Frustrated

You never bargained for this when you decided to become a charge nurse and work with geriatric patients did you? The friendly way to interact with this person is to just say "Come on, xxx, help over here in the dining room." Make the command more specific, such as "start feeding Mr. xxx" or "help Mrs. xxx get seated at the table over there". Do it in a pleasant tone. Show and teach if you need to and they are willing to accept this. You shouldn't have to do more than that if they have a willing attitude.

However, I suspect from the way your post was written that you are not going to be so lucky as to have this person just jump to a task you ask them to do, am I right? Is this a problem employee? An insubordinate employee? If so, then before you say or do anything, I would discuss it with your director of nursing to find out just how far in authority you can go with this person in terms of discipline. I learned many years how to deal with that kind of employee. I take them aside, tell them they can either do as I have instructed them because it's their job or they can clock out, go home, and I'm writing them up for insubordination, bad attitude or refusing to do their work. If they refuse to leave I call the police to escort them out. Then, I later need to document for the director of nursing the facts of the incident so the DON has some proof of what went on in order to apply discipline or fire this person. If administration doesn't back me up, I ride the rear end of these kinds of employees and make sure they are doing their jobs (which they usually aren't, so I catch them doing nothing all the time, thus resulting in one write up after another). Eventually, they get tired of working with me and either refuse to work on my unit or quit. Either way, it's the end of my problem.

Yep! And you know what? The other staff with thank you for it. I've had multiple CNAs call off when I work....Hmmm, maybe its because we all work together when I work?

It took me years, tears, a couple of "How to Deal with Difficult People" seminars and reading several books on how to deal with difficult employees to become proficient at dealing with these kinds of people. I'm great to work with! Those that don't want to work—bye, bye. You're not going to be "working" with me or my patients for very long. Guarantee it.

thsnursluvsgeriatric. . .one of the enlightenments that I got very early into my career in supervision and management was the huge gap in the attitude and behavior of those who were subordinate. I was shocked that so many other people didn't feel the same toward the duty they owed the organization that employed them. Most will never make it to any kind of leadership position even though they may long for it because they lack the thinking and behavior for it. I saw this even among the RN staff. The really good employees are few and far between. People will subscribe to the idea of teamwork, but only so far as their immediate work group. They conveniently ignore that there are other units and other groups of employees in the facility with whom they also need to team up with and be cooperative. As a manager you'll see this because you see larger groups of subordinates.

A good leader will always find work. It takes time to develop skills to deal with nincompoops who don't want to follow rules and do their jobs like they're supposed to. It's complicated further by other leaders with whom you work who let these degenerates get away with that behavior because they don't know how to deal with them either. So, the nincompoops begin to think they are really something and they have some kind of power. Wrong. You, at present in your learning mode, have to learn how to explain it to them. It gets easier with each one. It's a bit emotional, stressful and draining at first, but after dealing with a handful of these types, you harden up and it becomes like any other procedure and skill—1, 2, 3, out the door! The sad news is (and I know you don't want to hear this) that this kind of low performance worker tends to be found in geriatric facilities more so than acute hospitals. I think part of the reason is because of the smaller numbers of administrative staff and the level of their education. In general, you find that as a worker's level of education increases, behavioral problems of an immature nature and slacking off on the job tend to decrease.

Sorry if I sound harsh. Some of my worst moments in LTC was dealing with difficult CNAs. But I overcame. Remember, first you attempt to teach and correct with kindness. When that doesn't work, get tough, follow your facility's disciplinary policies and get 'em out.

Daytonite - any book titles you recommend?

There are three books that I recommend. I used the first two mostly to help me describe the behavior of some of the CNAs as I was writing them up as well as to help educate me as to the games they were playing. The Eric Berne book is a classic among clinical psychologists. If you think you know a lot about people's behavior you need to read what Eric Berne has to say! After reading about the games he describes you'll start viewing some people's behavior very differently as you begin to become more aware of how they are manipulating or trying to suck those around them into their little games for their own self-satisfaction.

• Managing Difficult People: A Survival Guide for Handling Any Employee by Marilyn Pincus
• Working with Difficult People by Muriel Solomon
• Games People Play: The Basic Handbook of Transactional Analysis by Eric Berne, M.D. (This is not light reading. It is usually recommended reading for anyone starting clinical counseling classes. I had to read it for a group psychology class that was required for my BSN program many years ago. The way Eric Berne has broken down how people manipulate and "play" others to get responses from them is very eye-opening.)

Once again IF staffing ratios were decent this would not be such a common senario, how can we affect change, so far the only way I can see is to UNIONIZE.Gees I am actually getting sick of myself having to repeat this time after time, I am out of the loop now , but for the sake of you young niurses and those that continue to fight the good fight, see the California Nursing association website regarding a Strong Nation Wide Union!Our only hope.

It's not always the case of being overworked. Some people are just bad workers and slackers. They would slack off if they only had 6 residents each. I've seen it in more than one facility. Get together with the staff and see how things can run more smoothly...they chant the same thing...more staff..more staff. We tried more staff and you know what happened? There were more CNAs sitting around not working.