Advice about CNA's who don't follow orders

Chad_KY_SRNA · Sep 18, 2005

I am a CNA and a nursing student and you don't cuss people in front of a resident, you leave your home life at the house and you take care of everyone and if your patients/residents can be handled by one CNA then the extra CNA better be helping out those who are short staffed. I am so lucky right now, the crew working my shift are my friends and we all take care of each other and if someone is having a bad night we help them as much as possible. When we are off, we do stuff together on our days off, they are like family to me. I will admit I went off one night at work and threw some stuff in the shower room and slammed the door behind me. All of my residents were in the bed, I went into a private area and I cleaned my own mess up and still got wrote up after I apoligized to her and the other CNA and she told me that she wouldn't write me up. I think there is a time and a place for everything and this aide needs disciplined.

DusktilDawn · Sep 18, 2005

I agree with Chad. The problem with your situation is that bad behavior has been tolerated in the past. Definately discuss the situation with your administrator. Having an administrator that backs you up is extremely important. Another thing that's important is having everyone on the "same page" with this issue, meaining the other nurses who are charge are enforcing the rules/team plan with consistency. I'm afraid you may have to write-up/document specific incidents. If you have the authority to send this person home for inapproriate behavior, do so, however document it and make your administrator aware of what you did and why.

Perhaps even "brainstorming" with your administrator and other staff on strategies to improve "team work" that includes both nurses and CNAs being involved in the process.

jennylynn22003 · Sep 18, 2005

I know that when the CNA's who read the thread starter they will think bad things about me, I adore cna's and treat them well. Today one cna called and said he would be an hour late. As I was the float nurse I went to the 2 hall he was supposed to be on and told the other cna I would help her til he got there. I answered lights, put people on the bedpan and various other things. She came up to me and rudely said, "I am not working this hall by myself" I had already asked another cna to come over from a hall that can be done by one. She was in the middle of dressing a patient and getting her up for breakfast. Another nurse had paged that someone needed to go over and help her. The cna went to the 1 hall where the cna was working with the patient, stood in the hall and rudely said, "YOU NEED TO COME OVER HERE NOW!!" The cna she yelled at has only recently started working there and so she told the nurse that she had to go. She continued to be rude to the cna and told her that she wasn't going back to the 1 hall when the late cna came. Told her that she was going to stay there and work for a change. I started writing her up for this part when she came over and asked the other cna on 1 to come help her because the other aide wasn't worth s____. I heard this and so did an lpn. I put all of it in the write up and asked her to sign it she refused "I am not guilty of anything." I told her that her attitude was the biggest problem and that upsetting a resident by being rude was unacceptable. Should I have sent her home? In the past this attitude was tolerated but now we have a new administrator and has been cleaning house. this cna has had an attitude for the last month because of something at home. I told her that she should leave it at home or take a few days off a week ago. I have had problem with a few other cna's here because they were allowed to do what they wanted knowing no one would write them up. There is one who will only work on a hall she likes and usually refuses to switch when she works a double because she has things already done. Today i put her on her same hall and she switched to the 4 they are supposed to go where they are assigned but no one has been making them do it. Now it is posted that they go where assigned but the ones who have gotten away with it still do. I can't go around writing everyone up but i also won't tolerate this behavior. I have never had this problem in other places where i worked and when i was a supervisor i would have fired them on the spot.

:angryfire

I"m a new member but when I read your problem I truely felt sorry for your situation. I have been a DEDICATED CNA for almost 6 years now. Our job is hard and stressful as well as rewarding. I am astonished that the CNA at fault has not taken responsibility for her actions. Our job is to provide the best care possible for the residents regardless of lack of staff. Where I work there is a shortness of staff all the time. I take care of well over 24 patients by my self. These patients are not easy to take care of but I do. its all about whether one can do his or her job. You need to have care and compation for these people, she needs to grow-up, be professional and do the right things. i feel you did right by writing her up, i would have clocked her out personally. As far as the other employees go, if you are the supervisor show them that you are. If they mess up, take charge, write them up!! Good luck and I hope this issue gets resolved for the residents safety and your sanity! :rolleyes:

cantoo · Sep 18, 2005

I'm a manager in a large LTC and I manage on average 30 to 40 CNA's on any given day. Sounds to me like this CNA is having some personal problems. The best approach may be to pull her aside and try to find out what's going on. There's no excuse for cursing or insubordination, but often there can be a way to "re-direct". Give her specific goals in changing her behavior that you both can live with and monitor her progress. Do you have a "coaching" plan where you work? One that sets specific guidlines? If not, you need to get with management and impliment one. Like the previous poster stated, you all need to be on the same page and you all need to be consistent. It sounds as though management has set you up for these problems with their inaction. There are times when sending someone home is the only coorifice of action you can take, but most situations can be handled if you have a good policy in place. It helps if your plan is geared towards self improvement instead of punitive dicipline. Hope this helps. Cantoo

pink2blue1 · Sep 18, 2005

Boy I picked the right day to read this post.....I'm a CNA, and have been for 3 years, also a nursing student. Today I had a problem with an RN who was extremely rude to me on the job. EXTREMELY! In front of patients, Dr's and other nurses (I work in an acute care hospital on a med sure floor) Anyways, I do feel you as the supervisor had the right to write her up if she was behaving this way. It's just the way I feel about the RN today who treated me badly. Just like crappy CNA's, there are crappy nurses out there too. She's one of them!

Sorry you are having to deal with this.

Shannon

10ACGIRL · Sep 18, 2005

I know that when the CNA's who read the thread starter they will think bad things about me, I adore cna's and treat them well. Today one cna called and said he would be an hour late. As I was the float nurse I went to the 2 hall he was supposed to be on and told the other cna I would help her til he got there. I answered lights, put people on the bedpan and various other things. She came up to me and rudely said, "I am not working this hall by myself" I had already asked another cna to come over from a hall that can be done by one. She was in the middle of dressing a patient and getting her up for breakfast. Another nurse had paged that someone needed to go over and help her. The cna went to the 1 hall where the cna was working with the patient, stood in the hall and rudely said, "YOU NEED TO COME OVER HERE NOW!!" The cna she yelled at has only recently started working there and so she told the nurse that she had to go. She continued to be rude to the cna and told her that she wasn't going back to the 1 hall when the late cna came. Told her that she was going to stay there and work for a change. I started writing her up for this part when she came over and asked the other cna on 1 to come help her because the other aide wasn't worth s____. I heard this and so did an lpn. I put all of it in the write up and asked her to sign it she refused "I am not guilty of anything." I told her that her attitude was the biggest problem and that upsetting a resident by being rude was unacceptable. Should I have sent her home? In the past this attitude was tolerated but now we have a new administrator and has been cleaning house. this cna has had an attitude for the last month because of something at home. I told her that she should leave it at home or take a few days off a week ago. I have had problem with a few other cna's here because they were allowed to do what they wanted knowing no one would write them up. There is one who will only work on a hall she likes and usually refuses to switch when she works a double because she has things already done. Today i put her on her same hall and she switched to the 4 they are supposed to go where they are assigned but no one has been making them do it. Now it is posted that they go where assigned but the ones who have gotten away with it still do. I can't go around writing everyone up but i also won't tolerate this behavior. I have never had this problem in other places where i worked and when i was a supervisor i would have fired them on the spot.

I don't think you as bad! I don't blame you one bit! I know what it is like being a CNA and I get told the same stuff from other CNA's that come from other facilities!... That's why I would rather be at a Assisted Living Facility and not a SNF.

dinkymouse · Sep 18, 2005

I am talking to the admin and don about this cna. I have tried to find out what is going on in her home life but she hasn't shared it with anyone. I used to be a cna also and I know what a hard job it is, but you suck up your bad mood and work as a team. We were short today but this crew worked as a team and everyone from staff and residents had a great day. I wrote up an aide today because she was highlighted and with 2 call ins she was supposed to stay but refused because she didn't have a babysitter. She understood that it was necessary to be written up and I suggested that when she is highlighted she needs to have a backup babysitter to cover the extra 4 hours. she was not snippy and even said she knew I had to do this. They know if they are highlighted at least a week ahead.

Today was so much better. The atmosphere was friendly and we all had a good time which certainly makes the day go much faster and easier.

Blackcat99 · Sep 19, 2005

Yes, the best thing to do is to send them home immediately when they say they are not going to do this or that. Then write them up for insubordination. I had to write up a CNA about 10 times before they finally got rid of him. Good luck.:)

casi, ASN, RN · Sep 19, 2005

I'm a CNA, and no matter whats going on, you have no right to yell, or throw a hissy fit in front of a resident.

I absolutely understand the stress of being a CNA and being short a co-worker. Especially if it's a co-worker who calls in sick or late a lot.

Daytonite, BSN, RN · Sep 19, 2005

The CNA doesn't need to sign the write-up. If the form you are using requires this, OK. When someone refuses to sign you go get another licensed nurse, approach her again about signing. When she refuses you write, "refuses to sign" where her signature goes on the form and have the other licensed nurse also sign (just like signing out narcotics!). "Refusing to sign" is great because it speaks volumes about this aides attitude. It shows she is subordinate and refuses to take criticism and direction. This is good for our team!

I generally wrote people up in a memo format. They were presented more as factual explanations of what happened. The signed form was the official disciplinary form. When the signed form started getting used that is serious stuff for the employee involved and forms the basis for firing them.

This aide is on her way OTD (out the door). Hang in there.

nelcoy4 · Sep 19, 2005

Daytonite, that's good idea. I had touble with cnas before, but I always went up the chain of command. By doing that sometimes nothing gets done unless the cna has a whole bunch of compliants.