Nurses General Nursing
Published Mar 20, 2003
blondie
28 Posts
The supervisors at my long-term care facility are getting rather frustrated with the lack of respect given their authority by the Certified Nurses Aides. A supervisor will tell an aide she needs to float to another unit to help out, and the aide will flat out refuse to go. She'll say, "I'm not going, and you can't make me go." This leads to long discussions, time which could be better used for resident care. Sometimes an aide will refuse to clock in until she's told on which unit she's assigned. She'll threaten to go home if she doesn't like her assignment. Supervisors cannot be as strict as they would like to be in enforcing the rules because they don't want to compromise resident care by lowering the staff:resident ratio.
My question is this: Since the aides are certified, is there any board to which they must answer in disciplinary matters? Can they lose their certification for insubordination and compromising resident care?
It seems to me that if they were afraid of not only losing their job, but their livelihood (their certification, and, therefore, their chance of working anywhere else as an aide), they wouldn't be so quick to defy authority and jeopardize the health of the residents.
Any answers?
Vailgang
105 Posts
I think that it is lack of discipline on the supervisor's part. If they can get away with it then they (the CNA's) will continue to do it. Yes, I can understand the reason behind not following through due to comprimising resident care but they need to have respect and show ALL employees who is boss. I guess you could say that I am probably known as a tough supervisor. I would rather do the job myself then work with someone who tells me how they are going to do the job. I had staff that said they were not going to do laundry because they no longer got their .25 cent an hour shift differential. I reached in my purse and gave them both 2.00 and said here, now let's do laundry. There needs to be a staff meeting to discuss this action or better yet there needs to be one on one counseling. Sorry to be so harsh but I have been in this situation as a charge nurse and it drives me crazy. Good luck and keep us posted.
BBFRN, BSN, PhD
3,779 Posts
Originally posted by Vailgang I had staff that said they were not going to do laundry because they no longer got their .25 cent an hour shift differential. I reached in my purse and gave them both 2.00 and said here, now let's do laundry. There needs to be a staff meeting to discuss this action or better yet there needs to be one on one counseling. Sorry to be so harsh but I have been in this situation as a charge nurse and it drives me crazy. Good luck and keep us posted.
I had staff that said they were not going to do laundry because they no longer got their .25 cent an hour shift differential. I reached in my purse and gave them both 2.00 and said here, now let's do laundry. There needs to be a staff meeting to discuss this action or better yet there needs to be one on one counseling. Sorry to be so harsh but I have been in this situation as a charge nurse and it drives me crazy. Good luck and keep us posted.
Originally posted by blondie It seems to me that if they were afraid of not only losing their job, but their livelihood (their certification, and, therefore, their chance of working anywhere else as an aide), they wouldn't be so quick to defy authority and jeopardize the health of the residents. Any answers?
traumaRUs, MSN, APRN
88 Articles; 21,250 Posts
You get respect by being respectful. If they don't want to work, fire them and hire someone else. If they get fired and it affects pt care, you call in the administrator, DON, ADON and MDS coordinator. You'd be surprised how fast you get CNAs that are good when you do this. I'm the wicked witch of the west and oh oh look out...the house is gonna fall on me!
Buddha
68 Posts
I was an CNA for seven years prior to getting my LPN. Without the CNA's I would never get my work done. I respect them not just because i was one, but because having a poor or fantastic
CNA make all the diffrence in the world. I have walked many a poor aide to the door that I witnessed abusing a resident and I have walked a few Nurses to the door also. The sorry thing was that the Nurse usually gets fired first. When I asked the management the reply I got was that "WE EXPECT MORE FROM OUR NURSES. WE EXPECT THIS STUFF FROM OUR AIDES." Everyone needs to be more professional including the management IMHO. Untill the corporation you work for gets tuff but fair the write-ups you pass out are just a waste of time and paper.
Disablednurse
414 Posts
As long as the CNAs know that they can run the facility they will do it. They want to get the admin, DON, ADON, MDS coordin, etc on the floor to do their job. That is why I could not stay caught up when I was working as MDS coordin, because the staff on the floor thought that I did not do anything except sit at a desk, so they thought that by calling in and refusing to do their job, I could do it. Admin and DON were so dumb that they could not catch on. I could not let the residents suffer, so I would do the work, Then I would get in trouble because I did not have my work done also. When was I supposed to do my work?
ChainedChaosRN
117 Posts
Respect goes both ways. First, if someone is hired to do a job CENA or Nurse, either do it or leave. This facility sounds exactly like the facility I am currently at when I first started.
The first month was hell. But, if you refuse to take an assignment or whatever, you leave and you don't come back. End of story, it's insubordination. If they want to discuss it later on break time, or after work, fine..we can discuss it. But patient care will not be compromised by making demands, grandstanding and threats. It took a couple of weeks of me standing at the door with the staffing book to quietly and firmly relay the message. It's not been a problem for a long long time now. I ended up firing about 5 CENA's and one nurse that ended up taking the leaving option. Which did hold up in the union arbitration. Simple reasoning: If you were hired to do a job, you refused, you lost your job.
Somebody needs to decide who is going to manage, the management or the employees. You can't have both.
Darlene K.
341 Posts
ChainedChaosRN - I completely agree with you. An RN that I worked with years ago (we did team nursing) once said to a CNA that was complaining about the job - "If you don't like what you are doing then either get another job or go back to school." As harsh as it sounded, it made sense. He wasn't going to tolerate her being rough or short with the patients. It's not the patients fault that we are short staffed or that someone feels they are under paid. If you agree to do a job, do it.
Originally posted by ChainedChaosRN The first month was hell. But, if you refuse to take an assignment or whatever, you leave and you don't come back. End of story, it's insubordination. If they want to discuss it later on break time, or after work, fine..we can discuss it. But patient care will not be compromised by making demands, grandstanding and threats.
The first month was hell. But, if you refuse to take an assignment or whatever, you leave and you don't come back. End of story, it's insubordination. If they want to discuss it later on break time, or after work, fine..we can discuss it. But patient care will not be compromised by making demands, grandstanding and threats.
sjoe
2,099 Posts
trauma writes: "You get respect by being respectful."
WRONG! You get respect by demanding and earning it.
disabled writes: "As long as the CNAs know that they can run the facility they will do it. "
Exactly, and so will anyone else.
All of the proposed "solutions" in the original post are about "How can we find a way to use fear to control these employees?"
Two problems: Your managers are NOT managing, and your supervisors are NOT supervising (though they are collecting and cashing the paychecks for doing so).
Training (for management and supervisors) is obviously needed here, or THEY need to be replaced by people who are able to do these jobs. Poorly trained and/or incompetent management (along with widespread absence of leadership) is one of the top two problems in nursing today, IMHO.
Remember:
lee1
754 Posts
"It's not been a problem for a long long time now. I ended up firing about 5 CENA's and one nurse that ended up taking the leaving option. Which did hold up in the union arbitration. Simple reasoning: If you were hired to do a job, you refused, you lost your job. "
Nurses work UNDER a license even though they might be working and paid by your facility. If you are compromising that license by allowing unsafe patient care then a "nurse" has the right to NOT accept such an assignment. If you fire her then I am sure she can also bring bring you up in arbitration as forcing the situation on her.