CNA troubles

[montinurse, BSN]

Hello everyone! I have started working as charge nurse LTC (skilled unit) every other weekend and a day or two during the week. I was a CNA while going through nursing school, so I am well aware of the amount of work they have to do. I value my aides very much, and their observations. My problem is: the whining and complaining. Constant. About each other, the workload (it's not fair that I have to...) and so on. Wanting to trade wings with other aides, he said, she said, it's neverending. I had a talk with them all- and told them to consider that their verbal warning. They have complained in front of residents, loudly, and not been so nice to residents.

What is the answer to this? Does HR need to be more selective, or is that possibe? It's obvious sometimes in orientation some of these people aren't cut out for the job. There are frequent call-ins, no shows, and that impacts the whole building. What's the answer to this? My facility doesn't have CNA training. Could that be the answer? I

[nc4986]

I think every job especially in the medical field should have training for new employees, how else are they to know what is/ is not aceptable behavior on the floor, half the time i truly believe that if someone doesnt hear what not to do they start to feel like they have an excuse when they are called out on it, its not right. and it causes manager and head staff far more grief than need be.

much love

peace out

[joprasklpn]

I think alot of LTC facilities are so desperate for any kind of help that they overlook things sometimes. I was a CNA for awhile before becoming a nurse and I know it is a demanding job. That still is no excuse to be rude to other employees or residents and family members. It gets frustrating for good aides to always be relied on while the slackers get the same pay and benefits. Maybe some kind of incentive program would help improve the attitudes.

[Mabel 29]

I experience the same complaints from the aides at the LTC where I work. It gets so bad that I have contemplated working in home care so that I don't have to listen to them anymore.

I think I heard the best one this week. An aide told me I need to do something about "Resident X" because it's not fair to the aides that she has loose stools so often!!!

I get so tired of listening to them complain that I do some of their work by myself instead of asking them to do it just so I don't have to listen to them complain. I already have 32 residents to take care of, and doing their work puts me way behind. At the end of the shift, the aides leave and I'm left to finish my work.

[AuntieRN]

They arent any different in the hospital either. I had a patient with a high ammonia level so we were giving her lactulose q1hr until she started moving her bowels...yes I am sorry they were so loose and they stunk so bad and she went so much but ummm thats the way we got her ammonia level down. The pt didnt enjoy it either.....

Ask one of them to toilet a pt because you are busy and they roll their eyes at you and tell you to do it yourself they are going on break....break??? What's that? I know its hard being an aide I did it for 23 years before becoming a nurse...but heck if you don't like it then go do something else. Im sorry I got ranting again....

[cathleenrmermaid7]

wow, do I know what you all are saying! I live in Maine and some of the worst things that annoys:nono: me is when cnas talk right in front of the residents as if they are not even there. I have actually been written up for not taking breaks. I don't smoke and I just chose to help out more when everyone has to take their smoke break I just take an extra moment to smile at a resident or talk to them if I can. I am a student Nurse right now and I have the utmost respect for RN's wow it is hard to get the degree and I show" as they say in Maine" DUE RESPECT" for RN'S and of course anyone in the health care system that really cares!

[tt-40]

Does anyone know if any of the East Valley hospitals in Arizona have a CNA program? please;, let me know you guys out there..... thanks.

[CoffeeRTC, BSN, RN]

Lead by example first off. Let them know what you expect from them and what they can expect from you. Reviewing the diciplinary process with them helps too. Like...this is a verbal warning...next time you will get written up for xyz. Adjusting your attitude and being respectfull is also key.

I think most LTCs are hiring anyone and a bunch at a time and just see how many will work out. Its very hard to be selective since the need for staffing is always so high.

When our facility did the training, most of the inhouse trained/ certified would be the best and stick around longer.

[CapeCodMermaid, RN]

There is much talk about culture change in our industry...patient centered care and the like. So far the biggest change I've seen is in the attitude of the staff. I was a nurse's aide, a staff nurse, a nurse manager......I am amazed at the way the CNAs speak to the nurses. One of them today told me that he wasn't going to take the piercing out of his eyebrow because he saw someone else wearing one. I told him it wasn't his job to police his co-workers and he said he wouldn't take it off till everyone else did. He told me when I told the others...that's when I stopped him. I told him he would be wise not to talk back to the DNS ...I'm the DNS and I wouldn't speak to anyone that rudely!

These kids and lots of them are need to get a lesson

[Daytonite, BSN, RN]

Please don't misunderstand or think I'm being standoffish, but I've been a nurse a long time. I started working as a nursing assistant in LTC when I was a nursing student and I've worked in LTC as a charge nurse and supervisor as well as worked for many years as a hospital staff nurse, nursing supervisor and unit manager. I've seen a lot of crap. Part of being a charge nurse in LTC (and I've worked plenty of skilled units in LTC) is riding herd on the CNAs who act more like a bunch of adolescents than they do responsible adults. It wears you out, I know. It's all behavioral. Nursing school didn't prepare us for this, but it's part of the job, unfortunately. Part of it has to do with the fact that not everyone who supervises the CNAs is on the same wavelength and exercises the same discipline and supervision over them. So, like children, the CNAs get very good at manipulation of the nursing staff. They learn just how far they can push each nurse. And then they go and gossip among themselves about it.

I took seminars in how to handle difficult people and I have a couple of books that helped a lot with dealing with the CNAs who were outright insubordinate or smart alecs:

• Managing Difficult People: A Survival Guide for Handling Any Employee by Marilyn Pincus
  
• Working With Difficult People by Muriel Solomon

Learning some assertiveness helps as well. Sometimes you just have to put your foot down. You may not be able to solve the facility problems with the CNAs, but by god, you can at least make your work shift livable. That's what I did. Every CNA I worked with learned real quickly what I would and wouldn't tolerate from them. They either did what I wanted or I found a way to make their life so miserable they either begged for an assignment on another unit or they quit. Either way was fine with me. And, I was glad to help them. I learned the policies and procedures and knew the rules for discipline like the back of my hand and applied them to the letter. Any CNA who was a problem I took the time to make sure their wrong doing got written up and documented for the DON and that the CNA knew it. They hated me--good. It kept them off my unit. I seldom was at the nurses station. I was in the hallways where I was always able to see what the CNAs were doing and saying. Like I said, if the other charge nurses and the DON weren't going to nip these problems in the bud, I was doing it on a one by one basis. You see, I had been a supervisor and manager in the acute hospitals so I knew how this disciplinary/documentation process worked even though some of these people that get hired to be DONs in the nursing homes have no clue about.

Now, I'm not saying I was mean in personality. Quite the opposite. I always tried to remain calm and keep my cool. I try very hard to be very fair minded and open to suggestions. I'm really very easy to get along with--until people start taking advantage or screwing off. Then, I'll hunt them down, watch them with the eye of an eagle and find every mistake they make. I'll be their worst enemy. It doesn't take long either. You get a rotten CNA and inside of a couple of weeks they are gone because they can't help but screw up all the time. It's not in their nature to do things correctly. You just have to be vigilant and take the time to document it all. Don't assume that other nurses are reporting and documenting their wrongdoing.

So, you can give me all kinds of crap about how you value your CNAs. I valued mine too. But not the ones that gave me headaches. I just did what I had to do to get them out of my hair.

[CoffeeRTC, BSN, RN]

Bravo Daytonite!!

[Simplepleasures]

In all types of jobs there are going to be the trouble makers, for no GOOD reason. But in LTC where there is overwork due to understaffing, reluctance to pay a living wage,the hiring of low caliber workers, who are only desperate for a job , willing to work for crappy pay, and dont really have the sincere desire to work with the type of patients that are in LTC, these isues will continue to happen. I believe if the wages and working conditions were better the culture in nursing homes would be better. It will always be a difficult job, but when the workload is managable, people are not so stressed and unhappy. I understand management has no power to improve this situation, it will take unionization and state and federal MANDATES before anything changes in LTC.