New LPN troubled with CNA's

Dixiedi · May 26, 2004

I am a new LPN. I have had my license for 8 months now. I have worked at my current facility (LTC) for 7 months. But I recently changed shifts. I now work weekend opt. I love the hours and being able to be at home all week with my kids, but the CNA's that work my unit, well, basically are horrible. They have worked this shift for (most of them, there are 4) at least 2 years. They are good aids for the most part. They only work 16 hour shifts Sat. and Sun., which in my opinion is too many hours for any CNA to work. Being a CNA is hard work, I know, I was one before I became a nurse. I have a lot of respect for CNA's, but only for those who have respect for their charge nurses, which they do not. They truly feel they run that unit and anything the charge nurses ask them to do, they take great offense too. Unfortunately about 2 weeks ago, I had a horrible experience with a patient who climbed out of bed and fell face first and hit the floor. This patient suffered some pretty serious injuries. I felt horrible, had to endure a lot of paperwork and sit in on many meetings with my supervisors, luckily the patient is fine, and is back with us. But now I am even more cautious and aware of what is going on on my unit. And the past few weekends I have noticed that some patients were not put into pajamas for bed, personal alarms not on, mats not down for those in low beds, and this is the kicker, a certain resident, 2 weekends in a row I found had no O2 on, which is to be on at all times. When I approached the CNA's about this, they became very defensive. Although, we talked, I thought it went well, and that was that. I came in that night, (I work 12 hour shifts) and they weren't speaking to me or the other nurse, they behind our backs, called the ADON in for a meeting at 10pm, I had no idea that they did this. So, during our "meeting" these 4 CNA's were yelling at the top of their lungs at the two nurses and the ADON. A truly pathetic display of immaturity and disrespect. These are the things that you are not taught in nursing school. The DON has now called a meeting with the two nurses involved, the 4 CNA's and the ADON. They say it's the nurses chance, and theirs, to let these CNA's know who is in charge. I'm not sure that this meeting is going to go well. I have a truly bad feeling about it. I have never had any trouble like this before with CNA's. I normally have no problem with them. I'm told it's just a "power struggle", but there should be NO power struggle, I'm the charge nurse.....period. Any suggestions on this problem would be greatly appreciated.

Document! It's your responsibility to see to it that your pt has the O2. If you instructed the CNA to put it on, and it is within their scope of practice at your facility, you must document that.

Write up an incident report. Outline your method of re-instruction and direction for your CNAs. Then, if they want to be jackasses about it, you are already covered. My bet is they will not be prepared to present their case. You will be.

SCRN1 · May 26, 2004

I understand. There's lots of great things about ours and then we have some who think they run the place just because they've been doing it for years and have no plans of going any further than being a "tech".

Best advice I can give to you is TRY to always keep your cool and behave in a professional manner. Continue to do your duty as charge nurse and continue to give them appropriate instructions. If they do not follow up on what you instruct them, report them. State facts only.

Good luck! Let us know how the meeting goes.

Blackcat99 · May 26, 2004

When I work in LTC's I give a few verbal warnings and that's it. After that I write them up each and every time. It then becomes the responsibility of the DON to deal with them. Usually the DON will talk to them and they either "knock it off" or get fired. It really helps if you have a good DON. Good luck.

LoriRN911 · May 26, 2004

Yes.........YOU are the Charge Nurse and it's YOUR licence on the line. They don't care, they have no licence to loose! Are you the only nurse on this floor or do you have another nurse with you? It is your responsibility to make sure the patients are getting the care and if you have to lay down some rules for these CNA's DO IT!!!! Your DON should hear your side of the story. Did you document the care these CNA's were doing? Remember, DOCUMENT, if it isn't documented, it didn't happen.

GOOD LUCK

CHATSDALE · May 26, 2004

I Have P;roblems Also In Ltc I Have Had Feeding Pumps Turned Off Because (they Were Beeping) Some Formulas Will Clog Up If You Do Not Flush And Find The Problem-----in Our Facility O2 Is Nurses Respondsibility But I Have Had Cna Ignore Me And Go And Try And Find An Rn When There Is A Problem.....very Frustrating When Someone Asks You What Is Going On With A Pt And You Haven't Been Told Anything....thank Goodness The Majority Of Cna S Are Not Like This Write Up A Counseling Statement And Document Everything That Goes On And Maybe You Will Get Rid Of Dead Wood

We Have Several Cna Who Work 16 Hr Shifts As Do Nurses I Don T Feel That That Is The Problem

bigred · May 26, 2004

Been there (am there) done that. If I got a dollar for each time I have locked horns with immature, obstinate CNA's, I truly could retire. We have the very same problem. Just the other day, another LPN commented on the way CNA's speak to LPN's. What do I do when I feel that a CNA is being disrespectful, not carrrying out a task that I ask them to etc? I report them and as was suggested in another reply, I document. I also keep my own records. I had a CNA tell me the other morning that I made a "bad" decision. She came to that conclusion because I decided to have 2 CNA's work on a designated unit instead of one CNA working by herself (with me present on that unit in the nursing station charting). The other 3 CNA's would work together on the other unit so they will not be "behind" later on in the am. I did not see that as a safe siituation in case I got called somewhere else in an emergency. That would leave one CNA by herself. It stemed from a CNA calling in for the early am shift. (6-2). Her replacement would not be in until the regular 7-3 shift. The charge nurse coming on shift suggested that I report the involved CNA's. Absolutely. So, like I said, been there, done that.

Take heart, you are not alone. I feel that you handled your situation in a professional manner. Good luck at the meeting. You have the right attitude.

TBLPN, LPN · May 26, 2004

Thanks for all the advice. Hopefully the meeting goes well and order will once again be restored!

Alnamvet · May 26, 2004

The solution is to get rid of all CNA's...they never have, nor ever will, be worth the effort to keep...I got rid of a boat load a few years back at an ED that I directed, and with the money saved, gave all the full time staff raises to the tune of $8-10.00 an hour per RN. The complaints about never knowing where the aids were were gone, and the RN's did not mine doing the additional scut work, since the hefty raises more than made up for the abscence of no loads.

Marie_LPN, RN, LPN, RN · May 26, 2004

The solution is to get rid of all CNA's...they never have, nor ever will, be worth the effort to keep...I got rid of a boat load a few years back at an ED that I directed, and with the money saved, gave all the full time staff raises to the tune of $8-10.00 an hour per RN. The complaints about never knowing where the aids were were gone, and the RN's did not mine doing the additional scut work, since the hefty raises more than made up for the abscence of no loads.

Gee that's a realistic plan for everywhere. Not.

KK92RN · May 26, 2004

The solution is to get rid of all CNA's...they never have, nor ever will, be worth the effort to keep...I got rid of a boat load a few years back at an ED that I directed, and with the money saved, gave all the full time staff raises to the tune of $8-10.00 an hour per RN. The complaints about never knowing where the aids were were gone, and the RN's did not mine doing the additional scut work, since the hefty raises more than made up for the abscence of no loads.

that would work if the patient load would be 3-4 per nurse for med- surg. anything else is just not safe.

leslie :-D · May 26, 2004

The solution is to get rid of all CNA's...they never have, nor ever will, be worth the effort to keep...I got rid of a boat load a few years back at an ED that I directed, and with the money saved, gave all the full time staff raises to the tune of $8-10.00 an hour per RN. The complaints about never knowing where the aids were were gone, and the RN's did not mine doing the additional scut work, since the hefty raises more than made up for the abscence of no loads.

oy vey. :rolleyes: