Bossy CNA's in LTC(long)

bon149 · Jan 27, 2005

Wow...I'm amazed...and blessed with good management and good CNA's. I have to be sure to tell them how wonderful they are. Just out of curiosity about how long do these CNA's work in that kind of facility? Our day shift has a great retention rate, our newest cna has been there at least a year and the rest are around 5-10 years. Night shift is the same, evenings are more difficult to staff and the girls tend to be younger. They have to be reminded to a bit more. But if the bar is high most of our girls strive to reach it. To each of you that has reported abuse to management and nothing was done, did you call state? And if so, what happened there?

dbsn00 · Jan 31, 2005

She is not a nurse? CNA in my eyes is a nurse. That was kind of rude of you. I have to back them up because I used to be there and if it was not for them you would be very unhappy. Lay off of them!

A CNA has NO business discussing a patient's condition or passing themselves off as a licensed nurse- while their role on a unit is vital, CNA's do not have the same medical knowledge or the same training as nurses, no matter how many years they've been CNA's. This CNA should have been written up at the very least. :nono:

1BlessedRN · Feb 1, 2005

Hey all, I need some advice. I am an LPN working a skilled rehab unit in LTC. i recently joined the company so I am new to them, but have been a nurse for nearly 6 years. Yesterday, I had a floating CNA on my wing, she was not used to the pace and routine of our unit and was struggling to keep up, so I asked one of the regular CNA's to give her a hand(the regula CNA only had three pts.!!!) i explaines to her that the other CNA was falling behind and was getting frustrated. She TOLD me in a rude tone of voice that" I gave her report this morning and I TOLD her, if she needs help to ask". I then said to her that I was asking for her. She proceeded with "WHAT DID I JUST TELL YOU !!!!" I was appalled! :angryfire Our unit treatment nurse was within ear shot and so was another CNA. I walked away at that time because I knew if I said anything at that point I would blow up! Also this CNA has been counseled for her tone of voice to pts. In my opinion, if she speaks to ME this way, how is she really speaking to the residents? I need advice on how to approach someone with this attitude, make my point and ensure that I am taking the correct action. PLEASE HELP!!

In situations like this there seems to be no right answer especially with no one backing you I had similar incidents as this to occur so I pulled the hotheaded rude CNA to the side and (unknowingly) had another nurse to witness...but I flat out told her that I was her supervisor and when it came down to patient/resident care that I expected that from her....and if she couldn't fulfill that position I was talking to the DON or (chain of command). This usually gets the I will quit attitude which is okay...or the fact that you stood up to her attitude which is better because then you will have established respect....sometimes its better we take matters in our own hands first when dealing with hotheaded rude CNA's this is after all within our scope:)

Lisa

tracimom · Feb 1, 2005

update.... the cna I was discussing in the original post was fired last week. What amazes me about this is she was totally devestated. Shocked that it had happend. While I'm sad she lost her job, I hate that for her, and I really do. She didn't need to be on the floor questioning the nurses and telling family things she shouldn't have. I am upset with the way it was handled. I think anyone in jepordy of losing their job should at least have an inkling before they get fired. Isn't that what write ups are for?

Jo Dirt · Feb 1, 2005

Where I worked when I was doing LTC that CNA you are describing would be run out on a rail.

Mandylpn · Feb 2, 2005

Thanks, did I mention that she has been counseled several times for her "mouth" and even put on final notice, so she behaves for a couple weeks and then goes right back to being herself. Also, she and the unit manager are good friends!

:angryfire Friends or not, the manager has an obligation to the staff and residents to keep the facility running in a calm and orderly fashion with assurance that the needs of the residents WILL be met. . :lol_hitti write her up! There are plenty of people looking for work. She can be replaced.

Mandylpn · Feb 2, 2005

:angryfire Friends or not, the manager has an obligation to the staff and residents to keep the facility running in a calm and orderly fashion with assurance that the needs of the residents WILL be met. . :lol_hitti write her up! There are plenty of people looking for work. She can be replaced.

Whoops, sorry I did not read your above post!!!!!!! :uhoh21:

Debbie_LPN · Feb 2, 2005

As I am just starting off as an LPN, I am gald I have something else besides a new med pass to look forward to!!! LOL

ayla1953 · Feb 10, 2005

To the CNA above who just said "lay off of them" because of CNA's like I just mentioned in my post above, I prefer to work without CNA's. I'll be done with school in a year and I'm going to an ICU position to avoid having a CNA. I much rather be responsible for the total care than spend half of my shift following an adult to make sure they've done thier job. Now I'm not slamming on the good CNA's there are some. But they seem to be few and far between. For every one great CNA there are 10 bad ones. It's a horrible feeling to have a great time during the down time of the shift with your cna and an hour later realize she made up most of your I&O's. I just rather do it all myself. Then if something is wrong, or not done there is only one person to blame.

Everyone needs to realize a few things about LTC.....

1. It's a hard job for everyone concerned.

2. The aides work the hardest, have the most physical labor, get paid the least and are respected the least. The nursing home business ( and that's what it is now) is made on the backs of the aides. If you have good ones, be greatful. If you have bad ones, get your education director involved and your unit manager and whoever else needs to be informed of the bad ones because they are that important. If you don't get any good response from them, get another job somewhere else. You were looking for that job when you found it and you can find another one.

3. LPN's are the nurse's on the floor, not the RN's. The RN's are only there to do the "big" paperwork and to "supervise" the LPNs and the CNA's. They don't do pt. care, we do, unless there are too many call-in's, and then they will have to take a cart.

4. Everyone has a boss.

5. Talk to everyone as if you respect their humanity, which we all should do, anyway. "You catch more flies with honey than you do with vinegar" is true, but don't be "too" nice because then you will get a lot of crap and will have to say "Don't mistake my kindness for weakness".

6. Do your job, let the superivisor do theirs, if you are having a problem with an aide, tell the supervisor and DOCUMENT the incident with the aide, what you said to the supe and what the supe said and did. DOCUMENT as much of everything that you feel strongly about, you will not remember it all later, take a break and go in the john and write it down as soon as you can because later on, your notes about the incident will be your best friend. Treat it like a nurse's note...date, time, be objective. Trust me on this.

7. Go home when the shift is over. Don't punch out and go back to the floor to "finish up". Take your breaks. No one is going to watch out for you but you.

I have been an LPN in LTC for over 20 years. These are only my opinions. But, last but not least, number 8

8. The aides work the hardest, get the least respect and get the least pay. They are the most important becasue they do ALL the pt. care. The LPN passes the meds, does the tx, etc. If you have a minute to spare, then you can do some butt wiping or transferring to the bed. But the aides have it harder than anyone, except maybe the residents themselves.

A good aide is hard to find, would you do their job?

LPN1974, LPN · Feb 11, 2005

I have worked as a nurse's aide. Back when I did it, we were just called nurses aides, not CNAs, didn't even have to take a class.

We trained on the job.

And it was very hard work, but I realized that I wasn't going to be able to do that hard physical work all of my life.

I'm not a very strong person physically.

Even being an LPN can be very taxing on me at times, but I think being a CNA would be harder physically.

So I respect the CNAs. I know they work hard. I've been there, too. But on the other hand, CNAs should also respect their supervisors, which alot of times are LPNs, in addition to RNs. We are there for a purpose....to provide patient care. NOT to make life hell for the CNAs. If a facility could be totally run with just CNAs they would do that. It'd sure be cheaper, financially.

But that's not the way things are done.

We have to have supervisors, and the chain of command.

Nuff said.

{It's just that some people just don't "get it"}

lilsis · Feb 13, 2005

It's hard when you're the new "boss". I love my CNA's where I work, but it wasn't easy in the beginning. If they ever talked to me that way, they got written up, along with if they refused to help with transfers and answering call lights. Nasty or not, that's neglect! They worked hard for me and I let them know I appreciated it--I was always there when they needed help, too. But, I was the charge nurse and had to make sure they were doing their jobs. That's how it is everywhere.

lilsis · Feb 13, 2005

6. Do your job, let the superivisor do theirs, if you are having a problem with an aide, tell the supervisor and DOCUMENT the incident with the aide, what you said to the supe and what the supe said and did. DOCUMENT as much of everything that you feel strongly about, you will not remember it all later, take a break and go in the john and write it down as soon as you can because later on, your notes about the incident will be your best friend. Treat it like a nurse's note...date, time, be objective. Trust me on this.

I just wanted to add that this is important! It's just like what we learn with charting-if it isn't documented, then it wasn't done. If you don't have documentation, then it will be your word over the other (do you have *proof* that you talked to someone about this? I don't remember that conversation, so on and so on.)