How would deal with these type of CNAs?

[Born_2BRN]

I am one among the newest RNs on a busy floor. Every shift I am struggling to help pt's ADLs with minimal CNA assistance. A few CNAs are plain horrible. They won't answer my pager or when they do they would tell me they are with another pt. I told them when they finished with the pt then come help me. Most of the time they don't so I ended up doing it all myself. At other times when they didn't come and help me they complaint that I left dirty linen on the floor. I told them I helped this pt and changed all her linens after she pooped or puke on herself and yes in between I also passing meds while another pt paging for pain medication as well. When they hear that they don't like it.

[LittleOldLadyWho, ADN, BSN, LPN, RN]

I was fortunate to have decades of management experience prior to becoming a nurse. So I came into the situation with the foreknowledge that employees listed as my responsibility (Aides) are members of my team. I treat them with respect and dignity as they are grown adults performing a specific and well defined job function. I immediately familiarized myself with their job requirements and worked alongside of them to gain a full understanding of their stresses and needs. As a Nurse, I am well aware that making their job easier in turn makes my job easier. I assist my aides whenever possible in order to maintain a smooth functioning shift. A couple of rules that I personally follow are:

1. The Aides are my fellow employees/team members. They are not my friends. My relationship with them is friendly at work but I do not have personal relationships with them outside of the workplace. This keeps the accusation of favoritism/bias out of the picture. It also helps to maintain a professional relationship wherein my position as a manager/supervisor with the right to discipline is respected and acknowledged.

2. I never speak to anyone in a tone or manner that I would not want to be spoken to. I do not yell, sneer, demean, order or call anyone "girl" or "kid". I am polite and I ASK for assistance politely. If I need to let an Aide know that a patient needs assistance I do so with the caveat "When you have a moment ( or chance) Mr/Ms So and SO would like....I told them someone would be in to assist them in a couple of moments". If I am able to assist the patient I do so.

3. NEVER speak to an Aide ( or really anyone) alone. Always have a witness to the conversation. This goes double for any disciplinary conversations. If I am having issues with the floor I will organize a meeting with all Aides and other nurses on the floor. I usually will have an outline of the meeting in written form with expectations fully defined. Best not to list any criticisms. And particularly do not to point out anyone in specific. I usually will go over this agenda with my supervisor prior to calling the meeting so that they are aware and approve of the meeting.

4. Be the model for what you expect. Set the example. I am never late. I have never called off. I do not indulge in gossip about other employees or patients. I maintain a positive professional attitude. I do NOT have my cell phone on the floor. I always let my aides and other nurses know when I am leaving the floor. I give report to my aides every morning. I praise my aides for a job well done most everyday.

One of my favorite sayings is "You get what you advertise for" If you wish to receive respect then you must act as someone who deserves and expects respect. Always remember that respect is definitely a 2 way street and most times we give more than we receive.

Your first rule of never doing anything with others outside of work stinks in my opinion. Many meals have been shared by me and my coworkers after a hard day or night. Baby showers, wedding showers, going to weddings of coworkers is common when the shifts can be covered. Hospital is not so different from any other company where someone might work. Lighten up some there. The second rule of calling cohorts by Mr. or Miss or Mrs. is strange and too formal for people who help wipe butts and all the other intimate stuff we do with our patients. Your third rule of never speaking to a person alone without a witness seems strange. If you have so little trust of the staff that you're afraid they'll misquote you or claim something that didn't happen - that's a big problem! Are you for real.

[DogWmn]

I find this thread quite interesting. From '72-92 I worked as an LPN in mostly hospital environments, Med-Surg, Ortho, ICU and even ED ~ I ran the suture/cast room. During that time there were NO aids/pcts it was just nurses. We also had team nursing back then. We were all professionals, the patients were well cared for, we got our breaks and if we had a late admission we all helped out so no one had to stay late or everyone did until the admission was finished. I LOVED TEAM NURSING. As LPN's were run out of the hospital I became a charge nurse on a Medicare floor of a very large SKNF. The Aids and Orderlies were good and caring. Again Team work in play. We had 1 RN as a shift supervisor and the rest of the floors had LPNs as med passers, treatment nurses and Charge. I left nursing after 20 years with burn out. In '08 at the age of 58 I lost a job and profession I loved as a Real Estate Title examiner. After 4 years of unemployment I got a job as a Patient Sitter ~ so I got a real eye opener as to the Techs ~ some were great, some good some awful and often it was directly related to floor management. September of '15 I was laid off 3 weeks before I turned 65. Soooo I am now in a CNA program through our local CC because I need to work at least part time to supplement my SS. I'm very surprised at the depth of the program. It has many more hours than OBRA requires. We learn not just the skills but the whys behind the skills. I start clinicals this week! then we go for 3 weeks of "boot camp" to prep for the 2 part state exam ~ a multi-guess test and a timed skills test done with a state examiner standing over you! I'm old enough that I sat for the State Test Pool exam.

I will be a "new" CNA soon and an older worker! I expect to be treated with respect by my co-workers and that means ANYONE be it nurse CNA, dietary etc. We are all there for one reason ~ care of the patient. So if one of you ends up working with me ~ I might not be the fastest, the strongest ~ but I will be a GREAT CNA!

So for those of you who are having problems with your co-workers you need to spend some time reflecting on WHY and figure out what YOU can do to implement positive changes. My instructor in my CNA class is ALWAYS positive ALWAYS and it's infectious and it's one infection we should all want to get!

To the OP ~ on your way to work think of one thing your grateful for ~ work on ways to walk through the door at work with a smile on your face and leave your problems at the door. Find little things at work that give you joy. If you can't do these things you need to consider either a job change or career change. Staffing in healthcare is abysmal and it's not going to get better. If you want to stay in nursing ~ become the innovator ~ the problem solver ~ work with ALL the staff to come up with ways for everyone to work smarter and involve the staff in these changes ~ make them feel they are part of the solution and part of the team. I wish you luck OP no one ever said working in the field of medicine is easy for anyone.

[PacoUSA, BSN, RN]

I'm lucky to work where I work, where EVERY single CNA on my unit (day, eve, and night) is plain AWESOME! Not one of them is lazy, and they work well with us nurses. And there are a good mix of men and women CNA's on my floor. We treat them with respect and they don't huff and puff when we ask them to help out. Everyone knows their scope, and no one thinks they are above the other. When I did clinical there as as student, they even treated me awesomely. Now as an employed nurse, I embrace their value. Without them, my job would be much more intense.

So, not so unfortunately, I have never met a bad CNA.

I recently noticed this post I made in August 2012 and was like WHAAAAT? I was clearly in a honeymoon phase here, and I must unequivocably retract these words from my mouth.

It is now April 2016. YES, I HAVE met several bad CNAs, including at the job above where I no longer work. Let's start off with the one that made up vital signs on my patients and entered them into the patient records and I proved it by asking each patient individually whether their vital signs had been taken within the last hour and they all said no. Then there is the CNA that consistently hid in the supply room texting her boyfriend when she should have been rounding. Then there is the other CNA or two that would push a Dynamap into the room while you are with a patient and say "as long as you are in there..." These all became apparent during the years I was there. At another hospital where I worked a contract, there was one CNA who agreed to help me change a 300# female bedfast patient and her bed linen after she had spilled coffee on herself. I ended up finishing the job by myself and right after I saw the CNA sitting at the nurses station browsing the internet!

I would like to add that 95% of the CNAs I have worked with so far have been wonderful and I could not do my job without them. But 4 years later, I realize that my judgment was clouded back then as a new grad and now I know better. I was so naive! LOL!

[cinnybug]

The Mr/Ms was in relation to the patient not the aides. My aides and I do call each other by our first names. Sharing meals or celebrations as a group is acceptable. What i was referring to is spending time alone with a singular aide. As to the witness issue well you may do as you like but it has been my experience that when administration starts asking who is responsible for something the lowest members on the totem pole will throw their supervisors under the bus. People as a rule hear what they want to hear and it is not uncommon for words to be misunderstood. Then HR simply has your word against the oher persons to go by.