Difficulty with a CNA

lonestar1983 · Jan 11, 2007

I am a CENA and i am in nursing school currently and i am also very passive and have a hard time with confrontation.... CENAs who act like the one in your situation give us all a bad rep and it makes me mad. Because i know my job is a "nurses assistant" and i am always happy to help with anything because it not only is a part of working as team it an excelent learning experience. If you have an aid who is not cooperating and not doing her job duties she is definetly in the wrong line of work. I know personally i do this because this is what i love and it is the most rewarding line of work!!! But i dont know if to keep on her is the answer because that will only make her not want to do the duties even more. But i wish you luck and i hope she doesnt ruin your opinion on CNAs because some of us are actually there for the right reasons!!!!!!

CaLLaCoDe, BSN, RN · Jan 11, 2007

"As a CNA myself (for now) I see both sides of the fence, I see some nurses the DO sit and play (yes ...play) on the computer

Please don't think for one moment if you see a nurse on line or looking through an avon booklet that we are lazy or doing something we shouldn't at work; this work is stressful and sometimes we take a time out just as you CNAs do thoughtlessly after we ask you twice to help gather people to clean up MR Jones who weighs in at 300++ and needs several people to turn him and end up looking for people ourselves while you stand around flirting with the morning phlebotomist. Mr. Jones is sitting in his own #!#!

and needs attending to now!

:trout: :trout: :trout:

CaLLaCoDe, BSN, RN · Jan 11, 2007

"As a CNA myself (for now) I see both sides of the fence, I see some nurses the DO sit and play (yes ...play) on the computer

Please don't think for one moment if you see a nurse on line or looking through an avon booklet that we are lazy or doing something we shouldn't at work; this work is stressful and sometimes we take a time out just as you CNAs do thoughtlessly after we ask you twice to help gather people to clean up MR Jones who weighs in at 300++ and needs several people to turn him and end up looking for people ourselves while you stand around flirting with the morning phlebotomist. Mr. Jones is sitting in his own #!#!

and needs attending to now!

:angryfire :angryfire :angryfire

squeakykitty · Jan 11, 2007

In LTC, some of the NAs come from different facilities, and just never learned. Many would ask me to do their vitals for them, some faked it.
The dirty little secret is this: there is alot of false documentation by some NAs, and often these are the same NAs who are considered the best in the nursing homes. They don't do it all, so they are done with their work sooner and are considered more efficient with their time management. Scary s....

If someone didn't learn, I wouldn't mind showing them and practicing with them. However, VS and accuchecks should NEVER be faked. The LTC I worked at, VS fakers would be caught fast, and be in trouble.

jene2000 · Jan 11, 2007

:welcome:

I am an RN and I view myself and my CNA as team. Most of the time it works out... I treat the CNAs with respect. At the beginning of the shift I go over our patients with the CNA and at that time delegate appropriate tasks. I usually don't have a problem, like I said.
K back to me... I'm an easy-going nurse that has a very good sense of humor, I'm also not as good with confrontation as I should...but I start losing my sense of humor when I have to ask a certain CNA to get a BP like 5 times or if there is a scheduled task like rechecking a temperatiure or discontinuing a foley... and I ask if she has those scheduled task results... no I didn't do it. Or how about at the beginning of the shift, I tell her so and so needs to be repositioned every 2 hours and that I will help her if there isn't another CNA available. What is it that she doesn't get? I am not delegating things that are difficult or that she hasn't done a million times.
I feel like I'm constantly going over her work and either doing it since she didn't, or redoing things... She CONSTANTLY is saying "Why, I normally do it so-so way or only once a shift for vitals" to everything. I've tried to be nice about it, but I'm to the point where I want to say, "Well this is what I need done, and if it isn't, there will be problems." Of course I'm too chicken with confrontation...
I guess the point to this is, how do you deal with a nursing assistant (or even other coworkers) that deliberately does not do what I ask them to do??
Thanks in advance (o and I'm working on this communication problem of mine by reading a book)
Thanks...Jenn

squeakykitty · Jan 12, 2007

In LTC, some of the NAs come from different facilities, and just never learned. Many would ask me to do their vitals for them, some faked it.
The dirty little secret is this: there is alot of false documentation by some NAs, and often these are the same NAs who are considered the best in the nursing homes. They don't do it all, so they are done with their work sooner and are considered more efficient with their time management. Scary s....

I wouldn't mind showing someone how to do BP if I had time and they were willing to learn, but faking them is just plain wrong and dangerous.

hecete · Jan 14, 2007

i work in ltc and have had similar problems with cnas. for the most part, they are really good, but the younger ones coming on board now, have a mouth and attitude and know how to use it. they are constantly bitching about being overworked, breaks, lunch times and on and on. they do so much bitching they can't get their work done. i've actually told several to clock out and go, but then extra stress and work is on the good remaining cnas. it's really a no win situation you're damn if you do and damn if you don't.:angryfire

nitewarrior · Jan 19, 2007

For right now I am a CNA, I should finish my LPN in 14 weeks. I can see both sides of the fence. We have CNA's that would not move if their own behind on was on fire. But we also have had, notice I said HAD, a nurse, who was just doing a breathing round, that would walk past 15 rooms to tell a very good CNA that a urinal needed emptying. The insulting part of that was that the CNA was on change/turn/check rounds and working toward that patient. I think that people need to pitch in and be part of a team. I hope that I never forget how to empty a urinal, but at the same time, I hope that the aides wont forget that if I ask them to do something, it is because I have another priority at the time not just because I am "too important" to do it myself.

This subject also brings up a concern I have myself. Have any of the nurses here transitioned from CNA to LPN while working at the same facility? My current employer has offered me a position, but I worry about getting respected when I ask aides that I have worked beside of to do something. I worry that they will think that they can just brush me off because not too long before I was one of them. Any experience with this or suggestions?

scrubsnhugsRN · Jan 19, 2007

For right now I am a CNA, I should finish my LPN in 14 weeks. I can see both sides of the fence. We have CNA's that would not move if their own behind on was on fire. But we also have had, notice I said HAD, a nurse, who was just doing a breathing round, that would walk past 15 rooms to tell a very good CNA that a urinal needed emptying. The insulting part of that was that the CNA was on change/turn/check rounds and working toward that patient. I think that people need to pitch in and be part of a team. I hope that I never forget how to empty a urinal, but at the same time, I hope that the aides wont forget that if I ask them to do something, it is because I have another priority at the time not just because I am "too important" to do it myself.
This subject also brings up a concern I have myself. Have any of the nurses here transitioned from CNA to LPN while working at the same facility? My current employer has offered me a position, but I worry about getting respected when I ask aides that I have worked beside of to do something. I worry that they will think that they can just brush me off because not too long before I was one of them. Any experience with this or suggestions?

My experience has shown me that with some CNA's it will be a problem, and for others it wont. Some of the CNA's that I work with now as a nurse, I was a CNA with. I try to do alot of my own work, even though I dont have a problem asking them to do it, they sometimes have a problem with me asking. So I do alot of it, and then they come around once they see me doing it, and start doing it themselves. If I ask them to clean a room from a patient who was just discharged I give them 10 min to start, at least in my mind, then I go and start doing it without asking again. Oh and then they show up! I was never a lazy CNA, and they know that. I did have one CNA say out of the blue, "Well don't treat us like we are stupid because WE decided to stay CNA's."

I was totally taken aback by that statement, and was very clear that I would never say or think such a thing!

As far as blood pressures go, it is somewhat an art to get them, and you have to encourage your CNA to become proficent in doing it, sometimes, the beat is faint, wrong cuff size etc...teach teach teach and empower...if it doesnt seem right then it most likely is not! This is what I teach my CNA's who are new out of school.

Good luck, just be sensitive, show them you are still a team member and dont treat them differently on the personal level and they will listen to you, and work with you!

PeachPie · Jan 19, 2007

One particularily difficult issue I have come across is when the person that is doing the crap job is of a different race than you. I have had this problem several times. The above confronting, reporting and talking with nurse manager take sooo much longer to get results. And sometimes the lazybones NA is accusing people of racism anyway! Um, it's not racism if you are actually not doing your job and people are speaking up about it with documentation to boot. The organization is so overly cautious in this situation because they don't want to appear discriminatory. In the meantime, patient care is crap and your workload multiplies because you have to do your job and the NA's job.
This makes me so mad.

I have seen sooooo much hypocritical racism. While working LTC as a CNA, I was one of two white people. Even though they were quick to accuse the one nurse with a backbone of racism, I sometimes got comments of, "I know this little whitey is not trying to tell me what to do," if I asked for help. Management wasn't much better. The truth about working in a place with majority ethnic minorities is that the minorities will often occupy the management positions as well. While this appeals to the ethnic minorities because they feel like they are with their own, downsides like favoritism and reverse discrimination may occur. I know this sounds horrible, but it does occur, and I am speaking from experience. The manager was just like the difficult CNAs. While they respected her and didn't consider her requests to be orders from a slave master (this is why they made her manager, because they could relate), racism was rampant. When I put in my two weeks, a lot of the nice coworkers and the residents' family members expressed condolences, saying, "The white girls never get a chance and never last."

Unfortunately, the racism card does work in the whiner's favor and makes it hard to properly discipline. Point in case: My dad is a teacher. He saw a kid of a particular ethnic minority steal something. He tried to take action, but the principal didn't want to risk an angry mob to accuse him of being racist, so the kid got off scot-free. I have a friend who is in a management position. He has an employee who refuses to wear a necktie, saying, "It's a leash that a white man forces me to wear." My friend has offered to let this employee wear traditional clothing, but this too is turned down. Even though dress code is enforced and most people would have been fired, HR let it go because they didn't want to face an ugly discrimination suit.

I don't get the mentality of people who use victimhood of racism as a shield and an excuse to be lazy. I don't see how having a good work ethic, doing the work that they are paid to be doing, and following the rules would make them, "white." Hmmm I'm a victim of racism too. My Japanese side was in the internment camps during World War II and my Scottish side was prosecuted by the English, yet I don't act obstinate and disobedient toevery request and reprimanding.

Daytonite, BSN, RN · Jan 19, 2007

This subject also brings up a concern I have myself. Have any of the nurses here transitioned from CNA to LPN while working at the same facility? My current employer has offered me a position, but I worry about getting respected when I ask aides that I have worked beside of to do something. I worry that they will think that they can just brush me off because not too long before I was one of them. Any experience with this or suggestions?

I went to work as a new grad RN in the nursing home where I had been a nursing assistant. Because I worked as a new grad on a different shift I didn't come into contact with any of my old nursing assistant colleagues. My problem was with the LVNs rather than with the nursing assistants. They were very much more experienced as charge nurses and were not willing to extend any empathy or help to me at all. They continued to treat me like a nursing assistant. They would also constantly report anything they felt I was doing incorrectly to the DON who would, in turn, call me into her office to talk. And, the DON was getting tired of it. She became their pawn and go between person telling me what they wanted me to know in their one-upmanship "game" they were playing . Looking back now I can see that the DON didn't have enough management skill or backbone to deal with what these LPNs were doing. It made me very aware of the power that game playing can do to people.

My advice is to find your first job somewhere else or, if you decide to stay at the facility where you are currently employed, make it clear to the DON that you want to work on a totally different unit of the facility where you won't come into contact with your former colleagues so you can avoid this kind of thing happening. I would also bring this concern up with the DON so he/she is aware that it might be a potential problem and will indicate he/she will back you up if things do occur. The problem of becoming the supervisor over CNAs that you previously were a coworker with, and that's what you will be is a supervisor of their work, is that some of the CNAs will expect special treatment from you or expect you to treat them like a favorite child. When that doesn't happen they get testy and pouty, just like children. Some just flat out resent that they now have to take direction from someone who used to be their equal. Just so you know, the problem is not you. The people who do this are, for lack of a better word, dysfunctional and never learned good citizenship or good work ethics. Unless you are ready and prepared to deal with this kind of behavior I really don't recommend that any new graduate nurse, LPN or RN, put themselves in this kind of position because it is often too overwhelming to deal with along with all the other things a new graduate has to learn. Something else. . .the people who turn on you like this are most likely not going to be the kinds of people who are likely to go back to school to better themselves. It took me many years to realize that not everyone in the workplace has the desire or the ability to want to improve themselves. That, unfortunately and sadly, is just a fact of life. As you will learn, not everyone shares our enthusiasm and joy of learning. Some people are perfectly happy to wallow in their negativity and misery and spend much of their unimportant lives trying to suck others down into their abyss of futility and hopelessness. DON'T FALL PREY TO PEOPLE LIKE THIS. They get their jollies out of seeing others fail.

Keep up your studies! Congratulations on your upcoming graduation!

DarciaMoonz, LPN · Jan 19, 2007

In this situation. I would pull the NA to the side and have a conversation with her to find out why she doesn't do what is asked. Let her know that you don't ask anyone to do something that you don't feel they are capable of doing. Make note of the fact that you talked to her, and let her know that if it continues that you will go to the supervisor, and address your concerns. You just have to follow the chain of command, but start with the source first.