Why are some aides so disrespectful?

[onthemark]

This morning I was treated very disrespectfully by an aide. I've been reading the threads on here about disrespectful aides to try to learn how to deal with this particular aide. However, from what I'm reading, it seems that it won't matter what I do or say -- the problem is in the system that allows them to get away with it. It seems that management and administration always side with the aides. Why is this? I feel that if an LPN were disrespectful to an RN or supervisor, they'd get written up.....why not the aides?

It is not necessarily because the aides are part of a union which suppports them because there's no union where I work.

Could it be that they know they won't be fired because they're too hard to replace at the low pay they're earning?

I just wonder why aides are allowed to get away with poor behavior when I don't believe any other level of nursing is allowed to get away with it. Does anyone have any insight into this? I'd like to feel that I could discuss this with my superiors or human resources but if they're just going to turn a deaf ear, then there's no point.

[gummi bear]

Nascar nurse said:

With all due respect, how much experience do you have in management? I will readily admit, I have my favorite aides and my favorite nurses but when you are a supervisor you must treat everyone the same. If you don't you will quickly get eaten alive by someone. You probably have no idea how manipulative some employees can be if they think they can get away with something. Consistency is key.

Also, when faced with a "he said, she said" situation between a nurse and an aide, I stand by my position of siding with the nurse. They are the professional, they are the one with the license and they are the one in charge (in the absence of a supervisor in LTC). If I honestly can't believe what my nurses tell me then I either need to re-educate them on how to deal with aides or I need to let the nurse go. I expect them to behave in a professional manner.

Well...... if you're going to believe someone based off of a title, and not on facts, then you've closed your ears from the beginning of the situation. I'm a CNA, and I actually decided to change careers and go back to college. It's funny that some people assume that I am uneducated because of my title.... until they get to know me, and some of the nurses learn that I have more college education then them. Don't be so quick to judge who is and who isn't a "professional". I've seen plenty of nurses doing unprofessional crap that should get them fired, but I happen to have a nurse manager that believes this same "I'll believe the nurse first" theory as well. Some of the nurses know this and use it to their advantage in situations where they choose to neglect their patients to go and socialize with others about their lack of a dating life. That pain medication or blood saturated dressing will just have to wait.

Please don't be this person. Hear both sides of the story, use good judgment, and then come to a conclusion after listening to all of the facts. I can't stand lazy people, license or not. But do not assume that a title can stop a person from be a liar, bipolar, lazy, or overdramatic. It happens everyday.

[Been there,done that, ASN, RN]

MsKeycena/phlebtech said:

There's no doubt that she was disrespectful. You have to treat every aide/person different as they all have their own characteristics and personalities. Being in the health field, not only do you have to learn your residents, you have to learn who you work along side too. I so disagree with Nascar Nurse. How can you side with the Nurse if you don't even get the aide side of the story. I think that is really unfair, don't you? I guess Nursing varies from state to state and ltc to ltc because where I'm from Nurse aides get paid fairly well and so do Nurses. But they would rather lose a dozen CNA's for one Nurse.

"Here's the situation: At 11:20am, the patient asked to go to her worship service which was to start at 11:30 on a different floor, and she needed to be taken in her wheelchair. I wheeled her down the hall and when I saw the aide sitting in the dining room looking at her cell phone, I asked her if she'd take the patient on to the worship service. The aide at first said, "Oh, she doesn't care about the service" but the patient spoke up and said, "Yes, I do" so the aide said to leave her there and she'd take her. It was almost 11:30 when a woman from the worship committee happened to come on to the floor. When she heard the patient was still on the floor, she offered to wheel her to the service. I took her to the dining room and there was the aide still on her cell phone.

In the afternoon, I approached the aide when she was alone and I could speak to her privately. I told her I was surprised that she didn't take the patient to the service, and asked if she was okay. She said, "Look, I've been busy all morning. If you wanted her there, YOU should've taken her." I said that I'd been busy, too, and when I saw her on her cell phone, I thought she had the time. She replied, "That was my break." All I could say was, "Oh, that was your break, huh?" and we both walked on our separate ways.

I am not happy with this. I feel I should've handled this differently but don't know what I should've done. And I also don't know how to go forward with this aide. Any advice any of you can give me will be appreciated. "

Elaborate on how "there is no doubt she was disrespectful"

[ktwlpn, LPN]

It really doesn't matter what kind of background you have or how many degrees you've got,if you are working as a cna you are going to be supervised directly by a nurse.The job description probably includes something along the lines of "and other duties as assigned" and that means that when the nurse asks you to do something YOU DO IT because she/he is your boss.I don't like to stereotype or generalize but in my experience women in the workplace respond very differently to direct orders then do most men.A certain demographic of women seem to need "handling" and validation (what I call verbal masturbation) This is very apparent with many cna's.In acute care if an RN barks at another RN during a tense situation it's not a big deal because they understand the stakes.

[Nascar nurse, ASN, RN]

gummi bear said:

Well...... if you're going to believe someone based off of a title, and not on facts, then you've closed your ears from the beginning of the situation. I'm a CNA, and I actually decided to change careers and go back to college. It's funny that some people assume that I am uneducated because of my title.... until they get to know me, and some of the nurses learn that I have more college education then them. Don't be so quick to judge who is and who isn't a "professional". I've seen plenty of nurses doing unprofessional crap that should get them fired, but I happen to have a nurse manager that believes this same "I'll believe the nurse first" theory as well. Some of the nurses know this and use it to their advantage in situations where they choose to neglect their patients to go and socialize with others about their lack of a dating life. That pain medication or blood saturated dressing will just have to wait.

Please don't be this person. Hear both sides of the story, use good judgment, and then come to a conclusion after listening to all of the facts. I can't stand lazy people, license or not. But do not assume that a title can stop a person from be a liar, bipolar, lazy, or overdramatic. It happens everyday.

It's amazing that people actually think they are hearing me say that I don't bother getting BOTH sides of the story. Of course I do. I am not an idiot and have years of experience. I'm actually pretty good at getting to the bottom of the he said/she said business but there are times that it is not clear. At those times I will side with the person with the education and the license to back them up. An aide could have a phD in some other field - I don't care, it is nursing education and nursing license that counts in this business.

I have a feeling some of you are just looking for an argument here. I have some absolutely amazing aides and I have known some terribly lazy or over dramatic nurses. Again, I ask, how much experience do you have managing people? Seems SOOOOO easy until you have to do it.

[ktwlpn, LPN]

Bottom line- we are a team and we are caring for someone's mother,father,spouse or child and someday it could be one of our own in that bed.Check your ego at the door and remember that a Higher power is working though your hands.You might believe that many people think we are just wiping butts and pushing pills but we know the truth.Look for validation within yourself.

[jadelpn, LPN, EMT-B]

Sometimes it is a matter of in report to say "worship service begins at 11:30 on floor 12. Please make sure that all of your morning breaks are completed by 11:15. At which point, you will be needed to transport patients."If you are the LPN in charge for a shift, schedule breaks and lunches at the start of the shift. Buddy CNA's up so that one reports off to another. If you are going to bring anything to administration, it should be cell phone usage anywhere but the break room on one's break. It think in this instance, to say to the CNA, "I think there was miscommunication the other day. I would like it not to happen again. In response to this situation and prevention of it happening again, I will be scheduling breaks from now on. I do prefer it if you treat the patients with respect, I think your comments were uncalled for, and should it happen again, I will be reporting the behavior. I understand that emergencies come up that necessitate someone excusing themselves to take a priority call, however, you need to communicate that to me so that the patients we are both responsible for have their needs met".

And to the poster(s) who suggest you should be able to "do it yourself"--the charge nurse should perhaps not be leaving the floor to transport a patient to an entirely different floor.

[kcmylorn]

LCinTraining said:

I'm still confused, if you had time to stop and ask the aide to take the patient to the service, why not take the extra few steps to just deliver her yourself? I do not see you taking any responsibility for this mishap, when the reality is, there is more than one issue to address. How many breaks does your facility give? Ours has a 15 at the beginning and a 15 at the end paid break. We also get a 30 minute unpaid lunch break. Are you suggesting there is not more than one break to your work day? Even an 8 hour shift normally gets a lunch break and a 15 minute (what used to be called smoke) break. Is it not plausible this aide was legitimately on her second break, since you saw her in the break room earlier?

You failed to ask the appropriate question. Then got angry at her for continuing with what she indicated was her break. She failed to tell you she was on break. I see this as nothing more than a communication problem, both of you need to resolve. And before I report someone for insubordination, I'm going to make sure there is actual insubordination occuring.

I understand you said you were busy. However, I feel you wasted time talking with this aide when you could have taken a couple minutes and done the job yourself. Then you would have been applauded by the patient. Now the patient feels like none of the nursing staff cares if her spiritual needs have been met, because both of you have failed her.

I have been disrespected by nurses before. I have seen aides disrespect nurses. It goes both ways. But this is not a disrespect issue. It may be a lazy aide issue, which needs to be documented further. But not one of blatant disrespect. You need to make your needs clearly known. My nurses do it often, "hey, I'd toilet patient X but I'm horribly behind with meds, could you go help?" or "you know Patient Z takes an hour to situate each positional change and I have to get this tube feed started, can you take care of it for me?" SURE! I'm your assistant. It's what I do. Do NOT, however,expect me to stop my break, which may be the only time I sit down for 12.5 hours to do work off the clock. It's illegal, last I checked.

Let's not pretend nurses get a free for all while aides do the grunt work. Treat me with respect, I will be your best friend and you will want to only work with me every shift. Treat me like the dirt on the bottom of your shoe, and I may magically never be able to find help for 2 assist patient lifts except for you.

Legally and technically- a licensed nurse is not 'obligated' to give any explain to the UAP why they are requesting something be done, The licensed nurse does not answer to the aid. Read the Nursing Practice Act- there is no excuse not to read it in this day and age with computers and "google"!!! As long as it is in that UAP's "job description" that licensed nurse can ask the UAP to do it with out the explaination. The explaination is a "fluff" courtesy.

whether or not the licensed nurse "had the time" to do it his/her self is not the point.

The aid could have just said that they were on break to be deliberately insubordinate and refusing to do an asked task that was in their job description ASSuming the licensed nurse wiouldn't know any better. Does any one want to give a good guess hwo many times this stunt has been pulled?

I can remember on one particular occasion I had a similar problem with an aid- it was on a stepdown unit. I had drawn up IV lopressor and was on my way into a patient's room with it, when another patient wanted off the bed pan in another room. I asked the aid to get the light. The aid told me to do it- I handed the aid the IV lopressor and told her to give the lopressor while I got the other patient off the bed pan- at which she promptly scream "I can't give that" I responded "exactly- now go get that patient off the bed pan"!! She toddled her arrogant butt into the bed pan patient.

If the UAP doen't like thier job functions- then go back to school. Insidently, that I have heard physicians say to some nurses.

While your reading the Nursing Practice Act- pay close attention to , don't skip over, the interpretive statement on "Delegation"

[kcmylorn]

Another tactic is to do exactly as the OP suggested- listen the aid's refused, check out their story. Stop what your doing. Carry out the task that was delegated to the aid- get patient to church service. call the supervisor. Tell the supervisor the refusal, that you had to stop what your doing and take care of the patient. And write it up with name, date and time and give it to nursing management. Say nothing to that aid.

[kcmylorn]

Another tactic is to do exactly as the OP suggested- listen the aid's refused, check out their story. Stop what your doing. Carry out the task that was delegated to the aid- get patient to church service. call the supervisor. Tell the supervisor the refusal, that you had to stop what your doing and take care of the patient. And write it up with name, date and time and give it to nursing management. Say nothing to that aid. Maybe that's the defination of getting along and team work!!

You can also refuse to work with that aid- because that aid doesn't take direction or delegation and you can't do both - the aid's work and your own.

[MsKeycena/phlebtech]

So what ur saying is a nurse is more important than aide. That they have a lively hood,husbands/wives, kid(s), house(s), car(s), bills....etc and an aide dont. Basically an aide is worthless becuz they have a certification and not a license. When all boils down if in trouble the consequence is similar. But I guess like you practically said who needs to hear an aide side of the story when u have Jesus the nurse standing b4 u. With all due respect that's a bunch of mess.

[Nascar nurse, ASN, RN]

MsKeycena/phlebtech said:

So what ur saying is a nurse is more important than aide. That they have a lively hood,husbands/wives, kid(s), house(s), car(s), bills....etc and an aide dont. Basically an aide is worthless becuz they have a certification and not a license. When all boils down if in trouble the consequence is similar. But I guess like you practically said who needs to hear an aide side of the story when u have Jesus the nurse standing b4 u. With all due respect that's a bunch of mess.

Here is the simplified version. Everyone has a boss. The nurse is the aides direct supervisor. The aide is to do what the nurse reasonably asks them to do.

(Walking away, shaking head and wondering where some people work that they don't have a supervisor that they report to). Stick a fork in me, I'm done too.