need to terminate

This is a disgrace but maybe just maybe she was having a really bad day or a crisis and this type of behavior is totally out of character for her. I would spot check her work to make sure that this this never happens again and if it did I would fire her on the spot. I think you should also have a very stern talk with her once she returns from suspension and let her know that you will be watching her like a hawk from now on.

I know it might sound evil of me but if you really shake her up she will be on her toes from now on. Even if she is lazy she will think twice about slacking off and will likely do her work from now on.

I think you should follow standard HR protocol and issue her a written warning for all offenses, giving her the oppotunity to respond in writing. This way she has a clear undertanding of what is expected. Then, if she continues, she know that she will be fired.

I just don't think it is fair to suspend her only to bring her back to issue a termination. If you felt that termination was warranted, then it should have been done rather than the suspension. Standard protocol would be first to issue a verbal warning, then a written, and finally a termination.

It would be a better learning opportunity for the rest of the staff if you threaten to watch her like a hawk and then follow through. And while you check up on her, be sure to look to the left and look to the right. The other employees will get the hint. Hopefully this will wake this particular employee up and she will turn around.

You skipped the warning and went for the suspension, so termination is the next step if she slips up again. I understand your anger, but sometimes people do behave in a manner inconsistant with their normal pattern, so lets hope this was the case with this CNA. Good luck.

Make sure your documentation is in order. On the formal disciplinary paperwork, make sure you put in that any further infractions or unsatisfactory work will result in termination. It covers you for any potential union or unemployment case.

I agree, you need to be all over her like a wet blanket, and I would call her in for leaving early and not clocking out,
In our facility if someone fails to clock out, they get a note from bookkeeping asking just for a signature affirming what time they DID clock out, (it happens people forget their magnetic card or forget to clock out),
We had a problematic nurse leave early then sign the paper to bookkeeping as if she left on time, we had her on camera that she left 2 hours earlier, all dressed to the nines, we called her in for lying on her paper to bookkeeping, she cried that she had to run out as her son was sick, we then showed her the picture of her leaving the building all dressed up with fresh makeup, she was speechless, and fired!!
BTW WHERE IS THE NURSE IN CHARGE????? why do you have to find the pts neglected, why doesn't she do rounds, is her nose so stuffed that she doesn't smell the urine?
I wouldn't fire her, but would put her on probation, day shift only so she could be under my watch, and I would talk to the other staff that witnessed this abuse and remained silent, they should have told her to do her work, her neglect reflects on the whole facility and unfortunately all LTC!!!

She's done this before and been counseled. She's lost my sympathy.

I support the termination. Although I believe in giving people chances, following HR policies to the letter, and helping others to better themselves, there are instances such as these, which border on patient abuse, that I cannot excuse. She violated the first command of, "First, do no harm." Even if you felt you were responding in anger, you already rationalized that there were no circumstances present (such as a severe shortage of staff-still not an excuse, but...) which would have prompted this action.
If you look at it from a surveyor's eyes, the issue was widespread (in her area), and actually did harm the patients - between their skin being compromised, and the humiliating experience of being found so soiled! I imagine some of them did not even have the ability to call for help, or even complain - which just worsens the effect of the action.
Had you terminated on the spot, I strongly believe you would have been able to defend yourself in any court of law, and if you were to report this action to the program board, she could lose her certificate.
Anyway, just my thoughts. I have helped many C.N.A's throughout my career in developing their potential, furthering their education and skills, and allowing a little slack with certain things when called for, but I have never tolerated actions such as these.
Remember, your first obligation is to the patient. Take a deep breath, pray and move forward.