  13. by   mizzou_ivy
    Even though we are told not to many of us bring our personal problems to work. I have been a nurse for many years and it seems that I have stellar CNA/helpers but then others are just plain worthless. I have one that spends her time looking for the other aides while she could be doing her work. My solution to the problem was to print out the specific duties of the CNAs and post it at their communication/charting desk. When I ask one of them politely to perform a duty that I don't have time for I may get gruff but they know now what is expected of them. I have been where they are and it takes a team to keep a floor running smoothly. If you can't take it and don't want to perform the duty there is no reason to stay for that shift, you may go home think if you really want that job. Attitudes change quite quickly if they are serious about staying.

    my 2 cents...
  14. by   mamason
    I've worked with CNA's like that. And usually, they were so overwhelmed with their job, it was just as hard for them to keep up as well as the nurses. I found that if I explained to the CNA how important a certain task was, and why we were doing it, they usually complied and did their best to get it accomplished. Sometimes, they don't quite understand ( not all CNA's) why certain things need to be done. Like, Accurate I/O's on a CHF pt. If I explained that this is a tool to measure wether the pt is retaining too much fluid etc. they would say, "OH...I see." This is in no way a put down to CNA's. I used to be one myself and I value their contribution to our pts very much. Couldn't do my job without the help of a CNA. I just think most of the time it's lack of understanding or they are so....bogged up with what's going on with a difficult team that day.

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