How do I handle insubordinate CNAs?

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I recently left my job at a very cushy well known research hospital to work at a federal hospital, taking care of a certain population. I love what I do, and who I do it for, but on this new floor there is NO teamwork.

There is one particular CNA (we only have 3 day shift CNAs) who just will not do her job, and will attack the nurses who ask her to do her job. I watched one day as a nurse had two cath lab patients arrive at the same time. THe charge nurse asked a CNA, in front of the other bad CNA to take vitals on one of them. The bad CNA then waited for the assigned nurse to come around to scold her for asking for help. The assigned nurse told her that she never asked for help, and didn't ask the charge nurse to seek it out either.

Last week, I had 3 discharges all scheduled for 1530. At 1400, I looked at the assignment sheet to make sure one particular one was hers before I asked her to dress him (a 95 year old man) in preparation to leave. I had to find her in the break room, talking to someone from another ward, on her cell phone texting, and eating fruit. I waited for there to be a pause in her conversation before I asked her to help me. She told me she did not have that room (she did, that's why I got my ducks in a row before I asked) and that was that.

How do I handle it without having a verbal altercation with her? I would go to my manager, but I honestly don't think that will help. I used to be a PCT, and a secretary, so I know where everyone is coming from, and I never would have dreamed of acting like that. Its to the point now, where I want to be passive aggressive and not help any of the nurses who have her assigned to their patients, because I don't want to pick up her slack.

I am tempted to start keeping a written record of all of the things that are done or not done, so that when I do ask to transfer to another position, its all in black in white. It also makes me glad that I chose not to receive the sign on bonus, and I am not stuck on this unit for 2 years.

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Specializes in Thoracic Cardiovasc ICU Med-Surg.

Write it up, send email to her supervisor and manager. Eventually the message gets across that that behaviour is not okay. After a certain amount of write ups, you can lose your merit increase.

Similar situation when I arrived at hospital I currently work out. Had to write a PCA up a couple times. She still gives attitude, but she doesn't slack for me either.

Also, I made an effort to praise her when she did an excellent job, and there were plenty of times that she did.

We have an OK working relationship these days. Hope things work out.

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Specializes in LPN.

I used to think everyone thought like me. So, I treated them with the same respect I thought I deserved. At some point, I realized you give them back the same respect they give you. So, if they are treating you in a harsh disrespectful way, that is the language they understand. I am not saying be disrepectful, but be more frank and harsh back. Let their attitude dicate yours. Don't feel bad when you are harsh and frank to some one would displays that attitude toward you, it is the only thing they truely will understand. You can work at relationship building at a later time.

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I would ask politely once, when you get any pushback write her a$$ up! And keep writing her up. She will get the message. Make sure you have at least one other nurse with you to witness her refusal to do her job. Ask a nurse that will back you up to be in the area listening. Are other nurses having this same issue with her? Can you all approach the DON together?

At my first nursing job I had the same problem and I kept finding one cna sleeping in the empty beds (I worked nights). She never did any work! It took so long arguing with her to try to get her to do anything it was not even worth the time. It got easier to just do it myself rather than hunt her down. I wrote her up to no avail, finally we ALL started writing her up. When we all did it together they noticed. They just moved her to another unit, but we got a GREAT cna in her place! Maybe she is on your unit now. Sorry. lol.

BTW I was scared to write her up at first, but what it did was, get all the other cnas attention. It is not fair that they had to do their work and her share.

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Specializes in ICU.

I strongly suggest you not to send a write up by email. The nuances of communication are never conveyed by email.

Go to the manager. Give details of the CNA attacking other staff, not be present when needed on the unit and neglecting her duties. Be factual and unemotional. She will of course have you put it in writing. Tell no one about this, no one.

Ask to have her set up a meeting with both of you so that you can express your concerns face to face and clear the air. Let your manager run this meeting. Now if your manager is intimidated by this person or doesn't have your back then that's a whole nother ball game.

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The more material you put in writing, both a diary and the write-ups of counseling sessions, the more you will have in your orificenal when it comes time for personnel decisions. A secondary advantage to putting things in writing is that there is written evidence that you are doing your job as a supervisor. The idea to have another nurse present as a witness is a good one. It never hurts to have backup. Don't hesitate to do the same for the other nurses. When the supervisors present with a united front, it goes a long way to create a positive influence.

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Is this really happening elsewhere? I too have this problem with one person in particular and I don't like confrontations myself, but being an LPN I want the job done and done right. I also am a pretty newbie at nursing and this particular job but I am not stupid! I however lack experience and handling such arrogance of this one cna or caregiver? not sure? I do not expect to get attitude and disrespect when asking a question to the aides on the floors but still get it. I have gone to my supervisor, she says they are testing me....my thing is that I should not HAVE to put up with this as their supervisor on the shift I work. I work well with everyone else. I am so unable to deal with this person I am at a loss of words and am soooo tired of the crap from this aide. I have kept journals, now I am just hoping I don't get booted cause I am new and now the waters are stirring!!!!!

nursing gal

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Specializes in ICU.

There will always be CNAs who do the bare minimum of work and who have a huge chip on their shoulder. These are not people who respond well to reasoning or kindness, they will perceive that as weakness. They love cat fights.

Give it right back with a I'm kidding but I'm not kidding smile:

"You need to inform me when you are leaving the unit."

"Please change Mrs. so and so"

"Do you have a problem with that?"

"The last time that I checked you weren't a nurse."

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If the facility has no policy in place or other nurses do not also do the same (asking the cna's to let us know when they need to smoke, or leave the unit or floor) then I am the only one stuck in a bad position, alot of resentment because I would then be the only nurse actually asking the shift I work to really work. I don't mind down time even, its not even my beef here, its the attitude when I do ask of something, anything that is....not that I mind down time, its the fact that I can't even be a nurse to my patients without attitude of why I do things I do....I have expectations as to when dinner is over, say 6 p and 10:30 or so the dining room still has not been cleaned, come on, is this too much to ask? Leaving things to be done at the last minute could cause it to not get done period especially if there were an emergency situation....then how would it get done? My point!!!! Get your work done then if you have downtime, go with it...thats all I am screaming at!!!! And I am actually fighting this entire process where I work....no one wants to be the bad guy on my shift, so here I am, the only nurse on this shift and when I work, its a problem, I expect work to actually get done!!!!

I know people looking for work, maybe we should post a sign hiring aides for my shift....give them something to think about!

nursing gal

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Specializes in Oncology, ICU.

You could be describing the place I left last summer, a Federal place. I tried every tactic known to elicit cooperation from one CNA who refused to help me in any task, was insubordinate, and openly slept on the job. When I complained to the Charge Nurse, she took the side of the CNA since there had been a prior incident in which a Charge Nurse was demoted for "picking on" the CNAs. I kept a log of the CNA's actions (most often, inaction) and wrote it up to the Nurse Manager who did not act on it and who was decidedly cold to me afterwards. I left the place since I worked nights on an Oncology floor where most patients needed total care and I would have 6 patients and no CNA help. I purposely sought out a spot in ICU for my next assignment so that I would not have the CNA issue again.

I would tell you to be careful, very, very careful. This is the same situation that bit me hard. Best to ignore the CNA until you can leave. Sad, but true.

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You have to be kidding me, right....that it bit you because of the insubordination! I am being very careful, but also documenting everything, and I mean everything!!!! I will not do anything about it, I have heard though, that this person has always been like this and I ask, why would anyone be allowed to act like this to another, especially when its someone that is simply asking questions, not directing nor being rude back? I continually keep on track, getting in my time, getting in my experience as time will only be the answer to this issue!!!

Only time will lead me to the right place...and I am sticking it out for now...and doing my job well, allowing those people that want to act with unkindness to continue, and they will eventually sink!

My days are too filled with love for the people I care about there, so I decided, just ride it out and let time tell who sinks!

Thanks for all the input nurses!

nursing gal

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I don't usually respond to many postings, but this one chapped me! I am currently a CNA and I will done with nursing school next June. I say write her up! It isn't just about being disrespectful, what about taking care of your patients. How many patients is she neglecting by NOT doing her job! Always keep it professional, I would not lower my attitude to hers if it were me. How you respond to her attitude is still your responsibility, not hers. Don't lower your standards just because she is not a nice person.

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