How to deal with lazy techs/CNAs?

[happyhippo]

I have been working for 2 years on a busy neuro floor. And lately I’ve been feeling really fed up with the techs working during night. First of all, our hospital requires each tele unit to be staffed with 3 techs at night. My unit, on the other hand, has been running on 2 techs at night for forever now because my manager doesn’t think that nightshift is busy enough and she also doesn’t want to spend her budget. We get a lot of total care, confused, violent, jumper patients. A lot of times we are short on nurses too. So we each have to take on an extra patient. And our night techs are known among the nurses to be very lazy and spoiled. For example, a lot of times when I ask the techs to help me cleaning up or repositioning a patient, they would say they’re eating. They get one 30 minute break like everyone else but they take a break to eat and then another 45 minute break later on. While we nurses are running around nonstop with little help. They never prep the room or come to help when there’s an admission from the ED. There’s this one tech who always argues when we ask her to put in an IV or help us reposition the patient. She would say something like “you just reposition them, let them sleep,” or “you can do it yourself.” She expects us to turn patients ourselves and I politely told her that I need help and I’m not going to risk hurting my back. They seldom answer patients’ call bells. They’d sit at a corner on their phone even though they see the call bell lighting up. They NEVER EVER do Foley care even though they’re assigned to do it. There are many more ridiculous things that they do. My manager and charge nurses don’t want to confront them because they’ve been working for a very long time and they’re really vocal. One tech has been at the hospital for 20+ years. One always gets heated up and threatens to quit. All nurses in my unit know about their reputation. One nurse told her preceptees to expect to turn and clean patients themselves when they come onto night. Instead of discipline the techs, my manager shifts the responsibilities onto nurses. We’re expected to do some of the tasks that the techs usually do because they can’t complete them on time. I understand that it is hard to take care of 12 patients and juggling tasks at once but it feels like we don’t receive as much support compared to the amount of work that we have. And that overtime really makes me feel extremely burnt out. 

I tried to phrase my requests in the nicest way like this is done for the patient and the patient wants this. There are many times I have to give them a big smile and puppy eyes for them to help out. But it’s getting to the point where I don’t want to want to bend backward anymore. What I ask them to do is not even for me. It’s for the patients. 

When I got floated to other units, I realized how much their techs actually do. And it really makes me hate working in my unit. Any advices on how to solve this problem? Or how to delegate better? 

[kp2016]

There is no way for you to fix inappropriate behavior that is well established and allowed by management. Reporting their behavior or trying to somehow change it with improved communication, delegation or explaining their job responsibilities to them will just put a target on you and likely make your shifts even more unpleasant. 

Assuming they wanted to change it a manager would need to work night shift, witness the unacceptable behavior and give the CNA's /Tech's official performance corrections / written warnings…… I could be wrong but I think this is wildly unlikely to happen.

I have worked on units that had similar problems. It didn’t change until we had a new manager who basically decided that certain “problems” that our unit was infamous for would no longer be tolerated. It’s amazing the improvement in the attitude and work ethic of the rest of the staff when you remove (fire) even 1 or 2 of the key trouble makers.

Sadly I think your best solution is to transfer to one of the unit’s that has 3 Tech's every night instead of 2, who are hard working professionals. The situation on your current unit will continue until staff openly refuse to work with these conditions.

[JKL33]

7 hours ago, happyhippo said:

Any advices on how to solve this problem?

Serious here: You leave. If you love everything else about the job it may be worth it to have a talk with your manager stating that things can't continue on the way they are--but that tends to have one repercussion or another.

I would advise against pandering. ? Reasons. Developing a good working/professional rapport is another thing, though, and you could choose to work on it if you haven't already.

In the end this is a ridiculous problem and your manager has chosen to let all of you struggle, so the next move is yours. I say your most viable options are to try the rapport thing for a few months and see where it takes you, or else just start looking for somewhere else to work. $.02

[happyhippo]

1 hour ago, JKL33 said:

Serious here: You leave. If you love everything else about the job it may be worth it to have a talk with your manager stating that things can't continue on the way they are--but that tends to have one repercussion or another.

I would advise against pandering. ? Reasons. Developing a good working/professional rapport is another thing, though, and you could choose to work on it if you haven't already.

In the end this is a ridiculous problem and your manager has chosen to let all of you struggle, so the next move is yours. I say your most viable options are to try the rapport thing for a few months and see where it takes you, or else just start looking for somewhere else to work. $.02

I have tried my best during the last 2 years to be polite and make friends with all the techs. I laughed and joked with them. But when it gets to doing serious work, they tend to refuse to do it unless you literally continuously begging them to help you. It doesn’t happen to just me. I didn’t want to confront them because management doesn’t do anything and it’ll just make everything harder than it is. I had planned to transfer to another unit but my manager begged me to stay until fall. I did owed her a big favor so I’ll stay until then. 

[RNperdiem, RN]

There is no changing the techs since this sounds like a deep-rooted problem. Transferring this fall is a great idea, but start doing your prep work now. Take a closer look at the units that interest you. Talk to the nurses there to get a feel of the culture and management style.

I hope you are doing overtime because you want to and not because you are being pressured into it. I suspect your current unit has a high turnover rate. 

My solution to the problem you have- I had CNAs who had breakfast break, cigarette break, snack time, lunch break, another cigarette break etc, was to move into an area of nursing where I didn't have to depend on CNAs to get the work done. In my ICU, the CNA can help push the stretcher, assist with boosts and turns and keep the supply carts stocked. 

[JBMmom, MSN, NP]

Unfortunately, people are people and when a behavior pattern has been established and accepted it's difficult, if not impossible, to change it if people are happy with it. If these techs are happy how things are it's unlikely that you, as one coworker, would have the ability to change it. If they don't see the importance of doing their job for the good of the patients then it's unlikely they are going to see a reason to change based on anything you could provide as feedback.

 As others have pointed out your best bet is probably to move on and find a unit with the support from coworkers that you need. It's unfortunate for your patients that this is how things are on your unit, but there are lazy techs and nurses everywhere, that's just life. Good luck!

[Been there,done that, ASN, RN]

"I had planned to transfer to another unit but my manager begged me to stay until fall.". You owe the manager NOTHING.. as they are making you pick up the slack for the slackers. Move as soon as you can. 

You can also go over their head and get a group effort going to report the slackers to administration.

[ThePrincessBride, MSN, RN, NP]

CNAs can put IVs in? Since when?

They are probably burnt out and feeling resentful, doing the work of 1.5 people. The manager NEEDS to hire enough techs and quit expecting people to work short-staffed. Your manager is part of the problem.

Also, not to excuse their behavior, but I have come across a LOT of nurses (who often have never been techs before) over delegate and burden their techs with work they could have done.

That being said, I totally get the frustration. I recently joined the float staff and I am now keenly aware of how terrible some of the techs I used to work with are. Many will sit at the nurses' station gossiping, a lot of them are young and immature. There really is nothing you can do but tell management and demand change and more staffing or quit.

I chose to move on and get a nice raise in the process.

 

[HiddenAngels]

Ha! I feel like this should be discussed in secret in our secret secret room..

[Advicenurse, ASN, BSN, RN]

I think it starts with your manager. I worked the floor for 10 years and we always had this problem. My manager seemed uninterested when we would tell her. It just makes your job so much stressful when you have 7-8 patients and are doing total care for them by yourself. The pt suffers as well as you. You will probably have to transfer to one of the other units because I can tell you from experience this will not change.

 

[HiddenAngels]

On 4/24/2022 at 2:08 PM, Advicenurse said:

I think it starts with your manager. I worked the floor for 10 years and we always had this problem. My manager seemed uninterested when we would tell her. It just makes your job so much stressful when you have 7-8 patients and are doing total care for them by yourself. The pt suffers as well as you. You will probably have to transfer to one of the other units because I can tell you from experience this will not change.

 

Nope it sure won't

[2BS Nurse, BSN]

"and she also doesn’t want to spend her budget" and "I didn’t want to confront them because management doesn’t do anything".

Red flags. Move on. You are not obligated to stay until fall.

"CNAs can put IVs in? Since when?"

Yes, CNAs and MAs have a wide scope of practice in my state. They can pretty much be trained to do anything (except administer IV meds). I believe this is state dependent. Phone triage is not within the MAs scope, but they do it all the time.