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?
Specializes in psych, addictions, hospice, education.
How about calling the nursing supervisor when the person is gone so the supervisor can witness it? You could talk to the supervisor ahead of time to tell her you'll be calling next time it happens. Then it's not just your word against the missing person's.
You need to do something other than just stew about it and let it continue to happen. You're responsible for what she does and doesn't do for the patients. Your job and license could be on the line...
Specializes in ED, Long-term care, MDS, doctor's office.
I agree with kooky kooky...Find out the exact policy regarding breaks and follow it to the letter..not just with this aid, but will ALL who you supervise...Let them know that this is how it will be when you are in charge & have them check in & check out with you whenever they leave the floor...You can keep a sign in/out log..If they are MIA when they aren't suppose to be, I would give them a verbal written warning and report this to your supervisor...This cannot be tolerated, as you are responsible and the enforcer for the facility policy...good luck:)
if she is gone for so long on her breaks, she may be falling asleep, which is a whole other thread altogether.
Calling the house supervisor might work. Saying that so and so went out on her 15 min break and has been gone for 25 min. As for having nicotine withdraw temper tamptrums,
what is she two????? Perhaps she just can't take the stress of the job.
We actually had staff pretending to be smokers because smokers were the only ones whose breaks were tolerated. Now they don't hire smokers. Eventually the problem will disappear, and no-one will get breaks, I imagine. But yes, don't tolerate this dereliction of duty. It's your license on the line.
eesh that sounds awful and stressful. sorry you have to deal with this.
most of the hospitals in my area are smoke free, and you must pass a nicotine test to get hired. the hospitals who aren't have plans to become smoke free within the next 2 years.
I don't think you can just wait for a pt to suffer harm. You are not effectively supervising if you don't correct problems. You are liable for that harm that you knowingly could foresee but did not try to prevent.
Sorry, I wasn't clear about documenting. I meant it to include reporting to mgmt the excessive breaks. Too often managers are poorly prepared for supervision, and think they have to build relationships with employees, rather than building an effective team.
She left to smoke when we were receiving a pt with a K of 8.8 and the WBF rhythm. Supervisor followed through on it and I didn't have to do a thing. It was perfect. She is transferring to another unit. There is a God.
I noticed in the facilities where I worked that the excessive breaks did not even have to involve tobacco. When the individual is a management favorite there is nothing you can do. However, I would still follow through with the warnings and writeups. Don't give TPTB any ammunition against you. You never know when their emphasis might change, and you do not want to be caught on the short end.
I have to comment on this one....I work in a facility that for assisted living and we have dementia also there. I say to you about this...what you are talking about is so common I am over it where I work. I get attitude, people missing and no one carries any radio's in case we need them even when we are supposed to. I guess I am supposed to yell to the top of my lungs to get attention should I need it....sad thing is that even when people live in assisted living aren't they supposed to be checked, like the briefs being dry every hour to 2 hours? OR AM I totally missing the point here?
Lady with real bad red area not changed for 5 hours, is this acceptable, and I asked cna, "she said she was dry"? really? I wander who I am really working with and should I continue to accept attitude, eyes rolling, people smart remarks as an LPN?
Whispera, MSN, RN
3,458 Posts
How about calling the nursing supervisor when the person is gone so the supervisor can witness it? You could talk to the supervisor ahead of time to tell her you'll be calling next time it happens. Then it's not just your word against the missing person's.
You need to do something other than just stew about it and let it continue to happen. You're responsible for what she does and doesn't do for the patients. Your job and license could be on the line...