Multiple CNA's refusing assigned task

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I'm looking for input on how you would handle a sutuation. There are 5 CNA's assigned to the unit they are also assigned halls.

The CNA assigned to the hall I was working had just left to take a lunch break. I went in to give a patient his medication and he told me he needs to use the restroom. I came out of his room and asked a CNA SITTING at the nurses station to help the patient go to the restroom. She responded with "No, I'm not going in his room, he is mean and ran me over in his W/C, he kicked me last time I was helping him." So I asked another CNA standing near the nurses station and she said "sorry I'm leaving". She was scheduled to leave at that time. Then one other CNA starts to walk by and I ask him. He also refuses. I was ready to scream.

While I understand that I am also capable of helping the patient to the restroom, I feel like if I am in the middle of med pass and there are CNA's literally sitting down that I shouldn't be the one toileting him. I always read the advice about time management on here saying "stay on task, delegate tasks that others can do, avoid interuptions while doing med pass".

I ended up calling the unit manager and a CNA ended up helping the resident but I fell like I could have handled the situation differently. By the time all of it was said and done I could have toileted him, but if I start doing anything they don't want to do they will let me do everything. I am sure of that.

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The CNA assigned to the hall I was working had just left to take a lunch break. I went in to give a patient his medication and he told me he needs to use the restroom. I came out of his room and asked a CNA SITTING at the nurses station to help the patient go to the restroom. She responded with "No, I'm not going in his room, he is mean and ran me over in his W/C, he kicked me last time I was helping him."

I would have said, "This sounds like a two-person job, let's go together." and grabbed the first CNA. While we assisted the patient, I would have made a big fuss about setting boundaries, and afterward, I would have encouraged the CNA to report any further issues to me as they occurred. I would have also encouraged the CNA to come to me for assistance when helping that patient in the future if they felt the need.

If the CNA remained uncooperative, I would have probably assisted the patient myself and then immediately requested a "huddle" with me, the CNA and the charge nurse. The assignment would need to be changed or the CNA would need to agree to do their job- one or the other.

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Specializes in Psych (25 years), Medical (15 years).
I'm looking for input on how you would handle a situation. ...

I ended up calling the unit manager and a CNA ended up helping the resident but I feel like I could have handled the situation differently.

Understandable situation. Appropriate feelings.

It is good that you're re-evaluating the situation and looking for ways to gain a new perspective, Dawneibals. A sign of good mental health and a desire to grow. Kudos to you!

Sour Lemon's advice was gold: Illicit help. Be an example of one willing to do grunt work for the benefit of the patient.

Hey Dawneibals- keep on keeping on!

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Specializes in Oncology.

"I'm giving you a directive, are you refusing?"

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Yeah, this is what I asked before I phoned the unit manager at home. She was like" I'm not doing it." And continued to sit there. The other girl I asked left and the guy I asked said no, then made sure to get busy doing something else.

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Specializes in Private Duty Pediatrics.
Understandable situation. Appropriate feelings.

It is good that you're re-evaluating the situation and looking for ways to gain a new perspective, Dawneibals. A sign of good mental health and a desire to grow. Kudos to you!

Sour Lemon's advice was gold: Illicit help. Be an example of one willing to do grunt work for the benefit of the patient.

Hey Dawneibals- keep on keeping on!

Elicit help, don't do anything illegal. :eek:

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I likely would have offered to help the patient. If the CNA still refused I would have helped him. After all there is only so long that you can hold it. Either way I would have taken the issue up with the manager. After all what happens when you are not available? Does the CNA just ignore this patient? We (the entire care team we) can't ignore a patient we don't like. The CNA either needs a new floor/ wing assignment, a CNA "buddy" plan if the patient is truely a risk, or a new job. I'm not always the most diplomatic person though.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

As former DON, I would ask can you do your job?

I am a big fan of assisting the CNAs , when scheduling is possible.

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Specializes in IMC, school nursing.

This is such an enigma for nursing. No other profession allows the support staff to say no, nor do any other professions have, let alone condone, overlap in duties. The fact that ADLs are not the exclusive responsibility of CNAs belittles our profession. The problem, management encourages this.

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Specializes in SICU, trauma, neuro.

I would assign this task -- not ask. Doing one's job isn't optional, and refusing is called insubordination.

(**Of course if the CNA has a legit reason, e.g. the guy likes to grope or has made false allegations against her, you'd need to work with that.)

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I am going to voice an opinion which, judging by the replies received whenever this type of question comes up, will likely be unpopular.

I come from a different era. When I was a tech it would never have entered my mind to refuse a request from a nurse to do something. I didn't think of it as a request, really, more of an order. I may have thought to myself, "what's wrong, is your arm broken?," but I complied. So did the other techs. We didn't expect to have a friendship with a nurse, although that did happen. It was more like the army. The RN is the commanding officer and you are staff to assist her. It was understood that refusing to do your job was a reason for losing that job. Maybe Sally Nurse is a pompous, lazy a__, but that should have nothing to do with whether you will carry out your assignment.

Today, I see recommendations on how to treat techs/aides so that they feel appreciated and will therefore do their jobs. I have no problem with making techs feel they are appreciated and are a big help to you. You should always strive for a happy team. But doing this so they will do their jobs is a different animal.

Techs who refuse without a good reason need to be written up for insubordination. If management refuses to do anything (and some will) you need to start looking for another unit if you don't want to be stuck on a unit where the techs/aides rule, know it, and feel perfectly OK bossing nurses around. Because without management intervention that is exactly the type of unit you will have.

We don't all have to be a big happy family in the work world, but we do all have to do our jobs.

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Specializes in Psych (25 years), Medical (15 years).
Elicit help, don't do anything illegal. :eek:

Well, alright, then, Kitiger!

If you want to be all ethical and morale about the whole thing!

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