I would really like some advice on how to handle this situation. I am working 12 hours nights in a busy ICU. We have a 61 year old CNA - the only CNA and no secretary- who takes a smoke break twice an hour. She is often gone as long as 40 minutes. Even during a code or when we have a very unstable pt or admission or if she is supposed to be watching a confused patient she will leave the patient, go out to med surg and find someone to sit so that she can smoke.She just disappears. She does not inform anyone that she is leaving the unit.Obviously this is really compromising patient care.If for some reason she is tied up helping with something she has a full blown nicotine fit and snaps at everyone, slams things, rolls her eyes and gives everyone hard looks. Unless administration or an MD is around, then she is the sweetest little woman in the world. Now I am lucky if I have ten minutes to eat something which I normally do around midnight.This CNA has a long smoke break, a meal break, another smoke break and essentially does nothing for two hours. No one that I work with wants to confront this person and our manager feels she is a great worker (she told him so).Has anyone out there had any success in addressing the problem of excessive breaks by the people who are supposed to be your ancillary staff?