Requesting not to work with certain person?

Specialties Geriatric

Published

Specializes in LTC, Dementia/Alzheimer's.

There's a new CNA on my unit. For several different reasons, I am seriously considering requesting her not to be assigned to me. 1) She's too loud and easily flustered for Alzheimer's/dementia patients. 2) She doesn't get along with the other aids and refuses to interact with them in any way. She won't speak to them, won't help them, and definitely won't ask them for help. 3) She goes to other units and complains/gossips incessantly about all staff members on my unit. 4) She exaggerates pt symptoms and I don't feel like I can trust her. On two occasions, she's told me pt were having trouble breathing. She led me to believe the pts were dying... when in actuality, one was perfectly fine and the other was congested (she was being treated for uri.) On another occasion, she told me a pt was vomiting all over the place was drenched in sweat, etc. Upon immediate assessment, pt was sleeping comfortably, not sweating, and there was a little spit in the trash can. Another incident, she told me "come quick!" that a pt was writhing in pain from a "migraine" and needed "something strong to stop her suffering. Again, I went straight to the room and found the patient asleep. I woke the pt and asked if she was okay and if she needed something for pain, she said "no, I have a headache, but it's not so bad."

Have you ever requested not to work with someone? Should I speak to my don?

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Specializes in Critical Care/Coronary Care Unit,.

This particular pca sounds very dramatic. Pt is writhing in pain, but in reality is sleeping quite comfortably. Perhaps she enjoys seeing you run. You can report the incident to your don and even request to not work with her, although there's no guarantee it'll happen...but if enough nurses report her...then hopefully management will do something. She sounds like the little boy who cried wolf...so be careful...perhaps one day, there will actually be something wrong with the patient. Good luck.

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Most of my bosses would turn my complaint around on me. They would say the CNA is a problem because I am a failure at supervising her. No help from them.

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Specializes in LTC, Dementia/Alzheimer's.

Thank you for your replies. I emailed my don and staffing coordinator. I made sure to mention it wasn't personal, but I just couldn't trust her. I pride myself in being able to work with just about anyone and have never really complained to my superiors before. I hope the request doesn't reflect poorly on me.

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Specializes in Med/Surg, Ortho, ASC.

What's done is done and I hope it works for you. However, a step that I would have suggested would have been to document these incidents. Granted, they are a matter of nursing assessment, not objective observations, but they are nevertheless patient care issues.

For instance, the incidents that you describe should be written up as poor judgment and lack of responsible reporting to you, the nurse. Document, document, document. That way, the onus is on the DON or NM to take action (or not) in the situation, and you have not singled yourself out as unwilling to work with someone.

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Specializes in PICU, Sedation/Radiology, PACU.

It sounds like this CNA definately needs some more education. Rather than requesting not to work with her- which will force other staff to work with her more often and depending on the scheduling might not even be possible, bring this matter to the attention of the DON. Explain, just as you did here, the issues you have noticed with her performance and your desire to correct them for the benefit of the residents and staff. The DON or manager, and other nurses, can sit down for a performance with this individual and explain the areas where she needs to improve. Maybe she can even identify the reasons that she does certain things. Maybe she has found that if she doesn't exaggerate the patient's condition then the patient doesn't get seen by the nurse. So this has destroyed her trust in nursing and helped to create this cycle. Effective communication and remediation goes a lot farther than refusal to work with someone.

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Specializes in PICU, Sedation/Radiology, PACU.

Just another note- when decidin how to handle a conflict, thick about how it would look during a job interview:

Interviewer: "Tell me about a conflict with a coworker and how you resolved it."

Employee: "When I worked in LTC there was a CNA who frequently exaggerated patient conditions, left the floor for personal reasons and had trouble working with the other aids. I notified the DON of the issues and we all met together to develop an improvement plan for this CNA. Since I was the nurse who worked with her the most, I did weekly performance evaluations to help her acheive these goals. The end result was a big change in the CNA, and the relationship among many staff members."

Compare to:

Employee: "When I worked in LTC there was a CNA who frequently exaggerated patient conditions, left the floor for personal reasons and had trouble working with the other aids. I was really upset by her attitude and didn't feel like I could trust her so I asked the DON to not assign her to my shifts anymore."

Which answer would you rather have?

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Specializes in LTC, Psych, Hospice.
most of my bosses would turn my complaint around on me. they would say the cna is a problem because i am a failure at supervising her. no help from them.

i ran into the same thing when i worked in ltc. anytime i reported a cna, i was asked why i had so much trouble supervising them. then i would be the bad guy.

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Just another note- when decidin how to handle a conflict, thick about how it would look during a job interview:

Interviewer: "Tell me about a conflict with a coworker and how you resolved it."

Employee: "When I worked in LTC there was a CNA who frequently exaggerated patient conditions, left the floor for personal reasons and had trouble working with the other aids. I notified the DON of the issues and we all met together to develop an improvement plan for this CNA. Since I was the nurse who worked with her the most, I did weekly performance evaluations to help her acheive these goals. The end result was a big change in the CNA, and the relationship among many staff members."

Compare to:

Employee: "When I worked in LTC there was a CNA who frequently exaggerated patient conditions, left the floor for personal reasons and had trouble working with the other aids. I was really upset by her attitude and didn't feel like I could trust her so I asked the DON to not assign her to my shifts anymore."

Which answer would you rather have?

I get your point, but sometimes the CNAs just don't care and you can set up alllll the hoops you want, and they'll fail. And I doubt (tbh) that the DON would go that far as to develop an improvement plan...in a lot of cases if things are going wrong (least where I worked) no one would tell you until you got a call saying "please don't come in". Hate places like that.

Up Vote Up Vote ×
Just another note- when decidin how to handle a conflict, thick about how it would look during a job interview:

Interviewer: "Tell me about a conflict with a coworker and how you resolved it."

Employee: "When I worked in LTC there was a CNA who frequently exaggerated patient conditions, left the floor for personal reasons and had trouble working with the other aids. I notified the DON of the issues and we all met together to develop an improvement plan for this CNA. Since I was the nurse who worked with her the most, I did weekly performance evaluations to help her acheive these goals. The end result was a big change in the CNA, and the relationship among many staff members."

Compare to:

Employee: "When I worked in LTC there was a CNA who frequently exaggerated patient conditions, left the floor for personal reasons and had trouble working with the other aids. I was really upset by her attitude and didn't feel like I could trust her so I asked the DON to not assign her to my shifts anymore."

Which answer would you rather have?

:lol2::lol2: In text book this might happen, but LTC is a whole different game.

Weekly performance reviews? Never going to happen.

What is she like with the other nurses? Maybe she exagerates things because they won't go and check on the resident in a timely fashion. I would have a little talk with her first. If that isn't changing anything..go up the ladder. You might not be the only person with problems. Put things in writting if you can and that will give the DON some proof and start the ball rolling.

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Specializes in LTC Rehab Med/Surg.

I'm going to be Devil's advocate. Be kind.:o

The CNA is excitable. Overreacts. Is it possible she truly believes the reports she gives you about the pts? Is it possible the pts are telling her one thing and you another? I try to not dismiss a CNAs concerns, even when I think they're groundless, because I WANT them to come and tell me about a change in the pts condition. I thank them and then explain why I don't think their concerns are serious. Maybe she goes to other units and talks about the staff on your unit because she knows you're talking about her.

The fact that she doesn't talk to the rest or you......it's difficult to work with people like that, but it takes all kinds.

"She doesn't help and doesn't ask for help" I'm paraphrasing. It would be human nature to to not help or ask for help from someone you know doesn't like you. It sounds like this person started out on the wrong foot and it has deteriorated every day since. Probably can't be fixed at this late date.

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Thank you for your replies. I emailed my don and staffing coordinator. I made sure to mention it wasn't personal, but I just couldn't trust her. I pride myself in being able to work with just about anyone and have never really complained to my superiors before. I hope the request doesn't reflect poorly on me.

I understand your concerns but I think you handled this badly and it will come back on you. You should not have emailed your DON and staffing coordinator, you should have requested a face to face meeting. The reason being that this is an issue where you actually need to sit down as professionals and have a conversation in which ideas are exchanged about how to resolve the problem. They get an email, well, to be honest, it looks like you don't have the courage to confront the issue head on and start a constructive dialogue about how to fix the problem. It also reads like an ultimatum.

Also, rather than just jumping right into a statement of "I don't want to work with this aide," you should have tried to explore less radical ways of handling the situation. I have worked with many aides who get really overly excited about patient issues because they lack the knowledge base that nurses have. That may not be the case here, but you should have invested a little time into exploring the aide's behavior before taking such drastic action.

In such cases, I use that as a teaching moment -- "yes, Mr. X has a temp of 99.3, but he's lying under five blankets and the room temp is 80 degrees. Please take off the blankets, turn down the heat and let's try again in half an hour." The reality is they are truly trying to do a good job and I always treat that behavior with the respect it deserves. "Yes, Mr. Y's Pulse ox is 84 on 3 L of O2, let's try checking the tubing and O2 tank and try again in a few minutes." (this actually happens all the time with a patient and his O2 sats usually instantly go up)

Also, I'm not sure why you would wake up a patient to ask about pain.

In addition, I have yet to work in a facility where nurses have any control over who they work with. I think you have overestimated your power here.

I think you did not handle this very well.

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