Difficulty with a CNA

nursewendii · Jan 22, 2007

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

Jenn,

I too have had many experiences with CNA and other co-workers not doing what is expected of them. I have found if not reminding them of their job doesn't work, go to your manager. But first, keep a log on what wasn't done so you have some evidence to back yourself up. Example: John Doe in room 122 was to have a bath on evenings and be repositioned every 2 hours and also vitals every four hours. CNA "Sally" only did the repositoning one time according to her charting. When confronted why she said that is how I was taught or because I didn't have time.

Explain to your manager that you have gone over things at the beginning of the shift and even offered to help, but you feel like you might as well do it yourself if you want to be sure the delegated tasks are done.

Good Luck,

nursewendii:nurse:

Cattitude · Jan 22, 2007

my original comment from yesterday was directed to someone who was being less than kind regarding the cnas that she works with. i was not trying to start a debate (which seems to be what happened) but was asking that this particular nurse not regard all cnas with the same distaste. however, my response was met with much sarcasm and on one or two occasions downright disdain for my profession.
i apologize to anyone that i may have offended with my comments, but would like to say that in order for any of us to provide the best possible care for our patients, wouldn't it be more fruitful to look at and listen to the opinions and ideas of the people that we work with the closest. i feel lucky, after this particular discussion to work with a team who is appreciative of each of it's members and who can work so well together. it's unfortunate not everyone here is so lucky.

it helps a lot if you use the quote button, we have no idea which post you were responding to. i thnk there were probably over 80 posts!!sure you were going to get some replies you didn't like. go reread your original post, for your very first post on a nursing forum, it was rather defensive and maybe a bit brusque? i know i lurked for a long time before i posted here and i sure didn't jump in with a post that was kind of rough on some of the regulars..

many of us have walked in the shoes of either being cna's or other ancillary staff working under the supervision of nursing. been there and done it. if you are graduating from nursing school, wait, work at least a year as a nurse, then come back and see if any of your views may have changed just a little..

again not all cna's are bad employees.

medsurgnurse, RN · Jan 22, 2007

I'm surprised that with that attitude you've lasted long in nursing. In the facility where I work there are only three things that an RN can do that I cannot. 1-pass meds, 2-pull orders, and 3-hang an IV.
Our nurses rely on us as their eyes and ears and can't keep up with us when they are assigned patient care. Our nurses are appreciative of our work and let us know it.

I am completely surprised that you are graduating from nursing school and believe that the only thing an RN can do that a CNA can not is pass meds, pull orders, hang IV's. That's almost comical. But the scary part is you're almost a nurse and don't understand what nurses DO.

cdean7660 · Jan 22, 2007

Hi everyone,

This is my first time posting. I just wanted to share an experience I had with a STNA. The aide had left the facility for at least an hourand a half, I know thisbecause the other aides had reporteds her to me. When she finally returned, I asked her where she had been, she staqted I was on the second floor. I told her no you were not because your car was gone. Then she started to swear. F* you, you think you are in charge, we can go outside, this went on for five minutes. I escorted her into an empty room and told her I will not have her talking to me like this, she also reek of alcohol. I went to the supervisor and wrote her up. the next day i asked abiut the write up he stated, Oh, I did not turn it in becaue I thought you would cool down over night. I told him no, so, I gave it to the next supervisor working the shift.This supervisor approacdhed the aide with the write-up. The aide stated that's not me that's not my style. The day after the write up, the aide called my house and threatened me, she statesd I am going to get you, not physically because you are already f* up physically but I am going to get your a** real good. My phone has caller ID and she did not block her number. I took the phone to th DON and also to the police in my city and filed a police report on her. The aide was terminated and the police called her home from the number on my caller ID and told to not call my houe again or swhe would be arrested. This has taught me to never make friends with an aide again.

cdean7660 · Jan 22, 2007

Hi everyone,

This is my first time posting. I just wanted to share an experience I had with a STNA. The aide had left the facility for at least an hourand a half, I know this because the other aides had reported her to me. When she finally returned, I asked her where she had been, she staqted I was on the second floor. I told her no you were not because your car was gone. Then she started to swear. F* you, you think you are in charge, we can go outside, this went on for five minutes. I escorted her into an empty room and told her I will not have her talking to me like this, she also reek of alcohol. I went to the supervisor and wrote her up. the next day I asked about the write up he stated, Oh, I did not turn it in becaue I thought you would cool down over night. I told him no, so, I gave it to the next supervisor working the shift.This supervisor approached the aide with the write-up. The aide stated that's not me that's not my style. The day after the write up, the aide called my house and threatened me, she statesd I am going to get you, not physically because you are already f* up physically but I am going to get your a** real good. My phone has caller ID and she did not block her number. I took the phone to th DON and also to the police in my city and filed a police report on her. The aide was terminated and the police called her home from the number on my caller ID and told to not call my house again or she would be arrested. This has taught me to never make friends with an aide again.

ybnvus · Jan 23, 2007

cdean7660, wow.. and I thought I had it rough.

I am a new CNA, when I say new, I mean..certified just a few weeks ago. My goal is LPN..maybe RN. But after today, I am seriously thinking about other avenues. I love my patients, I love my job, but w/o teamwork... I do not foresee myself being able to do this much longer. Only 3 things kept me from quitting today. One is my nurse, he is awesome. I have learned so much in the short time I have been under him. I may not always get the VS to him, but I do my best to get what he needs done. The other is another CNA whom I work really well w/when we can team up. But if I leave, all the pooh comes down to her...and she may quit too. Mainly because there is no "teamwork" w/the other CNA's. Thirdly, and most importantly, I love the patients.. I really do. Someone has to be there for them. I understand the nurses point of view, it shouldn't be hard to get a few seemingly simple things done... but when you are up to your elbows (literally) in pooh, you have call lights going off, you can't lift the person you are trying to clean up on your own (amazingly some CNA's are houdinis), the patient assignment changes halfway through (for the 2nd or 3rd time), the linen cart is empty, finding soap is like finding gold, it's after 1pm and you still haven't had lunch, let alone a 15 min break...you still have another shower to do, it gets overwhelming. Then you get hit with CNA's raunchy attitudes when all you did was finally finish w/a patient (no other CNA in sight) and offer to help w/the rest of the food trays...(even though no one helped you).

You're supposed to clock out @ 3pm..but you are stuck in a room cleaning a patient because at the last moment.. they did what comes naturally, and I just cannot walk away and leave them, so now I'm in trouble for working a few mins over..d*mned if I do, d*mned if I don't.

I had a CNA tell me today that I need to take my breaks, the patients will be there when I get back. I have a problem with leaving people in their "mess", I just can't do it. Not too mention some things HAVE to be done by a certian time, so I keep pushing through til it's done. I guess I'm just too slow.

And I cannot clock out knowing one of my patients is in need of cleaning, yet I can't tell you how many times I've come onto my shift, and they are so bad...the sheets are soaked. What am I doing wrong??

So cdean7660, not all aides are bad.. I, for one, really try my best. I want to be a good CNA..but I do not think I am cut out for it. Over the past few weeks, I have gone home in tears. If (that's a BIG if) I do go on to be a LPN or RN, I pray I never forget how it was to be a CNA. And no, I do not think it is any easier to be a LPN or RN, I see what my nurse(s) go through, I see the frustration, and how much they can be taken advantage of, which is why I try my best to do what's needed.

novermyhead · Jan 23, 2007

I notice you are 24? Well, I am 23 an a new RN..I have the same problem but only with a few of the aides. I think they feel threatened and jealous that the "new and young nurses" are telling them what to do...well most of the time it is just ridiculous to try to ask some of them to do something.
I took the issue to my nurse manager and she has done nothing about it...so what I do is if I need a BP, foley emptied, someone repositioned, whatever..I just do it myself. It might take you an hour to find them and then talk them into doing what it is you want..just do it yourself..atleast that is what I do. It usually is a task that will only take 2-3 minutes anyways.
mostly...there is no teamwork haha. I get a lot more done with the RN/LPN helping me than what meI could ever get from an aide. I guess in the end we are the liscenced personnel anyways.

I'm in my 2nd year of nursing school...as well as a CNA in home health care. I have only been a CNA for 5 months. I have not read in any thread about how the moral of CNA's could be low due to the fact that they really are UNDERPAID for the amount of work they do. Everyone is an INDIVIDUAL with different ideas, personalities, and characteristics. I do not work under a RN I work privately but my great-grandmother is in an nursing home and I have seen for myself the holier than thou attitutude that SOME of the RN's have with their tech's this does not apply to you at all don't get me wrong but this is the majority or the norm. Some people don't give the RN a chance to prove that he/she may not be a ***** like the last RN, and some RN's don't give the tech's a chance to prove that they are NOT lazy and shiftless workers. It is really a breakdown of communication between the RN's and the tech's and not that one person is a ***** and the other person is lazy. Try having a 1 on 1 meeting with all tech's and let them know what you expect and what the reprimands will be from "this point on" that way if something is not done...well then you will know that you made yourself clear and everyone is clear in their understanding and you are all on the same page.

allantiques4me · Jan 24, 2007

cdean7660, wow.. and I thought I had it rough.
I am a new CNA, when I say new, I mean..certified just a few weeks ago. My goal is LPN..maybe RN. But after today, I am seriously thinking about other avenues. I love my patients, I love my job, but w/o teamwork... I do not foresee myself being able to do this much longer. Only 3 things kept me from quitting today. One is my nurse, he is awesome. I have learned so much in the short time I have been under him. I may not always get the VS to him, but I do my best to get what he needs done. The other is another CNA whom I work really well w/when we can team up. But if I leave, all the pooh comes down to her...and she may quit too. Mainly because there is no "teamwork" w/the other CNA's. Thirdly, and most importantly, I love the patients.. I really do. Someone has to be there for them. I understand the nurses point of view, it shouldn't be hard to get a few seemingly simple things done... but when you are up to your elbows (literally) in pooh, you have call lights going off, you can't lift the person you are trying to clean up on your own (amazingly some CNA's are houdinis), the patient assignment changes halfway through (for the 2nd or 3rd time), the linen cart is empty, finding soap is like finding gold, it's after 1pm and you still haven't had lunch, let alone a 15 min break...you still have another shower to do, it gets overwhelming. Then you get hit with CNA's raunchy attitudes when all you did was finally finish w/a patient (no other CNA in sight) and offer to help w/the rest of the food trays...(even though no one helped you).
You're supposed to clock out @ 3pm..but you are stuck in a room cleaning a patient because at the last moment.. they did what comes naturally, and I just cannot walk away and leave them, so now I'm in trouble for working a few mins over..d*mned if I do, d*mned if I don't.
I had a CNA tell me today that I need to take my breaks, the patients will be there when I get back. I have a problem with leaving people in their "mess", I just can't do it. Not too mention some things HAVE to be done by a certian time, so I keep pushing through til it's done. I guess I'm just too slow.
And I cannot clock out knowing one of my patients is in need of cleaning, yet I can't tell you how many times I've come onto my shift, and they are so bad...the sheets are soaked. What am I doing wrong??
So cdean7660, not all aides are bad.. I, for one, really try my best. I want to be a good CNA..but I do not think I am cut out for it. Over the past few weeks, I have gone home in tears. If (that's a BIG if) I do go on to be a LPN or RN, I pray I never forget how it was to be a CNA. And no, I do not think it is any easier to be a LPN or RN, I see what my nurse(s) go through, I see the frustration, and how much they can be taken advantage of, which is why I try my best to do what's needed.

You sound like a wonderful person.If I worked with CNAs like you,Id still be in LTC,But my experience was different with NAs>I was the one running without lunch or breaks,cleaning up my pts cause they had an accident,and I coulnt find my NA cause she was on her break or whatever.Also times are so bad now.When I was an aide on a bad day we had like 6 or 7 people (complete care)You desrve to be comended for your conciensciousness and kindness.

Daytonite, BSN, RN · Jan 24, 2007

I can't tell you how many times I've come onto my shift, and they are so bad...the sheets are soaked. What am I doing wrong??

You're not doing anything wrong. It's not your fault that patients are being left like this. You need to have the support of the charge nurse on the off-going and on-going shift to help with this kind of problem. What we did was have the off-going aides make rounds with the on-coming aides. Any patients that were found soaked or soiled were to be taken care of immediately by both. If it was getting to be a pattern, it was addressed with the off-going aides. This had gotten so bad in one facility, that the DON started having both off-going and on-coming aides sign a form that they had made rounds so she could track any complaints of previous shifts leaving patients wet or soiled. It was amazing how the patients were suddenly looking clean at change of shift. Not only that, but giving the aides this kind of support by the charge nurses and DON got some of them using their assertiveness skills. When oncoming aides would find more than one patient of an off-going aide's in a mess, they would demand that aide get those patients cleaned up before they clocked out.

Like I said, you need the support of your charge nurses to do something like this.

PralineLPN · Jan 24, 2007

I had a med tech question me about what I needed the keys for. I told her there was a pt in respiratory distress and I needed nebs immediately. Finally I got the keys after convincing her it was an emergency. What is it with these people? And before that, she told me to wait for narc keys. All she had to do was reach in her pocket and give them to me, but she makes a big deal of it. I would have given the meds, but she had some issue with that, so I left a list for her. I'm going to the manager if she pulls this crap again. First of all I shouldn't have to explain myself to a med tech, second of all, if there's an emergency, I do not have time to grovel before her to get keys. Then she has the audacity to say the state will be eyeballing me because I'm new on the unit??? The state will eyeball everyone equally. Some people are so ignorant it makes my BP go up 20 points.

Are med techs even considered "licensed" staff?

mkahnlpn · Jan 19, 2011

I completely completely agree! I love that "I am a CnA and I luv my residents!" lol then turn them like your should! LOL

classicdame, MSN, EdD · Jan 19, 2011

not all CNA's are crazy. I have worked with some great ones. But your story really is scary - so many nut cases out there!