CNA Drama!

[Dobbysanurse, BSN, RN]

Ever have an aid that you just can't rein in and manage? Well I have one. I've been a charge nurse in a TCU for awhile and usually have a fantastic working relationship with my CNAs & LPNs but there is a new CNA "Kim" that was hired about 6 weeks ago that is unruly difficult to manage. Not to diagnosis but she has markers of a histrionic personality. Anyway the last time I encountered her I noticed she was getting extremely flustered with the number of call lights. I heard her muttering/swearing to herself in the hallway about them but as no one but myself was within earshot I let it go. I understand being stressed & overwhelmed and who doesnt swear under their breath at times? However, as the night goes on little things keep occuring. She left the floor 4 times without notifying myself or the other CNA for cigarette breaks, she refused to answer a resident's light because she knew this resident wanted to go to bed and she wanted to go on supper break and to top it off I caught her several times with her cell phone which my facility and myself have an ABSOLUTE zero-tolerance policy towards. I casually spoke with her near the end of our shift about these things and while she didn't seem thrilled she listened and agreed to do better. Rightfully, I should have notified my DON about the cellphone which may have resulted in termination but I wanted to give her the benefit of the doubt and allow her to correct her behavior.

Anyway the shift is coming to an end and the other CNA asked Kim to finish putting their last resident to bed while she would do that last shower for the night. At this time it was 20 minutes before the end of Kim's shift. At this time Kim marches off the unit once more without notifying me but I happened to see her leave from down the hall. I popped my head in the shower room and asked the CNA what happened and she told me Kim said "hell no Im not putting that resident to bed. My shift is over in 15 minutes and it'll take me 20 minutes to get him done". The other CNA also informed me that this resident had not been toileted since before supper as he had company all evening. (a whole other ball of wax) I found Kim sitting by the doors waiting for the NOC shift and pulled her aside and attempted to talk to her. She immediately started crying and moaning about how she did her fair share of work and so on and so forth. I tried to be understanding but held my ground that she needed to attend to this last resident before she could leave. Kim, who mind you is 45 years old and with 20+ years CNA experience cried the rest of the night - she managed to get this resident washed up in be before the end of her shift even so she got out on time!

Fast forward to a few days later and my DON wanted to talk to me -urgh - Kim apparently told my DON I had told her "I dont care if you're here until midnight you're putting (res) to bed". My only response was "are you kidding me?" Thankfully my DON and I have history going back to when we were both CNAs and she's pretty astute to dramatic CNAs so nothing came of it but an eyeroll on the DONs part regarding the drama of the shift.

So, to close this long rambling post, I'm working with the same crew tonight and just dreading the drama. What do you guys do when working with difficult aides? Should to play the friendly teamwork makes the dream work nurse, or do I become a barracuda?

[caliotter3]

Take the hard line. Write her up. Inform the DON. Keep tabs. If she eventually leaves, your unit will be the better for it.

[BirdieBird, BSN]

I agree, since you've verbally discussed the issues with this CNA, the next step is a documented conversation. Hopefully, Kim recognizes you are attempting to make her a stronger teammate. If she doesn't, you've taken the proper steps in correcting the issue and can pass that on to your superiors. CNA's like this are maddening, unprofessional and often uncaring. Sadly, their behaviors take away from our vulnerable adults who already lack so much in life, it's not a good situation. A few months back, I had a CNA who was affected by performance issues. I did just as mentioned above, and for a period of time she tried harder. I could see the difference. I was disappointed when she submitted her resignation to our facility. So, best of luck in addressing this matter. Please, if you have time, update us on how things go.

[HiddenAngels]

Take a time out. Meet with her one-to- one and see if you can uncover any issues/stressors she may be having. If you don't feel comfortable then maybe ask someone else to sit in. She may legit be doing the brunt of all the work.. Idk.

If not then yeh go the disciplinary route... But make sure not to harass her.

[Glycerine82, LPN]

I would have told her to clock out and go home. Then I would have put the pt. to bed myself and forward her write up to the DON to call her in and deal with. Totally unacceptable and I don't want someone like that caring for my pts.

[rcampbell4]

I always go the "I really want you to be successful and remain part of our team but I need you to..." route. It signals to the Aid that you do really want them to be successful, but that it's not guaranteed that they will remain part of the team, but have that conversation and any future conversations with another nurse with you, she's already showed you she'll lie on you.

[Smoo218]

Just report someone immediately if it's that bad! I reported fellow CNAs my first day as a CNA and my boss thanked me because she'd heard whispers but had no formal complaint.

[Neats, BSN]

I would write her up, if she cries this is affecting the other staff and residents. I would send her home. Tell the DON she needs to go it is only going to get worse. She does not need to be in your facility. Let the DON send her on her way. She is not only setting herself up for failure but your facility as a whole for failure. This kind of behavior will not change and you have seen this person is not truthful.

If she is on your shift I would break her tasks into 2 hour chunks and go back to ensure they are done. Then give her more work. Time the breaks and Lunch.