Help with Major CNA Problems

  1. The facility I work with has a big problem with CNA laziness and bad attitudes. They refuse to work together for the most part, neglect the patients, lie in their charting, and if they do decide to wash a patient up it's with the help of the nurses and because we asked them to. They won't do anything without us holding their hands and leading them around for each task. This is not every CNA, but definitely the majority. They talk a good talk and rarely get in trouble for their actions.

    I HATE asking every two hours "Did you turn this patient?", "Can we go wash this patient up?" and force them off of their butts to go do something while they glare at me. They have read and reread their job description and signed off that they understand what it is they are supposed to do at work. Patient care as a team with the help of the nurse and OTHER CNA's. But that never happens.

    Our supervisors say WE (the nurses) are supposed to make them accountable. But all we get is backlash and bad attitude. I don't want to feel like a slave driver. I have very sick patients to monitor and at times critical issues to deal with. Of course I will help wash up patients, even by myself if things are busy, and be dripping with sweat in effort to help the team and have things go smoothly. But when I'm killing myself on the floor, not getting a break so the CNA's have their 2,3,4+ hrs of internet/social time, it really makes me upset. Especially when it's at the expense of the patient. NOT to mention I am not getting paid for doing two jobs.

    My question is... HOW do the nurses make the CNA's accountable for their jobs without treating them like children and holding their hands? They really have no motivation to complete their jobs because they know they can get away with it. My complaints usually only go as far as the nursing supervisor, but I think I am going to start writing many emails to our nurse manager, HR person and our CEO.

    This has been a problem for years, but I've recently reached my very limit when a CNA made me go cry in the bathroom because I was so frustrated with the bad attitude and being treated basically like dirt.

    If anyone has any help or ideas to offer it would be greatly appreciated.

    Thank you!
  2. Visit JSBoston profile page

    About JSBoston

    Joined: Sep '09; Posts: 145; Likes: 281
    RN; from US
    Specialty: 5 year(s) of experience in Med/Surg/Onc, LTAC


  3. by   topher-67
    That does sound bad. Can you not document and write them up? Does your employer have some type of disciplinary course of action for CNA's who don't and won't do their job? I know not every place is perfect, we have our share of slackers & loafers too. But, at the same time there is a good mix and we fellow CNA's tend to ride, push, and squash the bad ones. Most of us understand what we have to do and get the job done.
  4. by   KarmaWiseRaven
    Have you thought of a new job? It sounds like even if you write all those people in the company things might or might not change. If it's a on going problem and really it stats with the admins on down to restore order and the order is broken and no one is backing anyone up It's time to get out really. I know you feel like your letting the people down. If your crying and so stressed you can't do your job or your doing your job but just half heated its time to get out. You might not know this but nurses become co-dependent of their job and really it's mental abuse. People think of abuse as a physical thing but for Nurse because its really all thinking the abuse is mental you feel don't want to go and you don't want to stay because of whats going. That's a co- dependence and mental abuse of the job. Start looking for a new job you might find a job that fits you better less stress and might be better pay. These are my thoughts use them as you wish... Anthony
  5. by   diligent-trooper
    Well, I heard the best way to get motivated, conscientious, integrity, independent, nurturing, and team building individuals: Is to pay for it! Stop paying crap wages, which only attracts substandard employees.
  6. by   NiquiCNA
    Hmm.. I would suggest a new job.. And rewarding CNAS who dont work.. thats useless. Many CNAs I know.. well, dont deserve the crappy pay they get, and if they are lazy and hate their jobs, why not go work fast food and make about as much? Writing them up usually does not help, as administration somehow magically finds the fault on the nurses part.. or just keeps a stack of write ups and never follows through... thats what makes it worse, because once they KNOW they can get away with it, then the behaviors escalate.. thats why I finally had to leave LTC, because I couldn't deal with the backstabbing, lies, and laziness of most CNAS.
  7. by   catlvr
    I have the same problem with some CNAs (mostly floaters) and made up a sheet of tasks for each resident, and of responsibilities for the dining room. While I enjoy the hands on aspect of nursing and will do anything to help if it improves care for a resident, I'm not enabling anymore - if someone doesn't want to do their job, I'll write them up. I'm fortunate to work with some fantastic CNAs, and I praise them to the sky - but the lazy ones who shortchange residents have *got to go*. I told the supervisor that I'm going to do this - she said "good luck".
  8. by   caliotter3
    Well you have the answer. They have no motivation because they know nothing will happen if they don't do their jobs. Until management starts enforcing a disciplinary policy that goes up to and includes termination, they won't be influenced to change. Fire the worst and start replacing them with people who want jobs enough to work and things will change. Once management starts firing nonperformers, things will start to turn around.
  9. by   scoochy
    I would start circulating my resume..........
  10. by   MattiesMama
    Quote from diligent-trooper
    Well, I heard the best way to get motivated, conscientious, integrity, independent, nurturing, and team building individuals: Is to pay for it! Stop paying crap wages, which only attracts substandard employees.
    So are you saying that increasing wages will draw in these motivated, conscientious people to replace the lazy, rude CNA's, or that increasing the pay of the CNA's will cause the lazy/rude CNA's to change their behavior?

    You should not need a monetary incentive to not neglect your patients or treat your co-workers with respect. It's called basic human dignity and taking pride in your work.

    Also from what I've seen CNA's wages aren't too bad, considering. Around here they make an average of $16 an hour, not counting differential. I've lived and supported my child as a single mom with half that.

    But I digress...

    OP-here is what I would do (and I'm a new grad so take this with a grain of salt) Call an informal meeting with them-nothing official, just like "hey, before we start our shift I want to meet with you guys so we can discuss some things" Then, calmly, rationally, but firmly lay out your concerns. Emphasise that you are adressing them this way because you want to have a chance to improve things, but make it known that if it continues you will have no choice but to take it up the chain of command and their jobs could be on the line, because it's a patient safety issue. Allow them an opportunity to voice THEIR concerns. Emphasise that they are a vital part of the team and that is why it is so important to adress this. Do it in small groups (maybe you could arrange it with the other nurses so that one charge nurse would meet with all of the CNA's on her shift, so it's not a big confrontational thing)

    If that doesn't work, report them to whoever you need to report them to and try to find another job...
  11. by   noahsmama
    When I was in nursing school, the CNAs at the hospital where I did most of my clinical rotations were a lot like the CNAs where you work. They would do vitals at the beginning of, and halfway through the shift, which would take them may an hour each time -- then, for the other 6 hours of their 8 hour shift, they became invisible. In theory they were supposed to help with meals, baths, etc, but good luck actually rounding up a CNA when you needed one.

    At the hospital where I got my first job as a nurse, the CNAs were amaaaazing! They were some of the hardest working, most dedicated people I've ever met.

    The difference? Management. At the first hospital, management was either oblivious too the CNA problem, or didn't care. At the hospital where I ended up working, God help you if the nurse manager found you doing anything other than working your butt off, and she was around enough and on top of things enough that she knew if people were working hard or not. Slackers were not tolerated.

    So, sadly, I'd have to agree with the folks that are telling you to polish up your resume -- and to do your best to find out about the CNA situation at any new position you might consider -- though that might be hard if you don't happen to know anyone who works at the facility. But, I really don't think RNs on their own can turn the CNAs around unless they are backed up by management.

    Good luck!
  12. by   Batman25
    You need to start a paper trail by writing them up ASAP. Do it as often as needed. Management can ignore the problem right now because there is no paper trial so it just keeps getting pushed under the rug. Bring it into the open with writing them up when they don't do their job. Write them up every day if need be. If management then steps up and they start getting fired word will get around and the ones that want to keep their job will start doing their jobs.
  13. by   Kooky Korky
    Quote from diligent-trooper
    Well, I heard the best way to get motivated, conscientious, integrity, independent, nurturing, and team building individuals: Is to pay for it! Stop paying crap wages, which only attracts substandard employees.
    I doubt OP is the one paying them. And if they aren't happy with their pay, there are many, many unemployed people who'd probably grab at the chance to receive it.
  14. by   Kooky Korky
    op, your only hope is to get a backbone. crying? no more of that. you are legally and ethically in charge of these people, so start acting like it. if your higher-up's don't back you up, then you might consider leaving. but shame on everyone telling you to leave without even trying.

    you need to be the cop to them because you are the one who is with them. the don, the administrator, etc. are not there with them, i assume, and you are. and you are, like it or not, knowingly or not, enabling them to take advantage of you and of the patients.

    you first need to convince yourself that you are in charge. then act like it. not saying it's easy but are you serious? 2-4 hours of internet/social time? and you are aware of this and letting them do it? what is wrong with you? i know it's scary to speak up, i hate doing it myself. but i'll be d****d if somebody is going to get paid to shirk work, neglect my patients, have me do their job while they get paid to be on the computer and socialize. i think your boss might need to make a rule that aides stay off of the computer while at work. period. no more than 1 can go on break or to meal at a time, all will either do their jobs or be fired. period. there are lots of people who will take advantage of you and of employers if allowed. apparently, few and far between are those who pride themselves on a job well done or who want to bring credit to those who raised them. slavedriver? not by a long shot. you are merely expecting this person to come to work to work.

    start small. hold a meeting with one cna individually. point out what you see being done wrong, say what your new expectations are. clearly. do not blink. believe you have a right and a responsibility to make her toe the mark. just start with the one who will be easiest to straighten out and see how that goes. then, when you are feeling stronger, move to the worst offender. once you either straighten her out or get her fired, the rest will be easier.

    be prepared for a battle. be prepared to document every violation you see, what you did about it, who you approached when the aide was rude or disrespectful to you about the new program. be prepared to have to defend yourself from false charges. try always to have witnesses around. if there's a house supervisor or other manager, take that person along when talking to these aides.

    it might be easier than you think. they are there 8.5 hours i assume. they are entitled to an uninterrupted 1/2 hour meal break. they can take other breaks if time permits. ask your hr department boss if you don't believe me. rest breaks are not guaranteed in most states. and they vary from 10 minutes to about 20 minutes, by state.

    you simply have to be prepared for some anger, maybe getting yelled at or threatened. if anyone does threaten you or worse, absolutely make a police report. call the police to come in and take your statement right there at work. i don't care what your boss says about that. you do not give up your constitutional rights or your civil liberties while at work. work is someplace you need them the most.

    think twice before quitting. why should you leave a job you like because of these lazy aides, who have just never had anyone take them in hand before?
    Last edit by Kooky Korky on Oct 3, '10