New LPN having trouble c CNA'S!!! HELP!!!

  1. I just started working as an LPN 3 months ago...I worked as a CNA for 5 years. I work at a wonderful geriatric facility. I am 24 and I am very passionate about my job, and I genuinely care about my patients and I also care about being a role model for others when caring for the elderly. My problem is that my CNA's are not working with me. I work 7-3 and have 26 patients, and as all nurses know there are treatments, paperwork, MEDS, families, as well as interacting with dietary, PT, OT, and many others...so much to do...

    My CNA's complain constantly....are loud, laugh, carry on...when in the dining room at meal, residents are ignored, yes they try to spoon food into their mouths but they don't talk with them, they talk loudly and laugh loudly with their co-workers...when I ask, and ask politely and many times offer my help to put a pt on the toilet or to put them to bed they don't do it at all and I end up doing it, or they roll their eyes....when I do something to try and help them out such as get more help when we are short, I get yelled at in front of residents that they don't need help and I did the wrong thing.

    I am talked about behind my back, they whisper and huddle in corners and I have heard they say I am too uptight for a 24 year old. I have spoke with other nurses and they have said that this has been a problem on my unit before and that other aides dont want to work there because of the aides that work there now. I am a kind, fun, and outgoing person....I am affectionate with my residents and I am hard working...I just want to see that they are taken care of well....how do I handle this, and what am I doing wrong? Please help
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  2. 23 Comments

  3. by   leslie :-D
    one of the most evident problems is if you are the only nurse speaking up to the cna's, then this will make you the 'bad guy'.

    clearly, if the nursing assts. knew their expecations and policy was enforced and consistent, there would be little problems. but like many nurses, they just don't want to confront the situations at hand. it's much easier to look the other way. sad to say.
  4. by   catcolalex
    dont like it? leave. go somewhere else.
  5. by   Darlene K.
    Do you have the authority to write the CNA(s) up? If so, I would write them up every time they rolled their eyes at me. Before long, they will know not to play those games when they are assigned to work with you. You can find these kinds of people everywhere you go. It is very easy for someone to tell you to go somewhere else if you don't like it. However, why not show the CNA's who is in charge, you are, not them . You have a license and are responsible for the patients care. Good luck to you.
  6. by   Rhoresmith
    I think writing them up would only cause you more problems. Maybe try baking brownies or ordering pizza for lunch and say I want us to be a team, we need to all work togather on this. Now we can do this the nice way or I will have to excert my authority and write you all up. Show them that you want to work with them not against them and give them that option. You have then put the ball in their court to decide what they want, then they are responsible for their write ups because you tried
  7. by   RN34TX
    Earle58 hit it right on. Another suggestion was going somewhere else which might help but if it is another job in LTC, it will probably be the same because those facilities are notorious for hiring the bottom of the barrel. When I was an LPN I worked in them and made some great money doing agency but it got too dangerous so I quit doing it.
    My last job in LTC I had a great manager who begged me to stay but I just couldn't keep fighting an uphill battle. You can't instill a work ethic in grown adults who were never raised to have one.
    There are great CNA's in LTC and I started as one but they are definitely in the minority.
    I always had the same arguement with management. They would tell me that I needed to more closely supervise and write up the CNA's if they were not performing properly. But nothing would ever get done beyond that.
    Then I would always tell my manager that if he/she needed to come to the floor every day and supervise me and make sure that I actually gave all of my meds and treatments on time and did all of my paperwork and the only way I would do it is if I were closely supervised constantly, then I would be fired because management needs to trust to an extent that I'm doing my job without someone standing over me all of the time.
    LTC wants to hire bad people and them dump them on the staff nurses and tell us that we are responsible for the care that they provide or fail to provide.
    I left my last job saying "If you want to hire them, then you be responsible for them."
    I went to ICU and do everything myself with no arguing and begging for help from a CNA and couldn't be happier.
  8. by   eddy
    I'm an RN... but it matters not.

    I run into this QUITE often as an agency nurse.

    But... I don't tolerate poor behavior and lack of attention to residents... period. I work my tail off, and I make sure that the CNA's/PCA's/PCT's/CMA's all see it. I give them specific expectations, and I make it clear that we can all have "fun" on this shift, IF everyone follows MY rules. If not, we'll have words.

    I'm semi-famous at one particular facility for saying to a lazy, loud, obnoxious, mean CNA, "You are worthless as a pimple on my left buttcheek. Clock out and get out of here. I'll do your work, and it'll be easier for ALL of us without you here." The CNA defiantly flipped me off and said some choice words and threats that I'd never be allowed back and then stormed out. Immediately following was a burst of laughter and clapping on the part of the remaining staff. The tone of the staff completely changed and we had a great night. We actually had plenty of staff that shift, so no big deal staffing wise.

    For what it's worth, the CNA was fired the next day and I've been returning to the facility for fill in shifts going on 2 years now by request.

    Revenge is sweet and sometimes well deserved.
  9. by   Todd SPN
    Unfortunately, you can't always be a friend to those you are in charge of. Keep in mind you are the one where the buck stops. Don't let the aides walk all over you. Tell them your expectations and do what you have to so your unit runs like you want. You are the nurse and they are the nursing assistants.
  10. by   GPatty
    Quote from eddy
    I'm semi-famous at one particular facility for saying to a lazy, loud, obnoxious, mean CNA, "You are worthless as a pimple on my left buttcheek. Clock out and get out of here. I'll do your work, and it'll be easier for ALL of us without you here." The CNA defiantly flipped me off and said some choice words and threats that I'd never be allowed back and then stormed out. Immediately following was a burst of laughter and clapping on the part of the remaining staff. The tone of the staff completely changed and we had a great night. We actually had plenty of staff that shift, so no big deal staffing wise.

    Revenge is sweet and sometimes well deserved.
    Hahaha
    I love it!

    Anyway~nursedes, have a talk with your supervisor and ask how she/he wants it handled. Explain that you want to be a team, but cannot do it alone.
    Maybe have a staff meeting with your CNA's and the DON present, so she/he knows what's going on.
    I had an issue with one of the CNA's just last week. She jumped in my face and cussed me and the whole nine yards, but I talked with my super, and the CNA has been fine since (doesn't talk to me, except for patient matters, which is fine with me!). Don't expect them to be your best buddy, but don't expect them to rule over you either. And be as uptight as you want to be for being 24! Sounds like you are doing your job!
  11. by   chattypattyCRNA2B
    Quote from catcolalex
    dont like it? leave. go somewhere else.
    This is not the answer. It is obvious to see that those patients on that floor need someone with sense to stay there. If every good nurse leaves because of a few stupid aides (who probably are unhappy about what they are doing and mad at you because you make more than they do - which if is the case they should go back to school, like we are doing) it will in the end affect the patients! You're the calm after the storm. Patients want to feel that they are cared about. Having you there is a good for them. Don't you hate it when you love your job and there is always some unreasonable and stupid co-workers around to ruin it.:angryfire Just do your job the best you can and pray for those people. Don't let their bad habits rub off on you and by all means don't take that stupid mess home with you! Just my 2 cents.......
  12. by   Darlene K.
    Quote from eddy
    I'm an RN... but it matters not.

    I run into this QUITE often as an agency nurse.

    But... I don't tolerate poor behavior and lack of attention to residents... period. I work my tail off, and I make sure that the CNA's/PCA's/PCT's/CMA's all see it. I give them specific expectations, and I make it clear that we can all have "fun" on this shift, IF everyone follows MY rules. If not, we'll have words.

    I'm semi-famous at one particular facility for saying to a lazy, loud, obnoxious, mean CNA, "You are worthless as a pimple on my left buttcheek. Clock out and get out of here. I'll do your work, and it'll be easier for ALL of us without you here." The CNA defiantly flipped me off and said some choice words and threats that I'd never be allowed back and then stormed out. Immediately following was a burst of laughter and clapping on the part of the remaining staff. The tone of the staff completely changed and we had a great night. We actually had plenty of staff that shift, so no big deal staffing wise.

    For what it's worth, the CNA was fired the next day and I've been returning to the facility for fill in shifts going on 2 years now by request.

    Revenge is sweet and sometimes well deserved.

    Eddy.....You rock!
  13. by   we_rn
    I have posted on the subject before. Much of the problems with bad CNAs are that they are bad employees. Unfortunately it is to often the case that the administration of the facilities we work for does nothing to get rid of bad employees. Further licensed nurses do not know what to do when faced with a bad employee. Union or not one does not have to tolerate substandard job performance.

    Training of the care staff is key but training of the licensed staff on how to deal with bad employees is also important. Nurses are not trained to handle staff issues. We are trained to care for patients and residents. Staff discipline is often done in a trial and error fashion. This is not good for all concerned and adds to the stress of working. Licensed nurses need to be proactive with this issue.

    I would like to see this issue tied to retention of licensed staff. There is a shortage of LPNs and RNs. If a facility wants to keep their licensed staff they should be willing to back them up when it comes to CNAs who under perform. This would greatly improve working conditions for licensed staff. I work in a facility where the CNAs are under control and do their jobs. The bad ones do not last long in this facility. It is a pleasure to work here. Less stress, less complaints from residents and their families. No nasty attitude from staff. The facility I work for wants to keep staff turn over low. It is expensive to hire and train new staff. The more education an employee has the more money spent. No need to say who cost more to hire and train.

    This is something that should be brought up at your next meeting with administration. If the licensed staff at your facility does not meet with administration you should start.
    Start on your units. Meet with your nurse manager and as a group unite to push for better care on your floor. This includes all shifts. In nursing homes where the licensed staff does not stick together the CNAs take advantage of this lack of unity by playing one nurse against the other. It does not have to be this way.

    Licensed nurse should be fair and consistent with staff. One set of guidelines should be used and used consistently for every on, every time every shift. Know what is in your job description ant that of the care nurses. Keep it on hand to refer to should a problem come up.
    You should ask for training in employee relations. We get in serviced on everything else why not this. If you have a human resources department where you work they have a great deal of information on this subject since this is what they do.
    Know your chain of command; know what to do and who to report to when a problem arises before the problem arises.
  14. by   nycegyrl
    Quote from nursedes
    I just started working as an LPN 3 months ago...I worked as a CNA for 5 years. I work at a wonderful geriatric facility. I am 24 and I am very passionate about my job, and I genuinely care about my patients and I also care about being a role model for others when caring for the elderly. My problem is that my CNA's are not working with me. I work 7-3 and have 26 patients, and as all nurses know there are treatments, paperwork, MEDS, families, as well as interacting with dietary, PT, OT, and many others...so much to do...

    My CNA's complain constantly....are loud, laugh, carry on...when in the dining room at meal, residents are ignored, yes they try to spoon food into their mouths but they don't talk with them, they talk loudly and laugh loudly with their co-workers...when I ask, and ask politely and many times offer my help to put a pt on the toilet or to put them to bed they don't do it at all and I end up doing it, or they roll their eyes....when I do something to try and help them out such as get more help when we are short, I get yelled at in front of residents that they don't need help and I did the wrong thing.

    I am talked about behind my back, they whisper and huddle in corners and I have heard they say I am too uptight for a 24 year old. I have spoke with other nurses and they have said that this has been a problem on my unit before and that other aides dont want to work there because of the aides that work there now. I am a kind, fun, and outgoing person....I am affectionate with my residents and I am hard working...I just want to see that they are taken care of well....how do I handle this, and what am I doing wrong? Please help
    I worked in a nursing home for 7+ years. As a Med Tech for most of it. I worked with Aides that were like that. And at times I may have been guilty of it too. Age is definitely a factor. Are they young? Education is a factor also. They need to be educated on their behavior and what is expected. It is supposed to be a family type atmosphere and people come from different backgrounds. In their family it may be loud and undignified.
    I think too that a meeting with the Nursing Supervisor is in order. Have all the aides there. You talk to them as well as the supervisor. Have these meetings regularly, like once a month. Let them know of progress they are making. Congratulate them on their "professionalism". Let them know there is a time and a place for everything and some of it might need to be talked about or laughed about at break time or after work. Maybe they could be taught to see what it looks like to the residents. They can have fun and enjoy their job but not at the expense of the residents. Sometimes they may need to be reminded to tone it down a little.
    As for not being enthusiastic about getting patient care done, they may be feeling like they have a lot to do also. They may have a routine in mind of who goes to bed when and what they are going to do next. And you can't really do that because something always comes up. Always. I think your helping is great. I always liked that so much.
    Yeah. You need to have a meeting. Even if it is after report. And follow through with what you will be prepared to do if things don't get better. The Administrator or nursing supervisor may need to make some suprise visits. That is always helpful. Get the attention off of you and on to someone else with even more authority. As time goes by you will be a friend to them. It will just take time. You seem to want that so I am sure you will be able to do it. Helping with passing out the ice water or helping them take someone off the toilet means a lot. Good luck.

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