Venting about a new CNA...this is really, really long!

Nurses General Nursing

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We have a new CNA that just started working night shift and she is going to drive me crazy. In the first place, she has been there for a total of five days and she is an expert on every resident in the facility. She is constantly talking about how this one usually does this or that one usually does that or how she is surprised that Mary slept through the night because she is usually up several times during the night or that Bill went to bed really early since he is always up past midnight. If we try to tell her that Mary was only up all night the first night she worked because her stomach was upset or that Bill was really only awake past midnight because he took an extra nap during the day she just laughs (well, cackles like a witch) and tells us that she already knows the residents very well and she know their habits, so we need to stop trying to make her look stupid. Whatever...:)

Then she has decided that she is the BEST CNA on the face of the earth. She used to work in the dietary department at another LTC but they wouldn't hire her as a CNA. She told me that they wouldn't hire her because she knows that every nurse there takes a lot of shortcuts and doesn't do their job properly, so they couldn't hire her because she would show them up! The said the CNAs are mean and they treat every resident poorly and every other person in the dietary department is lazy and that the whole department will probably collapse now that she is gone. She is already complaining about other staff members here and talking about how she hates following a certain CNA because she knows she is going to find a mess and that the residents are going to be awake all night because they weren't put to bed properly. She did find four residents with soiled briefs after following this CNA the first night she worked, but we has an outbreak of stomach-type flu that day and over half of the residents were pooping and puking. The CNA she is complaining about is actually quite good at what she does...I would be honored to have her care for me!

After hearing and seeing all of this, I talked to her about professionalism and how she needs to be sure she statements she is making are accurate before openly criticizing other people and the job that they do. I also told her that she is out of line to complain about other professionals and say they are not doing their job, when she really has no idea what their job truly is. I told her that if she has that many concerns about the care given at her old facility, she needs to take it up with management at that facility instead of bringing it to ours. She just laughed and said I must have a lot of friends working there if I am so willing to defend them. Oh, boy...:)

After slamming every CNA in the facility and telling us how she is going to be the best thing that ever happened there she started in on the local police department. She is angry that they won't retrieve keys when people lock them in their cars, she doesn't understand why they don't have an emergency fund to pay for locksmiths for people who can't afford them, she doesn't know why they pulled her over for going 75 MPH on a 60 MPH highway...don't they care that she was late for work? The police are incompetent, they are only there to pick on honest people, they make too big of a deal out of noise complaints, they are all sleeping with one another, they spend too much time drinking coffee, and they don't do a good job of keeping the teenagers in line after school. When I told her that I am really good friends with most of our police officers and that I think they do a very good job and that they only pull you over, watch you, tell you to turn your music down, etc for a very good reason, she asked me how many of them I am sleeping with.

And she hates the housing authority and the people at the state because they don't distribute things like food stamps properly. She lives in a subsidized housing complex and is angry because there are ants in her apartment and there are wasps by her door. Right now there are wasps everywhere...you can't go outside anywhere without seeing them. She told us that she had two wasps on her door so she went to the office in the apartment complex to get some spray for them and they wouldn't give her any. They told her that they don't have any in the office and that she just needs to go inside and if any wasps get in, the needs to kill them with a fly swatter. Apparently, she is allergic to wasps, so she called 911 on her cell phone, told them she was going to be stung by wasps, and then went inside her apartment (I knew I had seen her somewhere before...I was the first paramedic there when we responded). She is also losing some of her food stamps because she went from a job that paid $5.15 an hour to a job that pays $8.50 an hour...according to her, they are cutting her from $450 a month to $400 a month and they will cut her even more if they find out that she gave custody of her first two children to their fathers! I'm tempted to call them.

The final straw for me, happened yesterday. I pretty much just rolled my eyes and blew off most of what she was doing until then. We have a resident that likes to stay up all night playing computer games. Since she is often awake until after 0300, she often skips breakfast and lunch and she is losing a lot of weight. I made a comment that I was going to ask the kitchen staff to leave her some snacks, so she could eat them while she is actually awake. She told me that she would be happy to talk to the dietary manger about it because they are very close friends. I told her, no, that I would take care of it. She told me about four more times that she could get it done much easier than I could because she has connections. I repeatedly told her that I was the charge nurse and that the request either needed to come from me, another nurse, or the DON. She just laughed. I talked to the cook that was on that day and that night, there were snacks left. This new CNA told me she had called the manager at home, so that she knew it would get done. I told her that I had already told her I would take care of it, that she was way out of line to call anyone at home, and that I did not appreciate her going around me, when I had already told her that it was my job not hers...I explained the chain of command and told her that if I hadn't taken care of it like I said I would, that she needed to talk to the DON about it instead of going over everyone's head and talking to the dietary manager. She told the CNA who was training her that I am jealous of her "can-do" attitude.

And finally, while she was making rounds on one hall, I made rounds on the other hall. When she came back to the desk, I told her that the other hall was done and that everyone was dry. She said, "Oh, they probably are." I said, "They are...I just changed them and yes, everyone is dry and repositioned." She told me that she would have to go and check since it is her responsibility. I told her that she was not to go and wake everyone up again and that she was not to check my work. So...while I was in the restroom, she went and woke everyone up and repositioned them to the side that I had just moved them from.

I am just about to strangle her...I have never worked with anyone who had gotten under my skin so much. I'm going to talk to the DON about it when she is in next week, but in the meantime, I am just going to grit my teeth and smile a lot.

Thanks for listening!

The collection of "issues" this person has both on and off the job suggest that she may have some psych problems that you are in no position to deal with.

What you are describing is the behavior of someone who has borderline personality disorder. To be fair, she may have nothing of the sort, but she ceratinly fits the profile.

BPD folks are those who, for whatever reason, stopped their social and emotional development at a preschool level. They may have continued to grow physically and cognitively, but the part that interacts with others arrested way back when.

Some of the characteristics--

--They live in the extremes, tend to see things in black and white terms, blow hot or cold, and can do a 180 in the snap of a finger

--They like to be the center of attention. It's all about them, and if it ever isn't, they do what it takes to yank the spotlight back where they believe it belongs. This includes being dramatic, using illness to their advantage, and bragging to the point where they sound delusional.

--They seem incapable of empathy and cannot put themselves in another person's place without feeling like they've lost themselves. This is too scary too contemplate so they can't let it happen.

--They are very poor at taking direction. Much like the two-year-old who insists, "I do it myself!" they think they have a better way. Or they just don't believe the rules apply to them. Speed limits are for other people. Job descriptions are merely suggestions.

--They don't handle correction well. Even the most constructive criticism is perceived as a personal attack or persecution because you never did like them in the first place or you're trying to get back at them because they pointed out something you did wrong. There is little, if any, ability to separate their core identity from their actions, so if you offer any kind of critique, it means you have rejected them on a soul-deep level.

--They have a ginormous sense of entitlement, which is appropriate in a toddler, but repulsive in an adult. The world lives to serve them. Rules are meant to be broken. You should welcome the chance to provide for them and theirs. You owe them.

I could go on and on, but I'm sure you get the picture.

BPD people are not hopeless, but they are wearying beyond belief. The only way to win with this kind of person is not to play. As Daytonite suggested, be absolutely clear with your direction, state what the consequences will be if she disregards your directives, and then follow through. If she does it right, praise her, being certain to link your approval to her exact actions. If she blows it, link your disapproval to what she did and write her up.

Borderline folks have a seriously impaired sense of cause and effect and often truly do not understand why people get so bent out of shape with them. This further aggravates their feeling that the world is out to get them. And feeds their feeling that whatever they do is justified because they're only trying to survive in a hostile environment.

The fact that her issues seem to pervade every area of her life means that you probably won't have much of an effect on her in the long term, but that isn't your problem. Right now, your job is to protect your residents, the other staff members, yourself, and your facility from the havoc that can be wreaked by such a loose cannon.

I wish you well.

That describes her pretty well...wow.

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