Frustrated

Daytonite, BSN, RN · Sep 8, 2006

you never bargained for this when you decided to become a charge nurse and work with geriatric patients did you? the friendly way to interact with this person is to just say "come on, xxx, help over here in the dining room." make the command more specific, such as "start feeding mr. xxx" or "help mrs. xxx get seated at the table over there". do it in a pleasant tone. show and teach if you need to and they are willing to accept this. you shouldn't have to do more than that if they have a willing attitude.

however, i suspect from the way your post was written that you are not going to be so lucky as to have this person just jump to a task you ask them to do, am i right? is this a problem employee? an insubordinate employee? if so, then before you say or do anything, i would discuss it with your director of nursing to find out just how far in authority you can go with this person in terms of discipline. i learned many years how to deal with that kind of employee. i take them aside, tell them they can either do as i have instructed them because it's their job or they can clock out, go home, and i'm writing them up for insubordination, bad attitude or refusing to do their work. if they refuse to leave i call the police to escort them out. then, i later need to document for the director of nursing the facts of the incident so the don has some proof of what went on in order to apply discipline or fire this person. if administration doesn't back me up, i ride the rear end of these kinds of employees and make sure they are doing their jobs (which they usually aren't, so i catch them doing nothing all the time, thus resulting in one write up after another). eventually, they get tired of working with me and either refuse to work on my unit or quit. either way, it's the end of my problem.

CoffeeRTC, BSN, RN · Sep 8, 2006

If administration doesn't back me up, I ride the rear end of these kinds of employees and make sure they are doing their jobs (which they usually aren't, so I catch them doing nothing all the time, thus resulting in one write up after another). Eventually, they get tired of working with me and either refuse to work on my unit or quit. Either way, it's the end of my problem.

Yep! And you know what? The other staff with thank you for it. I've had multiple CNAs call off when I work....Hmmm, maybe its because we all work together when I work?:monkeydance:

thsnursluvsgeriatric · Sep 8, 2006

You are right I did not expect this, I've always been a very consicentious employee and it surprised me. I think that discussing it with my director is a great idea. This girl is well groomed but to straight forward with the residents and seems to want to manage all her time her own way. I have always given staff allot of leaway if they manage their time pro resident style, but once I see them slacking off so that someone who is busy steps in, well that grates on my nerves.

Thankyou both for your responses, I have read many of your postings in the past and enjoy your thoughts. I too, like you girls am a team player but at times find no place to vent my frustration and it's great to have this avenue of support and advice.

Thanks you've made my day.

Daytonite, BSN, RN · Sep 8, 2006

yep! and you know what? the other staff with thank you for it. i've had multiple cnas call off when i work....hmmm, maybe its because we all work together when i work?:monkeydance:

it took me years, tears, a couple of "how to deal with difficult people" seminars and reading several books on how to deal with difficult employees to become proficient at dealing with these kinds of people. i'm great to work with! those that don't want to work--bye, bye. you're not going to be "working" with me or my patients for very long. guarantee it.

thsnursluvsgeriatric. . .one of the enlightenments that i got very early into my career in supervision and management was the huge gap in the attitude and behavior of those who were subordinate. i was shocked that so many other people didn't feel the same toward the duty they owed the organization that employed them. most will never make it to any kind of leadership position even though they may long for it because they lack the thinking and behavior for it. i saw this even among the rn staff. the really good employees are few and far between. people will subscribe to the idea of teamwork, but only so far as their immediate work group. they conveniently ignore that there are other units and other groups of employees in the facility with whom they also need to team up with and be cooperative. as a manager you'll see this because you see larger groups of subordinates.

a good leader will always find work. it takes time to develop skills to deal with nincompoops who don't want to follow rules and do their jobs like they're supposed to. it's complicated further by other leaders with whom you work who let these degenerates get away with that behavior because they don't know how to deal with them either. so, the nincompoops begin to think they are really something and they have some kind of power. wrong. you, at present in your learning mode, have to learn how to explain it to them. it gets easier with each one. it's a bit emotional, stressful and draining at first, but after dealing with a handful of these types, you harden up and it becomes like any other procedure and skill--1, 2, 3, out the door! the sad news is (and i know you don't want to hear this) that this kind of low performance worker tends to be found in geriatric facilities more so than acute hospitals. i think part of the reason is because of the smaller numbers of administrative staff and the level of their education. in general, you find that as a worker's level of education increases, behavioral problems of an immature nature and slacking off on the job tend to decrease.

sorry if i sound harsh. some of my worst moments in ltc was dealing with difficult cnas. but i overcame. remember, first you attempt to teach and correct with kindness. when that doesn't work, get tough, follow your facility's disciplinary policies and get 'em out.

banditrn · Sep 8, 2006

Daytonite - any book titles you recommend?

thsnursluvsgeriatric · Sep 9, 2006

Thankyou so very much for your imput, daytonite I did not find you harsh. I found that you spoke on some of the realities of long term staff. I have found that certain types of leaders and support staff close their eyes to the neglect of the elderly. At times the staff seek acceptance, this then becomes more important then descent or appropriate leadership and care. I've seen leaders gossiping when they should be guiding. I really appreciate your honesty, you sound like a fair person.

I have also found that allot staff want to shift blame. Accountability has never been an issue for me. If I did something wrong please tell me is my attitude. But I've had girls shift things to look as though I were to blame, what is that all about. People like that Scare me.

I am glad that you overcame the negative affect that difficult staff had earlier in your career. I really want to learn how to be a good leader and to be able to deal with difficult people more effectively. I've read some things on the internet and would like to read more. So I am open to more suggestions, books etc.

Thanks for the suggestion banditrn...

Daytonite, BSN, RN · Sep 9, 2006

There are three books that I recommend. I used the first two mostly to help me describe the behavior of some of the CNAs as I was writing them up as well as to help educate me as to the games they were playing. The Eric Berne book is a classic among clinical psychologists. If you think you know a lot about people's behavior you need to read what Eric Berne has to say! After reading about the games he describes you'll start viewing some people's behavior very differently as you begin to become more aware of how they are manipulating or trying to suck those around them into their little games for their own self-satisfaction.

Managing Difficult People: A Survival Guide for Handling Any Employee by Marilyn Pincus
Working with Difficult People by Muriel Solomon
Games People Play: The Basic Handbook of Transactional Analysis by Eric Berne, M.D. (This is not light reading. It is usually recommended reading for anyone starting clinical counseling classes. I had to read it for a group psychology class that was required for my BSN program many years ago. The way Eric Berne has broken down how people manipulate and "play" others to get responses from them is very eye-opening.)

Simplepleasures · Nov 21, 2006

Once again IF staffing ratios were decent this would not be such a common senario, how can we affect change, so far the only way I can see is to UNIONIZE.Gees I am actually getting sick of myself having to repeat this time after time, I am out of the loop now , but for the sake of you young niurses and those that continue to fight the good fight, see the California Nursing association website regarding a Strong Nation Wide Union!Our only hope.

CapeCodMermaid, RN · Nov 23, 2006

It's not always the case of being overworked. Some people are just bad workers and slackers. They would slack off if they only had 6 residents each. I've seen it in more than one facility. Get together with the staff and see how things can run more smoothly...they chant the same thing...more staff..more staff. We tried more staff and you know what happened? There were more CNAs sitting around not working.

ns lpn · Nov 26, 2006

I agree at my work the shift that works best is the night shift and thats b/c there are less staff. I'm not saying it's perfect their are other issues but the CNA's are more likely to tell the other when they're not pulling their own weight b/c they depend on each other more. Also nights have allowed me to get to know them better and realize which ones are really the poor workers.

umpalumpa14588 · May 6, 2010

Thank you all for your stories & sharing of knowledge. I am in a difficult situation right now too. I am an LPN in LTC. Day to day goes pretty smoothly, but every once in a while, things go bad. For the second time in a couple weeks, I had to turn a CNA in for something she was doing very wrong. I was off the next day, and then when I returned yesterday, everyone was mad at me. I finally found out that the CNA totally lied about what I said, and now I don't know how to handle it. I believe the nurse manager has talked to her about it, but I want to confront her in front of the NM to clear the air & put it to rest. She just ranted & raved to everyone we work with yesterday instead of letting it go. What to do?

And yes, I do agree that people do NOT hold themselves accountable for their own actions. If I did something wrong, I admit, correct & move on. When I have had to deal with CNAs doing wrong, they immediately try to throw me under the bus. HELP!