Help!!! Insubordinate CNA!

[nursejent245]

I work in a LTC facility on the night shift. I have a CNA that complains about everything. The first 3 hours of my 8 hour shift consist of listening to her moan and groan about everything and everyone. On a daily basis she flat out refuses to do such tasks as giving restless residents snacks to help them sleep, assisting 1-assist residents without 2 assist, cleaning wheelchairs, pick up the dining room, e.t.c. She is caught frequently complaining about the facility and other staff in front of the residents and her morale is very low and is rubbing off on the other CNA that she frequently works along side. When she is asked to stop and taken aside and told to go to the Station Director or the Director of Nursing with her complaints, she has 100 reasons as to why this will not work. It is miserable working with her and it is becoming very hard to achieve an acceptable level of care the the residents need all while listening to, watching and trying to correct her unprofessional and unethical behavior. If I spent my night "writing her up" for the things she did or refuses to do, I would spend my whole shift doing write ups on one person. This is a nightly thing and it is exhausting!!!! Help, I have no idea has to how to deal with someone this disgruntled and insubordinate.

[tothepointeLVN, LVN]

Just start writing her up and eventually she will be dismissed.

[JB2007, ASN, RN]

Just start writing her up and eventually she will be dismissed.

This is good in theory, but in reality the DON will not fire this CNA. You will get something along the lines of we are short staffed and there is not much that can be done about this employee at this time. If the CNA is getting on you last nerve tell the CNA that she is getting on your last nerve. It is blunt to the point and there is no question in that person's mind that they are annoying you beyond belief. I am not usually that blunt, but desperate times calls for desperate messures. Be perpared for the silent treatment if you go to this extreme, but oh the silence is great sometimes.

[Xbox Live Addict]

Just start writing her up and eventually she will be dismissed.

Yep. Management can only throw away so many Employee Counselling Forms, and it will look bad if this aide does something that puts the facility in jeopardy, and they didn't investigate previous complaints about her.

Document what she is and isn't doing thoroughly. Try to get a couple of witnesses too. Some of the stuff you say she is doing could potentially get her in trouble with the State.

[biker nurse]

have you thought of calling the state anonymously for the care she gives??

[Melinurse]

I would give her a warning ( I assume you have already done so ) and then start writing her up. Get witnesses if possible and when possible. Talk to other nurses and see if they are also having issues with her. Perhaps if other nurses are also having these issues you could all go in to resolve this with the DON? This sounds like a patient safety issue so present it that way to the DON. Good luck with her and getting the situation resolved. Keep us posted as to the outcome.

[pjdxxxwa]

Long term care is an underpaid, profit making facility by corporations much of the time. Is your facility of this type or one that truly cares for the welfare of its residents? Which one it is will make a difference on how (if at all) they handle this situation.

First, you MUST go by policy. If policy tells you write up this CNA, do it. And keep a copy for your own records to CYB. I do not trust ANY facility to not pass the blame my way and I will be prepared.

If after so many written up charges of various kinds you do not see consequences you have two choices. Report this lack of carrying to the licensing authorities of your states (which can bring a lot of grief down on YOU if they mention who brought this inform to them) or look for a different job elsewhere and get out of there for your own peace of mind.

Having said that let me share with the group something that I discovered doing hospital duty as a new nurse years ago. I began working at a hospital that had modular nursing. Each nurse had a module in the midst of her patients and had one CNA assigned to her. :typing

After a few months I was talking to a nurse who had graduated from a different school and when mentioning this particular CNA she said called her horrible, never could find her, argumentative and so forth. I let her know that I had no trouble whatsoever with this woman. Here is why. :wink2:

I treated her as a partner with me in the care of patients. I let her know how important her job was in its own way and I was always available for her to help turn or move heavy patients. I gladly answered her questions about health or why the body reacted in such a way, the rationale about treatment and so forth when she was curious. Of course, it was understood that if time did not allow this I would do so as soon as I could. :redpinkhe

The other nurse? She made it clear to her that such and such was the job of the nurse and anything the CNA was assigned to do was HER responsibility. The A&P was something the nurse worried about and no point telling the CNA anything that did not concern her anyway. Etc.

I gave her respect, as opposed to the I am better than you treatment. Because of that my CNA was not hesitant to come to me immediately to tell me that she was trouble a problem counting a new patients pulse who was just admitted for abdominal pain. When I tried and found it racing I immediately looked at her chart for medications taken at home and saw she was on cardiac medication. We moved her to ICU within 5 minutes of a code blue. If she had been on the other nurses floor, the know it all nurse

may have walked in of a dead patient.

All nurses should remember one thing. No matter which job we have been hired to preform we are a part of a team with a common goal. To get or keep a patient at

optimal health. That includes building each up and treating each one with the respect

we believe we are to be treated with. That will make the job so much easier for all concerned. :wink2:

[lindarn]

Yep. Management can only throw away so many Employee Counselling Forms, and it will look bad if this aide does something that puts the facility in jeopardy, and they didn't investigate previous complaints about her.

Document what she is and isn't doing thoroughly. Try to get a couple of witnesses too. Some of the stuff you say she is doing could potentially get her in trouble with the State.

And don't forget to make copies of everything for yourself.

Lindarn, RN, BSN, CCRN

Spokane, Washington

[Thornbird]

I know how frustrating this can be. I am assuming that, having been a CNA, you accord your CNA's with basic respect. Now you have to let her know in no uncertain terms that 1) you're not her friend and don't really want to know how she feels about every little thing and 2) you're not the DON so can't change things anyway. Let her know that you have your own work to do and she needs to be doing hers. Be tactless and blunt if you have to.

As seemingly pointless as it is, you do have to keep writing her up and save your copies. If you can get similar (preferably written) input from other nurses and even CNA's (they couldn't possibly appreciate this woman's work habits) it will strenghten your position. One person like this can poison a whole unit or, if the place is small, the whole shift.

Talk to your shift supervisor and the DON about this, often! Eventually something will get done.

[pielęgniarka, RN]

MAKE the CNA write up a list tonight {that way she will not be complaining to you for at least a little bit}, of all these grievances and then YOU leave a note for the DON, to make an appt with this CNA, so those 2 can sit down and brainstorm on how to better improve the working conditions of the facility. {I've been in your position!}. Tell the CNA it's her own fault if she has information on how to improve the facility (or her own job) and the residents suffer because she doesn't act on it.

[BradleyRN]

If I spent my night "writing her up" for the things she did or refuses to do, I would spend my whole shift doing write ups...

That is your job. If she intimidates you and you are afraid to write her up, then that is what needs to be addressed first. A team is only as strong as it's charge nurse. You owe it to the residents that depend on you for their well being to not allow this type of behavior to continue. Counsel this woman about the inappropriateness of her negativity in front of the residents. When she is insubordiante, WRITE HER UP! Until you utilize the methods of disciplinary action available to you to handle these situations, then it will continue to be partly your fault.

[Daytonite, BSN, RN]

write her up. she is breaking the rules and you are permitting her to do it. eventually, other cnas are going to follow suit and you will have more than just her being insubordinate. if you don't have the time to write her up at work, then do it at home and take the write up in the next day in a sealed envelope and slip it under the dons office door. i used to do this all the time. the don cannot do anything without written documentation. but let me point out that if a patient fell, you would make time to take care of business with them. the "never had time" excuse doesn't hold a lot of water in retrospect when these cnas are standing in front of the bosses to account for some eventually outrageous thing they have done that results in an injury to a patient. and you will feel horrible when you realize that "if only" you had taken some time to write them up you might have prevented a future patient from being hurt or mistreated by them.

when i worked in ltc i learned that writing these kinds of cnas up only needed to happen once or twice. after having to be counseled by the don theses cnas get embarrassed or very aggravated and they broadcast their visit with the don to all their buddies if they have any. the smart cnas take note and learn not to copy the behavior. often these troublemakers end up getting written up again and end up quitting or getting fired.

please realize that failing to discipline her or follow the facility rules of discipline is failing to perform your own job responsibilities as a charge nurse. so, just as she is breaking the rules, so are you.

a student was worried and asking about this on the student forums yesterday: https://allnurses.com/forums/f50/cna-s-not-wanting-help-out-338680.html