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.
Sorry to have chapped you! I am fairly new there, and yes, my superior has just recently told me that this person is like this, so it tells me that they, my superiors are not going to change anything nor do anything about this...I will speak up when due, and to this person, but I am also doing my job first hand, this person is not necessarily not doing their job, they are just giving me hell in the mean time!
Definitely stand up to her- she is testing you. Writing her up should be a last resort. She will sabotage you until the day you leave if you write her up- maybe even get you fired. With employees like this often management is aware and they leave them alone either out of their own fear or because they could cause trouble for the company in some way. We have an aide who has a disability- I won't specify what, but she is terrible and they don't dare do anything because she sued her last employer big time over her disability.
Be strong, and insist. YOU NEED TO DO THIS AS SOON AS YOU ARE DONE WITH YOUR BREAK, THIS IS YOUR ASSIGNMENT, I ALREADY CHECKED. THANK YOU, I KNOW I CAN COUNT ON YOU. Don't get snippy just strong and professional.
Insubordination is an ongoing problem everywhere, because those who do it, find that it works for them. Make it not work for them, by using direct observations about their behavior, so they can see it and know you won't put up with it!
That doesn't mean that you get into out and out mutual slinging of abuse. When addressing the situation, try to avoid using "I", "you" or "we". That inevitably puts each person addressed in an adversarial role. Observations can be shared by describing the scenario and enlisting their input, without pulling rank or threatening first.
With the hider, the insolent, and other brash rules breakers, say, "This isn't a regular break, as that happened an hour ago. If additional time is needed it can be arranged beforehand, so let's discuss this quickly. Patients needing care re waiting". Keep your voice and facial expression as neutral as possible (requires acting skills).
Then discuss the workload expected of the contrary person, and engage their opinion about whether it's doable, without suggesting that if it is not, they might get a less taxing job! Then ask what is needed for them to get the combined workload done, flexibly, as it's everyone's work. Rubbing noses in misbehavior is productive for further discord, so keep it light, without blame.
Always talk to one individual at a time, unless you are the charge nurse and have done that and then called a meeting, due to unresolvable differences in your staff. Keep that positive, with the common understanding stated, that getting along and getting all the work done efficiently together is the objective.
It will help if tools such as "transactional analysis" is taught beforehand, and everyone understands the usual techniques that cn be counterproductive. When one is seen, call it as such just as lawyer in court might say, "Objection", in a non accusatory way. That would be when lines are crossed and the discussion gets away from "adult to adult" observations and suggestions. This really works.
Accelerating problems to a "paper trail" with a formerly valuable employee who may be having a difficult day, is unwise. So it's best to know the players, by asking others who have worked with him/her successfully, what works for them. Learning that others have "put up and shut up" for a long time, means the resolution will take longer..... needs frequent follow-up, and the desire of everyone is to get all of the jobs done, realistically.
of course meetings such as these open other "pandora's boxes" for examination, which should be listed and promised to have another resolution session at another time. Be firm about that, and set a date for it later. Keep to the issue at hand!
I had the same problem when I was a graduate nurse. One nurse tech would always say she was overwhelmed and could not do anything for the patients when they asked for more water, etc. The funny thing is that she was taking her prereq's for nursing school!! One day I overheard someone ask her to do something and she said, "What's the nurse doing?" I think it needs to be pointed out to them that you are allowed do their entire job but they cannot help you with anything that only a nurse can do. There's no way a nurse can pass meds, do assessments, and chart on everything if they are also doing the tech's job. You can remind them of their scope of practice and your scope of practice!! I'm not sure it will work, but it explain to her why you're asking you to help you with the things she's able to do.
I'm learning to let my nurse manager know what's going on and also I tell her that I'll be talking to the person and let her know what happens. She always wants me to put my concerns in writing. I then go to the person and take her aside. Nobody likes to be confronted in front of others. I would have let her know point blank that she does in fact have that pt and she needs to get him dressed and ready for d/c. If she refused again, I would put it right back at her and say "Are you refusing to get the pt ready for d/c per your job description?" I've learned that I have to make myself clear, crystal. This is part of your job description and by refusing to do what you agreed to do when you accepted your position is not okay.
I would be on her touching base with her throughout the shift until she could get it together or leave. I'm quite sure her coworkers are aware and is affecting their perfomance as well. Either they need to pick up the slack, or they are observing what they can get away with. Either way, not a good thing.
I do hate this part of my job. It's never easy and I'm not comfortable with it at all, but it's worse if I do nothing. Good luck!
Everyone seems to have problems with the PCT's at some point. There's one on my unit that's been there for 32 yrs! She acts like she runs the place. She disregards new grads. Pushes them aside at times and the last time I worked, tried to get me to do some her charting. I finally gave it back to her. I asked her why I needed to do her job 15 minutes before end of shift. I told her that when I was a tech I never treated my nurses that way and that I would be talking to someone to find out about that BS. 10 min later she came back and said she did the charting. I think you have to push back. She's probably going to keep pushing until she consistently get pushed back. It's unfortunate, but I think you have to decide that you won't be bullied.
Specializes in ER, OR, ICU, PACU, POCU, QA, DC Planning.
This is a terrible situation to be in, for sure. I don't envy you. I agree with Lamazeteacher, but this is hard to do (keep calm) when you are a newer nurse.
I would go to the manager, maybe the director, for back up. I would also remind them that, even if this is a union job, the real contract is the paycheck. If she is not willing to do the job, she should not be getting a paycheck. PERIOD.
Also, I would be there offering my help in turning, bathing, etc. It's harder for her to get out of the assignment when you are standing there waiting to help HER. You can also get a better assessment done at that time.
Good luck on this. And, be careful. I hate to think this might escalate into a workplace violence scene.
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.
you are so..........correct in stating that you must speak their language. there are so...many bad cna's and i don't get it. i have had to deal with some really nasty ones who will actually lie about what has been done with the patient. at first, i would just hold it in and do it myself - believe me that stopped years ago. it actually got so bad with one cna on my shift, i told her to "clock out" and see the nurse manager tomorrow (too long and too much to get into now), as she was now a liability on my floor at that point. you must write up an insubordinate cna otherwise you will never get the respect and you will continue to do the work that the cna is being paid to do.
i do want to also say that there are some wonderful, over the top, go the extra mile....etc., cna's. thank goodness for those responsible ones - and i do make sure that they also get plenty of kudos as they deserve the extra $$. shout out to all the great cna's i've worked with! it's unfortunate that it takes only one lazy, irresponsible, negligent and miserable, "you owe me attitude" cna to make it bad for so many.
I am going to say, first stop ASKING her to do her job. Remind her of her duties when there are discharges and things happening outside of the normal routine. Insubordination is a fire-able offense in most areas of nursing, but if no one reports it or takes corrective action then it can't be fixed. Fix it for the sake of the patients and you will have a clear conscious, fix it for your sake and you are no better than her. Maybe she needs some new motivation to be proud of her work? Maybe she needs a career change and is afraid to take the first step? If you approach it with true concern for her work ethic and with the desire to help her be better and more efficient, she may not take offense.
But then again some people are just mean and rude and should not be working in patient care, maybe she is one of those.
Let the situation develop new management skills and dealing with insubordination, see this as a learning opportunity for you and not just the giant pain in your ars that it seems like.
I on the other hand would write her up and bring it as far up as the chain command would allow me. Its allowed because people choose to ignore it; wanting to avoid confrontation. I feel sorry for the whole floor who has to deal with this. If the cna is treating YOU like that, I can imagine what shes doing to the patients. If your command in charge will not deal with it, contact your OMBUDSMAN office and file a complaint with them. I know it's extra work on your end, but you will sleep better knowing you are in the right and did the right thing and eventually could get that person fired. Period.
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sanchezlpn
30 Posts
Sorry to have chapped you! I am fairly new there, and yes, my superior has just recently told me that this person is like this, so it tells me that they, my superiors are not going to change anything nor do anything about this...I will speak up when due, and to this person, but I am also doing my job first hand, this person is not necessarily not doing their job, they are just giving me hell in the mean time!
nursing gal