Advice about CNA's who don't follow orders

Daytonite, BSN, RN · Sep 20, 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.

My experience with most nursing homes is that the DONs are too busy or just have their heads kind of buried in the sand working on other things when it comes to the day to day dealings with aides who are real problems. I learned that there is something we as charge nurses can do that allows us to get some control over these situations. This is one of the things I like about nursing homes. In so many of them we nurses have a lot of autonomy and it seems like a lot of the administrators are willing to almost hand it over to us. This works the opposite way too which is why it is sometimes possible for one or a small group of bad aides to "take over" and get away with a lot of unacceptable behavior.

Another reason I don't particularly like to use the form that the CNA has to sign is because it is a more formal disciplinary action. When you start going that route, it's like a previous poster called cantoo says. You have to write up goals and make a plan of action designed to result in corrected behavior. That's fine for someone that you think is worth saving and you want to keep as an employee. The simple write-ups work just as well. I can include a line at the end of my memo that the CNA was infomed of which policy or rule they were breaking and that they were told by me to stop doing that. Most aides won't understand the difference between the two forms. Your ultimate goal is to get them to behave or leave. By the time you have to resort to writing someone up you know you have a problem employee who is just not going to follow the rules. These rotten ones usually get fed up after being written up a couple of times and go. They rebel by bragging to all the other CNAs about being written up, but the fact is that they realize they are in trouble and their cronnies are also watching to see what is going to happen to them. In a lot of ways they pretty much shoot themselves in their own foot once you start to get assertive with them.

jeepgirl, LPN, NP · Sep 20, 2005

You should let them stay on the hall they started working on at the beginning of the shift, and not just switch them for the heck of it. It's called continuity of care. If that person started out the first part of their shift (the first part of the double) on one hall, let them finish it out. It is much easier that way for everyone.

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.

NannaNurse · Sep 20, 2005

This is such a sad thing............our CNA's are the 'backbone' of nursing and without them we, as nurses, cannot do our job effectively. They are our eyes and ears. They spend more time with the patients and they don't get the credit or the pay that they deserve!!!

Just like one of the others said, there are 'crappy' CNA's and there are 'crappy' nurses.......I AGREE!!!!!!

The one thing that I can see is that most CNA's don't realize that their job is HARD!!! You have to be a dedicated, committed person to do the job of a CNA. I know because that is where I started out.

If you can't handle the stress or the heavy work load, find a job somewhere else. You will work hard, be paid little and get even less respect.

Just know that from this nurse, if you are a CNA, you are about the closest thing to 'godly' that I see!!

Thanks for all you do!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

babytaz · Sep 20, 2005

: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!

its good to see the post that ived been reviewing for a while. hi! im a nurse in the philippines and presently i am working as an academmician. im teaching caregiver students and nurses. our traning center ( caregiving course) is planning to open a cna program. but there are a lot of cna programs here open for those who want to work abroad. definitely our graduates will be deployed abroad. but the thing is, my manager is asking me about the essentials of cna. i dont know exactly what kind of information does he need. probably he is a businessman and having difficulty expressing the right term for his need. basically, what he wanted is something that the other schools or training center does not have. ived downloaded red cross and other schools of cna in US and researched it. and actually ive come up with a good curriculum ( i believe so!!) that is patterned in US. but the thing is he is looking for inouts that i cannot even integrate what he really wanted. and as a nurse he expects me to spearhead the cna program. but being a nurse to administer a NEW program is different. if its not too much i'd like to ask for your testimonies and what's the best thing about your experience on both the clinical and theoretical field. i hope i am not asking too much but i would be grateful if yu could grant my request....

anybody who can give inputs??? please feel free to post! thanks! :wink2:

kats43 · Sep 20, 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 am a charge nurse. And sometimes it isn't an easy job. That type of attitude is not acceptable at all. I would have sent her home. I have a good crew on my shift.But they know that the residents come first.The aides are a very important part of nursing and We couldn't do without them. But they def shouldn't be alowed to run the show . thats why there is a chain of command.

Daytonite, BSN, RN · Sep 21, 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.

You are so right, casi. Supervisors who yell at the people they are managing are showing their lack of control. It also sets up situations where people feel hurt and there are a few nuts out there that will want to take revenge. I think the expression these days is to "go postal" on you. We definitely don't need that to happen. No job is worth getting so worked up about that you lose your cool and end up getting beat up or shot for it too. :uhoh21: