How would deal with these type of CNAs?

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I am one among the newest RNs on a busy floor. Every shift I am struggling to help pt's ADLs with minimal CNA assistance. A few CNAs are plain horrible. They won't answer my pager or when they do they would tell me they are with another pt. I told them when they finished with the pt then come help me. Most of the time they don't so I ended up doing it all myself. At other times when they didn't come and help me they complaint that I left dirty linen on the floor. I told them I helped this pt and changed all her linens after she pooped or puke on herself and yes in between I also passing meds while another pt paging for pain medication as well. When they hear that they don't like it.

Specializes in cardiac-telemetry, hospice, ICU.

I'm all for giving anyone the benefit of the doubt, but there are some that never will get it. Lazy all the way through. Those are the ones who burn my cookies. I guess the good side of it is that I appreciate the good ones all the more. Note to self: tell the good ones I appreciate them very much.

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Specializes in CCRN, ED, Unit Manager.

I wasn't aware that there were CNA's that were good, lol.

All kidding aside, I've only met one CNA that was actually helpful. 23 year old young man wanting to become a nurse ... he'd come running across the floor to help with absolutely anything. Unfortunately he had the lowest seniority so instead I always saw the other CNA's that hide in the coffee room or something.

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It sounds to me that your management support is lacking. I would think if this is an ongoing issue than if it has been addressed with the CNA's on an individual basis with no effect, then as a registered nurse who is accountable and registered, I would likely go to my management to support. If that doesn't work, I would likely look for alternate work as your licence isn't worth the grief. Your first focus should be medication accuracy and safety of the patients/residents. If you're too tired from doing the other work, then what?:sleep:

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I would also like to say, I am a registered nurse who worked hard to assist the unregistered staff who worked in the long term care facility that I worked in for two years. I did help every day, and I relied on those unregistered staff to be my eyes and ears, as they knew the residents/patients best. Sometimes they don't get the appreciation they deserve for sure...

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First of all, you need to be polite and firm at the same time. Do not bark orders. I can't tell you how many new RNs I've gently coached, whispered hints to, trained on the crash cart and many other procedures over the years. NEVER discount anyone on the floor, ESPECIALLY if they have more time in than you. You can learn from everybody and should include everybody as a team member, right down to housekeeping and maintenance. If you do that from the start and honesty value all the input you get while you're new, you will go far. Keep the good ones close to you, they could save your job (and butt) someday. Ignore the bad ones attitudes but keep at them politely and professionally. Certified NURSE Aide means AIDE THE NURSE, too! Like someone said before, you have to earn their trust. I've seen plenty new nurses hit the road after a few weeks on the job. Don't let that be you! Good luck and hang in there!

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Specializes in Neurosurgery, Long Term Care,.
I placed dirty linens on the floor because I had changed the entire bed actual two of my four pts' beds that shift. I didn't have time to run back and forth. There wasn't any linen bag in the room. Like I said most of the time our floor is busy. In that same time my other pts needed me. I feel their medical needs supersede this. So I tried doing the best I could cleaning them up given them new clean fresh linens then move on taking care of other pts. I told myself I would come back for those dirty linens, but other things kept me running and I forgot altogether. This CNA found it on the floor said do I (me) really leave a dirty linens on a floor, really?!

I'm sorry but it doesn't matter that you changed 2 of your 4 pts beds and had other things to do. It is never acceptable to leave dirty soiled linen on the floor. If yuo can not see why then I suggest you review universal precautions and your facilities infection control protocol. As a CNA of 8 years and a nursing student in my second year, I understand that there are lazy disrespectful CNA's. I also understand that as a nurse it is a lot to do the meds, charting, and assessments on 4 patients but try doing vitals, bed changes, toileting needs, the nurse's grunt work, plus running to get drinks and snacks and all the personal little things patients needs for 12-15 patients. I can not stand when a nurse thinks she is above and beyond what I do. If I am not busy tending to someone else that is one thing and if that is the case that person does need to be approached but don't leave a room that you are doing something in to come and get the CNA because you feel that is there job or leave dirty linens on the floor for the CNA to pick up because you are busy. guess what we are busy too!

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There are some CNA's that don't do anything. However, as a cna myself on a busy floor I try my best. But I'm new also so I'm still getting used to doings things as fast as possible and figuring out things that don't go as planned. I do however, answer call lights and requests from nurses as long as I'm not in the middle of something (bed bath, potty assistance, etc). From my experience, the more senior nurses understand a little bit better and can help out more than the newer nurses.

And dirty linens on the floor is a HUGE issue at my hospital. Definitely could be written up or fired because of it. If the cna is busy and/or won't help then grab the linen cart and all the linens you need on one trip so you don't have to go back and forth.

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I'm a CNA at a long term care facility and none of my nurses do what you do. They don't change a bed, they tell us to do it when they are done. Your CNA's should appreciate that you do that much! An RN supervisor passed me in the hallway the other day wheeling someone to their room to use the bathroom, once she saw me, she stopped dead in the hallway turned around and called me to take her to the bathroom, which her room was 5 feet away. Anyway the patient almost went in her pants due to this just because the nurse didn't want to take the 2 mins to put her on the toilet, patient is continent all she had to do was get her on the toilet. I wished there were more nurses like you at my facility. Oh wait I'm sorry they do help, when the state surveyors are there, then all of a sudden they are multitalented changing diapers and everything. And don't get me wrong we do have a few helpful nurses but some are just as lazy as most of the CNA's. At my job I find the CNA's, like myself, who want to become nurses and/or are going to nursing school tend to be the most help and most professional. Most of the one's that have being doing it for years or have no plans on going any further tend to have the worst attitude. They do nothing but ***** and moan how they hate their job and they treat the nurses and other CNA's like crap. And its not all of them but most of them. I think you need to be more stern and write them up if you find it necessary. Eventually they will get over it and probably respect you more.

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Thanks all for your comments and input no matter if it was negative or positive. I tend to find better support from nurse interns/CNAs then actual experience CNAs. From now on I'll try to improve myself and never leave dirty linen on the floor. I know it was my fault to ensure this will not happen again. But one thing is I refuse to let them CNAs walk all over me. Gaining respects can go both way.

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I feel that it is simply about respecting all individuals on the team and helping eachother out. I have encountered some CNAs that have been on the floor doing patient care longer than I have been a RN (this month makes 2 years for me). I verbalize the respect that I have for them, and tell them that I will learn from them just like they may learn from me. They seem to really like that. I also do not abandon my patients in times of need.

For example, if you have someone who needs to use the bathroom, and your CNA is busy with another patient, put the patient onto the toilet. If they are a major fall risk, stay with the patient, of course. If not, tell the CNA that the patient is on the toilet and to take them off whenever they get the chance. Patient care and safety is always the priority. One must be able to delegate though. It is all about reaching a happy medium. A RN is a supervisor of sorts: You do not want to come off to hard (too strict) or too soft (which can be interpreted for weakness). Your goal is to achieve a happy medium of both so that you are approachable yet firm with your work expectations.

Praise all of your peers for their accomplishments, especially the CNAs. I have met alot of hard working CNAs. Let's face it: They work hard for what little money that they do get. They can be knowledgeable and caring professionals, and should be treated as such.

For those CNAs who absolutely insist on giving you a hard time, hold them accountable. Pull them aside and assess what the issue may be. Verbalize your expectations for behavior. Also verbalize that if certain behaviors do not change, you will pursue a written method of holding them accountable, following up with the charge nurse and/or maybe the nurse manager. It is true: Whenever you start anywhere as a nurse, you will be tested: Your fellow nurses watch your nursing practice while determining if they can trust you; the CNAs are doing the same thing. Some of the CNAs also see how much work they may be able to avoid as well. As long as a nurse is respectful yet firm, things should be a fine as they can be in what I affectionately call the "Controlled Chaos" of the floor in the hospital.

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A lot of this thread really revolves around one thing; being prepared! I am a new grad that worked as a student nurse tech while in nursing school. So, I have the privilage of seeing things from both perspectives. Ultimately, it was your responsibility to pick up the dirty linens not another co-worker that did not perform the work. I know that prioritization can be frustratingly difficult when multiple pts are having issues at the same time, but remember you are only human and can only be in one place at a time. The lesson here: try and make sure you have the necassary items to complete the job before you get started, and do not fret about pain medication (fret about the codes/rapid responses though!) when your elbow deep in cleaning somebody. Being a role model and effecient nurse does get noticed and respected by your fellow co-workers. Also, teamwork flows in both directions! I always ask my co-workers, RNs, LPNs, and CNAs if they need help with anything and have found that many will now do the same to me!

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Specializes in Medical Surgical.

I have been through this before. Let your manager know what's going on. Give then "the talk" letting them know that you expect certain behavior that you consider this talk the warning and that you will be moving on to write ups next. Then write up the ring leader when things don't change. My tires got popped when I did this, but it was worth it because I was shown new respect and got the help I requested. I always make a point to tell CNAs when I do stuff that would be considered their scope on my floor so they know I help them. And also help them anytime they request.

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