I've just begun my first nursing job the first of July. The floor mgr states I'm set to go on my own, without a preceptor since I'm doing well. Things have been good until today. I really try to not bother my preceptor, but for some reason today stunk!! Even the CNAs were nasty. I really need the CNAs to help me as I'm so new, but I can almost read their minds...they act like I do nothing!! I had no breaks or lunch today I was so busy. I asked for two sets of vitals to be taken and within a half hour they were done, but my preceptor came over and said something about it. I'm sure it was because the CNA complained to her about me which really frustrates me. I have to say I treat everyone with kindness. I thank the CNAs for all their help. I do my best to keep a great attitude and to this point I have not been a jerk to anyone. Like I said, I'm new and it's too easy to be a jerk to others. I don't want to live like that. I can't tell you how many urinals I emptied today. Should I be letting the CNAs know everytime I do this!!?? Of course not!! I do everything when I have time, but I had a lot of paperwork, meds, etc today and couldn't help the CNAs as much as I would like. Once I feel more at ease, I have no problem helping to change an Attends or whatever is needed. Right now, I'm just struggling to keep my head above water. How do you handle the nasty CNAs/nurses? I'm not expecting life to be perfect, but like I said, I've been great to everyone, and don't expect others to be jerks to me. If I have too many days like today, I won't be staying.
I have found that if I can impart a bit of knowledge to the CNA's they feel more empowered and they respect you more. For example, when we are watching a patient's behaviour because of a change in medication, or watching for side effects, I post a note for them outlining what to watch for and why. And/or I sit down with them for a five minute interval in the day and explain to them why something is happening with a particular resident. This way, they are:
a) feeling like they are equals to you, not beneath you
b) given valuable time from someone who is taking the time to share something valuable to them
c) and therefore, feel empowered and respected and will less likely want to go running to management at the drop of a hat to tattle tale on silly things or talk behind your back because they get a small picture window of what your job REALLY entails.
Believe it or not, some aides actually feel that a nurse who does a lot of their work is an intruder. Some do not understand that you are trying to help them. They believe that you are doing their work because they didn't get to it fast enough or you don't like the way they do it--and they start to resent you. Then, the nastiness and slow shuffling of the feet start. This is bizarre thinking, to be sure, but don't discount this as a possible reason for their attitude. These are not people who have the same degree of education, and some of them come from odd backgrounds where what we would consider to be a helpful gesture is seen as an insult. Do not expect them to talk about it with you either. It would be like pulling teeth. In their bizarreness they fear being labeled as a troublemaker. It stems from their position of powerlessness and correcting something like that takes a great deal of effort and time which at this particular moment you do not have.
"Bizarreness" :chuckle Okay, I just thought that was funny. Bizarre thinking is different from irrational thinking, which is what I think you mean. All of us are capable of thinking irrationally, though not many of us think bizarrely.
There is a certain degree of truth to that. If you do my job for me when I know I have to do it, and haven't forgotten about it, I sometimes feel like I'm incompetant. It sometimes bothers me that I can't be expected to do even menial tasks. But I do appreciate it when someone sees it and picks up the slack for me. :imbar
Don't assume that we don't have the same level of education, it's just may be a different kind of education. I have a bachelor's degree, but obviously not in nursing. It's in psychology. I'm not the only CNA in the building with a bachelor's, either. Not all CNAs come from "odd backgrounds." :stone
I will admit, I'm not much for communication when I feel that an RN is being disrespectful to me. I tend to shut down, though ironically I tell patients it's important to talk about their feelings. I don't like confrontation. Maybe I'm afraid that it won't improve the situation anyway, though I know that's not necessarily true with all people I deal with.
Part of it can be a powerlessness issue. I feel like I should be in a position of more responsibility, and I resent doing "menial" work. I didn't go to college for THIS! But I do my tasks anyway, rarely complaining (after all, this is what I signed up for). I will be moving on to a higher position soon, it's just taking them forever to get their butts in gear for things to move forward. The state of MD is frustrating sometimes; they almost never do anything in a hurry.
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Lisa, if you approach the situation in a nonjudgmental manner, the CNAs may listen to you. Don't accuse anyone in particular of doing something they didn't do (I'd address them as a group). I would stress the importance of working as a TEAM, and their contribution to the team is important.
Also let them know that if any one of them feels they are having a difficult time, they can talk to you in private to discuss it with them. Maybe there is a reason you don't know about that is preventing them from working at their full capactity. Encourage communication! This will make you open to them so that if they have issues, they can discuss them without fear of judgment from other staff.
Thanks for your support everyone!! I agree this med-surg floor I'm on is a stepping stone for me and I will keep moving ahead. As far as helping the CNAs - you're right they are suppose to be there for us, but I was told early on, don't ever act as if you are above them by never emptying a bedpan or a urinal or any other CNA job duty. That atttitude causes issues and resentment which serves no purpose, thus what I meant about trying to help them out some. I feel like if I tell them everytime I empty a foley or a urinal, I'd be throwing it in their face like they weren't doing their job....again, causing more harm than good. It seems like a no-win situation.
I think I will speak with the one CNA having the biggest attitude problem. I must say I always thank everyone for their help during the day, especially the CNAs because they are so helpful....generally!! It just irritates me that she/they are already backstabbing me. The nurse mgr who I really should be worried about is very supportive and happy with me. I just don't know why I'm letting the CNAs get to me. I think I'll speak with one CNA in particular, let her know I appreciate her, tell her to try to be patient with me while I'm still new and have her come directly to me should she have any future problems. Maybe the difference is I'm 15 years older than her!! Age does have its benefits I guess.
No matter what is said/not said, done/not done, in any tone imaginable can be taken the wrong way in which the recipient becomes a victim of some sort. This walking on eggshells around CNA's (or anyone for that matter), would get very old, very fast for me. ~Diane
Specializes in med/surg, telemetry, IV therapy, mgmt.
I have found that if I can impart a bit of knowledge to the CNA's they feel more empowered and they respect you more. For example, when we are watching a patient's behaviour because of a change in medication, or watching for side effects, I post a note for them outlining what to watch for and why. And/or I sit down with them for a five minute interval in the day and explain to them why something is happening with a particular resident. This way, they are:
a) feeling like they are equals to you, not beneath you
b) given valuable time from someone who is taking the time to share something valuable to them
c) and therefore, feel empowered and respected and will less likely want to go running to management at the drop of a hat to tattle tale on silly things or talk behind your back because they get a small picture window of what your job REALLY entails.
lisa-I feel your pain! I'm a new RN as well & am super nice to every single person I work with & do my best to help out the CNAs as much as humanly possible-even though I take such short breaks it's not even funny. Anyways, I find this still isn't "enough" for some CNAs-like one in particular I work with who is really really annoying me. I help her out a lot when I can & ask her very nicely to help me with certain tasks. Yet she still acts way out of line often! Here are 2 examples: I worked with this one very complex, kind of mean at times patient -I'll call him Mr. X-I had him M-F all last week -I was in his room almost all the time, despite the fact that I had 2 other patients as well. I had to give him 20+ pills at various times, 2 swisj & swallows, 4 IV morphine pushes at various times, Three other IV meds, three bags of antibiotics, he had a CPM machine, a PICC line, Foley, the list goes on & on. And on top of all this, he could be nasty too-not fun one bit-esp when you have him 5 days in a row. Anyhow-so I was in his room for god knows how long at one point, & my back was killing me already-& he asked me to fold his sheet over him in half, so I did-but of course I didn't do it the exact way he wanted, so I'm trying to do it again to please him & the CNA I was working with says to this "Oh Mr. X-we're still teaching her." !!!!!!!!!! I was soooooooo ticked off at her I started to say something like I know how to fold sheets but got interrupted-I was sooooooooooo angry. She made me feel stupid in front of a patient.
Two more examples with the same CNA-I had admitted a new patient from the ER & was done assessing him & was now orienting him to his room & showing him how his call light & everything else worked, when in the middle of what I'm saying this same CNA says to me (she was in the room too-taking his vitals) "Get out of the way" & she waves her arm at me to get me to move so she can press a button on the bed so she can weigh him with the bed scale. Oh my god! I'm still talking to the patient-I am his nurse after all & she decides she can totally interrupt me & very rudely too to tell me to get out of the way? What ever happened to politeness? So all I could get out to say to her was "Sara (not her real name)-really! " I know I should've said something else-I was just so angry & plus I was so busy I didn't even have time to sit down & talk to the jerk! Ugh!
THEN-a third example-I just hooked up my patient to a hep drip & to an IV pump-& was trying to hurry cuz the patient transport people were waiting to take him down to his echo test-& this same CNA was in the room with me to help me walk the patient over to his stretcher & she's watching me put the Iv tubing into the pump & she says "There are bubbles in the tubing there." Oh my GOD!!! First of all, there were not even any bubbles in there-I checked, second of all, I'm the nurse-not her! She didn't even go to nursing school! And she decides to check up on me in front of my patient too! My preceptor was there with us too & she told her "It's ok-there's nothing there." I was so incredibly angry with her-I know you're all going to tell me I need to talk to her or anyone else if they try to pull this crap again-& I will say something-I think I get so shocked when she says things that I stand there tongue tied! Ugh! If any of you have advice on how to talk to her, please let me know. I did not go to nursing school & pass my RN boards to have a stupid CNA who is so rude annoy me like this. Thanks.
Don't feed the dog that bites your hand...I really LIKE that saying!! :)
Good advice from everybody and hopefully you will feel more assertive soon. You 'read' like the 'too nice' kind of person...the type that the bullies and lazy azzes will take advantage of. You will need to toughen up and manage your team..YOU are the leader, YOU delegate. Don't feel badly about 'not helping the CNA's do their job" ...if you have your OWN duties to do. Explain to them you are new and getting used to YOUR job and that's your priority. In time you will learn how to streamline, and then you will have more time to assist if you wish.
Don't feed the dog that bites your hand...I really LIKE that saying!! :)
Good advice from everybody and hopefully you will feel more assertive soon. You 'read' like the 'too nice' kind of person...the type that the bullies and lazy azzes will take advantage of. You will need to toughen up and manage your team..YOU are the leader, YOU delegate. Don't feel badly about 'not helping the CNA's do their job" ...if you have your OWN duties to do. Explain to them you are new and getting used to YOUR job and that's your priority. In time you will learn how to streamline, and then you will have more time to assist if you wish.
Best wishes and keep yer chin up!! :)
Mattsmom-what would you do though if the CNAs are being rude to you? (like the one I was describing above?) What exactly should I say to handle this? Thanks!
Specializes in med/surg, telemetry, IV therapy, mgmt.
For those of you who are having problems with CNAs that are making inappropriate comments. . .it's a bit of a shock when it happens and you can't always come up spontaneously with a good response. Like any other nursing procedure, you need to prepare for this. Work up a little list of things you could say back in these moments. Try to keep them concise. Then, practice saying them to yourself, or in a mirror. For those of you with kids think about some of the things you tell them when they've gone past the boundaries. If you have any materials on dealing with difficult people read them over again. Assertiveness techniques should also be reviewed again. I would also suggest that you write down any statements you plan to say and put them on the back of your report sheets so you have them to refer to. The first couple of times you confront somebody is difficult. Try to remain as calm as you can and not shout. It's OK if you're shaking like a leaf inside. :chuckle By not shouting you are leaving the door open to a good relationship with the person. Confronting other people gets easier and easier each time. Especially, as you discover what statements work.
one of the duties as a licenced nurse is to delegate nurses aides. nurses have to check on the patients and make sure the cna has done their job and if it wasnt, its nurses job to ask them to do it, for example, emptying the urinals and doing vital signs. your job is to delgate them, not doing their job because you want to be nice to them. i remember i checked on my patient who is on tube feeding and cna left head of her bed down while changing her and i immediately raised her head. if she aspirated on tube feeding, then it is my license that is going to be in jepardy, not cna's. you want to be nice? help the out when your cna asks you for help, but dont do their job. they will take advange of you.
Mattsmom-what would you do though if the CNAs are being rude to you? (like the one I was describing above?) What exactly should I say to handle this? Thanks!
-Christine
Hmm. Well a lot depends on the individual and the setting..I am a acute care nurse primarily...so perhaps some LTC nurses AND LTC CNA's can best answer your question here.
When I was new I did exactly what Daytonite advised: come up with an assertive response to smart aleck comments and practice them in front of a mirror or with your DH, etc.
I would probably make a comment (even in front of other staff members) that 'I thought we were a team here?? Weren't you new once and didn't you need some help while YOU were first learning your first job out of school??? Give me a break. In time I will get faster and can then return the favor, but for now...I will need and will ask for your help". In time if this kinder approach didn't work, I would take them aside and remind them of their job description and if they were confused about it. This would be related to the manager as a counseling if possible. Then the documentation starts each time you get an attitude.
Last ditch if you have management's backing: I have asked (in front of witnesses): 'Are you refusing to do what I asked you?' In most facilities refusal will be grounds for termination. (check your employee manual)
Now thats just me...others may have their own suggestions which I look forward to reading. Frequently these political/human relation aspects of our job are the hardest to master. Good luck to ya..I remember being new kid on the block!! :)
I don't like confrontation. Maybe I'm afraid that it won't improve the situation anyway, though I know that's not necessarily true with all people I deal with.
DG5
120 Posts
I have found that if I can impart a bit of knowledge to the CNA's they feel more empowered and they respect you more. For example, when we are watching a patient's behaviour because of a change in medication, or watching for side effects, I post a note for them outlining what to watch for and why. And/or I sit down with them for a five minute interval in the day and explain to them why something is happening with a particular resident. This way, they are:
a) feeling like they are equals to you, not beneath you
b) given valuable time from someone who is taking the time to share something valuable to them
c) and therefore, feel empowered and respected and will less likely want to go running to management at the drop of a hat to tattle tale on silly things or talk behind your back because they get a small picture window of what your job REALLY entails.