Disrespectful Nurse aids - page 2

I am a new grad RN that started in October. Overall people on the floor have been supportive. But I'm having trouble with some of the assistants. I work on an oncology floor so weights and I/O are... Read More

  1. by   Natkat
    It seems to me she has her panties in a knot because you have moved on to the next level and she can't, for whatever reason. That issue can be dealt with over time, but the priority today is making sure the patient is okay.

    If it were me, and the person couldn't clearly remember who had what blood pressure, I'd go take it myself. There is too much at stake at the moment. I'd also walk behind her and assess urine and stool after she has done it, not saying anything to her, just because I need to know.

    The problem is that while she's taking out her frustration on you, it could leave you in a really bad position. This might be her intention, but then again, maybe not. Some people are capable of being that hateful. There is also that chance she's just having a hissy fit and not giving any thought to how her temper tantrums are putting the patients in danger and your license in jeopardy. If you can focus on making sure that the care is done right, it will keep you from thinking about her so much and it won't get to you so much.

    Chances are, she'll get over her resentment over time and she'll be more cooperative. You can decide for yourself how long you're willing to wait for things to change. If after, say, 3 to 6 months she still acts like that, then I would think of moving on.

    You could try confronting her but size up the situation carefully. Sometimes these things can backfire. In this case you have to be more careful because she's been there a long time. It's harder to get rid of people who have been around forever. Meantime, as someone suggested, jot down incidents as they happen. I sincerely hope you won't have to do anything about it and she'll settle down. But just in case it doesn't get better or, God forbid, it gets worse, you have documentation.

    Good luck.
    Last edit by Natkat on Dec 3, '07
  2. by   COTA_2007
    Quote from motorcycle mama
    I had an aide once call me to get up from my charting to come stand at the shower room door to keep an eye on her patient. I thought she had something important to do. She went and sat in my seat and called her friend to see if she wanted to go out that night.

    It didn't happen again.
    That reminds me when I used to work on an adolescent psych floor as a tech. I was doing a 1:1 down the hall watching a patient and another tech was in the dayroom watching the other kids. Anyways the other tech called over the LCSW to watch the kids, because she had to do something. The LCSW and myself kept looking over at each other wondering where she was. It turns out she was around the corner talking to her friend from housekeeping for an hour while the social worker watched the kids for her.

    Some times I noticed techs can be brazen and really try to push limits with other staff to see how far they can get with them. It use to upset me when I was a tech to see them taking advantage of other.
    Last edit by COTA_2007 on Dec 3, '07
  3. by   Ms Kylee
    We're not all like this... some of us take things seriously. I am lucky that I have nurses that come and check urine and stool if I say something just doesn't look right, can you check it? And I don't flush it till they say I can. When I take vitals, I take a sheet with me and write down every patient's room #, their vitals, and the time I took them. Anything abnormal, I report to that patient's nurse, and when I chart, I write "reported xxxx to XXXX, RN". That way my butt is covered, and so is the nurse's.

    I just cannot believe aides act this way and get away with it. This crap wouldn't fly for a minute on my floor before she would be shown the door.
  4. by   Tweety
    Quote from Kylee45
    We're not all like this... some of us take things seriously. I am lucky that I have nurses that come and check urine and stool if I say something just doesn't look right, can you check it? And I don't flush it till they say I can. When I take vitals, I take a sheet with me and write down every patient's room #, their vitals, and the time I took them. Anything abnormal, I report to that patient's nurse, and when I chart, I write "reported xxxx to XXXX, RN". That way my butt is covered, and so is the nurse's.

    I just cannot believe aides act this way and get away with it. This crap wouldn't fly for a minute on my floor before she would be shown the door.


    It's maddening that a few bad CNA's can ruin reputations isn't it? Kind of like when people say "nurses eat their young".

    I've long learned that when a CNA tells me to check something out with a "this patient doesn't look right" statement, I immeidately drop what I'm doing and check it out. 99.999% of the time they've just saveed a bad outcome from happening and and perhaps even saved a life. We RNs like to take the credit, but often it's the astute eyes and ears of the CNA that is most important.
    Last edit by Tweety on Dec 3, '07
  5. by   abooker
    I'm very fortunate with the aides I usually work with on my hall. There are problems sometimes when aides usually assigned to other halls float over to mine. I've heard a lot of attitude; "This isn't my hall" (after asking for monthly vitals) and "That resident is not assigned to me" (In response to helping a lady to the bathroom while the other aide was at dinner) and my all-time favorite, a complaint about me to my supervisor - "Make that nurse stop telling me how to do my job!"

    I'm wondering if sometimes you have to reprimand someone, and then the other disrespectful aides get the message - at least for awhile - that you expect them to do their jobs. For me, it isn't the disrespect, but the fact that vital signs aren't complete, residents aren't turned on schedule, and there is dried, crusty stool all over the resident I'm treating for a pressure ulcer, even though her brief is clean. This last problem re: dried stool is purely hypothetical and would never happen where I work. Never, ever.

    Where I've encountered disrespect, from aides and peers and supervisors, is when I question whether something is right, and I get what I call the "How DARE you" response. I think the "How DARE you" statement comes from a guilty conscience. When I shared the hypothetical dried stool problem with my NM, I was told, "You can write her up for insubordination" (I'd immediately pointed out the problem to the aide and had requested she clean the stool so I could do the dressing. I received a huge "How DARE you" response. She called me the B word).

    If this had actually happened, I'd want to write that aide up for improper personal care technique.

    But I can't write the aide up for this, because I couldn't prove it - I couldn't prove that my resident hadn't produced a very dry, smeary stool that had hardened instantaneously on contact with this resident's skin without a drop of it getting on her brief. And I hadn't personally inserviced this aide that she needed to clean residents' bottoms when changing their briefs. And I couldn't prove that some sudden, previously unreported emergency had occurred which forced this aide to heroically rush to the side of another resident in distress, thus leaving the trivial dirty buttocks issue unresolved. Grrrrr ...

    Addressing a personal care issue would imply, hypothetically, that my facility as represented by this hypothetical aide might possibly have provided improper personal care, and this must never be documented anywhere, ever.

    Insubordination is ok to document.

    Disrespectful nurse aides ... is that the core issue, or is there something else going on? The "How DARE you" response is disrespectful, as is being ignored, or gossiped about, or lied to. The problem is that writing someone up for insubordination leaves you open to a "not a team player" attack. I've only been nursing for a year, but the key for me is to not take it personally. The B word is kind of complementary, really. I know that sounds weird, but if the best response someone can come up with is a personal attack, than they've realized they can't argue with the facts of whatever you're questioning and must stoop to change the subject by attacking you, personally. If you're getting "attitude" you've won.

    Remember, being a good nurse is not the same as being a nice nurse. Insist that people do their jobs to the best of their ability, and they'll treat you better. Don't take "attitude" personally; it's their chip on their sholders, not yours. The vast majority of aides are great, they just don't get recognized or appreciated because often their job is noticed only if they're not doing it. Try to catch the problem aides being "good" and complement them on it, if you are sincere.

    Best of Breed
    Last edit by abooker on Dec 3, '07 : Reason: clarity
  6. by   jlcole45
    I know it's hard girl but you have to call them on it - as it happens. Be assertive, brief, and clear. No smiles, no apologies, and only a thank you when it is done properly. You are the RN, and your job first and foremost is to be a patient advocate.
    You must have accurate vitals!

    It's time to do some writing up! The heck with being nice, you're there to do a job not make friends. A patient's health is on the line and if they don't get that then they need to find work and the nearest fast food joint.

    As you can tell I've had my fill of incompetent, lazy, uncaring nursing aides with an attitude.

    It's a shame because it's usually just one or two but their bad apples and sometimes their attitude rubs off on the good ones.

    Good luck.
  7. by   mizfradd
    Quote from Tweety
    It's maddening that a few bad CNA's can ruin reputations isn't it? Kind of like when people say "nurses eat their young".

    I've long learned that when a CNA tells me to check something out with a "this patient doesn't look right" statement, I immeidately drop what I'm doing and check it out. 99.999% of the time they've just saveed a bad outcome from happening and and perhaps even saved a life. We RNs like to take the credit, but often it's the astute eyes and ears of the CNA that is most important.

    Thank you! :icon_hug:

    Some of us are proud of our chosen career as CNA's and strive to do our very best for our patients and superiors.
    I enjoy my work and believe me, there's not a jealous bone in my body over not being an RN....I never wanted to be one and I'm perfectly happy with my choice. I love being a caring and hardworking CNA.
  8. by   al7139
    I read this and had to put my two cents in:
    I am an RN and I spent part of nursing school working as a nursing assistant. Because of this I can look at both sides of the issue.
    As a nursing assistant, I worked with nurses who I got along great with and nurses who I couldn't stand. Now, I understand that nurses have their role, and the assistants have theirs.
    I have found that the nurses who I hated working with when I was an NA had the attitude that they couldn't do anything but push meds and do assessments, and they were above the "lowly" tasks of getting vitals, toileting, or bathing a patient. If I needed help their attitude was that it was my job, and deal with it. Meanwhile they are talking on the phone, or sitting around and gossiping with their co workers.
    There are nurses that are just the opposite, and will willingly help with the "menial"tasks if they have time.
    Now, you don't sound to me like the first kind of nurse, so I have to assume that the attitude you are getting is because of a preconceived judgement that nurses don't do these tasks and think they are above doing the "menial" jobs.
    Having been on both sides, and having experienced that same attitude from NA's, I can only say that I have favorite NA's that I like to work with, because thay are on their game, understand how busy we nurses are, and if they need me, I know it's something I need to check out. I also see when they are swamped, and will help if I can. Besides, what better way to assess skin than to help clean up a pt, or look at stool or urine.
    It took a while, but once the NA's saw that I would help if I can, their attitude changed towards me.
    Amy
  9. by   DeLana_RN
    (((( Hugs ))))

    Been there, dealt with that crap, first on a med/surg floor and later in a dialysis clinic. It's difficult - like pp have said, there are jealously issues, age, and of course they're testing you right now to see how much they can get away with. And although you are an RN, and clearly their superior (and they know it!), it can still be difficult to assert yourself and ask them to do their jobs. After all, they can make your life miserable, and they know it.

    All I can say, hang in there. Treat them with respect, ignore some things (pick your battles), help them if you can, but don't overdo it. Eventually, it will get better. Do not make enemies (if you have a real problem with one or more, insist that your manager deal with it, while keeping your confidentiality!)

    Best of luck,

    DeLana
  10. by   Okami_CCRN
    Everyone loves bashing the NA's because its so easy to do. but we do so much and get such little recognition. There are days when I have 15+ patients and I change everyone, pass out water, do my glucose testing, draw blood, organize the rooms. and RN's still want more. Today I had 28 patients and I still had RN's asking me for glucose results when I have 28 patients to take care of. I find it extremely unsensitive and disrespectful for them to not ask but demand I do that for them. RN's need to understand that yes they have to chart and pass meds but they must help the nurses assistant because we're not there to chat and gossip but to take care of patients. It really pisses me off when RN's talk about us being jealous because we "couldnt pass Nursing School" not all of us want or went to nursing school. Im going through nursing school right now and I will never be a lazy RN because my patients need me. *sigh* Please guys just help our ur NA cause we're swamped and tired and the smell of stool gets to our head.
  11. by   holdensjane
    Quote from dar15
    Did you say that you worked with these staff previously as an aide? That they orientated you?

    It does sound like sour grapes! Suddenly you have gone to the next level, and they don't like it!

    Question...Were they like this to you before you became a new grad?

    No i wasn't treated like this before thats why I don't understand where all this is coming from. I've had other aides that have been wonderful and I don't meet the this kind of resistance. I always tell them to let me know if they need my help. Its not like I boss them around or anything. what is difficult for me is that I see the way these seasoned aids act and it appalls me because when I was an aide I would NEVER act like that. I would didn't care if I had to get ten bps on one patient, IT WAS MY JOB. and I noticed that anything this particular aide has to report about my patient she will ONLY report to my preceptor like weight discrepancies, even though i'm nearby and am more accessible. She WILL WAIT until two hours later to report it to my preceptor. I only found out because I overheard her saying it to her. which btw, it wasn't anything to worry about because she was comparing the wrong weights, and I already calculated weights earlier and they were fine. But it was just the idea that I she obviously noticed an issue and instead of addressing it to me when I was available, she waited TWO HOURS just so she could report it to my preceptor and not to me. I keep telling myself to pick my battles because I'm still struggling just to keep my own head above water. whch on another note, please tell me I will get better at being a nurse. I always feel bad when a multidisciplinary member asks me a question about the patient that I don't know the answer to but my preceptor is able to answer without even thinking about it. How does she do that?!

    p.s I don't think its jealousy because two of these aides are in their fourties and fifties and have lives established for themselves so i don't think there would be reason to be envious of me who just graduated college.
    Last edit by holdensjane on Dec 4, '07
  12. by   juicyjake
    That's just what happens when places are understaffed. The aides are overworked and so are you. You need their help, but they are already overloaded, and have probably been mistreated by about 75 percent of the nurse that they are HELPING.
    I have some absolutely outrageous stories about lazy lazy lazy/ignorant nurses.

    Let me go into just one.
    the CHARGE nurse on our floor was up at the desk. The desk is right next to "room X".
    In room X is a little old lady with sundowners and a bed alarm and a severe fall precaution. I'm in the break room halfway down the hall eating my "lunch" and sitting down for the first time in 7 hours.
    So...The bed alarm goes off, and what does the CHARGE nurse do? She walks her butt right past room X and down the hall to tell me that her alarm is going off. I was in disbelief. I had already heard the alarm and was running out the door to meet her halfway.
    "Room X's bed alarm is going off." she says.
    My jaw just dropped to the floor.
    This poor old lady could have been on the floor with a broken hip that could have possibly ended her life, but GOD forbid this nurse would step in there to intervene because that is MY job as a care tech.

    It's ashame that we have to be at such a battle with each other (RN's and PCT's) because we are supposed to be on a TEAM.

    I have even had nurses call me from the room and ask me to come get a set of vitals on that patient. DID YOU FORGET HOW TO TAKE A _______'IN BLOOD PRESSURE?

    phweew...I feel a little better.

    My point being that tech's/aides have been mistreated by so many RN's that every time someone asks them to do something, they feel like they're being pushed around/taken advantage of/unappreciated.


    We have a computer in every room at my hospital and we chart the vitals as we go.
    Maybe you could pull the tech aside and tell her that all of her hard work is being wasted if you can't see the vital signs that she has taken when you need them. Tell her that you appreciate her help, but maybe you could both modify the system when you work as a team, so you're both happy.

    Good luck!
  13. by   NurseKatSteeZ
    You know what, I think they just feel like they CAN do this to you because of your age and because you are a new nurse. I, myself, get this from some of my CNA's. I feel like I'm not assertive enough, or that I'm too nice. But they really do walk all over me, and I need to do something about it. I try, but I'm just too passive. I'm 24, and have been an LVN for a year now. I always feel like they don't take me seriously. I always catch them lying to me, or tryin to get away with things. I always tell them things in a nice way, but the things I tell them seem to go into one ear and out the other. Finally, my DON gave me a little lecture about being THEE charge nurse. She told me I really need to toughen up my game, and if needed, write the aids up or simply clock them out and tell them to take their attitude somewhere else. Hope everything works out well!!!

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