Lazy, attitude giving, lip smacking, eye rolling CNA's trying my sanity!

[Longleggedstar]

I could literally go on and on. I work in ICU and was doing home health. But the Home health census has been slow so I picked up an LTC facility on my days off (I'm paying off student loans). I love LTC, and the places I have worked at before (in a different state) was AWESOME! But the LTC I am at now, I have NEVER experienced such (for a lack of a better word) ghetto acting CNA's. The atmosphere here is different, the CNA's seem to have so much authority due to the decades of service there. I guess my question is, have any of you dealt with this type of "situation" how do you delegate in this type of environment without fear of your tires being punctured or punched in the face! Literally, one employee angrily told me, "Leave me alone, just because your an RN, don't mean you run sh**). Evaluating the attitude coming off of her, I kindly shut my mouth and walked away. I wrote her up of course, the nurse on staff that had to sign the write up with me literally said, "I was wasting my time" with the write up, and she was right!

I am not leaving!!!! This job works nicely for me, I just need advice on how to effectively deal with my "not so lovely" CNA's. An tips/tricks are greatly appreciated.

[Been there,done that, ASN, RN]

Been there, done that. I have been threatened for writing up CNA's for lousy work ethic and insubordination. Their threats did not scare me, management supported me and dealt. However, if management is not going to respond to your write-ups and start the disciplinary process, your hands are tied.

There are many other places to work, where you have management support.

[dishes, BSN, RN]

Sorry to say, but one individual cannot effectively change embedded behavior that has been allowed to poison a workplace. It doesn't matter what tips/tricks an individual uses, if they don't have buy in from the team and incentive to make changes.

[amoLucia]

Am curious - are your CNAs union?

Regardless, there always has to a paper trail in order to start any disciplinary->termination process. Document as you did.

Did you follow-up with your DON? You did the writeup, but was it presented to the CNA? Then there's the disciplinary step that usually comes from the DON, even if it's only a 'verbal' between the DON and the CNA.

Whenever you do some kind of disciplinary activity, make sure you absolutely have a second person (nurse or HR) witness present for you, and usually a union person witness is present for the CNA.

It's a start - sounds like it hasn't been done in a loooong time. Also, remember that one CNA is prob not the ONLY one who needs some 'attitude adjustment'.

I'd keep on top of issues with your DON. And it may be sloooow to change. If the conditions do not change for whatever reasons, you may just have to consider another position. Sorry about that, but some things may not be changeable.

[RNperdiem, RN]

I could overlook some problem attitudes if the residents on the LTC were getting the care needed. If the CNAs are doing their work and the residents are properly looked after, then maybe they don't need much delegation.

If, on the other hand, everything falls to you, it sounds like the CNAs run the show and there is no fixing the situation.

[caliotter3]

I have never worked in a LTC facility where management backed up the first line supervisors in general, and me in particular. In some places the other nurses made matters worse because they bought into the CNA behaviors because of perceived commonalities. Actually, they were part of the problem. That has never stopped me from taking appropriate action at my level, short of sending a CNA home. In the end, I have even had management use my inability to work miracles against me. Quick to punish the nurse, never look at the CNA. I find this type of management style to be institutional in LTC facilities. That is the major reason I won't work in one short of someone holding a gun to my head.

[Longleggedstar]

Am curious - are your CNAs union?

Regardless, there always has to a paper trail in order to start any disciplinary->termination process. Document as you did.

Did you follow-up with your DON? You did the writeup, but was it presented to the CNA? Then there's the disciplinary step that usually comes from the DON, even if it's only a 'verbal' between the DON and the CNA.

Whenever you do some kind of disciplinary activity, make sure you absolutely have a second person (nurse or HR) witness present for you, and usually a union person witness is present for the CNA.

It's a start - sounds like it hasn't been done in a loooong time. Also, remember that one CNA is prob not the ONLY one who needs some 'attitude adjustment'.

I'd keep on top of issues with your DON. And it may be sloooow to change. If the conditions do not change for whatever reasons, you may just have to consider another position. Sorry about that, but some things may not be changeable.

No unions here...The DON's knows about the situation, she is the one I gave the report to (BIG MISTAKE not following the chain of command). The report was then given to my unit manager, who then gave it to the CNA supervisor. The CNA supervisor stated that she would handle it. When I returned to work I asked so what happened, she says, "I talked to her". That was last week, yesterday I asked her to answer the call lights. (The other CNA working with her on that hall was on break) She says, "that's [Jane Doe's] side of the hall, we don't play that round here, she know to take care of her patients before she go on break. I looked at her and waited for about 30 seconds in silence. She then got up handed me a write sheet and left. She handed ME the write up sheet!!! What the...So I had no choice but to stop charting and get up to answer the light and change the patient myself. I wrote her up again and gave it to the unit supervisor. We will see what happens. Something has to happen because this is too much for me.

[Longleggedstar]

I have never worked in a LTC facility where management backed up the first line supervisors in general, and me in particular. In some places the other nurses made matters worse because they bought into the CNA behaviors because of perceived commonalities. Actually, they were part of the problem. That has never stopped me from taking appropriate action at my level, short of sending a CNA home. In the end, I have even had management use my inability to work miracles against me. Quick to punish the nurse, never look at the CNA. I find this type of management style to be institutional in LTC facilities. That is the major reason I won't work in one short of someone holding a gun to my head.

Luckily, at this facility, the nurses are with me and sick of it as well. Even little things like our CNA's sitting at the nurses station on the phone when we need to chart.I feel so defeated here, maybe it is time to move on.

[MikeyT-c-IV]

I was in a similar situation but as the nurse manager of a unit. I inherited some problems to say the least. Performance improvement plans were promptly initiated with aggressive but fair timeframes and indicators. Long story short I was privileged to hire some very professional and talented CNA's and RN's. The overall tone and attitude of this unit changed, in fact, became amazing.

Leadership must be proactive. That's the bottom line.

[Buyer beware, BSN]

OP,

This CNA's attitude reeks of contempt and disdain for you. I have a chuhuahua exactly like that. If she doesn't like something or has to do someome that doesn't suit her mood she snarls ever so subtly and goes about her business.

Now in comparing chuhuahua to the CNA I must say that at least chuhuahua serves a purpose. She constantly surveys the property is protective of family members and will sound the high-alert in a moment's notice.

Now tell me, just what is it that this CNA does?