How do you deal with an insensitive CNA? - page 2
I'm a new registered nurse, I work on an Alzheimer's unit. There is a CNA who is being repeatedly scheduled on my shift, and to tell you the truth, I just don't know what to do with her. She is way... Read More
Apr 18, '09Specialty: 2 year(s) of experience in Pyschiatry/Behavioral (Inpatient) ; Joined: Jul '08; Posts: 95; Likes: 66Snitch her out to the boss, that kind of talk to the patients is very inappropriate.
Apr 18, '09Joined: Oct '06; Posts: 194; Likes: 152Quote from ThankfulnurseWhen the issue is flat out verbal/emotional abuse, I would sure hope the staff acts hastily. Abuse is inexcusable.Wow, i'm glad that i don't work with any of you all. You guys are quick to want to fire some one.
That is far from being insensitive, anyone with half a brain and a conscience who truly cares for the residents would never make them cry like that by bluntly speaking to them in such a manner. If I were sitting next to one of my relatives and an aide coldly told them their husband was dead (knowing fully well that this person obviously didn't know this, otherwise they wouldn't be asking) and they began to cry like that. I'd be taking it to the highest authority.
Deliberately saying something that you know will upset them (and on more than one occasion?!), and then laughing about it?
That is just as barbaric as slapping them in the face.
Would you honestly want someone who obviously has no regard for people's feelings, and is so cold and uncaring, to be working for you?
Apr 18, '09Occupation: L.P.N. in LTC Specialty: med surg,homecare,hospice ; Joined: Aug '00; Posts: 4,682; Likes: 4,824Verbal abuse like that is grounds for immediate dismissal at my facility. I always wonder what a person like that is capable of behind closed doors -I believe she would not hesitate to cross over into physical abuse if she has not done so yet.It often starts like this- verbal abuse then uneccessary roughness turns into flat out abuse...Report this-document exactly what you saw and heard and make 2 copies-1 for your DON and 1 to keep....Check your facilities administrative policies,too.Mine are very clear regarding this type of behavior but you almost always need collaboration.Start the paper trail-she is going to dig her own hole...
How would you feel if your mother was being treated this way?
Apr 18, '09Joined: Oct '08; Posts: 52; Likes: 24contact the ombudsman, im sure the hotline number is posted somewhere in your facility, i cant stand cnas abusing the elderly! When I worked as a CNA the obudsman numbers where everywhere.
Apr 18, '09Joined: Jun '07; Posts: 285; Likes: 188Quote from dnp2004Mine too.Actually they are licensed in many States, including mine.
Apr 18, '09Occupation: emergency room nurse From: IL, US ; Joined: Jan '04; Posts: 899; Likes: 508there is at least one bully on every floor/unit. she does this because she can. don't let her bully you or your pt's. her behavior is inappropriate and she needs to know that. of course when you confront people like this they try to make your life miserable, but she can only do what you let her. take notes and of course involve management. i know alot of nurses that have quit their jobs over people like this and as long as you fight for your pt's and stand your ground about what is professional and unprofessional behavior she will less likely mess with you.
Apr 18, '09Occupation: ADON of a SNF Specialty: 20 year(s) of experience in acute care and geriatric ; Joined: Jul '05; Posts: 983; Likes: 533\speak softly and carry a big stick,
Try not to overreact, it will only blow up in your face.
Document what you have seen and witnessed as abusive behavior, write down other witnesses as well,
Invite the CNA to a meeting, invite your immediate supervisor as well (don't do the meeting without a witness)
Speak softly, dont shout- and start off the meeting explaining the ground rules, you called the meeting as you saw problems with her behavior to the patients, and you dislike her aggressive attitude on the unit as well as her insubordination to her superiors. ( If she lacks respect for her superiors, she certainly lacks respect for her patients...)
You speak first and expect her to listen and then she will have a chance to respond, The purpose of the meeting is to improve communication and quality of care on the units. No one is threatening anyone's position on the unit, the tone must remain respectful.
Stay focused on your goals and be objective when possible.
Expect her to attack your work and when that happens, bring the meeting back to your goals, you may tell her that you called this meeting in order to improve her performance on the unit , if she wants to discuss your's that can be done at a later date.
Make it clear that only you decide assignments and breaks for the CNA's, and you will not tolerate abusive behavior to the patients- verbally or otherwise.
You should also schedule an inservice on abuse. (others will have heard and seen and take example to her behavior).
Keep memos on all meetings and make copies for her personal file.
She is testing you, stay calm and controlled. Expect her to attack back as the best defense is a strong offense. Dont get sucked into defending yourself. It is not her job to supervise you, it is your job to supervise her. When she attacks answer, " I hear you but we are not discussing my job performance at the moment, if you have complaints we can schedule another meeting where I will be happy to listen to all you have to say.
Be open minded and dont paint her into a corner, leave her an opening to maintain her dignity and improve her behavior. Try not to make the meeting personal- focus on improving the behavior.
You have your work cut out for you, but things could improve.
Regarding her age, treat her with the respect she deserves, and expect respect in return. Age is not the issue here.
Apr 19, '09Joined: Feb '09; Posts: 113; Likes: 177Quote from Thankfulnurse????????????? Could you please explain why you feel she should not be fired for this type of behavior directed at the elderly patient? Do you think we are too quick to fire the CNA in question?She doesn't need to be fired. She is used to having her way. Maybe this new nurse can speak with the CNA about her behavior. Then if she continues she can report it to her manager. Then it is up to the manager what is done. Wow, i'm glad that i don't work with any of you all. You guys are quick to want to fire some one.
Apr 19, '09Occupation: ADON of a SNF Specialty: 20 year(s) of experience in acute care and geriatric ; Joined: Jul '05; Posts: 983; Likes: 533Unfortunately you have to understand the politics involved, a DON or Administrator is more likely to listen to the seasoned , elderly CNA than a new nurse (unfortunately - sad but true) and its all verbal abuse not physical so the CNA can lie and say she didn;t say it and most likely the other staff are afraid of her and will swear that they didn't hear anything. Or she can say that it was taken out of context and make up stuff against the new nurse.
I have seen it all.
It is not so simple to fire her, you would need proof and witnesses and warnings. Dont forget this is a CNA with many years experience in this facility.
Reacting emotionally to this problem is not going to solve it.
I believe that is why the OP wanted advice on how to deal with it.
Good LuckLast edit by achot chavi on Apr 19, '09
Apr 19, '09Joined: Apr '09; Posts: 210; Likes: 190I witnessed a number of times on Alzheimer's units were CNAs will tell the patients their spouse is dead and so forth. I think it is cruel. I have had many CNAs tell me that the patient needs to know. I do not have specialized training for Alzheimer's and have no idea what type of training if any the staff has had at this facility. In any event to laugh at a patient and be cruel with remarks is totaly unexceptable. I think there does have to be training provided to the staff and the nurse had the responsibility to not only set the example, make on the spot corrections but also report it to management.
Apr 19, '09Joined: Feb '09; Posts: 113; Likes: 177You could not even get away with acting like that at a convenience store.
Apr 21, '09Occupation: RN Specialty: 3 year(s) of experience in Mental and Behavioral Health ; From: US ; Joined: Jun '07; Posts: 305; Likes: 519Thank you all so very much for your replies to me. I'll tell you haw this went. When I got in yesterday, I requested a meeting. Another staff nurse was in charge, so she called the Director of Education in for support. (This is not the first time a nurse has had trouble with this CNA.) I took the CNA to her office and sat her down. She was really nervous, and asking questions, which I refused to answer. When we got to the door, I said, "I want you to remember that I love you."
The Director of Education let me say just what I've told you, and let her defend herself on each point. The DOE sided with me, and told her that we don't do reality orientation. The CNA denied laughing at the resident, and denied saying to her, "You're family brought you here and left you." I told her that that is what I had heard, and that I never wanted to hear anything like that again. My voice was very soft. The Lord was helping me.
I brought up the issues of her challenges to my authority. She attacked me back. I apologized for what I did that she perceived as rude. The DOE took up for me, and reminded her that I was the supervisor.
The shift went along nicely. The CNA was smiley and sweet as an angel. The other CNAs did what I told them without giving me trouble or running to the CNA who thought she was in charge to get it changed. I was able to focus, and get more of my work done. It worked out well, and I'm so glad the management supported me.
Apr 21, '09Occupation: ADON of a SNF Specialty: 20 year(s) of experience in acute care and geriatric ; Joined: Jul '05; Posts: 983; Likes: 533You did great- like I wrote, speak softly....just be cautious with this CNA, all conversations with witnesses, etc.