How would deal with these type of CNAs? - Page 4

If I am busy, I am. I am the one who has to prioritize. I work very hard and always help everyone at work. RNs, LPNs and aides, even if " it's not my patient." ETC.I will get vitals, blood sugars etc, for other nurses, instead of sitting at the desk doing nothing like many of my coworkers do. i have never asked anyone to help my pt to the bathroom, change a bed, while I went to the linen room with mcdreamy or mcsteamy, sat at the desk doing nothing, etc. At my job I will get my pt's vitals ( the aides are supposed to where I work) if I can or am in the room. If I ask for help then I NEED IT. 1 pt needs pain meds RIGHT NOW, one has stat orders, another needs help to the br. Why should any wait, so an aide can sit at the desk on facebook( have seen it time and time again). I can't believe how much I let this go in the beginning. I am smart enough to usually know who is not busy and can help me. If I ask I excpect it or just politely say you are busy. Why do I have to justify myself/rationale every time. Some are lazy , very lazy. There are a few like this at my job and will either outright refuse to help everyime, or sit at the desk and do nothing, not even his/her assignments whether you are a lazy nurse or not. Some shifts I dread because of who is scheduled. Other shifts, i see who is scheduled and know that at least I can count on a good team.

I am fair and get along with most of the CNA/PCTs but I will speak up if they aren't being fair with me (or the patients). The other day I was in a patient's room giving him medications. A bed alarm goes off on a patient who is a very high fall risk. I look out the door and the PCT is standing at the nurse's station talking to a co-worker. I got mad and said "So is anyone going to check on that bed alarm" and then run down the hall to go check on that patient. Luckily he was sitting up in the bed and hadn't go up yet. I had to leave the computer and all the meds in the other patient's room (which we all know is a no-no). These are the situations when I get mad. Or if a PCT goes to lunch without saying anything or takes more than a 30 min lunch. I tell all my co-workers that we are all adults and should act as such. I don't feel like I should be looking all over the hospital for someone. After giving several warnings about the same thing, I will go to the manager. I used to feel bad about doing stuff like that but there is only so much I can take.

I have encountered techs that basically have the attitude that "I've been here way longer than you, I'll still be here when you're gone so I'm just going to put you at the bottom of the priority line when people ask me to do things." I had one that straight up, no matter what was going on, when I would call her or ask her to do something, she would just say she couldn't do it. Fortunately she got fired for other reasons, but I pretty much just tolerated it because our manager did not stand up for anyone.

I have come to learn that many CNA's/PCT's are not exactly sure what your role as the registered nurse is. I have had my fair share of unlicensed personnel give me the "why can't you do it" speech. I have learned to be firm and forward during situations like this. A CNA is a certified nursing ASSISTANT. They are there to perform basic level tasks that allow the registered or licensed practical nurse to practice skills and procedures that are above the unlicensed personnel's practice. If you have a patient who is in pain or requires medication or assessment for an acute problem, and you find that the ancillary staff is resistant to assist with ADL's, don't hesitate to remind them that as a registered nurse, you can do their job but they can certainly not do yours.

On the same token, when you have the time to do so, never hesitate to get your behind out onto the floor and assist the CNA's. This will establish you as a leader that actually leads by example.

I work most of my hours in a busy ICU in which the RN's perform total care for their assigned patients so I of course love floating to other units where I am blamed for being "too good" to perform certain tasks.

Sorry, I don't have much advice, just empathy as I struggled with this too. IMHO, there are three types of CNAs. The first type, you never have to ask to do anything. They always jump to help, have vitals and everything done without any prompting, and always remember to report abnormal results. The second type gets the job done more or less, but needs a little prompting and sometimes "forgets" to tell you important abnormals. The third type is the hardest to work with. Getting this type to help is like "pulling teeth." They roll their eyes when asked to do something within their job description while sitting at a desk on their iPhone.

My best advice(after I said I didn't have any) is to remain professional and set out specific directives. Ask, don't be bossy(I had to work on that). If the specific directives aren't met after repeated one-on-one attempts to correct the employee's error, then a write up may be in order or you may need to address it with management. IMHO, management is a last resort though. Unfortunately, it also depends on the culture of the unit.

p.s. As far as the dirty linen on the floor, I personally wouldn't have left it on the floor if I started the task.

Ha!! I wish I had learned this sooner! I had one CNA that I will never forget who walked all over me for a while until I finally stood my ground. I thought being nice would work; Ha!! I finally broke down and wrote her up for her behaviors. It was nice to leave that facility finally having her respect(though not her liking me). Unfortunately, if other CNAs see you as a push over, they will lose respect for you too.

It's hard for new grads. I've been out of school and at my hospital for two years. They are testing you, to see how you work, your abilities, and your attitude. I had this happen to me as well and once they saw that I would get knee deep in it with them they accepted me. They know I will help at anytime for any task. If they see me changing a patient they will come in and assist or take over so I can get back to charting or whatever. I answer call lights, change patients, assist to bathroom, etc. They know if I ask them to change so and so it's because I am busy not because it's "not my job". So I have an awesome team, not one CNA to complain about but I do watch them with new nurses and I see they are feeling the person out.

All the reasons I left bedside nursing and hope to never go back!

Write their names down with name date and time with a brief description of what happend.( called cover your butt)

Write down time and date you spoke to them about the behavior and their response.( called cover your butt)

Write down when you went to the Nurse manager about it- name date and time( called cover your butt)

Don't be shocked if nothing comes of it, If an insident occurs( patient harm or you get reported by patient or family), you have documentation to take to court- give the court the CNA's name, the insident, date and time. No way take the blame for an insubordinate CNA's/PCT's. Once you have spoke to them about it, you have done your due diligence. Going to your manager- you have done your due diligence also. let themplay with the judge!

Your documentation shouldn't be common knowledge- keep it for your own records. let a court and a judge correct these CNA's/PCT's if need be may be they would rather hear it from a judge than a "new nurse"

As far as leaving dirty linen on the floor- take your linen hamper in the room with you- don't leave it on the floor if a fall occurs and the breach in infection control practices is on you.