Help! Insubordinate Nursing Aides

[yadda_yadda_yadda, LPN, LVN]

I haven't posted many times here, but always receive support & wise advice when I do..so here goes:

I work LTC on the Pacific Coast..and work @ a place where nurses aides are allowed to carry on conversations that are "un-lady-like" while providing care--as if their residents can't hear them...while feeding residents, and while providing all aspects of resident care. Some use "ghetto-talk" while providing care & all attempts to correct it fall on deaf ears--there is no pathway to accountability--and talk about passive-aggressive retaliation once a nurse attempts to reprimand? OMG is putting it MILDLY...to the point where one might fear walking to their car after dark.

Before everyone gets riled up, I've written these aides up, counseled verbally and escorted a few to the manager's office. Behaviors that are unacceptable (by my way of thinking) are overlooked @ this facility.

My only expectation is that the aides provide the care that they are trained and paid to do--and do their best to be a lady or gentleman while on duty. Is this unreasonable? Am I being unrealistic?

Today, after sharing this with the DNS, I was told that I "have a negative effect on the entire building"--I was told that aides "dread working with me" ....and she went on to say that "the 3 weeks I was on vacation were the calmest that the building has been" since I was hired.

------then she threw in ......." now, I don't want you to leave......."...............Hmm. Well, it's pretty clear that you just wish I wasn't HERE, that's crystal.

In the entire time I've been employed @ this facility, I've never once been written up... & never have had any type of evaluation or appraisal of performance.

I attempted to defend myself, inquiring as to whether the DNS saw the "dread" as proof that the aides assigned to my hall knew each day what the expectation would be & simply weren't up to providing quality care---(therefore, making my hall "miserable")----and perhaps the other halls subsequently became "affected" by their complaining about having to do their jobs, as opposed to taking smoke breaks 15 minutes after clocking in, being made to turn their residents, change their incontinent garments, and actually.....hmm...WORK for 8 hours, instead of goof off...or being asked to put a lid on their 'baby-mama-drama' for 8 hours, quit texting while feeding residents & quit talking about their most recent hangover.

I was also told that I was, what the DNS termed (gotta love this) 'a rough B-tch' on the floor. I was too busy trying to see through my tears to even attempt a rebuttal to that. I'm so soft-spoken & mild mannered I'm a cream-puff to many.

Totally don't understand WHERE that could've come from. My 19 year old & husband laughed their heads off at those words ever being tagged onto me.

Before you all start suggesting that I begin walking towards the door, BE ADVISED, I'm already doing it...quickly.

Have any of you ever experienced BS like this? And how in the WORLD did you survive it with your head held high until making a graceful exit?

Please don't respond if you're going to just attack. That mindset solves nothing & offers nothing constructive at all.

[nyteshade, BSN]

Well kudos to leaving. Sounds to me like the DON prefers quantity over quality, and I feel for those residents...I hope they complain to get a change going, because I think that is the only way.

[morphed]

Unfortunately, you and your efforts are not appreciated at your facility. You're doing the best thing by leaving because if the DNS really cannot see beyond

everyone's complaining and realize that you are trying to make the place better then it's only a matter of time before you're fired. If the DNS was backing you up, then I would say there might be a slight benefit in staying, but you're not getting the support from management that you need. I would say your standards would be welcome elsewhere, but anytime you try to change the culture of an environment you will be viewed as the one that's causing trouble. Good luck to you (and I agree that you clearly have higher standards than everyone else, and that is a good thing!).

[pielęgniarka, RN]

Do you have an employee handbook for your place of employment? If so open up to the page where it talks about violations of policies and procedures. It should clearly state what are appropriate reasons for corrective actions for any violations (even a conduct or attitude that reflects badly on the employee or the facility or that adversely affects the way the place operates is grounds for group 1 violation where I work.)

There should be a corporate compliance helpline or hotline you can call if your complaints are falling on deaf ears. Read through the policy, get your facts all written up and organized nicely & ask for clarification at a corporate level. Don't accuse, just ask for clarification because according to the policy this type of conduct shouldn't be happening. If you don't have a number handy look for it next time you are at work, it should be listed in the employee handbook or posted in the breakroom or something. You are obligated to do what you can to report any suspected violations of codes of conduct to a human resources representative, supervisor, administrator etc. If someone's not helping you right now keep moving up the ladder until someone does. It is sickening to work with PUNKS like that and I am sorry you are not getting the support you need and that the residents are suffering because of it.

[caliotter3]

She told you off plain and clear and made it obvious that she really does want you to leave. Leave the facility and the DNS can have all the ghetto behavior she wants, since she seems to prefer that behavior in the work place. Personally, I am with you on this one.

[Hospice Nurse LPN, BSN, RN]

Yadda----I FEEL your pain! I worked at a LTC just like that for a few months. At first, I thought you were writing about the place I used to work! I worked 7p to 7a and worked with some of the laziest people I'd ever met. Most of the CNA's refused to get vital signs, rolled their eyes when they were asked to turn and change the residents, took excessive smoke breaks, and a couple would even leave the bldg for 3 to 4 hours while on the clock. I actually made rounds every hour and made the CNA's do the same. Incidently, the other LPN on at night slept most of the night and her CNA's would wake her in time to do accu-checks and pass am meds!

Verbal warnings, writes-ups, conversations to the DON and administrator did absolutely nothing. Like you, I was told that I was the problem. Making those poor women actually DO THEIR JOB. Didn't I realize most of them had young children and some even worked two jobs? This is my problem? Needless to say I resigned. My license and my sanity were much more important than that paycheck.

I'm not making generalizations, so please don't flame me, but I see that many LTC's are famous for hiring CNA's who don't want to work. I realize that the pay is low and the work is physical, but if you can't come to work and have a minimum of respect for the people living there, then I really don't want to work with you. Maybe you can learn to ask, "do you want fries with that".

I know there are many excellent CNA's out there, it's just that a few bad apples will always spoil the whole bunch. I now work in home hospice and work with two of the most wonderful CNA's. These ladies care about the patients and their families. Both of them call me throughout the day to let me know if there is anything out of the ordinary going on with the patient.

Hopefully, you will have the opportunity to work with a group of great CNA's at your next position. Good luck!

[Batman25]

The inmates are running the asylum and management is letting them. You can't fix this. I feel for the residents. Leave. This place will bring you nothing but continued sorrow and disappointment. I'm sorry.

[bubblymom373]

The facility sounds like it is being run by the CNAs. They do and say what they want and no consequences. I would not want to be there when state comes .

[JDZ344]

I hate it when people discuss their personal lives over the top of a pateint or a residents head. even if they are unconcious. It is not appropriate. My fellow aides do it all the time (and I have probably been guilty of it by association).

If your DON won't listen, and the aides won't change, then I agree, time to find yourself a job where you will be appreciated!

[annacnatorn]

How fast can you fly?

I think that once you vacate the said LTC...the State should be called and notified of the situation, I might be out of line here, but this is uncalled for. The Residents come first, always and it does not sound as if they are. I would be thrilled to work along side of you. You request, I produce. Just that simple. If the CNA's find it appropriate to do that sort of thing then they should not be working in that capacity period.

I wish you well on your job hunting. May our paths cross over one day.

[eriksoln, BSN, RN]

My facility has gotten outta hand with regards to the CNA situation, but I deal with it differently.

At my facility, the aids are given so many pt's and so many different duties, most of them are burned out and fed up.........worse than the RNs by miles. For the most part, they come in, do what they feel is fair for their pay, and let the chips fall where they may as far as anything not getting done goes. My facility can not, even in this time of people scrambling for employment of any kind, fill its CNA positions. They have a rep. in the community and there are just no takers. The current CNAs know this and basically dare administration to get rid of them. Hustle and accountability are not in their creed. Many of them have been working very hard at lowering expectations, and they have. Some have worn down management to the point where they get a pat on the back just for doing vitals in less than three hours (on 12 patients).

Me, in the end, if something goes wrong, it'll be my license on the firing line, not theirs. I've never been called to court, but, somehow, I don't think a defense of "But your honor, the CNA I was working with was not motivated and that lead to the problem" will do me any good.

So, on my nights, with 8 patients, I basically walk into it knowing I am for the most part performing primary care. My assessments are detailed and complete, because I can't count on vitals being done on time or hourly rounds being done (they just sign the entire shifts worth of signatures at the start of the shift, this despite me and two charge nurses explaining how this is considered false documentation). I get an idea of who I must keep an eye on more than others, watch the fall risks closely and barrel through my duties like a race care driver. Quality is a mirage. Everything is rushed as though I am suffering from ADD and have other things on my mind. "Customer Service" is nill............non-existent...........nowhere to be found. Requests for water or blankets and other sorts of things are often forgotten in my whirlwind of work.

In the end, PG scores suffer, the hospital's reimbursement reflects it, and management is left staring at us all wide eyed wondering why. They've been told why, yet staffing does not improve and disciplinary action is not taken against the CNA's who work at a crawling pace their entire shift, avoiding everything but the most necessary duties. The whole routine repeats itself, round and round...........until the next meeting, and they are told again what the problem is, and again do nothing about it. Its like the Van Halen song "Here we go round round round, run running round round round."

There are only two conclusions that can be drawn from management's/admin.'s lack of action with this problem:

1. They are incapable of fixing the problem, so they play dumb and pretend it does not exist.

2. They don't care.

Not sure which it is, but either way, its not my problem. I'm put in a situation where only the most generic care is possible, and thats what the patients get.

[cad2nurse]

Boy do I hear ya, and I am a CNA! The talk that goes on is unacceptable. The attitude is also unacceptable. But will it change, probably not. Why? Because these are the people that they can get that will stay while the rest of us run as fast and far as we can. Oh and I might add, the nurses that participate in the same attitude and discussion format really need to get a boot in the you know what. I am just amazed at the behavior that I witness everday. But on a positive note, I do know the owner and well, I am pretty sure "a little birdie" will be telling him a few things that he didn't know but the nursing staff does know. I know that LTC is stressful but everyone must remember these people are someone's mother/father, sister/brother, daughter/son and they deserve to be treated with respect and dignity. And sometimes I find that with just a little effort, the residents respond in such a positive manner that it makes my workload much lighter. Instead of fighting about things, they participate and we all win!