Venting about a new CNA...this is really, really long!

Nurses General Nursing

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We have a new CNA that just started working night shift and she is going to drive me crazy. In the first place, she has been there for a total of five days and she is an expert on every resident in the facility. She is constantly talking about how this one usually does this or that one usually does that or how she is surprised that Mary slept through the night because she is usually up several times during the night or that Bill went to bed really early since he is always up past midnight. If we try to tell her that Mary was only up all night the first night she worked because her stomach was upset or that Bill was really only awake past midnight because he took an extra nap during the day she just laughs (well, cackles like a witch) and tells us that she already knows the residents very well and she know their habits, so we need to stop trying to make her look stupid. Whatever...:)

Then she has decided that she is the BEST CNA on the face of the earth. She used to work in the dietary department at another LTC but they wouldn't hire her as a CNA. She told me that they wouldn't hire her because she knows that every nurse there takes a lot of shortcuts and doesn't do their job properly, so they couldn't hire her because she would show them up! The said the CNAs are mean and they treat every resident poorly and every other person in the dietary department is lazy and that the whole department will probably collapse now that she is gone. She is already complaining about other staff members here and talking about how she hates following a certain CNA because she knows she is going to find a mess and that the residents are going to be awake all night because they weren't put to bed properly. She did find four residents with soiled briefs after following this CNA the first night she worked, but we has an outbreak of stomach-type flu that day and over half of the residents were pooping and puking. The CNA she is complaining about is actually quite good at what she does...I would be honored to have her care for me!

After hearing and seeing all of this, I talked to her about professionalism and how she needs to be sure she statements she is making are accurate before openly criticizing other people and the job that they do. I also told her that she is out of line to complain about other professionals and say they are not doing their job, when she really has no idea what their job truly is. I told her that if she has that many concerns about the care given at her old facility, she needs to take it up with management at that facility instead of bringing it to ours. She just laughed and said I must have a lot of friends working there if I am so willing to defend them. Oh, boy...:)

After slamming every CNA in the facility and telling us how she is going to be the best thing that ever happened there she started in on the local police department. She is angry that they won't retrieve keys when people lock them in their cars, she doesn't understand why they don't have an emergency fund to pay for locksmiths for people who can't afford them, she doesn't know why they pulled her over for going 75 MPH on a 60 MPH highway...don't they care that she was late for work? The police are incompetent, they are only there to pick on honest people, they make too big of a deal out of noise complaints, they are all sleeping with one another, they spend too much time drinking coffee, and they don't do a good job of keeping the teenagers in line after school. When I told her that I am really good friends with most of our police officers and that I think they do a very good job and that they only pull you over, watch you, tell you to turn your music down, etc for a very good reason, she asked me how many of them I am sleeping with.

And she hates the housing authority and the people at the state because they don't distribute things like food stamps properly. She lives in a subsidized housing complex and is angry because there are ants in her apartment and there are wasps by her door. Right now there are wasps everywhere...you can't go outside anywhere without seeing them. She told us that she had two wasps on her door so she went to the office in the apartment complex to get some spray for them and they wouldn't give her any. They told her that they don't have any in the office and that she just needs to go inside and if any wasps get in, the needs to kill them with a fly swatter. Apparently, she is allergic to wasps, so she called 911 on her cell phone, told them she was going to be stung by wasps, and then went inside her apartment (I knew I had seen her somewhere before...I was the first paramedic there when we responded). She is also losing some of her food stamps because she went from a job that paid $5.15 an hour to a job that pays $8.50 an hour...according to her, they are cutting her from $450 a month to $400 a month and they will cut her even more if they find out that she gave custody of her first two children to their fathers! I'm tempted to call them.

The final straw for me, happened yesterday. I pretty much just rolled my eyes and blew off most of what she was doing until then. We have a resident that likes to stay up all night playing computer games. Since she is often awake until after 0300, she often skips breakfast and lunch and she is losing a lot of weight. I made a comment that I was going to ask the kitchen staff to leave her some snacks, so she could eat them while she is actually awake. She told me that she would be happy to talk to the dietary manger about it because they are very close friends. I told her, no, that I would take care of it. She told me about four more times that she could get it done much easier than I could because she has connections. I repeatedly told her that I was the charge nurse and that the request either needed to come from me, another nurse, or the DON. She just laughed. I talked to the cook that was on that day and that night, there were snacks left. This new CNA told me she had called the manager at home, so that she knew it would get done. I told her that I had already told her I would take care of it, that she was way out of line to call anyone at home, and that I did not appreciate her going around me, when I had already told her that it was my job not hers...I explained the chain of command and told her that if I hadn't taken care of it like I said I would, that she needed to talk to the DON about it instead of going over everyone's head and talking to the dietary manager. She told the CNA who was training her that I am jealous of her "can-do" attitude.

And finally, while she was making rounds on one hall, I made rounds on the other hall. When she came back to the desk, I told her that the other hall was done and that everyone was dry. She said, "Oh, they probably are." I said, "They are...I just changed them and yes, everyone is dry and repositioned." She told me that she would have to go and check since it is her responsibility. I told her that she was not to go and wake everyone up again and that she was not to check my work. So...while I was in the restroom, she went and woke everyone up and repositioned them to the side that I had just moved them from.

I am just about to strangle her...I have never worked with anyone who had gotten under my skin so much. I'm going to talk to the DON about it when she is in next week, but in the meantime, I am just going to grit my teeth and smile a lot.

Thanks for listening!

I have read every post on this thread with great interest. I work with a CNA on nocs in the hospital that has the same attitude and plays the same games. She has even cornered me and tried to argue with me about my care of patients. She insists on going into pt rooms twice a night to empty garbage and give them ice water despite my specific instructions not to enter a room. I should clarify, I am talking about very stable post-partum mothers - not critical, unstable and scary cardiac patients.

Unfortunately reporting her and writing her up has not done any good - except get me locked in a room with her by my NM and told not to come out until we worked it out:angryfire :angryfire :angryfire :angryfire

I am back to working up the gumption to go thru the effort of writing her up again for every infraction. I know she is walking on thin ice due to absenteeism, but she is also going to retire next year. I am tired of hearing how much better things will be when she retires - she needed to go years ago.

Anyway - I feel for you. Good luck. At least yours is still on probation and hasn't been bounced from department to department for years just to get her to retirement.

Specializes in NA, Stepdown, L&D, Trauma ICU, ER.

Wait...just re-read your post...were you implying that since cotjockey was the Charge, she would take the heat if they were soiled/unrepo'd? I'm not sure how to interpret what you mean.

~Lori

From my 3 years as a CNA and almost 2 as an RN, I can attest the the responsibility of the nurses for the actions (or inactions) of the CNA. While what the OP did on one hall may technically be the realm of the aide, the responsibility for it falls squarely on the shoulders of the nurse. If the residents get skin breakdown, the nurse is going to be the one questioned about it, mainly "why didn't you make sure they were turned and dry?" It is the nurses responsibility to make sure the CNAs are doing the things they're supposed to (vitals, turns, baths, accuchecks etc) not the other way around. As an aide, I had to deal with a nurse who'd sit at the desk, reading Cosmo, yelling, "Is anyone gonna get all these lights!?!?!?!" When she said she'd changed someone, I just documented it on the rounds sheet as "Changed per M Lazy, LPN" I wasn't going back around and waking up a patient who had supposedly been changed, but I wasn't going to catch heat when day shift came on and found them soaked either.

Specializes in Hospice.

I too agree that Daytonite's advice is excellent- obviously very clear communication (blunt!) and directions are necessary. I've worked with a couple of CNA's who have some of the behaviors/ characteristics as cotjockey's CNA. Most either seem to get their act together quickly or end up leaving... a few stay forever and try to make everyone's life miserable. Maybe having someone who isn't intimitated by her, won't put up with her antics/ attention seeking behavior and is willing to work with her will help her get her act together. I think it is very admirable of cotjockey to be putting the effort to resolving this situation. It sounds like she has the basic skills necessary to do a good job as a CNA. However, it will be her attitude that stands in her way. Good luck!

Specializes in geri, med/surg, neuro critical care.
As an aide, I had to deal with a nurse who'd sit at the desk, reading Cosmo, yelling, "Is anyone gonna get all these lights!?!?!?!"

Doncha just hate that?!? I was a CNA for 7 years, and I remember a handful of times when nurses would just sit around bs'ing, and there'd be half a dozen call lights going off...hello?!? It's not like just because you have a professional license that you're above and beyond all that! Jeez! :trout:

~Lori

From my 3 years as a CNA and almost 2 as an RN, I can attest the the responsibility of the nurses for the actions (or inactions) of the CNA. While what the OP did on one hall may technically be the realm of the aide, the responsibility for it falls squarely on the shoulders of the nurse. If the residents get skin breakdown, the nurse is going to be the one questioned about it, mainly "why didn't you make sure they were turned and dry?" It is the nurses responsibility to make sure the CNAs are doing the things they're supposed to (vitals, turns, baths, accuchecks etc) not the other way around. As an aide, I had to deal with a nurse who'd sit at the desk, reading Cosmo, yelling, "Is anyone gonna get all these lights!?!?!?!" When she said she'd changed someone, I just documented it on the rounds sheet as "Changed per M Lazy, LPN" I wasn't going back around and waking up a patient who had supposedly been changed, but I wasn't going to catch heat when day shift came on and found them soaked either.

:yeahthat:

As for the nurse that wouldn't get off her butt. Just this weekend I had the same problem with a nurse reading the newspaper. She asked me if I was going to get those lights because the noise was bugging her. I calmly walked right up to her and asked her if her hands were painted on. She got up.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
As an aide, I had to deal with a nurse who'd sit at the desk, reading Cosmo, yelling, "Is anyone gonna get all these lights!?!?!?!"

Oh yeah, worked with one of those too, only her preferred reading was "Better Homes and Gardens" or "Southern Living". Brought a bag of mags every night.

Specializes in geri, med/surg, neuro critical care.
I'm going to talk to the DON about it when she is in next week, but in the meantime, I am just going to grit my teeth and smile a lot.

So, did you get a chance to talk to the DON?

Sounds like a nurse I worked with. I won't go into details, but its depressing to think there are more like her out there. She worked construction before she moved in state and took nursing classes and was hired at a local hospital. I was a new grad and I never knew someone could be in so many places and know so much!! She also managed to make my patients made. Several told me not to let that b**** back in their room. When I quit, the nurse manager said it was my lack of confidence that made her have to check on my patients!! Oh, and I never heard of this happening but correct me if I'm wrong, but she was putting a foley in a male patient with the door shut and I could hear him yelling at the end of a 20-ft. long hall! When I made some remark about never hearing a patient yell so loud, her statement was, "He's a wimp."!!

I don't know what it is, but nursing seems to attract people that like to bully others (patients and other nursing staff).l

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

I had a CNA with this kind of attitude and behavior. I would feel very offended and defensive. Sometimes she would say things in front of the patient like, don't do this, do THAT! etc... She was so smart, I guess she felt she was smarter than most people and acted out of that. I did have to speak to her about her role and my role, and especially that if she had concerns she should voice them OUTSIDE of patient rooms. I did end up speaking with the nurse manager about her a few times but the NM wanted me/us to work it out ourselves (there were other nurses who had had trouble with her).

She was also one to do her own work very quickly (TOO quickly I thought) - and be sitting on her butt while the rest of the CNA's busted theirs. So I would instruct her to "answer that call bell" or "Help the other CNA's to finish before you sit."

After working with her and getting some of this through to her (ie insubordination, respect, etc), I realized that part of her attitude was frustration; and I kinda pushed her to go to nursing school since she WAS bright, knew her stuff, and WAS a natural leader. She has since enrolled in nursing school, and her attitude WAS better. I don't know how she is making out since I left the job - but all of the above did help.

This type of CNA is the one that i would just take under my wing... nuture her need to be needed and fine tune that "can-do" attitude w/ a healthy dose of denture duty.... make her soak and polish everyone's choppers... and let's not for get the ever popular w/c cleaning... and you know, we really need to straighten up the linen carts, and etc.... she'd be MOMMY's LITTLE HELPER... and she would get busy work... every freaking hr and she'd earn her pay... I'd fix her lttle ol' wagon....lol

My word, i have known so many CNA's just like her , it drives me crazy for they think they know everything.. As a CNA myself i find it tiresome and harrying to have someone make such a nuisance of themselves . Now if i were in your shoes as her direct supervisor i would have to be very formal with her ..First i would try to counsel her verbally , it seems as if you have tried this route already ,speak to your DON about the problem that you having with this employee , she may need to be written up or counseled further by the DON then maybe she would grasp some understanding of the error of her ways... My worry would be , if she treats her peers and supervisors with so little respect and consideration , i shudder to think how she would treat the residents , something must be done about this lady and quickly....

The collection of "issues" this person has both on and off the job suggest that she may have some psych problems that you are in no position to deal with.

What you are describing is the behavior of someone who has borderline personality disorder. To be fair, she may have nothing of the sort, but she ceratinly fits the profile.

BPD folks are those who, for whatever reason, stopped their social and emotional development at a preschool level. They may have continued to grow physically and cognitively, but the part that interacts with others arrested way back when.

Some of the characteristics--

--They live in the extremes, tend to see things in black and white terms, blow hot or cold, and can do a 180 in the snap of a finger

--They like to be the center of attention. It's all about them, and if it ever isn't, they do what it takes to yank the spotlight back where they believe it belongs. This includes being dramatic, using illness to their advantage, and bragging to the point where they sound delusional.

--They seem incapable of empathy and cannot put themselves in another person's place without feeling like they've lost themselves. This is too scary too contemplate so they can't let it happen.

--They are very poor at taking direction. Much like the two-year-old who insists, "I do it myself!" they think they have a better way. Or they just don't believe the rules apply to them. Speed limits are for other people. Job descriptions are merely suggestions.

--They don't handle correction well. Even the most constructive criticism is perceived as a personal attack or persecution because you never did like them in the first place or you're trying to get back at them because they pointed out something you did wrong. There is little, if any, ability to separate their core identity from their actions, so if you offer any kind of critique, it means you have rejected them on a soul-deep level.

--They have a ginormous sense of entitlement, which is appropriate in a toddler, but repulsive in an adult. The world lives to serve them. Rules are meant to be broken. You should welcome the chance to provide for them and theirs. You owe them.

I could go on and on, but I'm sure you get the picture.

BPD people are not hopeless, but they are wearying beyond belief. The only way to win with this kind of person is not to play. As Daytonite suggested, be absolutely clear with your direction, state what the consequences will be if she disregards your directives, and then follow through. If she does it right, praise her, being certain to link your approval to her exact actions. If she blows it, link your disapproval to what she did and write her up.

Borderline folks have a seriously impaired sense of cause and effect and often truly do not understand why people get so bent out of shape with them. This further aggravates their feeling that the world is out to get them. And feeds their feeling that whatever they do is justified because they're only trying to survive in a hostile environment.

The fact that her issues seem to pervade every area of her life means that you probably won't have much of an effect on her in the long term, but that isn't your problem. Right now, your job is to protect your residents, the other staff members, yourself, and your facility from the havoc that can be wreaked by such a loose cannon.

I wish you well.

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