Tell the CNA to clock out and go home - page 5

by Blackcat99

10,598 Views | 50 Comments

Things are changing now at my "Anything goes" LTC. We are now being told that we are not to put up with any CNA insubordination anymore. We were told that if a CNA refuses to do what we tell them to do, that we are to tell them... Read More


  1. 0
    Quote from multi10
    Your language is inflammatory: You compared CNAs to "slaves." You believe that CNAs rebel. (Most don't.)

    You believe that the nursing staff is "holier than thou." According to you, there are nurses "on power trips."

    You are "so far only the second (known) advocate for CNAs", but have you recognized other posts and threads on AN where CNAs also lament their lazy, uncooperative colleagues? These wonderful CNAs pick up the slack because they genuinely care about the residents and, because of the lazy ones, they have to work harder.

    I believe she was sticking up for the CNAs.

    If people are so upset with their lazy CNAs why do places insist on a year's experience? I know a lot of people who went to CNA classes and can't find jobs because of this. Fire the ones that don't want to work and hire those who do even if they are new.
  2. 0
    Management has told us nurses that they cannot fire the lazy nasty hateful CNA's because they are protected by "the union."
  3. 3
    Quote from Blackcat99
    Management has told us nurses that they cannot fire the lazy nasty hateful CNA's because they are protected by "the union."
    I've been the DNS in two union buildings. You certainly can fire people. It isn't done on a whim and all the documentation must be in place. Of course they can go to the union and you'll have to go to an arbitration hearing, but the aggrevation that brings is far less than dealing with the consequences of a bad employee.
    amoLucia, Blackcat99, and morte like this.
  4. 2
    Quote from mazy
    To me it sounds like they are putting the nurses in an untenable position. Why is management making you do their job? It seems like a set-up that will create an adversarial environment between nurses and CNAs, when they should be problem-solving and finding ways to make the units go smoothly.

    You guys are all front line staff and the management should be doing whatever they can to promote a healthy team environment. If that can't happen it is on them to look at their staffing and hiring practices, and additionally address discipline problems and find ways to create a positive working culture. Making the nurses do their dirty work is just wrong.

    Not to mention the fact that if you send a CNA home, now your unit is working short. No one wins with that. Except management -- one less paycheck to worry about; they've got a unit that is drowning and understaffed, but now they can just blame the nurse for sending the CNA home.

    I wouldn't want to be in your shoes.
    I appreciate the support if I have to send someone home. The aids are working under my license; we need to be able to enforce that relationship. Sending someone home, provided they are already aware of that possibility, is the logical decision for dealing with someone who is not meeting the standard of care their job entails.

    I'd rather be one person short than have my residents subjected to a neglectful/abusive work ethic.
    Hygiene Queen and Blackcat99 like this.
  5. 3
    What works for me in relations with my CNA's is first off, I ask them how they're doing when they arrive for work and check in with them a couple times throughout the shift just to make sure they're OK. If they're not, I try to help them with whatever their issue is, even if it's just to listen to them vent. When I make assignments, I know who likes what hall and assign them accordingly. I ask them when they'd prefer to take their lunch breaks. If we're short, I call them all up and let them divide up the assignments. I am there to iron out any issues if they can't come to an agreement, but they're all adults and can usually work it out among themselves. In other words, I treat them like adults and allow them to make choices for themselves where I can. From what I have seen, that goes a long way in making them feel valued as employees and as humans and not just a tool used to complete said assignment. They know I'm busy as I know they're busy. If I can handle something quickly instead of having them grab a towel or whatever, I'll do it. They also know if they need help transferring someone or simply pulling someone up in bed they can come get me and I'll help. I show them respect and they afford me the same in return. They will do what I ask of them because of that. I've used that method in every building I've worked in and it works every time. It takes longer in some buildings to achieve that because so many CNA's have been treated badly by nurses that a lot of them don't trust us and do think we're all a bunch of "lazy arses" as I've been told by many, many CNA's. I am also aware that there are some CNA's that have a chip on their shoulder and simply do not want to work, or will do the bare minimum to get by to the detriment of the residents. Those CNA's should be written up and terminated accordingly. I find that those type are the exception rather than the rule. However, one bad apple in the basket can poison the rest, so they should be dealt with quickly. I am not saying that my way is the right way, but it has worked well for me so far.
    Hygiene Queen, wooh, and Blackcat99 like this.
  6. 3
    Something that you may try before coming down as the heavy is to let them rant while you stand there calmly and quietly and while looking them dead in the eyes ask "Are you refusing to give patient care?". Initially (when working is such an environment as you wrote about) it is often followed by loud protests etc. Do not react. Do not try to cut them off. Wait till they finish keeping your earlier stance and again keeping non-confrontational eye contact repeat the question. This will often leave them stammering.

    Now, if the person in question is just lazy and used to doing nothing the confrontation may continue, at this point with their refusal to comply, I would send them home. And I would tell them why, using no emotion. Just flatliy state the facts and let them know that you will be following this up with a write up and that the DON or HR will contact them in the morning for follow-up. Just make sure that you alert the DON.

    Sometimes, this is done because of caregiver fatigue, fear of the task or because of prior abuses by superiors and I have found that the second time I ask this question, it will end up in tears and the real reason for the outburst will be spoken. Once the reason for the outburst is finally out in the open, we address the issue together and move on. No need for a write up and most of the time, no hard feelings and the relationship between us (and the unit as a whole) is stronger than ever. They then find out that if they don't know how to do something or are simply overwhelmed with the assignment or workload, they can just come to you, knowing that you will at least try to help THEM find a solution.

    At one point this had occurred. What I found out at that facility is that the aids made up the group assignments. And what this group would do is to cherry pick the easiest patients for themselves and give all the lifts and toughest ones (often giving them twice as many patients to top off having the toughest patients). After a short shouting match, I looked over the assignment sheet and found the reason for the outburst. Needless to say, the assignments were more evenly distributed. I was able to keep the ones that really wanted to be there...as for the others, most made the choice to find other jobs that would tolerate this type of behavior and get paid not to work.

    Best of luck!
  7. 0
    I sent a CNA home with a fellow nurse documenting to back me up, CNA was sleeping on the job. Upper management fired the CNA based on my and the other nurse's documentation (went to get her on another unit to witness the CNA asleep so it wasn't just my word against the CNA's) and I didn't feel bad about it. I was tired at 4 AM too but I was working!
  8. 1
    My *incredibly awesome* ADON has started being our unofficial mediator when an issue of attitude arises. I am a DON that would most likely have failed long ago without her. We are completely different people, and we balance each other so well. When our CNA's, LPN's, RN's, or anyone for that matter gets belligerent or disruptive or rude, they take an immediate time out and go to the "mediator". It's so simple, but it works! I live and work in a *very* diverse area, so it's been difficult to say the least. It helps to remember that a lot of times the attitudes are coming from overwhelmed, overworked, underpaid staff. We should be tuned to that as managers. There is, of course, that CNA or LPN or RN that just thinks they own it all and those, well, they get canned.
    LockportRN likes this.
  9. 0
    Quote from mazy
    To me it sounds like they are putting the nurses in an untenable position. Why is management making you do their job? It seems like a set-up that will create an adversarial environment between nurses and CNAs, when they should be problem-solving and finding ways to make the units go smoothly.

    You guys are all front line staff and the management should be doing whatever they can to promote a healthy team environment. If that can't happen it is on them to look at their staffing and hiring practices, and additionally address discipline problems and find ways to create a positive working culture. Making the nurses do their dirty work is just wrong.

    Not to mention the fact that if you send a CNA home, now your unit is working short. No one wins with that. Except management -- one less paycheck to worry about; they've got a unit that is drowning and understaffed, but now they can just blame the nurse for sending the CNA home.

    I wouldn't want to be in your shoes.
    I was told by my DON when I reported an incident to her that dealt with a CNA, that I had the "right to send her home right then." The CNAs were VERY cliquish, so I can only imagine how I, the newbie at the facility, would be treated from all CNAs after that. How are we supposed to work as a team if we are continuously reminding the CNAs that we have the power to send them home. Its a fine line to walk. Yes, we are technically their superiors, but I would also like to get through my shift without payback from CNAs everyday. Instead of stressing to us nurses that we have this "power", how about they stress to the CNAs that attitudes will not be accepted?
  10. 0
    okay i am just going to say this, CNAS work very hard. i know from experience in my teenage years before i became a NP. I think you need to reflect on yourself and see how your delegating your tasks. If you see a CNA is overwhelmed or very busy dont keep adding tasks. i have worked with many lazy nurses and have seen them treat their CNAS like crap. Sometimes its not what you say its how you say it. When you delegate something give repect. to get repect you must give repect. And help out somtimes dont be one of those nurses who just sits around doesnt answer call lights or do anything thats " CNA " related. You need to get to the bottom of what the situation. Obviously you are not treating your CNAS with repect or they wouldnt be so insubordinate. Im not saying their arent a few bad eggs out there. Sure there are but after this post and comments. im just sayng. I dont think you would be sending CNAS home if you took the time to treat them with respect and say what is the problem? what can i do to make your assignment easier. also always offer to help it goes a long way. .
    Last edit by RN/MSN2410 on Aug 10, '13


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