How do you deal with an insensitive CNA?

[arelle68]

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 older than me, and has been a CNA since I was 8 or something. She feels like she is firmly in charge of the unit, and tells the other CNAs what to do, when to take breaks, and when to go home, and then loudly informs me of her decision.

What concerns me the most is the way she treats the residents. When my one my residents was talking about her husband, the CNA informed her quite flatly, and publicly that her husband was dead. This made my resident cry. Later, the resident was talking about her home and family, and the CNA told her, "You're not home. You're in a nursing home. Your family brought you here and left you." The resident started to really cry then, and say, "My family would never do that to me!" "Well, they did!" is what the CNA said back, and laughed. My resident was distraught by this time, and so was I.

Later, this same CNA ignored me while I was desperately trying to get her attention to get her to get up and put a walker in front of a wondering resident who is a fall risk. She was chatting it up with the girl from housekeeping. I finally shouted at her to get her attention. I never shout at anyone. I didn't know I had it in me, and I shocked myself. It still feels hot in my chest. It gave me a headache.

I am frusterated. Please give me advise on what to do about this.

[dnp2004]

Outright abuse is grounds for immediate termination and reporting to the licensing/certification authority. In some cases, it is grounds for criminal charges. Any supervisor who observes such and fails to take action, incriminates themselves.

Yes indeed! In my State the supervisor or any other medical employee who observes abuse and turns a blind eye, is actually committing a felony. Thus they can serve prison time and lose there medical license.

[indiansfan]

Watch your back, you may get fired like I did.....because thisaid was about the same & the DON did nothing after I reported things several times....

Good luck

[TheNewCuteNurse]

You write her up and remind her what her job description is.

[indiansfan]

That works unless your DON favors the aids. I was wrongly accused of "misconduct" because of an irate aid, was terminated & denied unemployment. Now here I sit looking for over a month & almost homeless because I can't find a position. I have applied for non-nursing positions too & up to 100 miles away.

I live in Dover, Ohio & have been looking as far away as Mansfield, Ohio.

Just makes me sick & I had no way to defend myself because Ohio is "at will" employment.

Be careful & watch your backs.

[Cherybaby]

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.

Seriously?:uhoh21:

I don't know. I think your tune would change if it were YOUR loved one who was on the receiving end of the abuse.

Just my opinion.

[branbran77]

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 older than me, and has been a CNA since I was 8 or something. She feels like she is firmly in charge of the unit, and tells the other CNAs what to do, when to take breaks, and when to go home, and then loudly informs me of her decision.

What concerns me the most is the way she treats the residents. When my one my residents was talking about her husband, the CNA informed her quite flatly, and publicly that her husband was dead. This made my resident cry. Later, the resident was talking about her home and family, and the CNA told her, "You're not home. You're in a nursing home. Your family brought you here and left you." The resident started to really cry then, and say, "My family would never do that to me!" "Well, they did!" is what the CNA said back, and laughed. My resident was distraught by this time, and so was I.

Later, this same CNA ignored me while I was desperately trying to get her attention to get her to get up and put a walker in front of a wondering resident who is a fall risk. She was chatting it up with the girl from housekeeping. I finally shouted at her to get her attention. I never shout at anyone. I didn't know I had it in me, and I shocked myself. It still feels hot in my chest. It gave me a headache.

I am frusterated. Please give me advise on what to do about this.

Where do u work??? ............I work with aids that have lots of exp 16-20 years........only one of them tries to tell me what to do............and of course i ignore her.......i have to listen to my charge nurse i dont take orders from other aids.......and i dont care how it was done back in the day........and if i ever heard anyone treating a resident like that id turn them into the state........i treat my residents the way i would want my loved ones treated.....it doesnt matter how many years exp u have that doesnt give u a right to be a jerk

[BOBBYCOOL]

I will never understand the human lust for blood and the dark desire to 'punish' others -I am sure for a moment it feels REALLY good. Do most people live with NO conscience? do they feel any remorse after punishing someone so severely? How COLD BLOODED can you be? How when a fish is vulnerable and wounded the sharks begin to circle and attack. The Salem witch burrning atrocities. The French Revolution.....let's chop off heads! How 99.99% of people are unable to see 'their own' mistakes and issues and ADMIT to ANY wrong doing, and how quick others are to judge and point fingers. Until you are wrongly accused you will not understand the turmoil.

If this RN had any smarts about him/her she/he would have pulled the CNA to one side quietly and addressed the situation WHEN it happened and inform her that such behavior is unacceptable and if there isn't a change then it will be reported to a higher authority. I don't think this RN is experienced enough to know how to deal with people, and there are too many adults who are still behaving like children and 'telling' on one another.

It makes me sad and fills me with disappointment.

[BOBBYCOOL]

p.s the fact that this person came to a message board online to ask how to 'deal' with this situation, further reinforces his/her inexperience in dealing with people, that's why we go to school to 'learn'.

Sounds like a drama queen who has no interest in a solution, rather intensifying a problem and people LOVE to do that. The solutions are simple, yet whether people know it or not they enjoy complications, it feeds their lust.

[ktwlpn, LPN]

I agree with the above -the first time you let behavior like that slide you have given tacit consentfor it to continue-and it always escalates.Almost every unit I have worked on in LTC has had an aide like that.If they don't hesitate to act in that manner in front of other staff you can bet they are doing worse in areas where no-one can see them. You have to take control of the situation and you have to protect the residents and the other staff members from this person...

[Emergency RN]

several issues here...

firstly, i agree that any aide, regardless of time on the job, needs retraining if he or she conducts themselves or performs their duties in a manner that is harmful or counterproductive to optimal patient care. that said, notice i didn't immediately say get rid of; why is this? because an institution has invested a lot in terms of time and money in that employee; correcting bad behavior, even longstanding ones, nonetheless returns an employee to productivity, which in the long run is more cost effective for the institution. simply discharging an employee without any attempt at corrective action would be pound foolish for any business.

from the op's description, the situation got to a point where an aide "runs the floor" can only happen if management allowed for it to happen. that is, if corporals are running the army, the fault is always because of a general's lack of leadership.

that said, the other issue i have is with the op's comment to the aide just before they entered their director of nursing education's office; where she tells the aide "i love you." excuse me, but that is entirely unprofessional and absolutely inappropriate. it may imply a certain sort of judeo-christian religious forgiveness on the part of the speaker to the listener, but that is something that frankly enforces one's own religious convictions onto another. in the workplace, that is not only inappropriate but also against the law, as it violates the freedom of religion framework for the listener. further, even if there was no religious intent in the message, it may be subject to misinterpretation or misconstrued as sexual harassment.

respondent bobbycool is correct in that observed errant behavior on the part of a subordinate needs to be immediately and professionally addressed. one should direct the aide to a private area where it should be spelled out and communicated in perfectly understandable terms what the observations were, what the misguided behavior was, and the consequences should that behavior be repeated. if said transgressions continue, then the disciplinary actions should go up the chain of command.

but lets sidestep the op's issue and direct our focus on what i think is really the basis for problems like these:

there is serious lack of training of nurses in the united states beyond dealing with nursing 101 issues, which then seems to constitute many of the questions and comments on this, and other nursing forums. we can write astute care plans about alteration in comfort secondary to blah blah blah... but don't know jack about how to deal with a family member that demands to see a chart against hipaa rules. we allow overly egotistic medical personnel to routinely run roughshod over us and don't dare whimper. we allow patients to assault us and then blame themselves for not having seen it coming. frankly, imho, nurses need to be trained in how to function in real world hospital environments before being let out of nursing schools. or else we're going to continue to have pillow fluffers who bemoan the aide usurping our authority, and five page threads like this, ad infinitum, et nauseam. the sad fact is, nursing schools don't really prepare nurses in dealing with the public as a professional should. that to me, continues to be a serious oversight for the entire industry. :icon_roll

support your nursing unions!

[topic]

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 older than me, and has been a CNA since I was 8 or something. She feels like she is firmly in charge of the unit, and tells the other CNAs what to do, when to take breaks, and when to go home, and then loudly informs me of her decision.

What concerns me the most is the way she treats the residents. When my one my residents was talking about her husband, the CNA informed her quite flatly, and publicly that her husband was dead. This made my resident cry. Later, the resident was talking about her home and family, and the CNA told her, "You're not home. You're in a nursing home. Your family brought you here and left you." The resident started to really cry then, and say, "My family would never do that to me!" "Well, they did!" is what the CNA said back, and laughed. My resident was distraught by this time, and so was I.

Later, this same CNA ignored me while I was desperately trying to get her attention to get her to get up and put a walker in front of a wondering resident who is a fall risk. She was chatting it up with the girl from housekeeping. I finally shouted at her to get her attention. I never shout at anyone. I didn't know I had it in me, and I shocked myself. It still feels hot in my chest. It gave me a headache.

I am frusterated. Please give me advise on what to do about this.

There should be mandatory training/testing for anyone caring for those w/ Alzheimer's/dementia coupled w/ monthly inservices.

I am a CNA and what your CNA is doing is ABUSE plain and simple. Abuse is any act, failure to act, or incitement to act done willfully, knowingly, OR recklessly through words or physical action which causes or could cause mental or physical injury. It is your duty morally and legally to not allow this to continue. The CNA is a bully and probably behaves this way in every aspect of her life. If I she was treating my loved one that way I would go after her job, your job for knowing about it, and any other staff that knew. I would report it to the state and not stop until all parties directly and indirectly involved were held accountable. I know the job can be stressful. I care for 34 residents on my shift, 26 w/ Alzheimer's, 2 w/ Parkinson's, and 6 Psych(all mixed together). I would never treat any of them like that. Right now she has a perfect set-up, the resident can't defend herself and none of the her peers or supervisors will defend the resident either.

[CNAKim2009]

It appalls me that you're being told on the posts here to find somewhere else to work. What does this solve? Yes, it may make your life easier, but what about the residents who are being verbally and physically abused? Leaving a facility because this isn't being addressed is no way to fix the problem. If the facility won't take action against abusive CNAs, then go higher. Go to the State, talk to a social worker, talk to the ombudsman. At some point someone has to address the problem.

As far as the CNA who's been there for forever, I would take her aside and explain to her that you respect the fact that she has been doing her job for a long time, but that by telling the other CNAs what they should be doing, etc, that she is disrespecting you and your authority as their nurse, and that you would appreciate it if she would respect you as a nurse. Kill her with kindness....she may have had a bad experience with a younger nurse who was just a pain in the a$$ and made her job harder than it usually is. And if she continues to disrespect you, have the DON speak to her about the issue. If she wants to be the boss...maybe she should become a nurse herself!