I'm the worst CNA they ever had

[jarae]

So I work for a home health agency and I've been doing this for a few weeks. I see two clients, 9-1 and 1:15-4. One is hoarder, keeps her house dark at all times, kitchen infested with ants, dolls everywhere, trash is emptied on the daily. She is a nice lady when she's in a good mood. My second client, a lady that I have only met with twice. She's particular about how she wants things done and her house is nice and tidy. We got along pretty well, I thought. She told me I was going to make a good nurse one day and that I was patient. Today, I arrived 2 minutes early to my second client's house. It was my second time meeting with her. I called her to tell her I arrived, like I did on the first day. She was mad that I was late, I explained to her that I had a client before her and am given 15 minutes for commute. She kept on fussing over it, saying that no one had told her anything, even though I did tell her on the first day that I see a lady before her... She was agitated that I called her instead of knock on the door. "Normal people knock on the door. Why would anyone call when they can knock on the door?" "Okay," I said, "Next time I will knock on the door." "Well go on, knock on the door." "You mean, right now, as we are on the phone?"

Seriously?

She gave me attitude as she let me in. Went on and on about how other people knock. I became annoyed very fast. I started in the bathroom and worked my way to the kitchen. I remember her husband telling me that's what their CNA of 4 years would do. They had a routine. Her kitchen is brightly lit up with natural lighting. She insisted I turned the light on so I can see what I was doing. I said it was alright and I would prefer to have the light off. She flipped the switch on. I told her again I could see just fine and flipped it off. She flips it back on. Okay, whatever. She watches me mop and sweep from the other room, the whole time. After I finish I go into the backyard to dump the water, hose the mop, set it out to dry, took the bucket bath in. She said I needed to mop the bathroom. Annoyed that she didn't say a word as she watched do all of that, I asked her if I could just clean the floor with a rag with a cleaning agent. She said she would like it mopped and that it has always been mopped and that she told me from day one it needed to be done. Which I honestly don't recall. I was flustered. I told her I will next time, and that I need to get started on other things. She says nothing for a while, sits down, and says, "I don't know how you're gonna make it." I ignore it and go to the bathroom to set up for her bath. She got mad that I didn't take the trash out first thing before I did anything. Like I said, she is particular about things. The whole time I was there, she kept on fussing and complaining about how I don't do anything right, I don't understand or speak english, I'm the worst CNA she's ever had, etc. Okay, lady. I am not a child, I am a good worker, and I am fast. I have a bad temper sometimes and I try to keep cool when I'm at work, but when she was speaking to me like that, the whole entire time I was there, I had to give her a piece of my mind, too. But I was not mean. I would just said she didn't need to talk to me like that and I was here to help her, she just needs to explain things once instead of going on and on about things (like knocking on the door), and that she didn't need to be mean to me. She said she wasn't mean and everyone loves her, because she is a good Christian. Okay.. After a while, it became kind of humorous that she would follow me around and insult me. I would just agree with her and say "Yeah, I'm the worst CNA ever. You got really unlucky there." "Yep, I don't know how to speak english." "I'll never make it in life." She tells me to be quiet and that if I were her kid she'd beat the **** out of me. This whole time I'm just cleaning. I ignore her again. She tells me she doesn't want me there. She called the agency to complain about me while I was in the same room, told them I didn't know anything, I don't do anything, I'm the worst, etc. I go into the guest room and start cleaning there. Off of the phone now, she says more stuff about not wanting me there, complaining about me, to me, some more. I step into another room and called the agency myself and told them she really didn't want me there, and they said it was okay for me to go. I use her telephone to clock out and she's yelling at me telling me to get off of her phone. That entire hour was a nightmare.

I came home and was never more happy to be greeted by my awesome, loving corgi. Maybe I should just look into working with animals, I thought.

I'm not sure what to think right now. I know I will have to deal with some pretty difficult people. Other than being a smart aleck as I was being insulted, I don't know how I could have handled the situation differently. I really don't. I can't just take all of her insults as I am on my knees scrubbing her toilet. I understand that clients will get annoyed and impatient with CNA's they haven't worked with before. Before I started working as a CNA I knew there would be times where I would be discouraged from pursuing a career in nursing. But I wanted to get my experience for nursing school. So far I just feel like a maid. I wanted to avoid LTC because of the running around, not having time to do stuff for patients, and the lack of interaction with them, and just the drama with co-workers. I know nursing is a difficult job, but in a different way. What I really want to do is neonatal or peds. I'm really hoping that along the way I don't get more and more discouraged from my goal. I'm not sure if I have a question, or really know what to do, or how to feel right now. I guess I'm just ranting.

[TheCommuter, BSN, RN]

You're a better person than me...I wouldn't have dealt with this repulsive client as professionally as you did.

When someone is incessantly complaining and being unreasonable, I have said, "If you think you can do it better than me, why don't you do it yourself?"

It shuts them up every time like clockwork.

[babilidose]

You maintained your composure really well. You do not have to endure abuse. Clients like this are the exception and not the rule. Best of luck in your journey!

[LV3677]

She gave me attitude as she let me in.

It sounds like you're the one giving the attitude.

I've had similar experiences with patients. However, it is not okay to be rude to them by being a smart orifice. You gotta think to yourself; Is this a battle I really wanna fight? It's a patient particular about her home being cleaned. Big whoop. Not worth potentially losing your job over it.

In these situations, I just say "Okay" to what they say (as long as it's not a patient safety issue). She wants the light on? Okay. I'll leave the light on. I understand you could see just fine, but who cares? She wants it on! It didn't affect your ability to do your work. She wants the bathroom mopped? "Okay, I'll be sure to mop it before I toss the water".

You're going to come across many a difficult patient as an RN- those who swear and spit, throw their s*it at you, make nasty comments to get a reaction out of you, give you attitude. Part of the job is learning to manage your responses and reactions to them. You want to work as a peds nurse? Guess what? Peds come with difficult family members, or those that think they know more than you, or those that truly do know more than you because that's their chronically ill child in the bed that they know how to care for. That temper that you speak of will not be helpful.

Control that temper of yours when "people are being rude to you." You can't afford to lose it on a patient/patient's family as an RN.

If you really don't want to do home health, then look for a CNA job in obstetrics to get some experience.

Just my two cents.

[TexRN, BSN, RN]

I don't understand why a cna is being a maid for someone.

[TheCommuter, BSN, RN]

Part of the job is learning to manage your responses and reactions to them.

I disagree...nursing is the only profession that seems to accept doormat treatment.

The client in the original post would have been kicked off the airplane if she was verbally abusing the American Airlines pilot. She would have been asked to leave the doctors office if she was berating her primary care physician. She would have been escorted out of the bank by security if she attempted to stand there and badmouth the bank teller.

Sorry, but other professions have a zero-tolerance policy to abusive clients. The nursing profession needs to get with the program and set these people straight.

[TheBlackDogWaits]

Sometimes writing your experience down is just the advice you need.... To see your experience in your own words so that later you can pore through your own thoughts and feelings to make sense of it...

Two months from now, you may be in a more rational head space to see your experience from an outsider's perspective.

I definitely think your client was out of line in how she addressed you, but as a nurse, you must attempt to look at the situation from other perspectives outside of your own. Home health patients are in a tight spot: they have the freedom of being in their own space without the freedom to do as they see fit, most of the time. You are an outsider in someone else's home; you're the guest. They are sick and don't have control, so they create an environment that addresses all these elements. Sometimes, they address and facilitate their needs in a very ugly way.

Im sorry that you have had a tough experience with your client. Perhaps you could see it as an opportunity to fill in any communication gaps you may have in professional environments.

Maybe it would be a good idea to find out what your clients need and like upfront, and then practice active listening?

Patients really love to see us write things down, I've noticed in my itty bitty nursey childhood. I hate to liken healthcare to food service, because gahhh we aren't glorified servers already, but think about when you go into a restaurant and order something even mildly different from a recipe and the server doesn't write it down (insisting they understand, they get you, etc), then your meal comes back all jacked. Writing down patient/client proclivities, needs or whatever can sometimes make all the difference. They speak. You write, smile, nod, repeat. They see your comprehension and commitment.

If, after making a couple rational attempts to foster a successful relationship with your client, she is still atrocious, request to be taken off of her case or start looking for another job.

Good luck!

[Purple_roses]

Oh goodness. I feel like I have had this client before. I'm also a home care CNA.

So here's the deal: we make what? $9-$10? Certainly not enough to put up with crap like that. I would take myself right off that case, and I have done so before. I had one lady get mad at me because I didn't know how to properly make fried oysters (ok lady, you hired a caregiver, not a chef). Then she became ridiculously angry that I reminded her to take her pm meds. My response to this was, "I'm so sorry I upset you. The only reason I brought it up is because I'm a caregiver and need to make sure you're ok." To which she became so ridiculously angry (seriously, I thought I was going to have a chair thrown at me) because i referred to myself as a caregiver, something that she (a crippled diabetic who hired me her own self--her kids did not hire me!) apparently absolutely did not need. I told her that I was sorry this offended her, that I would not refer to myself as a caregiver, and then I promptly texted the scheduling department and had them take me off her case permanently.

So in a nutshell: don't be afraid to take yourself off that case.

[Purple_roses]

It sounds like you're the one giving the attitude.

I've had similar experiences with patients. However, it is not okay to be rude to them by being a smart orifice. You gotta think to yourself; Is this a battle I really wanna fight? It's a patient particular about her home being cleaned. Big whoop. Not worth potentially losing your job over it.

In these situations, I just say "Okay" to what they say (as long as it's not a patient safety issue). She wants the light on? Okay. I'll leave the light on. I understand you could see just fine, but who cares? She wants it on! It didn't affect your ability to do your work. She wants the bathroom mopped? "Okay, I'll be sure to mop it before I toss the water".

You're going to come across many a difficult patient as an RN- those who swear and spit, throw their s*it at you, make nasty comments to get a reaction out of you, give you attitude. Part of the job is learning to manage your responses and reactions to them. You want to work as a peds nurse? Guess what? Peds come with difficult family members, or those that think they know more than you, or those that truly do know more than you because that's their chronically ill child in the bed that they know how to care for. That temper that you speak of will not be helpful.

Control that temper of yours when "people are being rude to you." You can't afford to lose it on a patient/patient's family as an RN.

If you really don't want to do home health, then look for a CNA job in obstetrics to get some experience.

Just my two cents.

I couldn't disagree with you more. It is absolutely not wrong to stand up for yourself. There have been times a mentally ill client has been mean, and I've accepted that because they cannot help what is happening to their brain--and most of the time they don't even remember it two minutes later. I will also accept meanness from a client who is going through something traumatic in life (emotionally or physically) because I also act out sometimes when I'm going through a tough situation. It's natural. But it is not ok for a mentally sound person to be mean and nasty and to verbalize insults all day long while the OP is trying to help. At least in a hospital setting, you don't have to stay in the room with the nasty patient all day. The OP had to stay there for an entire shift with just that lady while she insulted her all day long. That is most certainly not ok.

[jarae]

I took myself off the case. I'm thinking about cutting back hours at the agency and working a higher paying job to pay the bills. I make 9.25 an hour, and miles are not reimbursed. Not learning anything medical, just feel like a maid. Definitely not worth it. I'm not even sure how I feel about the agency itself. I had an interview 2 days after I applied, they called my references that day, had orientation the next morning as well as a drug test. And I was already able to start the very next morning. I have my CNA license obviously, but I just kind of thought there would be more training involved. I was just thrown onto the floor.

[LV3677]

I couldn't disagree with you more. It is absolutely not wrong to stand up for yourself. There have been times a mentally ill client has been mean, and I've accepted that because they cannot help what is happening to their brain--and most of the time they don't even remember it two minutes later. I will also accept meanness from a client who is going through something traumatic in life (emotionally or physically) because I also act out sometimes when I'm going through a tough situation. It's natural. But it is not ok for a mentally sound person to be mean and nasty and to verbalize insults all day long while the OP is trying to help. At least in a hospital setting, you don't have to stay in the room with the nasty patient all day. The OP had to stay there for an entire shift with just that lady while she insulted her all day long. That is most certainly not ok.

Purple_roses, I apologize, my post sounds doormatish- that we shouldn't do anything to patients who are being rude. I do believe that we should set limits for patients.

[Purple_roses]

I took myself off the case. I'm thinking about cutting back hours at the agency and working a higher paying job to pay the bills. I make 9.25 an hour, and miles are not reimbursed. Not learning anything medical, just feel like a maid. Definitely not worth it. I'm not even sure how I feel about the agency itself. I had an interview 2 days after I applied, they called my references that day, had orientation the next morning as well as a drug test. And I was already able to start the very next morning. I have my CNA license obviously, but I just kind of thought there would be more training involved. I was just thrown onto the floor.

Good for you! Do what's best for your learning experience. I actually really like my job and my company, and right now I've got some clients that I would miss if I left. But I am considering applying for a tech position at a hospital after this semester of nursing school so that I can practice more skills and maybe (hopefully!) be hired in at that hospital once I graduate.