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.

Ugh I stopped reading when you pulled out the mop.

I be damned to be doing janitor work when im a nursing assistant. Chile please.

Healthcare was a bit of an adjustment for me. Growing up I had to do what made sense and was right, didn't matter if it was what I wanted or not. With healthcare - it's basically a "the customer is always right" kind of attitude. If the client/patient/resident wants a light on - just leave the light on.

You have control over the personal part of your life. Keep your living space the way you like, maintain relationships the way you like, etc. When it comes to working in healthcare - you help your client keep control over their life. You might have a better way of doing things, but they're not interested in that. Think of it this way - people that need healthcare don't have a lot of control or independence. E

mpathy is what helped me change my attitude. Your client wants to clean the house for herself, but can't. It probably drives her crazy. So when you do things her way - you are really doing something for her beyond cleaning her house.

As a home health aide, cleaning was part of my duties, most cares do not take an hour or whatever time you're allotted, so cleaning might be added to help the client feel like they're getting their money's worth. It doesn't make sense for them to get charged $50 an hour or whatever it is for someone to come out for 15 minutes to help with a bath.

Some people do not hold back when they get upset. If you get smart alecky with them - that's not going to help. If you feel like you don't want to stay - you don't have to. The company I worked for wanted caregivers and clients to both be happy with the match. If I didn't want to go see a client then I told them so. And if a client didn't like me then I didn't go there anymore. That's the nice thing about home health.

In nursing, I don't know what happens when a nurse and resident/patient/client don't get along. I work in LTC now, we're usually short staffed so it wouldn't be practical to find a nurse or caregiver to match each resident. Even when we're fully staffed, I would never go get a nurse from a different wing to help out with a difficult patient. I think if you want to continue with nursing you should try to find a better way to cope with difficult patients because they can all turn difficult, no matter how sweet they usually are. People that are sick or hurting don't always care about other people's feelings and they shouldn't have to.

1. Try to remember it's not personal. If someone carries a grudge that's on them. Also, most people would probably apologize if they could and I have had people apologize, so it does happen.

2. If someone requests something you think is silly, but it's not harmful to them or you, why resist? You're getting paid either way, so just do it their way. You can always make suggestions and if they don't like it, so what, it's not your house and they're paying for your services.

3. Put yourself in their spot. Imagine someone coming into your house and telling you how to clean, etc. Imagine that you are an independent person doing whatever you want whenever you feel like it, but now you have a condition that requires other people to help you. You have to wait for them, you have a lot of different people coming into your house, you're worried about money, insurance, your kids, etc. You'd probably feel pretty helpless and dependent on everyone. Just ignore stuff like complaints about not knocking. Yeah, it's a silly thing to complain about, but telling her that doesn't accomplish anything except you lose a client and possibly the company loses the client as well. I change the subject when stuff like that happens. I'll say something like, "Oh, I'm sorry about that. How was your day so far?". Even though I'm not sorry. I grumble about it later to my husband. If you get cases where there's 24 hour care and you get to meet some of the other caregivers, you can grumble to them for sure.

I hope that helps, sorry if I rambled, long week here....... (grumble grumble :) )

People in pain act out. You aren't invited into your clients' homes because they want a maid service, you're there because they've become too debilitated to maintain their own personal space. They might ordinarily be capable of expressing gratitude in other circumstances, but when you're in their private space, they have nowhere else they can be to process any underlying resentment they have about needing your care. A person who is fastidious about keeping her living space clean and orderly will take pride in that, and by doing that work for her, you're inadvertently taking that away from her.

Was her behavior appropriate? No, absolutely not. But it also wasn't unprecedented.

While I want to make clear that this wasn't necessarily about you, and that you aren't the "worst CNA", your lack of compliance toward her requests likely escalated the situation far worse than it could have been. If a client asks you to mop the floor, you mop it. If they ask you to mop the floor three times, you mop it three times. Truthfully, if I were her, it wouldn't have occurred to me either to ask you to mop the bathroom while you were mopping the rest of the house. In any case, it's not your job to think about how their house should best be clean. Let the client take the initiative on that.

Also, here's the trick to dealing with patient-bullies: kill them with kindness. When you respond to a rude or insulting comment with true calmness and humility, like it was an ordinary thing to say, most people will actually be too embarrassed to try anything with you again. They'll learn that you won't engage with them on that level. Either that, or they'll get bored.

I would say your experience was atypically bad in this case, so don't get discouraged, but do expect more hostility to come your way in the future.

Four words that can dampen the fire in a tense client/patient/resident situation: "Thank you for sharing." The other person feels validated but you never agree or disagree. It works quite well.

Specializes in ICU, MS, BHU, Flight RN, Admin.

I notice a lot of folks are believing that the CNA flipped the lights on...I got that the patient was the only one flipping lights. The CNA stated that she could see, the pt insisted, then changed her mind and flipped them back off.

Specializes in Psychiatry, Community, Nurse Manager, hospice.

First, I want to tell you that your English is excellent and I would not have known that you were not a native speaker if you hadn't told me.

Second, you are not being paid enough. Not even close. A maid earns about the same, if she works for an agency, much more if she works for herself. And no maid would put up with this client, they would fire her in a heartbeat. There are plenty of rich people with clean houses to work for, who won't even be there when they work.

You are a CNA, dealing with an ill person. It's a lot more work and it deserves a higher wage. Part of dealing with ill people means dealing with their issues. Like Grntea said, many have issues with control. Seems like this patient was very stressed out about having to get used to a new aide, with new routines and new habits, a new personality and dynamic.

You didn't click and it went badly enough that I agree you should be off the case.

But you have gotten some good advice here about how to change your responses for future clients. I think it will help you to be a better nurse, to learn the skills of de-escalating, and helping your patient feel comfortable. These are the skills that distinguish you from a maid. Also, you may have learned that this type of work isn't for you and that's okay.

I don't think anyone should take abuse. But I don't experience it as abuse if and when my clients gripe, yell or insult me. (I work in mental health, not as a nurse or CNA.) That having been said, I am paid very well for what I do, much more than a CNA. I think it is abominable that our CNA's are paid poverty wages, and I wouldn't blame you for getting another job that pays better.

But if you do want to be a nurse one day, I encourage you to try out some difficult-patient skills, and keep the job part-time to get experience with this. Grntea's advice is excellent; about getting out a pad and pen and writing requests down. Also, avoid confrontation and argument. Show the patient you are there for her and learn trust building skills. This is what a caregiver does, above and beyond a maid.

Specializes in Med-surg, home care.

Wow, that's rough. Honestly I don't think you handled the situation badly at all. You weren't disrespectful or cussing based on what you said so I think you handled it as best as you could. Unfortunately that is how it is when you are dealing with people sometimes. I am not a nurse (pre nursing right now) but I work in the public sector and although most times I get along with clients I have had my share of hell raisers. Nursing I am sure is similar. Please don't let this discourage you from your goals. It won't always be like that but if you could get reassigned I would if I were you. Good luck with everything.

Specializes in Registered Nurse.

Well, you did better than I would have done 6 days out of 7 of the week! lol I would have been smart alecy a lot sooner OR just said out loud- "Are you serious?" In any case, I think homecare is a different CNA environment and not a place for everyone. It's tough when you have to stay in the house a couple hours or more.

I understand how hard it can be to keep your cool when people are insulting you. Although it's natural to want to stand up for yourself and put them in their place, it will only escalate things. I find the calmer I act, if someone is going off on me that when they see I'm not fighting back, they begin to feel stupid for being so angry and it deescalates things. I've created great relationships at work with "difficult" patients because I give them the feeling of control they are looking for. It doesn't work for EVERYONE, but it does work, try it!

Thank you everyonefor the advice. I am for the most part a calm person. I don't mean to cause any trouble. I was upset that I got yelled at the moment I arrived and called. In fact, when I arrived, I even thought to myself, "Should I call or should I knock? Maybe I should call, since it is what I did last visit and then I can ask her what she would prefer." So I called. Obviously upset she asked why I was late, when I was in fact 2 minutes early. I explained to her that I had a client before her that ends at 1, and my next shift with her starts at 1:15, and that I told her this before. I can't say I was too thrilled to have to knock on the door while we were on the phone, even though she knew I was waiting on her front porch. She let me in. Still upset. Still yelling. Still going on and on about the door knocking thing, even after I apologized and said I wasn't going to do it again, probably more than I should have. After a while I walked over to her to look her in the eyes to say, "Look. I already told you I was sorry and that I wouldn't do it again. You need to understand that I am new, and that everyone has different preferences. Some people like things tobe a different way, but I don't know, because I am new, and this is my second day with you." She proceeds to say that normal people knock, they have aperfectly good door and didn't understand why I just didn't knock. Just being a difficult woman. Why? Maybe because I am new and she THOUGHT I was late Iwasn't being taken seriously, or because she thought I was late, and on the second day, that I was trying to take advantage, I don't know. I shouldn't have flipped the light switch back off after she flipped them on. I was hot and sweaty from being in the 100 degree heat, and I was just being mischievous from the incidents that followed up to that moment. I wish she would have just left me alone to clean. She watched me like a hawk the whole time, even when I went out to dump the bucket and set the mop out to dry. Yeah, I was very upset when she said, "I didn't see you mop the bathroom floor." Honestly I did not know that was what she wanted. I was never instructed to do so. Her bathroom is the same size as mine if not smaller, and I thought it would have been fine to just use a rag. She was just doing this to be difficult. Again, why? Because she was upset she thought I was late or that I didn't knock? She could have told me before I put the mop away that she wanted the bathroom mopped. That upset me. It's hard for me to say, "Oh gosh, I'm so sorry! Let me bring the mop and bucket inside for you! So sorry!" Because it's ingenuine, and I won't mean it, not after being treated like that.

Someone mentioned something about my native tongue. I'm an Asian American raised here in the states. I don't have an accent. That comment (from my patient) was rude, arrogant, and unnecessary. That was when I stopped apologizing.

Also, I was not trained by another CNA or anything. I had no one to show me the ropes. Is that common for most home health agencies? Someone mentioned something about that too. All of my experience was done in clinical at school.

I can learn to be more patient. But to what extent?

When I was working as a new CNA @ a hosp, the person I was being hired to replace (she was retiring) really couldn't have cared less abt me shadowing or learning. What did I do, found a completely awesome PN who helped me learn the ropes more than I'd have expected. I did that for a few years up until I grad from PN school, then I was working mainly in LTC. Now I'm going back to get my RN online.

Specializes in Post Acute, Med/Surg, ED, Nurse Manager.

I think you cpuld have handled it better. The trick to being a CNA with difficult people is building a repore. While you are building it remember your paid by the hour do it their way. Does it really matter what order you do things? Just take a breath, let it go. Getting snarky is not helping. Dont give attitude back. Just point out, I am new to working with you, it takes time to figure out a routine. Or, I have a few personal things I need to do for ypu, ( bathing, ADL's ) would you like to do it before or after I clean up? As what they want and do it with a smile. If they get grumpy its usuallt becauae they want to feel importang and powerful. They lost a lot of control as they aged. How can you redirect that? What else makes them feel valued? Compliment something find a connection you share and redirect the conversation.

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