Wrote up a CNA, but I was the one who got the boot!

Nurses Relations

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About two weeks ago, I had an unfamiliar CNA on my night shift. She was 'helping out' with a shortage apparently. I am new on the job as well. I had previously been instructed to ''hold accountable' the CNA's on my shift by 'writing them up' for every infraction (something I had chosen NOT to do) Not until the night I had this individual on my shift who would not provide vitals or answer call bell lights. When I witnessed her eating on the shift while charting and ignoring a light going off right next to her (her patient also) I asked if she was going to get that. I was asked in return if I was going to get that. From there, she just went off and proceeded to tell me to write her up because she was going to be just fine, that I was the one on thin ice and that they were always talking about me on the first shift. This behavior went on for the better part of an hour, despite my telling her I would have to write her up if she did not stop (I was professional about it), I tried to call the unit manager (she didn't answer), I finally called the DON (the one the CNA said would protect her). The DON didn't tell me to send her home, she didn't ask to talk to her, she said, "I'll take care of it in the morning." Well, when I go in with my documentation in the morning, the DON didn't give me the time of day. Everyone was looking at me sideways as well. I was told the CNA was out of town for a furneral and wouldn't be back all week. I was told my a fellow worker to take it to human resources, which I did. Long story short-girl was never out of town, she was at work the whole three days I tried to resolve this. She did not get in any trouble. They had her apologize. They said it was a clean slate. They said they wanted me there on the job (I offered to quit because as I told them how would I have any credibility on the job if a CNA was allowed to yell at me for an hour on the floor and still keep her job). I was ASSURED I was a desireable employee- blah, blah, blah.

Fast forward to today, when I wake up to a human resource/DON speaker call telling me I am being 'let go' for poor performance and, get this, being 'disrespectful to a nurse' and the claim of a witness on that.

Wow! REALLY??? I have this fellow RN, also new on the job, but been there a few months longer than me. When I take the shift from her, she gives me 'orders' as to what I am to do on my shift, without EVER being charge nurse. Meanwhile, she actively sabotages me to the DON and unit manager by tattle telling any imagined flaw from my shift (she's 7-3, I'm 3-11 lets also throw in there that an 11-7 shift exists) Basically, I got tired of her dumping her left over work on me so I chose not to do it. So, when I came in in the next day, she told me my assignment for the shift was to give 3 enemas!!!! Yeah, right. We didn't have 'words' but I did question her when she made the statement "I put Ms So n So on Sudafed". I asked her, "You put her on Sudafed? Or, you called the doctor and she put her on Sudafed?" This aggrevated her you see because my confused former classmate seems to not understand the scope of our nursing practice does not include up doing things like deciding on our own to say, do an Oxygen test and take away someone's O2 on our own initative while monitoring sats for 48 hours, and instructing all the other shifts to do the same, THEN taking the info back to the doctor to see if THEY would like to DC the order (instead of asking the Doctor simply if we can do it in the first place and following said order). She REPORTED me to DON for being disrespectful. The interesting thing is the claim of a witness when we were alone in the med room???

I'm venting her because I'm really frustrated about how to deal with the social aspect of being a nurse. How do you survive the sabatour who has the ear of the managers when you work solo on the evening shift so they don't know you. How do you manage CNA's when the managers don't back you up, but punish you for trying to do your job? (I forgot to mention that after I wrote her up, I discovered I was NOT parttime as my unit manager had told me, but was still PRN. For a month, I had labored under the idea I was a parttime employee and stopped job hunting). Once I turned in that write up, my hours were cut from 15 shifts (three a week) to every other weekend only! Turns out the CNA was a long term day time employee. And did she ever LIE through her teeth. Claimed I said, "I'm an RN. I DON'T answer call bell lights!!" I'll also throw in there that I am the minority in the building and the DON the protector is of another race as is her posse of CNAs.

SO it's back to the job junt. I'm just wondering if this will be the continual theme to nursing- back stabbing fellow nurses and lazy CNAs.

Please advise!!!

Specializes in FNP/FPMHNP-BC.

I am very sorry for what happened to you. Sometimes you just got to keep your mouth shut and do what u have to do. I realize long time ago that ultimately the patients are entrusted to us by doctors. I have never heard a doctor walking on to the unit and asking a CNA how the patient is doing today and when was the last time you give s/he pain medication. Whatever happens to those patients are our responsibilities and not the CNA's. When you are new to a unit you really don't know who knows who. This is my opinion. I would of answered the call bell because 9 out of 10 the CNA would come and tell me that the patient needs the nurse.

I am very sorry for what happened to you. Sometimes you just got to keep your mouth shut and do what u have to do. I realize long time ago that ultimately the patients are entrusted to us by doctors. I have never heard a doctor walking on to the unit and asking a CNA how the patient is doing today and when was the last time you give s/he pain medication. Whatever happens to those patients are our responsibilities and not the CNA's. When you are new to a unit you really don't know who knows who. This is my opinion. I would of answered the call bell because 9 out of 10 the CNA would come and tell me that the patient needs the nurse.

Thank you for your post. In our facility, when the bell goes off, the resident want to use the bathroom or be put to bed. It's rarely a nursing issue. It's a time management issue. If do all those things, I can't get the meds passed and the treatments done-my ration was 19 rehab patients to one nurse and I also was expected to respond to the lights of the other 25 residents as well. I did answer lights. I did what I could. I did toilet people and put some to bed as well. There just aren't enought hours in the shift to do this multiple times on a shift. Just not possible.

Basically, I got tired of her dumping her left over work on me so I chose not to do it.

We didn't have 'words' but I did question her when she made the statement "I put Ms So n So on Sudafed". I asked her, "You put her on Sudafed? Or, you called the doctor and she put her on Sudafed?"

The first one would be grounds for dismissal where I work. The second one would just annoy me.

Move on. Sounds like that job wasn't a great fit for you anyway. :)

Specializes in FNP/FPMHNP-BC.

I understand. I am not saying that you was in the wrong. Just that some people you just can't beat them. So you know the old saying, " if you can't beat them join them".

Specializes in FNP/FPMHNP-BC.

OP how long have you been a nurse?

Graduated in December 2011; passed first NCLEX attempt on March 5th 2012, received license on March 7th. Started soft job search in April-just a few attempts at the online job posts at the local teaching hospital, then waited out the month for replies- nothing. In May, put in a few LTC apps in one local town. Son came home from army deployment of a year, so I took sometime with him til I started applying again in Mid June. I started getting creative then-substitute school nurse, emergency training with Red Cross, volunteering with local free clinics (was a GREAT idea-starting back up on that next week), flu clinic at Walmart, kept applying to all three hospitals etc. Then, I put in two more LTC apps in another local town. In July, I had three interviews back to back and had to juggle because I didn't know which would turn into a job. Ended up with the place I just left in August orientation til end this week.

Bet you're wondering why I can't just answer a simple question? Would it help if I said I planned to be a writer when I was in school and studied journalism in college first? lol

I seriously don't know what I want to do with my license so I will go back to exploring all the leads I had to put on hold when I actually started working. Plus I can finish off my semester with better grades than I started and get the spring semester set up.

On happier news, my daughter just blew her SAT out of the water so she is a good position to hopefully find funding for her college dreams next fall. Yea!

The first one would be grounds for dismissal where I work. The second one would just annoy me.

Move on. Sounds like that job wasn't a great fit for you anyway. :)

Who would get fired, the one who did the dumping or the one who didn't pick up the slack? I tried to do the extra stuff, but started getting in trouble for not finishing my own stuff. In the end, I just got in trouble for both anyway...'Rock and a hard place."

Specializes in Med/Surg/.

In a NH the CNA is the backbone of the group. Hopefully you will have a good group. One thing that always worked with me is to praise your girls/guys as much as possible and help them when they are running behind or two things at once. Now to prevent taking advantage of the offer at some point let them know you will help if they need you but you have your own work to do also. I also let them know there is not one thing they do that I have not done for years. CNA was not invented for 10 yrs when I got into nursing and only some hospitals had them even then. We also had to do more with the NH Pts then as the CNAs were well overworked. They will respect you more for a kind word. They are like elephants with long memories. They never let things go. And in case you did not know nurses are one of the most backstabbing people there are. You would do well NEVER to trust anyone unless they were your childhood buddy or your very long time BFF. It will keep you out of trouble!...........Good luck with your next try....

Thank you for the good advice. I did try with the CNA's to be polite. I greeted all of them, asked them nicely when I needed something, explained why something was important if I asked them for it and thanked them in advance. I'd smile at them when we crossed paths during the night and ask em how it was going. I told more than one of them that I appreciated them on more then one shift. I thanked all of them as they walked out past the nurses station at the end of shift when I was charting. I tried to be light hearted and joke with them if they were charting on the wall station if I was charting at my station. Heck, my partner nurse on the 3-11 shift, we both pitched in and bought them pizza one night. We had already planned with our regulars to pick a night we were all there to do bbq in November. And I was gonna bake something if we worked the holidays in December. We were trying to build our team up because they get dumped on just like we did by the ever critical day shift that uses the other two shifts as a scape goat for all problems. Why don't we just buy jerseys and admit we are on rival teams, for gosh sakes?!? The day shift is the favored shift because it's the DON's and unit managers shift. My problem CNA came from the day shift crew-and brought that big attitude with her. Yes, some of the CNA's on the night shift are young. And, I freely admit their job SUCKS!!! They have too many residents who have over paid for tip top service wanting to be the first on the list and reporting you when they aren't. What they don't realize is that no matter how much they paid to be there, the ration is still 9-1 CNA and 19-1 nurse or 25-1 nurse on LTC side. They did not pay for the one on one care they think they paid for. Life lesson there! Save the $100K a year and keep mom home. Bring in a nurse for the few tasks she is needed. Mom would be happier with family than stuck i some pretty decorated cell that they now call her 'home'. Get real.

BTW- we were classmates, but it was a large program and I never met her while in school. She's my son's age. It's a shame that we couldn't have been more of a support to one another. It was the last thing I expected when I took the job. I was glad a classmate was there because I thought we could look out for one another. Boy was I wrong!

MotherRN- just out of curiosity, what were your grades like compared to hers? Is it possible she felt your being there was going to rock her boat and make her look bad? She probably had it out for you from the moment you walked in the door. I had this happen to me once- I was working perdeim on a stepdown unit in a hospital, this LPN was working Fulltime and got laid off. Big party booh hoo's, the whole 9 yards. I wasn't getting enough shifts so remained perdeim and I went to a LTC facilty as a part timer and low an behold who was working there. I was thrilled there was some one I knew and we had worked well together. Well, boy was I wrong. This LPN was nasty, demeaning and outright embararsing to me every chance she got. A shouting match ensured which she started out of nowhere and like you, in the med room and I was fired. This happens all over nursing. It has been allowed to go on. The majority of nursing don't even know it is wrong.

I learned from then on - never work with an old co-worker, no matter how well your think you get along. I guess the same should hold true for old class mates. When I say nursing can't handle certain things and situations- I really do mean that. It comes from years of seeing it. i can tell you- it is NOT getting any better. I don't care how many anti bullying and civilty campaigns they push. It just makes for good press to hide the real ugly of nursing. It's to bad one has to "dumb themselves down" so someone else doesn't feel bad or look bad!! The need to go to psychiatrists and take a pill.

Thank you for the good advice. I did try with the CNA's to be polite. I greeted all of them, asked them nicely when I needed something, explained why something was important if I asked them for it and thanked them in advance. I'd smile at them when we crossed paths during the night and ask em how it was going. I told more than one of them that I appreciated them on more then one shift. I thanked all of them as they walked out past the nurses station at the end of shift when I was charting. I tried to be light hearted and joke with them if they were charting on the wall station if I was charting at my station. Heck, my partner nurse on the 3-11 shift, we both pitched in and bought them pizza one night. We had already planned with our regulars to pick a night we were all there to do bbq in November. And I was gonna bake something if we worked the holidays in December. We were trying to build our team up because they get dumped on just like we did by the ever critical day shift that uses the other two shifts as a scape goat for all problems. Why don't we just buy jerseys and admit we are on rival teams, for gosh sakes?!? The day shift is the favored shift because it's the DON's and unit managers shift. My problem CNA came from the day shift crew-and brought that big attitude with her. Yes, some of the CNA's on the night shift are young. And, I freely admit their job SUCKS!!! They have too many residents who have over paid for tip top service wanting to be the first on the list and reporting you when they aren't. What they don't realize is that no matter how much they paid to be there, the ration is still 9-1 CNA and 19-1 nurse or 25-1 nurse on LTC side. They did not pay for the one on one care they think they paid for. Life lesson there! Save the $100K a year and keep mom home. Bring in a nurse for the few tasks she is needed. Mom would be happier with family than stuck i some pretty decorated cell that they now call her 'home'. Get real.

And who did that for you-the nurse with all the responsibility for their actions or lack there of!! After all- you passed out meds for "Their" residents, you assessed"Their" residents, you called the doctor for "Their"residents. you sidned off the admission orders for "Their" residents

The only thing I know about her academics is what she told me on the first few days I shadowed her. She confessed that she was sick due to the extreme stress of our last rotation, so sick that she suffered migraines and had to be hospitalized. So, basically she fell short of making the needed 70.5 in the final course to graduate. She said they, the instructors, wouldn't give her the time of day so she went over their heads all the way up the ladder with a letter writing campaign until she was allowed to graduate from the program. I assume this means she did it a little later than the group because this effort would have taken time to reach a conclusion. I assume her grades must have been okay throughout the program or else she wouldn't have had much of a leg to stand on in her defense that it wasn't fair to fail her on so small a percentage because she had the legitimate excuse of being ill.

As for me, I am a good student. I probably should be in education and not nursing. I have five kids that I have home schooled for the past twenty years from K-12 grade. The oldest graduated college already, my second son is a junior, my oldest daughter just aced her SAT and is applying to schools. In the nursing program, I was the student who would get A's on all the tests and thought I was gonna get an A in the class, then messed up ONE exam which always left me with an overall B. So straight B's in nursing school. I had a 4.0 when I started though and combined with my GPA on my prereqs I was able to be in the nursing honor society thankfully. She was not in the nursing honor society with me.

My weak point is that I am somewhat mild mannered and soft spoken in public (used to be shy kid) so I have to warm up a bit. I also am nervous working with my hands when I am unsure of what I am doing whereas some are able to just jump right in and be really extroverted socially. But, my personality type is also an asset because I am sensitive to others feelings and know how to be that person you can tell anything to who won't knife you in the back later for it (like some people I know!)

I'm having a pleasant night with the kids (even though we just watch a horrible Adam Sandler movie 'That's My Boy!") and this is my first Friday night off since Before August 31st! So, I'm feeling generous right now and somewhat charitable in my attempt to understand her behavior. She's 25. Not married yet, no kids, no prior degree. This job and a nursing school 2 year degree are probably the biggest things that have happened to her so far and her boyfriend just popped the question and they are now having a house built. Heady stuff for your mid twenties. She reminds me of one of my sister in laws who was a yuppy engineer back in the '80's. I would describe her personality as hauty. She has recently been cast in the role (in her mind at least) of "big woman on campus" at the facility because she works the day shift and mingles with the management daily. Her head is so big, it's a wonder it fits through the door in the morning. So, her idea of report is to dictate her own personal orders of what you are to do on your shift and then be upset and complain when they aren't carried out. It was just so hard to sit there during report and be talked down to and ordered about by someone my son's age! And, I knew that when I had had enough and asserted myself, I would be painted as the bad guy and in trouble for it. So, I kept quiet cause I needed the money. But, when a nurse starts acting like a doctor and telling you to do things she wants done, like D/C orders for O2, orders that did not come from a doctor, then she is operating outside of our scope and if I follow her lead, so am I. Enough.

I don't think she knows my academic record. I wasn't asked and I didn't tell. I didn't try to intimidate her, I'm actually really comfortable with young adults. I just try to be funny and light. Couldn't say for sure what her problem was with me, but it was there from the beginning. Maybe my age made her uncomfortable and she was trying to show me we were equals by being so condescending, maybe she perceived a threat that was not there. And maybe she's just another entitled young adult in America these days with not respect for their elders. (okay, I can see if I continue, I will not be so generous afterall) so I will end on that note.

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