Fellow CNA won't follow routine

[mstearns09]

Let me preface this by saying I believe this issue to be partly resolved, but that I'm looking to prepare myself for the immediate future.

I work with one particular part-time/PRN CNA on the Sundays I am scheduled to work (and on entire weekends during holiday breaks) who normally does not work 1st shift when she works. She normally is scheduled to work 2nd shift. Obviously, the routines and procedures one each shift are different as each shift requires different things. She told me out-right from the beginning that she was not familiar with 1st shift and would need guidance. I was okay with that, but I've now worked at my facility for almost 3 months, and she still refuses to do any of the routines I have explained to her every time I've worked with her.

We often will have the tray cart waiting with trays to be passed and she will have one patient up. I usually end up running around, getting patients up quickly with a nurse, getting them to the dining room or scrambling to pass trays which are not as hot as they were when they first came out of the kitchen. I have asked her several times not to give a particular patient her bed bath before breakfast but she still does. I've explained to her the purpose for making sure the same patient has TED hose and shoes on for transfer but she still puts the patient in just non-skid socks. On Sunday, I point-blank told her that this patient had to have TED hose AND shoes on. When I went to get the patient up for lunch, she had put the TED hose on but put the non-skid socks on her instead of shoes.I have explained to her numerous times that on day shift, we follow a different routine only to hear, "Ok," and see the opposite done.

Just this weekend, she made one attempt at offering baths to three patients, all refused to some degree, and she never reported it to the nurses nor did she attempt more than once. These three patients (males) had not changed clothes, been shaved, or had oral care done all weekend. When my full-time fellow CNAs came on shift on Monday, they were livid. She knew one patient had family who visit every Sunday and that he needed to be clean and presentable. Instead, she waited until his family showed up to make an attempt at cleaning him up. He went three days without having a bath, and had the same stained, rumpled t-shirt on when they showed up. She promised to shave him but Monday morning, he still had not been shaved. I had even explained to her that if she did not get him cleaned up, I would be the one held responsible for it because I was the only full-time CNA on duty that weekend.

Every time I work with her, we are late passing lunch trays because she waits until the last minute to get two particular patients up. I have asked her several times to make sure they are up by a certain time so we can pass lunch trays at a decent time. I always end up being the one getting them up and making lunch trays late.

Today, we had a CNA meeting and having stewed over this since Sunday, I finally found the courage to say something to our DON. This particular CNA was not at our meeting; she drives an hour to work at our hospital on the weekends. The DON indicated that this CNA has expressed her frustration with not understanding our routine or "getting it." I told the DON that I had tried many times to explain our routine to her but that she still refuses to follow it. When I make suggestions on how we do it during the week, all I get from her is: "That isn't how we do it on evening shift." The DON hinted that maybe she needs to not schedule her to work on day shift if she's having that much difficulty following our routine.

I feel that for the long-term, this is probably resolved. However, I have to work two more weekend with her and I would like any advice on how to deal with her refusal to follow routine. I've said things nicely and I've been on the blunt side with her. I just don't know if I just need to finally be sharply blunt and tell her that she needs to do our routine. I haven't involved the nurses in this because they seem to always be tied up in the ER since people tend to wait until the weekend to get treatment.