Help with hopeless horrible nurse's aides

HAngel · Dec 10, 2004

I've been in LTC (employed, not living!!) for almost 10 years. I still love it. I am an RN, a nurse manager (for the past 1 1/2 years and currently a BSN student).
I've learned a couple of things along the way. Treat others as you would like to be treated and it will eventually come back to you. How are we treating our CNAs? How are we treating or LPNs and RNs? How are we treating the folks who bring the clean resident laundry back to the floor? Hopefully with respect. I tend to be a little bit of a Pollyanna and think the best about everyone before I think the worse. Is the CNA on her cell phone because she has to call her pediatrician's office when they open and she is not allowed to use the phone at the nurse's station, or not allowed to make personal calls until her break (at perhaps 10:00 am when it's harder to get a good appointment her your her sick child after work because all the good appointments are taken by then?) And, yes.....I know that everyone's response will be that the CNA is on the phone with her friends, etc. But, please take into account that it just MIGHT be for another reason.
As a manger, I try to say, "Thanks, that was a really good job" more often than, "Can I see you in my office for a minute?" I make sure I praise the staff (EVERYONE) in front of their colleagues so that everyone knows what the other person has done that is GOOD. Yes, that person may have just been doing their job but, so what? What's wrong with thanking someone for that? How many times do we go to the grocery store, or the bank, or a clothing store and thank the clerk when we are leaving? Why do we thank them........they are just doing their job. That's what they get paid for, isn't it?!!!!! And remember, we can all thank our colleagues, you don't have to be in management to appreciate when someone has done something.
Another thought.......if I have an employee with an "attitude" who suggests that perhaps I should be out on the floor helping them more, I ask them to come to my office and pick one of my tasks to do. They usually look at me funny. Then they realize that, yes, I may be able to do the work that they do (I also was a CNA once) but they are not able to accomplish my work for me. If I spent my entire day helping to pass meds, toilet and feed people, I would have to work an entire extra shift just getting MY work done! This usually gets the point across, and I try not to do it an "holier than thou" attitude. It just depends on the attitude I am approached with.
Hope this has helped. :)
Jan

AWESOME!! :) Agree!:)

Hangel

HAngel · Dec 10, 2004

Here's what happened to me this past weekend. My CNA and I had a patient whose family had complained to management, administration, etc. about the quality of care Mr. X had been getting. When I came on duty Friday, the social worker was there trying to straighten out some lingering customer service issues with the wife. I thought, okay, I'll have this patient the entire weekend because they know I will bend over backwards to make this man as comfortable as possible.
I told the CNA to make sure Mr. X was turned every two hours (explaining the above scenario to her). All went well until Sunday. During rounds he told me that he was hurting really bad,"I think I've been in this position too long". I asked him if he was being turned often enough by the CNA and he frowned. He also asked to have perineal care given because he was itching down there. I went to get pain meds, asked the CNA to make sure she turned him and to give him perineal care. ( I personally had turned him several times myself and attended to various needs during the shift.) She told me that she had just done it an hour before and walked away in a huff. When I went back into the room he said that "she just handed me the washcloth" and stood there. He was not a happy camper.
I could see that this might be leading to more complaints to administration, so I spoke with the supervisor, the CNA, etc and documented that the patient had full BUE ROM and could clean himself and to see the flowsheet for turning (every two hours). I just wanted to nip any future problems in the bud and didn't think much else about it. This is a Rehab floor by the way.
But, the CNA got royally upset thinking I had reported her to the supervisor and had documented something bad about her so she went into the patient's room and asked the patient why did he report her to the nurse for these things. I was appalled!!!! Then he asked to speak with me because he told her that he hadn't said anything. Sheesh. I told the CNA I could not believe she confronted the patient like that--and she had taken an Amazon of another CNA in there with her when she did it. If I was the patient, I would have been scared to death.
I showed the CNA what I had documented. It did not reflect bad on her at all. I spoke with the supervisor again and told her I was not going back into that room--shift was almost over. He was either going to call me a liar or yell at me for repeating what he said and I wasn't going to be the fall guy. And, I was not going to call him a liar even if he has been a difficult patient.
It just made me so angry that this CNA had to make things much more difficult. Shift was almost over, all she had to do was turn him in a timely manner and keep him clean and dry. After it was all said and done, I wish I would have reported her because what she did was not professional at all and reflected badly on the both of us. If I could go back and do it again, I would have handled the situation differently.

I'm really not sure that I've ever confronted a patient... I've been assertive, especially those that are inappropriate (God bless Friday nights in the ER:), but never anything like that. More of when someone says something inappropriate saying, "I do not wish to be spoken to in that way." (which we are allowed to say and do.) She was completely out of line... I'm not a mgr (just an aide and BSN RN student) , but I would expect someone with that attitude to be spoken to. That's a legal issue and an ethical issue.

Hangel

stormy_61 · Dec 10, 2004

That CNA was totally out of line and should have been reported and written up I've been a CNA since 82 and have never confronted a patient like that. When we become CNA's we are aware of our duties and that is making the patient comfortable that includes peri care ,ROM and what ever else we need to do.

KacyLynnRN · Dec 11, 2004

I was a CNA for 3 years way-back-when, and while it is the hardest job I've ever had, I took that job with an understanding of the work I was expected to do everyday, and with knowledge of what I would be paid, no matter how low it may be. And I accepted the position knowing those 2 things. And I feel I was a pretty good CNA. I didn't always have time to do everything I needed to do, but if I couldn't do something I would be very honest with the LPN/RN and tell her ASAP so we could fingure something out. Low pay and tough working conditions does not excuse people for doing a lousy job. If they can't do the job, then they need to get out.

MZachry · Dec 11, 2004

Good luck. I worked as a nurse tech when I was in college. It was horrible, back-breaking thankless work. The nurses were rude, they did not help at all, they were patronizing and they tended to treat the aides like property(where's my aide?). Plus some of them made it their mission to see that you never took a break or stood still for more than 10 seconds so they were constantly looking to keep you busy. I will never forget how I used to get to work and I would be taking my coat off and they would be in your face talking about what needed to be done. And all of that for NO recognition and piss-poor pay.
Anyway, my point is that I can see why many of them would be less than motivated to do a great job. And I have been on the other side and I have worked with some great aides and some shamefully lazy aides. But I still remember what it was like.
Good luck.

A few years back I decided to go to work as a teacher's aide at the high school where I graduated from to get out of the house. (Obviously it was not for the money...lol) Anyway, my dept. manager was exactly how you explained the nurses. She never let me have a minute to breath it seemed...claiming the reason of having to keep me busy, or they would end the position. I'd go to the office and see the other aides chit chatting with the principals! So, as I came home everyday upset (as she NEVER would let one day slide without saying at least one rude comment), I had to quit. Loved the school, loved the people.....hated the attitude of one person that thought her masters degree gave her the right to belittle anyone that walked by her with out a masters or a phd.

Some people are so rude. Maybe in her own little, jealous way, this was her way of making herself feel better about how her life turned out....I don't know.

I feel sorry for anyone that has to deal with this. On the other hand, I hate people being lazy, hiding instead of working, and the worst is dishonesty!! If an aide doesn't want to clean a pt., then they shouldn't have taken the job.

--my two cents and more-- lol

wesfrogRN · Dec 11, 2004

I know how hard it is to work as a nurse assistant. I had to work as a NA until I passed my boards. I worked for a grand total of 3.5 years as a NA, 2 years while in school and 1.5 years after graduating with my BSN. I did my job and I always gave 110% even though I was very underpaid and the work was very demanding. I now treat my NA's how I wanted to be treated....with a little respect. But there are still a few that come to work with an attitude problem and it rubs off on some of the others. We've (the nurses) have written up these few that talk all day on the phone, sit and watch everyone else do the "hardest" labor (e.g. lifting the heaviest patients to/from bed and the toilet) but our manager just pulls us aside and says, "You're having a problem with so-so, then you need to take them aside and talk with them." I thought the whole point of being the manager was to "serve the floor" and take care of issues when they arise and help out. You're not suppose to "pass the buck" and give your staff more to do than take care of their patients.....you're the manager, you're in charge, you do it! So maybe that's where some of our problems are....in management. I think that some forget what it's like to really be on the floor and working side-by-side with the other nurses and the NA's. :eek: :uhoh21: :uhoh3: :angryfire