CNA issue~can anyone advise?

we_rn · Jul 7, 2004

I have worked many years in long-term care as staff and as a supervisor and have run into my share of trolls. Do your self a favor. When interviewing for a job in long-term care ask about the staff and how disciplinary problems are handled. Know up front if a disruptive employee can be escorted out to the building by security or the police if they will not leave voluntarily. I have done both. Know who to call off shift should a problem arise. If you don't like the answers you get at interview don't take the job. You do not have to work with lazy aides with bad attitudes.

It is not impossible to fire a union employee. Know what is in the union contract or how to proceed if there is a problem. Know upfront if you will be backed up by administration. You will find out very quickly during orientation if that is the case. If you are not backed up then you will have a hard time getting rid of a bad employee. If you are backed up then most of the time you will be asked to send the person home pending investigation. Learn the correct way to document disciplinary problems. Most nurses do not know how and when to do this right and end up making matters worse. If it is a union matter then a shop steward must be present.

You have to have the correct documentation and a strong gut because you are in for a long fight. Bad employees will fight for their jobs and will sue for unemployment benefits so your documentation has to be good enough to stand up in court. Bad employees will play every card imaginable to keep their job. I have been accused of sexism, ageism and racism during discipline sessions. Have a second licensed nurse with you when you discipline an employee. If no other licensed nurse is available then a manager from another department will do. You need a witness for support and to back up your version of events.

However if you handle the situation right you will get a reputation for someone not to be messed with and your staff will fall in line. There is always a leader and that is the person you want to identify and go after. The rest will fold after the leader is put in their place or fired. Remember aides do not make much money and need their jobs. Most live from paycheck to pay check and cannot afford a protracted job search once they are fired. Quite a few work more than one job as well as overtime and thus are trying to pace themselves by not working any harder than they have to. That is not your problem.

If bad aides can intimidate a charge nurse into letting them slide then so much the better. You do not get paid to do their work; you have enough of your own. You are also there to care for the residents and not act a social service agency for aides with problems. Remember if an aide is verbally abusive to you just imagine what they are doing behind close doors with the residents.

BHolliRNMS · Jul 7, 2004

call your don before your next shift and ask her if she has spoken to this cna and what you should do if she has another outburst. It can be seen as resident abuse if the residents are frightened by her tantrum. If the don has not addressed the situation, speak with the administrator. Follow your chain of command as high as you need to. Just follow it and document everything.

If the cna continues her previous behaviors, clock her out and send her home. If you will not min. staffing standards if you do so, call the don first. If she doesn't respond, call the administrator. I would not work with someone acting like that.

Your residents deserve a better environment. I'm sure you aren't the only nurse she is acting out toward. Have you talked to any of the other nurses?

jschut, BSN, RN · Jul 7, 2004

Well let's look at it another way....
How long has she worked there?
Are you telling her how to do things she has already been doing for years and years?
Are you treating her with respect?
Do you trust her and treat her like you do?
Are you much younger than she is?
Do you talk about her behind her back?
I worked my way through nursing school as a CNA and I can tell you firsthand, that about 1 in 5 nurses treat CNA's like dogs. Remember she is doing a tough job for very little money, and perhaps she feels justified in her behavior toward you.

I don't know how long she has worked there, but I know it's been a long time.

I don't tell her "how to do" anything. She does her job. She's just rude and disrepectful. Such as the time a resident saw her down the hall and asked me what her name was, I told them, she heard me say her name and turned and said "What? What'd you want?" and when I told her I was telling a res who she was, she said, "Well, you don't have to be so damn rude about it!" (Was I?)

Another time, I was on the tele with pharmacy and couldn't run and unhook a g-tube so she could take a res to the restroom easier, so I told her she was going to have to take her, tube and all....she stands in the hallway and yells down to me, "It's not MY job!" I said, "Tonight it is!"

Age? I am 41, and she is in her late 30's. 38, I think.

And I talk about her to my boss. Once.

I also worked my way thru nursing school as a CNA, and was one for about 20 years before that. I have run into a couple of rude and hateful nurses, but for the most part, I got along fine. I know firsthand about a thankless job for little money.

And since I have become a nurse, I have had no trouble except for a few who don't want to do this or that, but this gal takes the cake with rudeness and hostility.

And if her behavior is justified, then I feel sorry....

we_rn · Jul 7, 2004

Well let's look at it another way....
How long has she worked there?
Are you telling her how to do things she has already been doing for years and years?
Are you treating her with respect?
Do you trust her and treat her like you do?
Are you much younger than she is?
Do you talk about her behind her back?
I worked my way through nursing school as a CNA and I can tell you firsthand, that about 1 in 5 nurses treat CNA's like dogs. Remember she is doing a tough job for very little money, and perhaps she feels justified in her behavior toward you.

All due respects most CNAs do not act this way. I was a aide and I certainly did not act the way this person is acting. I know first hand how difficult the job of an aide is. The person in question is just a bad employee. There is no need to undergo self analysis to figure out this aide's problem. The aide is responsible for her own job and how she conducts herself on the job. I hold aides to a high standard since they have to most impact on the quality of life for the residents they care for.

Aides also have to accept the fact that they have the least training and skills and are thus low man on the totum poll and has to follow a chain of command which includes the licenced nurses she workes directly with. To bad if she has a problem with this. When I have a problem with an aide like this I tell them to earn their credentials just like I did. Only when we are carrying the same level of responsibility can we address each others as equals.

What this aide is doing is trying to control the unit to her advantage. She is showing a lack of respect to the licences nurse who is responisble for the conduct of the unit during her shift. This cannot continue and should be addressed sooner rather than later.

obeyacts2 · Jul 7, 2004

It sounds like this person crosses the line from rudeness to insubordination when she refused to take a res to the bathroom as requested, even though the gtube is a pain to deal with. Dont stand for it!! She will push and push to see what she can get away with. Know for sure how much backing you will get from your superiors as far as writing up/disciplining CNAs. Secondly, is this aide a "pet" of administration? If she has been there 20 yrs this may be the case. If so, better tread lightly. Doocument, document, and document some more. Once you have your facts in order, go to your higher ups. Dont let her drag you into namecalling or backbiting, or you will lose. Whenever she pulls some nonsense, write it up/address it, but make sure YOU are consistent in your response to her behavior. If your facility administration will not back you on this RUN!!! You dont need this aggravation.

Laura

Chevelle · Jul 7, 2004

Don't let her do this to you. For starters do the residents see and hear this disrespect? If the top dogs won't listen, I would remind them that without the residents, they would not have a job and the residents do not deserve to be exposed to such hostility.

jschut, BSN, RN · Jul 7, 2004

Well, here's the news.

I called my boss, who was very understanding and said I handled it very well with what I did, and she agreed I can send her home if it starts again.

She is going to call the aide and tell her how to act tonight at work. No dicipline, no nothing. I am a bit disappointed in that.

Said she talked to the other night shift aides who told her I do homework (which I did take my Spanish book in one night to read at lunch~ and I told her so.) ANd their big gripe is that I never answer call lights they say. I named off a few of them I did answer the other niht specifically, and she sais, "I know. I know". But in my defense, I guess one of the other aides told her I am always doing something, whether it be at the computer doing charting or something...

I do like my boss, but am a bit disgruntled at the way this has been handled, I must say.

pcelest2003 · Jul 7, 2004

It's a damned shamed that you had to go through the drama. As a CNA/PCT in the ICU we don't have time for all that crap and niether should your Cna's. This type of stuff goes on in LTC in a lot of states. It' seems as thought only the bottom of the barrel cna's get hired in LTC's. However, there are some ignorant ones on med surg as well. But the more acute the pt's are there tends to be more professional assistive staff. This is only my opinion. I am very sorry that you went through all that. I apologize on behalf of all the pct's out here that work hard burst their behinds for their nurses.

But I must say in most acute care hospt. LPN's don't get respect like the nurses. The only things that seperates here is an advanced med certificate. Other than that, LPN get put into rotation with the aids. I noticed in LTC , LPN's run the show. I've even seen some as charge nurses. Make that broad respect you as a person an the title that your worked for. I guess being a male. There are just some things that I cannot and will not tolerate. Do not let her see you sweat , Ever!! Once she's seen that Sis you've lost the battle.!!!

Nurse Ratched, RN · Jul 7, 2004

ANd their big gripe is that I never answer call lights they say.

That's the complaint that honks me off. I *KNOW* the kind of paperwork you are saddled with in LTC - she's lucky if you EVER have time to answer a call bell. (Plus, if she wasn't so busy yelling at you and being passive aggressive, she'd have time to do it!)

:angryfire breathebreathebreathe, Ratched.

And, as you started your original post, the vast majority of the aides I've worked with are great, but those few problematic ones will really get your undies in a knot.