help me encourage CNAs

yousoldtheworld · Oct 28, 2008

"drama on the floor between the CNAs; CNAs not wanting to train new hires, resenting nurses and administration changes, griping, lack of professionalism, loss of excellent patient care..."

These are the things that I have dealt with everywhere I work and some of my biggest pet peeves! I wish I knew of a good solution. It might help if, in your presentations, you have someone speak who is also a CNA - possibly one who has been at the job for a long time. That person could talk about those issues and demonstrate how they are harmful for not only the work environment, but the patients as well. The reason why I think it might be more effective to have a fellow CNA as a speaker is because I've found m any aides I've worked with won't take what a higer ranked person has to say seriously I've heard them say "yeah, easy for you to say, you're not the one out here working as an aide", etc...which is silly, I know, but it happens. Good luck.

rancelumsden · Oct 29, 2008

"drama on the floor between the CNAs; CNAs not wanting to train new hires, resenting nurses and administration changes, griping, lack of professionalism, loss of excellent patient care..."

Sorry, I have to 2nd that!

I have a bit different perspective from others as I didn't become a CNA until age 53 and worked as a white collar employee all my life (and have multiple degrees). I took the job because I could get a job --- I've admitted that on these forums. Helping people made it worthwhile --- but it was not the motivation to go into it.

Now, having said that, I see a lot of poorly educated people going into this field who can hardly, and in some cases, cannot, pass basic reading tests (I know I'm going to be flamed for this:angryfire).

You cannot teach professionalism to someone --- you can show them how to be professional, but they have to assume the attitude. Same with motivation --- cannot be taught and comes from within. You have poor employees, nothing will make them motivated or professional.

I believe until the profession of CNA (and it is a profession), pays better and has strict CNA-to-resident ratios, and attracts many more people, you're stuck. Basically, CNA's should be written up and warned when they create 'drama' that is witnessed by residents or the public, or refuse to assist new hires, and other issues. But until you can actually terminate people with the knowledge you can get a better replacement, you're stuck.

So, the answer is to have good ratios, many people on-call so that when someone calls in, you're covered by an experienced person. Also, you're disciplined for excess tardiness, no-shows, and other infractions which seems to be spotty.

Not going to happen until you know there is more competition (which you can create by better salary/benes/ratio), and/or the ability to easily hire replacements. Will that happen? Not with the LTC industry as it is managed today........

I know, cynical answer, but health care ranks as one of the most poorly run businesses in this country.

zacsmimi · Oct 29, 2008

I hear what you are saying. I cant change ratios and salary. I understand the obstacles. :banghead:

Help me know what I can say that will encourage them.

I know that motivation comes from within - and I do believe that professionalism can be taught (like, manners)...

people arent in this field for the glamour... :bowingpurso there has to be a common thread of decency and caring about others at the core of most, right?

I need to sell the idea that a lack of professionalism hurts the patient - even when not directed at them. Thats the rub. :nurse:

rancelumsden · Oct 29, 2008

We'll see if anyone else responds ---- I won't keep posting after this. I cannot argue the 'can one teach professionalism' or not. But I still believe that the CNA issues will NEVER be resolved until CNA's are treated as professionals (gotta give respect to get it....). Salary issue is not the main problem. The following are:

Must have:

strict ratios

a bank of registry people to be called for coverage

no demanding double shifts, coming in on off days, etc. (coverage)

consistent application of rules

These are 90% of the complaint postings and more importantly, the greatest reasons for turnover and 'poor attitude'. People will work at a dirty, low paying, physically demanding job. But they will not tolerate an inconsistent environment --- not knowing how many residents they will have to deal with and no backup, being called in or made to stay because there is no backup (registry CNAs), unfair distribution of holiday shifts with no differential, inequitable application of the rules (some people are 'favored' and others are not). This is what you read on this forum day in/day out.

cjcsoon2bnp, MSN, RN, NP · Oct 29, 2008

As I new CNA I feel like I haven't been doing it long enough to become discouraged or warn down yet and I am hoping that those things will never happen to me. I think you need to remind CNAs exactly how they fit into the health care system, we are the front line in patient care and patients are often relying on us for help doing the activities of daily living (especially in LTC.) In my workplace we have meetings with our supervisor (not always scheduled but regular meetings) which are sometimes one on one and sometimes with a group and we discuss what our concerns are with clients, new ideas for client care and how we feel we can improve the workplace and our work as CNAs. It isn't about being talked down to or being lectured, its about discussions and the exchange of ideas between RNs/LPNs and CNAs on how to improve our patient care. As it was mentioned you have new CNAs, really good CNAs, some good CNAs who have lost their way and then some CNAs that need to do another job. These meetings serve to remind CNAs how important they are and that their ideas and feelings do count, it also helps to avoid good CNAs from losing their way and CNAs who have lost their way may be reminded why they went into this profession. Good luck!

!Chris :specs:

classicdame, MSN, EdD · Oct 29, 2008

I believe many people tend to live up to our expectations. As an Educator myself (hospital) I hold two CNA workshops/year. It is mandatory. They are served food, get some kind of gift, and the workshop is planned the same way I plan nursing workshops. We cover traction, safety, new products, skin care------ whatever. They get a chance to gripe and I share comments (without names) to the nursing directors. I take their evals and on the next workshop I include as much as possible that was previously requested by them, regardless of how insignificant it may seem to others. Admin and I are working on a clinical ladder for CNA's to give them more pay. Oh, at the workshop I have other disciplines come in to speak. For instance, PT gave everyone a gait belt and showed them how to use it (Admin paid for them and, at $8, was some of the best money we have spent). So there are ways if you get creative. Also, there are websites pertaining to CNA education.

allnurses Guide · Nov 3, 2008

"Now, having said that, I see a lot of poorly educated people going into this field who can hardly, and in some cases, cannot, pass basic reading tests (I know I'm going to be flamed for this)."

YOU ARE DEAD ON... no flaming here.

You are also talking about people who can barely figure out how to take care of themselves... no sense of responsibilty... and then putting them in a position where responsibilty is VITAL!!

I have always wished to see more stringent standards for the education and certification of aides.

Question is, would anyone want to do it then?

It's so EASY to do... and it pays more than Burger King.

And then, are we really that dependent on "warm bodies" to merely fill the holes that we have to worry about taking these folks out of the picture?

It is a catch 22.

But I do believe zero tolerance for immature, irresponsible behavior is key.

But if the question is, how do you encourage them toward a desired performance, I guess my answer would be it starts with their education.

Zero tolerance, higher expectations.

It continues with management.

Zero tolerance, higher expectations.

Then your co-workers.

Zero tolerance, higher expectations.

What you should, in theory, have left are the "fittest" and most teach-able.

But face it, you can't always teach everyone.

Those who get it, get it.

Those who don't... do we really need them to hold such a precious position?

Gosh, it makes my head hurt...

johnsboo · Nov 21, 2008

As a CNA for 14 years in LTC, and now a CNA/SN in a hospital on the Med/Tele unit, I have seen every type of CNA, and every CNA/RN relationship there is.

I was a NA for many years before they even had Certification. I was not required to take the Certification course, as in my state it was grandfathered in for previous NA's.

But, I took the course for my own personal education. And just in case I went somewhere that may require it.

I have to say that many of you are dead on about something. The Nursing Assistant field has more people that are uneducated, irresponsible, and lack self-esteem, and have no goals in life other than making a paycheck, and living less than moral or ethical lifestyles. I am sure there will be some hatemail from this, but if I am truly wrong, please by all means prove me wrong in my day to day dealings with my co-workers.

The CNA course does NOT prepare you for what the realities of this job entail. Just as Nursing School does not prepare you for the realities of being a floor nurse.

There is politics, resentment, anger, lack of caring, and indifference in general everywhere, not just in nursing. But, when your job is caring for human beings, that is not acceptable.

The one thing that cannot be taught and that must come from within is a feeling of pride, and professionalism for what you do, and who you are and WHY you do what you do.

Without these things, you will NOT be effective, and you will be worn down.

The things you are talking about discussing in your educational presentation have all been done to death, NOT YOUR FAULT, we are all at a dead end with this and noone knows what to do.

The Good CNA's already know this stuff, and are tired of the riff-raff in our ranks. The rest of them really don't care what you have to say. That is the reality of the situation.

I wish I had the answers, I really do.

All I know is that a person's happiness in what they do comes from within themselves and they are the ones that reap the true reward of doing for others with a selfless attitude.

And over the past 14 years, I see less and less of this.

I am going to school for my RN right now, and my goal is to be an educator as well, I hope that I too can find the right words and tactics to deal with this situation, it is WHY I want to be an educator.

The status quo is appalling!!

The needs of the patient should always come first!!!!!:redbeathe

pagandeva2000, LPN · Nov 22, 2008

Many of the issues brought up can't be changed overnight, but the zero tolerance can happen easier. I think that there should be policies in place for bullying in the workplace. Many times, CNAs and nurses bully each other laterally and vertically, making the postions hard to endure and this leads to absences, patient neglect and stress. Nurses that insult CNAs should be written up...CNAs not assisting each other should not be tolerated. Starting to set a place that is tolerable to work in is important to me.

Tippy-ta-ta · Nov 28, 2008

I have to say that many of you are dead on about something. The Nursing Assistant field has more people that are uneducated, irresponsible, and lack self-esteem, and have no goals in life other than making a paycheck, and living less than moral or ethical lifestyles. I am sure there will be some hatemail from this, but if I am truly wrong, please by all means prove me wrong in my day to day dealings with my co-workers.
The CNA course does NOT prepare you for what the realities of this job entail. Just as Nursing School does not prepare you for the realities of being a floor nurse.
The one thing that cannot be taught and that must come from within is a feeling of pride, and professionalism for what you do, and who you are and WHY you do what you do.
Without these things, you will NOT be effective, and you will be worn down.
The status quo is appalling!!
The needs of the patient should always come first!!!!!:redbeathe

I totally agree. I have been both appalled and impressed by some of the CNA's I have worked with. I have seen some really sloppy looking CNA (and Nurses too.) I agree that in order to do a good job. you must have a sense of pride in the job that you do. So many times I have felt less than proud of myself and my work because sometimes I feel it goes unappreciated. When I get to that point, it is time for a vacation. I have left nursing a couple times only to go back to it, because I missed it. It's a hard and challengin job, the hardest challenge I have found is being taken seriously.

How would you encourage your CNA's? A pat on the back, include them as part of the nursing staff. let them know that they are appreciated for all they do.