I was lucky at work yesterday I had a great assignment. Towards 5 pm the unit secretary came to me stating that a RN on the other end of the hall was drowning, she was answering so many of her patient lights that she was falling behind.
As I passed the nursing station that Rn's CNA and the charge nurse were socializing. I said to the CNA can you check on your patients and see if there is anything they need such as water. She said " my patients don't need anything they are okay" to which I replied, your nurse is drowning I will help her pass meds can you check on your patients and pass water. She did not move, nor did the charge nurse, Meanwhile I approached the drowning Rn asked her what I could do to help her as I was all caught up. She told me she needed help with her meds, so off I went with her MARS in hand passing out the meds, and as I ran across water pitchers was placing them on a computer desk in plain site of her CNA. When I completed the medications, I walked to my end of the hall, gathered up my own water pitchers again CNA is still standing at the desk, and then picked up HER water pitchers and filled them all and distributed them.
I then thought about what had happened. I next wrote out a three page memo giving the above abreviated version of circumstances. I then photocopied it, gave it to the CNA. My words were it is up to you as to whom the originals get turned in to. Amazingly later when I asked her about it. She stated she did not care what I did with them. I responded with ( ) Can't you just for once say okay" reason being most often when asked to do anything she always has a smart mouth remark and doesn't do it..
so,,, I turned the memo into our Nurse Manager/supervisor.... A part of me feels badly, in 30 years I have never done this to a co-worker. I have always believed in talk to the person first, which has before gotten a positive response. I know I have no control over another person. Yet, I like this CNA personally, but I don't like how she left her nurse stranded to do both jobs one of which was the CNA/s while she socialized.. Was I way wrong? any suggestions ?
I do not plan on treating this CNA any differently that I have before I still like her. I hate conflict , I prefer resolution.
Like many CNA's out there, she feels that she is "untouchable". Many are probably intimidated by her, and it is high time somebody wasnt!
Why is that? I don't think I'm irreplaceable, why would a person with minimal education and no license think they're better than I am? More experience does go a long way, don't get me wrong, but why on earth would a CNA treat me like dirt?
Arrgg... I have a lot of frustration over this issue and no clear answer. I think it's really a problem with management that isn't usually addressed appropriately.
All in all, I think you did fine in a tough situation.
When you go back to work, keep it positive (sounds like you will) and hopefully the CNA will step up to the plate (and be positive as well).
I am at my third hospital in a short "career" as CNA while I wait to attend nursing school. The first hospital had terrible ratios for the nurses and the CNAs and nurses were run ragged and could not do a good job as I saw it. The second job had better staffing, but poor infection control (all levels of staff and even doctors were guilty of it there). My third hospital has great infection control, good ratios for nurses, and very good teamwork between nurses and CNAs. I almost gave up on nursing as I was so disgusted with my first two experiences. I am glad I went back for a third try.
I wonder if you might look around at other places that might suit you better in the long run. :)
Good luck to you. You sound like a thoughtful and caring person --and a good teammate.
For the poster with the comment about proactive rounding --it is a good idea that works. In my facility, CNAs round on odd hours and nurses round on even hours. I notice that patients hold their requests for when I come in.
Sonora, first thanks for your comments. as to working elsewhere. I love my job, I love the types of patients we have. I have been here for almost ten years. One bad day, nor even a couple of less than perfect working teams do not make for a need to look elsewhere for a job. 95 % of my co-workers and all of management are great, they and the patients are what have kept me working on this unit in the hospital.. But thanks for the suggestion. perhaps someday I will feel a need to change for sake of sake.
Specializes in A little of this & a little of that.
I think you did OK. I would be more assertive, as others have said, giving her an actual directive. If she refused I would be even more blatant "that was not a question/request, I expect it done NOW".
Definitely communicating with your manager and shift supervisor is indicated here. The charge nurse encouraged this laziness and insubordination. Do whatever "writing up" you are allowed to do, as you did, every time it happens. Ask the RN who she was assigned to, to do the same or co-sign yours.
You're a good nurse. I always like working with someone who "has my back" and do the same for others.
I would have stopped at the first request. After that it would have been an order. If she still didn't move to do what was told... that is insubordination, grounds for termination. Sorry, But i don't put up with that type of behavior in my staff.
Specializes in Community Health, Med-Surg, Home Health.
I don't think you were wrong, and I also believe that the charge nurse should have chimed in to encourage the CNA to do her work. I am very friendly with one of the nursing supervisors, because she knew me for many years before I started working there (she also supervised my mother, who was a CNA before she died). This supervisor calls me to chat, invite me to her office for lunch, etc...however, she WILL NOT compromise patient care. If she sees that I have to medicate, teach or interact with a patient for any reason, she will say to me to call her back or visit when I am finished completing my duties. She will not be responsible for me being distracted and will make sure that she demonstrates by leaving the area or pitching in to help.
I would have stopped at the first request. After that it would have been an order. If she still didn't move to do what was told... that is insubordination, grounds for termination. Sorry, But i don't put up with that type of behavior in my staff.
Having grown up in Wi, yes insubordination and such was drummed into my head. However here in Florida it seems to be much different. Thankfully most everyone I work with is great, and almost everyone will do whatever when requests are made.
But I hear yah all. I will try to work on being more direct. To me asking someone to check on their patient and waters was direct. But that is only in my mind. I now realize some people need commands/order to do, which is not a form of communication that I like to either use or receive for that matter. I will find some means of communicating more directly without losing my self in the process.
Specializes in med/surg, telemetry, IV therapy, mgmt.
There have been several threads about belligerant or subordinate CNAs lately. Is there something in the water?
I went through this with CNAs when I worked in nursing homes. I don't like conflict either, but unfortunately there are some who thrive on it. You have to cut these people out of the herd if they don't respond to normal counseling and discipline. I am surprised that the charge nurse who was chatting with this mouthy CNA at the nursing station didn't say or do anything to this CNA either. Sounds like that's another problem as well. I wouldn't have even bothered to show my write up to the CNA. I would have just given it to the manager. Feel badly if the manager doesn't do anything about this because that would be an even bigger problem.
I used two books to help me cope with goofballs like this:
Managing Difficult People: A survival Guide for Handling Any Employee by Marilyn Pincus
Working With Difficult People by Muriel Solomon
Also know your CNAs job description and the facility policy on discipline. Follow good principles of delegation:
Primary concern is to make sure that the patient is safe
You must know the job descriptions and abilities of the healthcare personnel and subordinates who you supervise
You must know facility policies and procedures
You must know your nurse practice act
You must delegate tasks to those who you know are capable of performing what you are assigning them to do
You base tasks that you delegate to others on your knowledge of the state nurse practice act, facility policies and facility job descriptions.
Give directions for the task that are clear in order to avoid misunderstandings
Give a deadline when you expect the task to be completed
Ask the person to repeat back instructions to verify they have the directions correct if you suspect they do not understand what you are asking them to do
Follow-up to make sure the task was completed correctly and by the deadline in order to evaluate the performance of the task (this is your supervision function)
Provide praise when tasks are done well and within deadlines; provide feedback and criticism when necessary
Assign same tasks to the same individuals if possible
Get wrongdoing documented on a facility form (if there is one) or an organized business style memo
Date
To
From
Subject
I often gave a copy to the CNA. A typed memo in a business style like this looks intimidating and serious to them--or maybe not. It looks serious to the manager. I always keep a copy for myself as well. Mention what rule was broken and how. Describe specific behavior and attitude. Don't feel bad when a CNA gets "attitude" like this one, becomes insubordinate and does what she did. She had a choice to do what was right or wrong. She chose wrong. There are consequences to all choices.
I always think of discipline as being similar to dog obedience. It has to be consistent and fair. The fact is that most of these kinds of CNAs continually screw up. A few write-ups and they are OTD (out the door). They pretty much self-destruct because they are so angry. Who they are angry at is not our problem. All I care about is that they perform their job and do it safely when they are working with my patients. Other nurses, like the charge nurse who was standing and talking with this CNA who want to permit them to slack off and be disrespectful to other charge nurses are just as worthless.
Specializes in LTC,Hospice/palliative care,acute care.
I was lucky at work yesterday I had a great assignment. Towards 5 pm the unit secretary came to me stating that a RN on the other end of the hall was drowning, she was answering so many of her patient lights that she was falling behind........
....... As I passed the nursing station that Rn's CNA and the charge nurse were socializing. I said to the CNA can you check on your patients and see if there is anything they need such as water. She said " my patients don't need anything they are okay" to which I replied, your nurse is drowning I will help her pass meds can you check on your patients and pass water. She did not move, nor did the charge nurse, Meanwhile I approached the drowning Rn asked her what I could do to help her as I was all caught up. .
Why did the unit secretary come to you? Why didn't she tell the charge nurse that the other RN needed help? Why didn't the other RN tell her charge that she needed help? It sounds like passive aggressive behavior is your workplace's solution to conflict. I think you did the right thing-I would have done the same but I would have encourgaed the other RN to march her butt down to the nurse's station and tell the cna what she expected from her.We have all worked with staff like this -when the behavior impacts on patient care you have to write it up and follow it through.It does not matter if you like the person or don't or if they have 16 kids and are supporting elderly parents-they have a job to do and they have to do it....You have to stand up for the patients
My reply to giving her a copy, was for her to digest the seriousness of not doing her job . Giving her some time to digest it all before I would follow through at the end of the shift by seeing the our supervisor/nurse manager had the memo. I wanted to give her an opportunity to see for herself what could have been different and at least acknowledge in someway in the future it would not happen again. It is my own style of dealing with people. I do not believe, it would have been professional on my part to not let her see what I wrote. I had nothing to hide, and again I do not believe in jeopardizing anyones job. I believe in allowing them to see the need for a change.
AS to the charge nurse, you are correct that would be a whole another issue , one that I am not going to get into with her. Again I like her personally, she can be very funny.
I do not see her as professional, and is another one who tends to be smart mouthed. I will let her so called equal another RN deal with her. It will not be me. She once yelled across the nursing station who has such and such room, this was shortly after assignments had been changed by the charge nurse of that particular shifts. I said, you do. She asked it a second time, to which again as I thought perhaps she had not heard me said you do. Her response " who made you charge nurse" I was so taken aback. That I have made a point to not challenge her on anything. I am pleasant with her, I will offer to help if she needs it. It is not reciprocal. I am not sure if it was her schooling, her culture, or that she has only worked on our unit for a year, or what it is. I know I am respected by all the other people I work with, that is enough for me.
I am not into insuborniation, and she appears to have a low opinion of anyone who she does not perceive as her peer. Perhaps she does not care for me personally. I don't personally care if she does or doesn't like me. Not the point. I feel I can work with anyone professionally.
sicushells, RN
216 Posts
Why is that? I don't think I'm irreplaceable, why would a person with minimal education and no license think they're better than I am? More experience does go a long way, don't get me wrong, but why on earth would a CNA treat me like dirt?
Arrgg... I have a lot of frustration over this issue and no clear answer. I think it's really a problem with management that isn't usually addressed appropriately.