Re: Disclipline "It seems to be a case of the inmates running the asylum or too many chiefs and not enough braves (as my father used to say in the pre-PC days). "
In my LTC, it depends on who the charge nurse is. Some nurses are ‘chiefs’ and other nurses seem to let the ‘braves’ (CNAs) be the ‘chiefs’.
"There is one CNA who continues to be insubordinate. The first time he refused to pick up any extra residents because there was a call out. The nurse, instead of dealing with him, called me. I explained to him about insubordination and told him if he acted this was again, I'd write him up. I explained to all the nurses on the units that THEY are in charge of the aides. So a few weeks go by and I get a call at home from one of the nurses telling me that the same CNA is paging overhead for people to come to his floor to help. I spoke to the charge nurse and told her to either get him to do his work or send him home. I found out on Monday that SHE did 5 patients. "
Most nurses in my LTC would have kept him there. The choices would be ... better to keep him there and to do some residents herself ...or ... send him home and have more residents for each CNA and to hear complaints and comments from the remaining CNAs. “because YOU sent him home, we have more work to do!”
We do not have any CNAs that refuse to pick up any extra residents, they may grip and grumble, but they don’t refuse. We do have some CNAs that will only do her own assignment (they have the same assignment every day they work) They will not toilet other CNAs residents, help other CNAs with transferring and repositioning residents, float to other units, ...
"Then again there were several callouts so I asked one of the nurses to send a CNA to the floor who had 3 aides...each unit has 40 residents and each is supposed to have 5 aides. She wanted to know why because that would mean HER aides had extra residents and she didn't think it was fair. I asked her if she thought it was fair that the CNAs downstairs would have many more residents each because they only had 3 aides. I told her I knew it was rotten, but I had to look at the whole building and asked her again to make sure a CNA went to the other unit......long story short, an hour and a half later no one had gone. "
When we have call outs, most charge nurses
will assign an aide to the heavier unit with
more total assist residents. A couple of charge nurses will
NOT assign an aide to another unit because that would mean her aides would have extra residents (who often need limited care).
It seems I am the only person in the building who cares about this.
We do have a few nurses who do care.
Most nurses don’t care anymore as the same things have been happening for years. They just arrive at work and ‘do their best’. A few have mentioned that: in the event of a call out, the heavier unit should be adequately staffed; CNAs will not have the same assignment every day they work, CNAs will help other CNAs, will float to other units, ...
Do the charge/floor nurses write people up or do the managers have to do it all?
The charge/floor nurse writes people up (what one nurse may write someone up for, another will not). The write up is sent to the DON who, at a future time, will discuss it with the person.
I have only known of two people that ‘hit the door’, one was for excessive absences, one for under the influence (? alcohol or drugs).
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