I'm the worst CNA they ever had

Nursing Students CNA/MA

Published

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.

I dunno. I think you have to feel sorry for somebody who is obviously so unhappy. That's a good way to let it roll off your back when people are like this.

I agree with the "Take notes" thing. As a matter of fact, when (not if-- when) you have your next patient like that, at the first hint of trouble, smile, stop, take out your pen, and invite her to sit down so she can tell you everything the "old" aide did. When she's done, read it back to her, filling in the blanks of all the details she didn't give you the first time. Thank her, because the old aide didn't tell you all of this and you are glad to know. If she adds to that list on your next visit, smile, stop, take out the list, and fill in the blank.

Believe it or not, most people are angry because they are afraid, and if you handle her in this way, you may decrease her fears. What does she have to be afraid of, you ask? I dunno. But seriously. People who are angry are always afraid of something. Remember that. It's a genuine "something medical" you learned from your brief experience with your patient. Yes, it is.

This is not being a doormat. It's a really a subtle way of gaining control, a way of getting her on your side, and getting you to learn what's going to work with her. Under no circumstances do you give her attitude back, or snark, or a piece of your mind. It is acceptable to say, "Please do not yell at me," and immediately redirect her to something else, like, "Now, where do you usually want this bucket emptied?" "How do you like your tea?"

Specializes in Med/Surg, Ortho, ASC.
I don't understand why a cna is being a maid for someone.

This! CNA's are not housekeepers. Is this always a part of your home care visits?

Specializes in HH, Peds, Rehab, Clinical.

Your job as a CNA is to clean their house? Oh HAYLE no

Sometimes HH agencies conflate HHA and Homemaker positions. This is not uncommon. They get better reimbursement for HHA than for HM.

Being in home care can be difficult. You will have clients that you will love like your own grandparents and then there will be clients that you want to just hide under you covers when the morning comes and wish it was the next day so you will not have to go to their house.

Everyone handles things differently, and I am not saying you are 100% wrong in your actions and comments, but I will say that some of the things that said probably did not help the situation any. I'd never turn the lights back off after she turned them on, or tell them I'll do that next time if they wanted you yo do something. to be honest no matter how horrible they are I personally never talk back to them. If anything I either say nothing or try to defuse the problems by asking them questions on how do you like things done.. and I also would say to them that I am new to this and if you just give me a little time I know I can do things to your liking and the way you want it. Also for instance when you found out after cleaning the mop she wanted bathroom done, I might feel a little upset about it but I just do it.. I'd would have said oh I did not know you wanted that done I'll do that right now for you.

If you gave it a good effort with good attitude and she is still bratty then I'd call and ask to be taken off the case.

As for the house work in general it is very normal to have shifts like this. You might help them with a shower and the rest of your time can be house keeping. I always say if you don't want to do housework then don't get into home care. It part of the job. If you only want to do personal care then work in ltc or rehab.

Specializes in Hospice.
Your job as a CNA is to clean their house? Oh HAYLE no

If she's a CNA doing intermittent visits, and is there for about 45 minutes, then no, cleaning house is not her job.

However, she has a scheduled shift of several hours. That means the agency is probably combining CNA/Home maker services. It works well for the agency. All CNAs can double as Home makers, but not all Home makers are also CNAs.

Specializes in Hospice.

As for the house work in general it is very normal to have shifts like this. You might help them with a shower and the rest of your time can be house keeping. I always say if you don't want to do housework then don't get into home care. It part of the job. If you only want to do personal care then work in ltc or rehab.

No, it's not always normal for a Home Care CNA to do this.

CNAs making intermittent visits are only in the home about 45 minutes. Their job is personal care. Period. They can tidy the patients IMMEDIATE area (like around the bed) in the name of safety, but they don't do house work.

This sounds more like a private duty situation, with the agency combining CNA/Home maker services.

OP needs to find an agency that will utilize her as a CNA doing personal care. LTC and Rehab are NOT the only places where CNAs only do personal care.

Yes what you are describing can be true. But our agency has a minimum 2hr visits. We don't go to 7 homes in a day.

I can't believe the responses I am reading. Cleaning may or may not be part of your job description - we don't have that information - regardless, your attitude and behavior sound way out of line to me. I was in home health for years before I went to nursing school. I would NEVER have argued with a patient like this. Flipping on and off the light switch? Arguing about which task to complete first? Saying anything other than, "Oh, my gosh, I'm so sorry! It will never happen again!" when the patient was uncomfortable with you calling her rather than knocking? Your behavior sounds incredibly rude, immature and passive aggressive.

I'm really not trying to be mean, maybe that came off a little harsh. But, these people are already lacking so much control - illness, having new, random people coming in and out of their HOME, declining independence...Like I said, no intentionally being snarky, but this made my mouth fall open. If you had come into MY house and behaved that way...oh, dear, you would NEVER have lasted long enough to talk back to me or my family that way. EVER.

You deserve credit for staying there a whole hour. I would have thought about leaving as soon as I could.

There is reason why you are going to her house to take care of her. She is old and unstable, which seems mentally rather than physically based on your description. If you happen to have her again, just try to do everything you did before based on her complaints (don't forget to knock on the door :wacky:). I agree, maybe bring a small note pad the next time and tell her to write down what she wants you to do. It will show you understand her distress and are making an effort to change based on her needs.

If you're really upset and the company isn't what suits you, I would quit and move on. You should not waste your time being upset with your job. There are plenty of CNA placements that may be a better fit for you.

To the OP:

Look, I wasn't there. I am only going by your post. I worked home health as a companion caregiver a number of years ago.

A very large part of the job is adapting to the needs of the client. Many of the clients I had were elderly and had few medical concerns...the family mostly wanted someone there to help the person get ready, make meals, remind them about medications, etc. The issue that I have with your post is that it seems like you were arguing about things that you didn't need to be arguing about....which set the client off and made a tense situation worse and worse and worse.

For example: the light thing. You are in their home. If they want you to turn the light on, just turn on the light! I understand saying once maybe "I'm okay with them off" but if they say ANYTHING else regarding that matter, I would have just turned on the light! And then, the whole thing about you repeating back to them "What do I know, I'm the worst caregiver ever, etc" is just uncalled for.

I like GrnTea's suggestion about writing things down.

I do not doubt that the client was rude, but I do think that you made a tense situation worse. It is possible that if you didn't do the whole lights on lights off thing and said something to the effect of "I did not realize that you wanted the bathroom cleaned, now I have run out of time for this shift but I will be sure to do it on my next shift" that the situation may not have escalated to the extent that it did.

People are often rude in nursing. I do not think that nurses and aides need to be doormats, but I do think there is a way to handle a situation and keep a rude comment or two from escalating out of hand. Do nurses/aides need to accept constant rudeness? No. But I do think that things like the light on/off thing and cleaning the bathroom are, like GrnTea said, about control. Giving them back a little of that control- especially when it really doesn't affect anything- should not be a problem even when you disagree and is, arguably, part the job.

I had a patient set up similar to what the OP describes a number of years ago. I would clean the patient's bathroom. The patient got very upset that I had used the 409 cleaner instead of some other bathroom cleaner. I told her "I use the 409 cleaner at my home and was unaware that you used something else. I will use the bathroom cleaner you want next time I clean the bathroom." And that was it.

The name calling and all of that...completely uncalled for. At that point I suggest saying "I am being respectful, please be respectful to me."

It isn't your job to correct them. It isn't your job to be right. It is your job to give them what little control they can.

Specializes in Long term care.

In that situation, I would have said from the beginning, ok, I'll knock on the door right now and from now on.

~she wanted the light on? Why argue with her?? What is the point in it?? It just set the mood and it continued to go down from there.

Remember, this is HER home. It doesn't mean that it is ok for her to speak to you in a demeaning way but, it seems she likely has some mental health issues and if you simply cooperated with her from the "knock on the door" or from the light switch, it probably wouldn't have escalated to the point it did.

Even if it did continue to escalate, it would have been more professional to simply excuse yourself to call the office and tell them that she seems very upset and ask for direction and even permission to leave rather than to engage her and respond to her in ANY way. At that point you are in a no win situation.

btw, being more of a house keeper to people who are either extremely messy or very picky rather than the CNA I was trained to be is the reason I no longer do home care. I'd rather run non stop at an under staffed nursing home!

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