How to deal with PCA bad attitude

[chenoaspirit, ASN, RN]

I am having a major problem with a PCA on my floor. She does NOT want to do anything, except what she WANTS to do. And I NEVER ask an assistant to do anything unless I absolutely cant do it by myself, which is RARE. Last night, I had a patient whose IV came out. He is a very combative, confused patient. He is unable to drink and his IVF's are the only source of fluid intake he has. Well, I had been trying to get someone to assist me for 4 hours to hold his arm while I start his IV. He is TB positive and everyone else couldnt help me because they had immunosuppressed, peds, etc and couldnt risk being exposed and then treating their patients. Finally, the charge nurse told this PCA to help me. The PCA proceeded to throw something down and yell at me. Well, she then was standing at the head of the bed and yelling at me while I was putting on my mask and still throwing things. She finally told me "well, get in here!". I was so nervous and upset. I was literally shaking while trying to start this IV. Thank GOD I got it on the first stick. I told her that Im sick of this. The whole floor deals with this all the time. But this is the 3rd time she has screamed and made a scene in front of patients, making them feel like they are a nuisance. The charge nurses and nurse manager knows this but no one will do anything about it. We are so short staffed, they cant afford to lose any employee. I have been at this hospital for almost 2 years and dont want to leave. But I can NOT work like this. What would you do?

[GatorRN]

What would I do? I'd write her lil butt up, but fast! I'd also suggest to all the other nurses to do the same when she throws her fits. When the mgrs collect enough write-ups, they'll have no choice but to correct the situation, or find a replacment for her. That type of conduct, especially in front of pts, should not be tolerated, for any reason. I can't believe they allow her to throw childish tantrums like that. Unreal

[KellieNurse06]

You can mess with her by just staring at her very puzzled and ask her if she's done....and if it were me (which obviously it isn't..lol) I would tell her she is being very hostile and making not only the patients uncomfortable but the staff as well. THEN I would tell her you will call 911 because she is out of control and obviously has some anger issues that should not be brought into the workplace due to her threatening manner..............I have a friend who is a nurse who works in a group home for DD adults and they had another nurse who acted similar to this...she said these very words to her and they have never had another problem again..and she said she can tell the person is practically foaming at the mouth to flip but will not because she knows what the consequences will be for her ridiculous behavior........people seriously need to grow up........ You obviously are a very fair person and don't ask for much...I am the same way & I hope I don't have to deal with a person like that......that must be awful walking on eggshells all the time.......good luck!

[Lacie, BSN, RN]

Myself, I would have and have done very similar as to what Kellienurse06 suggested. I have just stood there until the person got quiet for a moment then ask very calmly and with a nice little smurk "If your finished with what ever it is your going through, can we get down to business and do what we are supposed to be doing". She knows she is getting a reaction out of you and knows it causes upset therefore draws attention to her. You are giving her power by allowing her to do this to you. Also as others have suggested "document, document, document" bring it to your NCM attention and let her know you are not comfortable with the conditions this person behavior causes in the unit. You will always work with someone that the attention seeker or the one who has thier little temper tantrums. Dont give in to the play.

[Melody1968]

I have been going through the same thing. I tried to talk to the PCA multiple times. She is always offended and starts yelling. After the third time, I called our floor manager and talked to him about the problem. One being that she did not tell me about a b/p of 70/30. Anyway, nothing was done and I am still having problems. So I talked to the manager again, and used words he would understand. Example, someone is going to DIE and then there will be a LAWSUIT. It is a very HOSTILE ENVIRONMENT when a PCA is yelling at me in the nurses station in front of drs. She is starting to get better. It is ridiculous the way the PCAs are allowed to get by with things and nothing gets done until someone is ready to quit.

[HyperRNRachel]

First write her up. Second, get a copy of what her responsibilites are and the time they are to be done i.e am vital signs documented by 0830. Third, write her up each and every time one of the responsibilites are not done or are not done by the correct time.

I had a CNA (and I use the term loosely) who thought it was o.k. to do very little work, lie to patients, lie to the nurses, and talk on her cell while in pateints' rooms. I decided it was time for her to go when she decided to talk very loudly about me at shift change at a very crowded nurses station, and she continued to do this after I instructed her that this conversation was inappropriate and she needed to get to work. I then immediately told the charge nurse that I wanted to unit director informed immediately. It got the ball rolling, and the CNA was fired after numerous interventions and plans for improvement by HR. DING DONG THE WITCH IS GONE.

After all she had done to me, said about me, and embarrassed me, it was still very sad to watch her try and keep her job knowing she was having car trouble and needed the money. But her laziness proved to be her downfall.

A good CNA is a great assest, a bad CNA is like having a 3 year old child on your hip for 12 hours straight!

[lauralassie]

I've delt with this too. The best thing I've found to do is approach her in a professional way, keeping your cool ,in front of other staff.(don't loose it in front of other staff or you'll end up the fool) .Maintain your position state her job responsibilities, your job responcibilites and her unprofessional attitude etc... ALWAYS ,,,,ALWAYS ! It may help to say something like. "If you need help be sure to ask me etc..." keep it on a professional not personal level. Don't give her amo. You need to one-up her so to speak. Keep in mind you are her boss, she has less education than you , you are the one signing your name on the chart as repsonsible. I've found once you stand up to staff or Dr's this way they leave you alone. (Oh yeh...You bet I'd write her up too!) Although, write -ups are usually a dime a dozen for most hospitals. So , professional confrontation in front of peers may actually make more of a statement.

[Mulan]

Write her up, and use quotes. If your NM won't do anything, go over her head, to the CEO if necessary. Give a copy to HR, and use the words hostile work environment, which is illegal.

[rach_nc_03]

I had a similar situation with a coworker- but the ranting maniac was the RN, I was the CNA.

This guy was *notorious* on the unit for being grouchy and mean to anyone except the handful of people he liked (maybe 5 of them). He was always trying to tell the doctors what to do (and I don't mean helpful suggestions based on good nursing observations, but order-barking). An attending once walked in on one of these rants (directed at a group of residents) and said, 'wow, jim, you're an MD now! congratulations!'

this guy, for whatever reason, hated me. no idea why. He'd report me for 'not following orders' all the time, but wouldn't give specific examples (I'd never refused to do anything I was asked to do, unless I was already assisting with another patient, and I would explain I'd help them ASAP). He would yell at me, bark orders, and demean me for absolutely no reason. Apparently (and this was the general consensus on the unit), he wanted people to bow down to his mighty intellect. He was smart, but an a**.

Anyway, I was 15 minutes late one morning because of ice on my street that i literally couldn't cross (sat there spinning tires the whole time). I'd called the charge and she knew about it. (The unit secretary, meanwhile, was pregnant and said the was late because she didn't want to slip on ice and fall and hurt her baby...she was 3 HOURS late.) When telling another coworker about the ice, 'jim' said, quite loudly, 'there wasn't ice at my house. I don't believe you. You're a liar.'

(for the record, he lived an hour away from me, so how the heck did he know?)

I said, 'i've put up with your intimidation and attitude long enough. When you can speak to me respectfully, like an adult, let me know. because I'm done listening to this.' I walked away and continued with my day.

For months, we would work together and he would only say the minimum he absolutely had to communicate to me. After 4 months or so, he started, slowly, showing me respect and pointing out learning opportunities for me with his patients. We were never buddies, but he eventually found some civility somewhere.

I've never understood bullies (and I believe this PCA is definitely bullying you). My mother would smack me silly if she saw me pitch a fit like that in a public place- let alone at WORK!

[Agnus]

You might say to this PCA as she throws her tanturm. "You are embarrasing yourself.

[BrnEyedGirl, BSN, MSN, RN, APRN]

Document, document, document,......had a dangerous PCA on our unit,..she worked 3-11 so both day shift et night shift were constatnly complaining about one thing or another,........after she "finished " my blood for me,..she didn't think it was running in fast enough ,....you know just helping me out,.( 70lb CHFer) ...last straw,...went to my NM,....after talking w/her realized that all of us had been complaining for months , to each other,..no one ever went to the NM,..she was clueless,.....gotta write it down to get anything done!!!

[NaomieRN]

I would write her up and have a meeting with her and the head of the department. It is not fair to you to have to put up with her nonsense.