warning or write up????

[MsKieshaRN]

I just started a PRN position at a LTC facility, and my 2nd night on the job, I had an STNA who really started off on the wrong foot with me. First she left for her dinner break at 6:45pm and did not return until 7:50, with the exscuse that she went to McDonald's and it was raining so she stayed in her car a little longer so she wouldn't get wet! Giving me this smirky face as she is talking too me. The policy for lunch is 30min, and if you leave you have to clock out and back in upon return which she didn't do according to payroll. The next thing she did was sometime after my 9pm med pass she cleaned two patients that happened to be tube feeders, and instead of asking me to hold the tube feed so she could reposition them, she took it upon herself TO TURN THE PUMPS OFF!:angryfire Both patients were lying flat!!!! When I asked her about this, with the same stupid smirk, she says yeah I turned them off so I could clean Mrs. So-n-so. I forgot to turn them back on. I told her you are not to touch the pumps you need to tell me when you need the pumps on hold not turned off. I will do this, not you. I don't know how long they were like this but she then says to me we do that all the time, you don't need to come do that for me, I know how to do it. ***!! Call me the bad guy, but I wrote her up. I get the impression from her that since she is older than me (15 years or so), and because she's been an STNA for 13 years she feels that she doesn't need to do the things I request. Is this a common?? I also work at a major hospital here in Cleveland,OH and the CTA/PCA as we call them I have no prob with regardless of age,race,gender. But other friends of mine that are nurses in LTC facilities have tons of problems. Sorry so long..

[gitterbug]

I think you were being tested by the CNA's to see how far you would let them slide on duties they know exactly how to do or not do. You did the right thing, but I agree that you need to establish a working relationship with the other staff. Maybe a few minutes of touching base before the actual crew hits the floor, just go over a few points you feel are important and let them know you will be there for them too. LTC is difficult to work at the best of times, so any thing you can do to promote good working relationships will only benefit everyone . Have a good day.

[chris_at_lucas_RN, RN]

You wrote somebody up on your second night on the job?? I don't think you should have written her up for doing something she was used to doing. You could have told her that from now on you want things to be done a certain way and then if she still kept on doing it you would write her up. You were only there for 2 days. Whoever was in charge before probably made them get away with whatever, so you need to talk to them first and let them know what you expect of them. I think it's very important to have a good respectful relationship with your coworkers/subordinates and you started out on the wrong foot.

I thoroughly disagree.

One, this is an RN and she is to be respected and obeyed by her subordinates.

Two, this stuff went on for two days. Personally I think she was a day late!

The aide knew not to do what she was doing. You should not have to warn someone about the obvious. She was in fact confronted, nicely it sounded like, but persisted in irresponsible and, in the case of the tubefed patients, dangerous behavior.

What happens to the risk to the patients while the RN is supposed to be nice to the malpracticing aide so they develop a good relationship? If they had aspirated or come to any harm, it would have been on the RN's shoulders. It is therefore her responsibility to properly supervise the carestaff so the patients are kept safe and the company's resources honestly managed.

Oh, she did that, didn't she! OP, you go girl!

In short--write-up.

[TraumaICURN]

You wrote somebody up on your second night on the job?? I don't think you should have written her up for doing something she was used to doing. You could have told her that from now on you want things to be done a certain way and then if she still kept on doing it you would write her up. You were only there for 2 days. Whoever was in charge before probably made them get away with whatever, so you need to talk to them first and let them know what you expect of them. I think it's very important to have a good respectful relationship with your coworkers/subordinates and you started out on the wrong foot.

It doesn't matter who was in charge before that let the STNAs get away with murder. The buck has to stop somewhere. There is no need of the OP to let them know what is expected of them when it comes to clocking in and out for lunch. That is discussed in general orientation. 30 min, and 30 min only. The STNAs took advantage of this, and deserve to be written up, beacause I'm sure it's not her first time doing it. Moreover, she didn't even clock out for them. She is defrauding the LTC facility. The rules and regulations were set before the OP even started the job, and the STNAs were well aware of them. It seems to me that the STNAs were testing the waters to see how far they could go.

[RNDreamer]

You wrote somebody up on your second night on the job?? I don't think you should have written her up for doing something she was used to doing. You could have told her that from now on you want things to be done a certain way and then if she still kept on doing it you would write her up. You were only there for 2 days. Whoever was in charge before probably made them get away with whatever, so you need to talk to them first and let them know what you expect of them. I think it's very important to have a good respectful relationship with your coworkers/subordinates and you started out on the wrong foot.

what someone is used to doing and what is SUPPOSED to be done are two different things...rules are rules, just because she is USED TO breaking them doesn't mean I should have to remind her what they are...She is not a child...I don't care if it was my second HOUR on the job, I would have written her up, too

[CHATSDALE]

write up was right, patient was put at risk, staying over the lunch time put a stain on your other staff

take a firm stand and if necessary find another job..don't risk your license

[nurseangel47]

Oh, the horror of working with CNAs like those described. I, too, have had nightmarish experiences with trying to deal with the lazies, the ones who absolutely do not care enough to be employed working with people period, much less the frail and needy elderly! I have tried the write ups, the reprimands, the warnings....always the cnas win at the ltc facilities I've worked for. I basically resigned after much conflict with one in particular. He then proceeded to follow me to the next LTC I worked for and was once again under my supervision....I felt like running to the DON to explain that I could not/would not be working the same shift with this particular person ever again and why. I didn't and guess what? He set me up to be fired one evening....so there went another job for me. Lesson learned. Next time I have a problem child like him, I intend to go to the DON earlier, document more frequently and carefully, not give him the opportunity to charm the powers that be that I'm the bad guy, not him....I could go on and on regarding lessons learned from this one terrible, self proclaimed "thug" of a cna....! I hope he is out of health care delivery now...he was also eventually fired from the last place where he got me fired. Management of LTC facilities needs to be more wary of who the hire and who they choose to keep for everyone's benefit. I never thought of going through the ombudman for the area, though. Great idea! Will definitely use that one to my benefit if it ever arises!

[Mizzyfrufru, LPN]

Kudos to the OP!

[TazziRN, RN]

CTStudent, you have a lot to learn........

[TDub, MSN, EdD]

You should not have to warn someone about the obvious. .

I love this quote! May I use it?

[TazziRN, RN]

I think it's very important to have a good respectful relationship with your coworkers/subordinates and you started out on the wrong foot.

I had to come back to this. You're right, it's important to have a respectful relationship but that goes two ways. The STNA, proven by her attitude, knows the difference between what is allowed by scope of practice and what is not. Even if the previous RN let her get away with it, active brain cells should have told her to cool it until she found out what the new RN is like. By not apologizing and promising never to do it again, the STNA smirked at Keisha. Smirking can be equated with gloating, but either way it shows the STNA knew she was doing something wrong and had a "Whatchagonnadoaboutit?" attitude.

[mr.ahp]

If you go around calling your aids, children or idiots, I can see how your lack of people skills might play a role in your problem. I'm an aid, hopefully not for too much longer, but for the moment i also have to deal with aids that dont carry their share of the workload and with nurses that dont have the leadership skills to nip probem's in the butt.