Dealing with difficult CNA's

JBMmom, MSN, NP · Nov 27, 2017

If they weren't bathed because they refused and you did your best to provide the best care there is no reason for you to feel guilty. If you didn't provide the best care you could have, then there might be some guilt warranted. There will always be someone around that feels they should point out where everyone else falls short of their standards/expectations. You can't please these people and I find it best to ignore them. If you feel you were unable to bathe the two patients for a legitimate reason and you should not have been made to stay, you should speak with the nurse privately and discuss what happened. If you stayed late to help out and get patients the care they needed, you might have to get used to that because we all end up late at times because things happen. I'm not really sure how this translates to you shouldn't be a nurse, are you concerned that you will have trouble with time management? Each work environment has good and bad aspects. Good luck in your future career.

Katiebug96 · Nov 27, 2017

I am going to take that experience, and learn from it. One of the reasons I didn't bathe one of the patients was because he was hullicinating and kept falling asleep, seconds after I woke him up. I gave him a partial bath to help clean him up a little bit, I checked his diaper and he was dry. I felt like he wasn't capable of a bed bath at the time. I asked him if he wanted a bath and he said no, then I asked him again and he said yes, then no again. Words were just getting mixed up. I just feel like I'm not fit for nursing because of people always getting on my case about what I need to do and what I haven't done. I love taking care of my patients, I try to sit down and talk to each one when I have the chance, I make sure they are in good care.

Davey Do · Nov 28, 2017

I just feel like I'm not fit for nursing because of people always getting on my case about what I need to do and what I haven't done.

Negative critiques of our performance is a difficult thing to take, isn't it Katiebug, especially when we attempt to do, in the very least, an adequate job?

There will always be someone around that feels they should point out where everyone else falls short of their standards/expectations.

Yes. To the Nth degree. It's easier to criticize others' shortcomings and take potshots from the sidelines, especially after the fact.

The only concept that helps me deal with these kind of negative reactions is to remember that all behaviors stem from the two basic emotions of love or fear.

People react the way they do because they want to positively express their emotions by showing love for someone or they behave negatively out of fear. A lot of People have low self esteems and increase their self esteem by putting others down. "At least I'm not as bad as him or her" they seem to say, "So that means I'm a good Person!"

These People are expressing the need for love of self and also the fear that they are not in control of others. Or, as JBMOm said, "Falls short of their standards/expectations".

We will deal with this negative reactions constantly throughout our lives, Katiebug, and we cannot allow others' perception of who we are be more important then our own self perception. We have to sleep ourselves, so it's best that we like ourselves as much as possible. And the way to like ourselves is through practise. And, as we all know, practise provides opportunity for possible improvement.

So, Katiebug, take this thread you've started as the first step in practicing to make your opinion of yourself, in the very least, as important as what others think of you. But not more important than your own.

The very very best to you, Katiebug. And welcome to AN.com!

Katiebug96 · Nov 28, 2017

Thank you very much! I will certainly do that!

Orion81RN · Nov 28, 2017

The nurse for your patient should have been your ally in this case. If you have a patient that refuses any care, you tell the nurse who then charts the specific details of refusal of care. That way, everyone's butt is covered when family or pt themself later complains care was not provided (neglect accusation.)

In this case, that oncoming nurse who made you stay, was completely in the wrong. If you tell your nurse of refusal of care, then your nurse on your shift can deal with that oncoming nurse and explain refusal of care. It is afterall the nurse who is ultimately responsible.

Im sorry you have to deal with such bs. Thank you for everything you do as a CNA.

Katiebug96 · Nov 28, 2017

Thank you, I will definitely make sure I tell the nurse next time!

JKL33 · Nov 28, 2017

Thank you, I will definitely make sure I tell the nurse next time!

The other (main) reason to notify your nurse when things like this happen is because s/he is responsible for further assessment of the situation, especially regarding the patient's health. You mention that care wasn't completed because one of the patients was hallucinating and not able to stay awake - if this wasn't typical the nurse would want to assess that patient (for medication effects, possible infection, etc.). Other than that, s/he may also want to know in case there is something that needs to be addressed with the plan of care (is this the 3, 4, 5th day in a row this patient isn't being bathed, and what can we do about that, etc.). The nurse may have immediate suggestions for the situation when you report things like this, as well.

Keep your chin up, as they say, and just do your best. Communicate with your nurse, and don't let others' criticisms get you down. :up:

Crush · Nov 28, 2017

All we can do is the best we can with what we know at that time and what is available to us at that time. If that is the case then no need to feel guilty. I have nothing further to add since the above have provided some good advise/wisdom.

Orion81RN · Nov 28, 2017

The other (main) reason to notify your nurse when things like this happen is because s/he is responsible for further assessment of the situation, especially regarding the patient's health. You mention that care wasn't completed because one of the patients was hallucinating and not able to stay awake - if this wasn't typical the nurse would want to assess that patient (for medication effects, possible infection, etc.). Other than that, s/he may also want to know in case there is something that needs to be addressed with the plan of care (is this the 3, 4, 5th day in a row this patient isn't being bathed, and what can we do about that, etc.). The nurse may have immediate suggestions for the situation when you report things like this, as well.
Keep your chin up, as they say, and just do your best. Communicate with your nurse, and don't let others' criticisms get you down.

This is absolutely crucial. You worded it in a concise manner, where I would have rambled at all the reasons the nurse needs to know. When a CNA reports to me a refusal, we go to the pt and assess the situation, figure out why they are refusing and if it is a clinical indicator of something else going on.

Speaking of, when a pt refuses care, please tell us as soon as you can. Too often right at end of shift, Im told by the CNA that pt refused. At that point its too late for me to assess, and I have to then pass it off to the next nurse. 1) that gives the next nurse extra work I could have done. 2) that is potentially delaying an assessment in a change in condition that needs to be addressed promptly.

Katiebug96 · Nov 28, 2017

I will make sure to do that now! I only work every other weekend, so I'm not familiar with what's been going on. I make sure I know what's wrong with my patients, and how they go throughout the day. It gets frustrating sometimes because I'm not told certain things and the CNA's/Nurses get irritated with me