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LTC problem getting assistants to respect me

I am a new graduate working in LTC, so far it has been okay. Honestly a lot of times I think I find more work because I am a new grad and I try to do things by the book that we don't have time for. However, I am having trouble because I am in my 20s and some of the older assistants do not seem to respect me. Before people start getting into you get what you give, I really respect the nursing assistants a lot and I always thank them and consider their POV because often times they know the residents better, however I am wondering if asking their input because I want to gather all the info before making a decision is causing them to not respect me. Usually I know what to do and I bounce ideas off of people but I think this is giving me an air that maybe I am not as confident? I just want to be the safest nurse possible.

What can I do to get more respect? The other day, the assistant decided to call for back-up when someone was in trouble before giving me a chance to assess and although I was grateful, because I was having a lot of issues pulling me away from my med-pass that day, I worry that that means they do not respect me and my judgement :(

I would be more concerned with how your supervisor perceives you. Some of the assistants will come around when they perceive that you have it together; others will never come around. Either way you have to get the job done. As long as your supervisor does not see a problem, then there is no problem.

I agree. It's kind of a slippery slope. When I was working in LTC I made sure that I listened to what the CNA's had to say but in the end, as an RN I had to also do what I felt was right. Many times CNA's become territorial with their residents and are protective. When they realize that you know what you are doing, most of them will come around.

Thank you, hearing that some of them will never come around makes sense with what I am thinking, because I know some of them have been doing it for 20 years and think they know much better than me even though they have no license. I keep thinking I'm fighting a loosing battle trying to please everyone, but you're right. I am being a little naive about trying to change people's attitudes because its impossible at times.

The supervisor does appreciate me because I do address things and immediately, at least I haven't had any complaints in the time that I have been there for a few months. And I would hope that they would address any issues they were having with me head-on because if I'm doing something wrong, I need to know and I'm still getting used to the many policies. I feel I am doing a good job practicing nursing as I have been taught.

I learned that you cannot demand respect-----you have to earn it. If they know that you know what you are doing, you’re confident, and you are a real professional person, then that should help. Also, you have to be courteous too. Sometimes they just become territorial and defensive if they feel that you are belittling them. (I am not saying you are, I am just mentioning some possible reasons why they act that way in general). Praise them when it’s due, but tell them too if there are patient issues that need to be addressed and done.

Some aides are fabulous and do their jobs well regardless of the leader. Others are meh and do a barely adequate jobs. Then there are the annoying, lazy ones. Just like nurses. I am betting that you are having the most trouble with the latter and some problems with the middle meh ones.

Just keep on managing. And sometimes it take a write-up to actually get someone's attention.

Thank you everyone. I just feel like when you do the right thing, everyone makes you feel like you're doing the wrong thing :( I had that happen today, because I could not help them with tasks which were less important than more critical things, thats what I was taught in nursing school, the critical things are more important. If the patient is safe, clean and healthy we will get to it....Thats my POV, and I feel like LTC is going to make me a bad nurse and cut corner in order to please :( :sniff:

I too was a new grad and young (20). I learned to always ask the CNA to do something and not order them. I understood they knew more about the patient and respected their opinion. I kept my professional relationships professional and personal, personal. Worked well for me for over 25 years.

Hi Ladies and gents.....

I thank you for your advice so much. I feel I can't take LTC as a new graduate because I am feeling so alone....I had to deal with one of the asssistants though I was as polite and professional as I could be about a behaviour not appropriate, if it were little I would have let it go and I did not get the most professional response back and this person has been there for a few years and is needed, who is management going to see the POV of....not me I'm new and a little bit green but I felt I knew what was right for the residents...:( I got into nursing because I love and care for these old people and want to treat them as nicely as if they were my family, not a job and I can't fight forever. I have been at this for a couple of months and don't want my resume to look terrible but there isnt many hours in a few weeks here anyways, i dont know if I should tough out the many hours I have coming up and then keep the position and go in for the occasional shift so it doesn't look bad if I have to quit when I speak to management about everything.

You're not going to have to quit. You're not the first new nurse to have to deal with insubordinate aides.

Calm down. It's not you, it's them. Your first year in nursing is almost a hazing. It gets better. Promise.

I am not going to have to quit, because honestly I can't afford it, but I do not know how I can stay if I am fighting a loosing battle on my own. However I found an old nurse who works there who advised me that I didn't do anything wrong and that sometimes things get out of hand and unfortunately despite all the tasks I have to do and how hard it is, you have to take this person aside and warn them about their actions. I just think some of them believe they can get away with things around me because I usually am pretty easygoing except when it comes to very important things.

I also am very sympathetic to how hard their jobs are, and I have to stop doing that because it gets me into trouble. Yes its hard and almost downright impossible, but thats every persons's job in LTC right down to the kitchen because they only get so much time to do a job.

Of course what she advised me to do is what I did at the time but the things that came out of my mouth probably weren't very effective because I was upset when I said it.

Mandylpn specializes in home health, LTC, assisted living.

I applaud you, LTC is a very tough place to work!

Hi, I`m in the same boat, new grad, in my 20s, working in a NH. This is my second month on my own, I also feel that some CNAs don`t respect me although I have been nice, polite...

I also feel sooooo overwhelmed that I can`t stop thinking about the job when I get home. I don`t have time to be the nurse that I thought I was going to be.

Hope things will get better for us! Wish you the best!

Me too, hopefully we can get better. Its just when you think the problem is all with you and you keep beating yourself up....thats the tough part....I guess we nurses cannot possibly control "everything" that happens.....

:nurse: If you are being treated with disrespect or an aide is rude ect. Pull her aside and privately speak with her. If the behavior continues write them up and speak to you immediate supr. Don't give up sister. There will always be staff that will "try" anyone and everyone in authority. For the aide that called in another nurse. I would nicely tell her if she had a concern to come to you and that if you feel you need assistance you will be the one calling for it.

Show confidence. They get worried if they see a rattled nurse.

Being a new nurse is not easy but you sound like your heart and your head are in the right place. Hang in there!!!!!!

VeronicaWileyRN specializes in Long term care-geriatrics.

Please don't give up. It doesn't matter where you work or who you work with there will be people that think they know more, do more and they say more. It is important with the CNAs that if you must confront one that you take someone (another nurse) and address the problem. You should always make the DON aware of the problem. DON may know that that CNA had attitude problems before and that CNA was written up. That CNA could be actting up with other nurses that you don't know about. Somethings that are important 1. don't let the DON see you setting at the nurses station unless you are working, 2. don't take frequent breaks, 3. if you have problems talk to your supervisor, assistant Don or DON. GOOD LUCK!!!

agldragonRN specializes in Wound Care, LTC, Sub-Acute, Vents.

hi, i`m in the same boat, new grad, in my 20s, working in a nh. this is my second month on my own, i also feel that some cnas don`t respect me although i have been nice, polite...

i also feel sooooo overwhelmed that i can`t stop thinking about the job when i get home. i don`t have time to be the nurse that i thought i was going to be.

hope things will get better for us! wish you the best!

me too, hopefully we can get better. its just when you think the problem is all with you and you keep beating yourself up....thats the tough part....i guess we nurses cannot possibly control "everything" that happens.....

i was 25 years old when i started working as a nurse in ltc. i am still the youngest now (27). the cnas can definitely make the job harder. i was "tested" numerous times by some of the cnas. it was very frustrating. it's good to seek the guidance of the seasoned nurses on your floor for advice and ask how to deal and manage the "bad apples". are you the only nurse on the floor? i hope not. i always went to my co-lpn on the other hall when i needed help dealing with the cnas. you also have to be a good nurse and show everyone that you know what you are doing.

don't give up you two. it gets easier once you learn how to deal with the bad apples. i still have one bad apple and argues with me once in a while. i try to resolve it on my own initially but when the cna continues to be insubordinate, i call the supervisor and ask her to come up and talk to the cna. this usually resolves the issue. it is your license on the line if anything happen to your patients under your watch so you must do everything to protect it. this particular cna, i don't ask her anymore. i tell her what to do now. it seems to work. you have to approach each of your cna differently.

good luck! ltc nursing is tough!

DizzyLizzyNurse specializes in Peds Medical Floor.

I worked as a CNA at my LTCF for 2.5 years before becoming an LPN and I had the same problem. Some of the aides I worked with as an aide and never had a problem with, suddenly had it out for me when I became a nurse. Just do your job, be polite, help out, and respect them. I second whoever said if they are being blatantly rude take them aside and talk to them. They will most likely come to respect you. Ask for hellp from the other nurses. I noticed as more new nurses started that those same aides had a tendency to act like that to any new nurse, whether new grad or seasoned pro. People do get territorial in LTC.

Nascar nurse specializes in LTC & Hospice.

I was a new LPN in LTC at 19...yes I said nineteen! At the time my CNA's were all in their 40's or older & all set in their ways. It was a long up hill battle. (I can still remember them planning to go out for a drink after work & their snide comments that they couldn't invite me because I was just a baby). I was told years later that there was bets on how soon they could "run me off"....fooled them as I out lasted every single one of them (I'm still there 24 years later, although I have quit and come back a few times). I was unit manager by the age of 22 or 23. I earned that promotion thru lots of hard work and by the time I was unit manager I had the respect of at least 90% of the staff. You will never have a 100% support. That's just the way it is & you just need to learn to live with it.

After all these years, my best advice..

1. Help when you can...it does build teamwork

2. Ask for help when you need it

3. Don't be afraid to admit when you don't know something. But, find the answer

4. Treat everyone fair. Don't make the mistake of only asking the one you can depend on for everything. It will build resentment in that person too.

5. Hold people accountable for their actions/inactions. When possible explain your reasoning.

6. Remember to say "Thank You" and "Great job today" - catch them doing something right. Brag about great care and great deeds in public! Complain in private.

7. Don't expect someone to do something they know you would never do (ie: empty bedpans, etc).


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