CNA Problems

Very normal problems, With the first I would sit down with a list of objective problems and suggested solutions. It truly isn't fair if she is asking for help for patients who should be cared for by one CNA and she needs help of a second CNA. If she is disorganized explain to her how she could work more efficiently and effectively.. Sometimes I 'pair' an inexperienced CNA with an efficient one and give them a double assignment to do together for two days so th new aide can learn from the experienced one.
The 2nd problem is worse. The patients, families and staff are quick to pick up on bad vibes on the unit. Insubordination is just plain dangerous in our field. This isnt the place to act out and if she is, I would report her and ask for a meeting with a supervisor or just ask to reassign her to a different unit with a warning that she can not behave this way or she will be fired.
A unit has to have harmony so that you can concentrate on your patients and making the unit a place for healing and wellbeing. A good atmosphere will allow everyone to work efficiently and happily!! Good luck!

Well, with the first CNA...at least she is trying. That is the first step in being a good employee. Just sit down with her and try to get her to see how you think she might could get better. Nine times out of ten, if they see it as "constructive criticism", then they will just take heed of it and try to do better.

The second problem is your real problem. Attitutide is a lot harder to change than pure inexperience. The first CNA may not know how to do her job effeciently, but she is willing to try. However, the second CNA seems to know *how* to do her job, but chooses to be belligerent about it. In other words, she just doesn't want to work. One the next infraction, since you have already warned her, I would start writing her up. If she is just not going to do right, the sooner you get her out, the better. Maybe she would just be happier if she transferred somewhere else. Then, maybe you could get someone to replace her who liked their job.

I sympathize with you... when *any* part of your team is not doing their job, it disrupts the whole unit. I am the type of person who will go out of my way to make my people happy...because I feel like a positive work environment is important. But some people you can't please...

I am a Cna and have been for over 25 years. I have worked with some of the worst cnas and nurses you can imagine. But no matter how much you try to suggest to a person a better and more efficient way of doing things some people just dont have what it takes to be a cna and nobody is going to be able to make her into one. Is she a new CNA? The way they train them now is they go to class about 6 weeks! and then turned loose on the floor! how in the world can they be fast and save steps overnight like that! and in reference to the CNA who thinks she is the Charge Nurse! she needs to be written up for refusing to do what the nurse has requested. She needs to realize that CNA stands for CERTIFIED NURSING ASSISTANT!!!that means assistant to the Licensed Nurse in charge .Mind you there have been times when I have questioned the nurse on a few issues but we are all there for the residents and when you have that usual trouble making know it all aide (and every place I have worked had one) there is going to be nothing but trouble ahead and you as the licensed in charge will be the one who will have to account for the patients that end up falling or are calling DHS saying they are neglected the list goes on and on but to make a long story shorter " I didnt see in your message as to the fate of this particular cna?
pumpkin92356 CNA `

Pumkin, you sound like a great CNA. I would love to work with you.

CNA #1 I would compliment on the very throrough job she does, but tell her that she is a bit slow and needs to work on being quicker. I would also ask her if there is any particular reason she is always asking the other aides for help. I'm wondering if she's afraid to move patients by herself. In any case, I would very kindly encourage her, again, to start doing more on her own instead of depending on the help of the other aides. From what you describe, I think if you tell her that the other aides are going to have difficulty getting their own work done she will understand that. I definitely would not tell her that the other aides have complained about her. I would make my talk to her more in the line of "I've been noticing how you do (this) and you do a great job, but you have to start working on your speed."

CNA #2 is subordinate. You've told her once you were going to write her up, so I wouldn't keep telling her that. When she argues about the hall she is assigned to during mealtimes I would just tell her, "I don't care. I want you on this hall." If she's got any smarts at all she'll realize she's gotten on my last nerve and shut up her whining. Same with the feeders. Pull her aside, "I told you to put the feeders in the dining room first. Why didn't you do that?" I'd also make sure she understands why the feeders need to go into the dining room first. That is the way I would confront her on these things from now on. I'd make sure she knew I was irritated with her. This kind of CNA is one of the few times I will actually use my authority and throw it in someone's face. Sometimes they'll straighten up because they realize they've gone too far. Sometimes they'll ask to work with another nurse which is just fine with me as long as she's out of my hair--let the other nurses deal with her, but I won't take her crap. Then, at the end of one of these harrowing days with her I'd tell her as she's leaving that I'm writing her up for her performance and behavior and giving it to the DON. Just do one big general write up for a whole day of her screw-ups and insubordination in the form of a memo. Kind of like a blow by blow description of what you've had to put up with during the weekend working with her. Let the DON sit down and discuss it with her. Bottom line is that hopefully CNA #2 will start to do what you have told her to do, or she'll just quit. You may have to go through this with her a couple of times since you only see her every other weekend. Just keep writing her up every weekend. She'll get tired of it and call off work, ask to work with another nurse, or quit. Any of these ways and she is, at least, no longer a problem. More likely, however, is that she has two weeks to "rest" before she has to work with you again. That's just enough time for her to get rejuvinated and start off irritating you again the next time you see her! LTC, gotta love it.

I am a CNA/CMT, I have worked in the same Facility for around 16 years. I have been through this time and time again, too many times to remember.
As for the 'Slow CNA'.... Okay, if her work is good except for the fact that she is slow, then my opinion is to 'work with her', talk to her about 'why she is asking for help getting up a 1 on 1 patient, have her get the patient up in front of you, assist her if needed, like someone earlier said, 'maybe she feels afraid, or that she may hurt the patient'...but as long as she is good to the patients, then she can be made into a 'excellent CNA'.
As for the other CNA, the one that thinks she is in charge.... ummm, seems to me after reading what you said that she may just need someone to finally write her up and put her in her place.
Good Luck
JWCDL@aol.com