Respect for New Nurses

Karou · Aug 6, 2015

Have you talked to the DON and/or ADON about any of this yet? What that CNA did was neglectful and reportable. You can't leave someone lying in bed for six hours like that. It doesn't matter what this CNA thinks of you, her duty is to the residents and she isn't doing her job. Unacceptable.

I would bring your concerns and this specific incident (also any others) to the DON. The DON needs to back you on this and remind the staff that they are accountable for their actions. There needs to be some sort of disciplinary response for that CNA and anyone else who fails to provide care.

You earn people's respect with time and consistency. It doesn't matter if they truly respect you, but they do need to listen to you and do their jobs correctly. Actions have consequences:

BloomNurseRN, ASN, BSN, RN · Aug 6, 2015

I think you basically have two options. You have to either put a stop to it with the DON and take control or you have to leave and find a facility that won't view you as a CNA any longer.

It won't be easy but you will have to write them up each and every time they are insubordinate or leave patient care undone. You will have to take it to the DON when they refuse to sign and stick to your guns about what's going on. You will have to stand next to them and express that the patient care will be done NOW by them and don't move from that spot. Stand silent until they get the picture that you're not going to do their job for them.

The other option is to find another job in which they only know you as a nurse and will respect you as such.

Getting these people to view you as a charge nurse may be possible but it will take work. Good luck!

macawake, MSN · Aug 6, 2015

Hi, I just graduated from nursing school in May and need some advice. I am a charge nurse at a nursing home that I worked at as a CNA when I was in nursing school.

Generally speaking I don't think that a promotion/change of job that puts someone in charge over former peers is an optimal situation. It puts a lot of pressure on the person who's still new and learning his/her new job and often causes resentment among the former peers. The behavior the CNA's are exhibiting doesn't come as a huge surprise to me. They feel like they can push you around, and they do.

I do not ask a lot of the CNAs, just to do there job. I am constantly saying if you do your job I will do mine, and there will be no problems. However they slack off on basic care for the residents.

How were things done in this facility when you were still a CNA? Is this slacking off/shirking one's duties condoned by management? What I'm really asking is, will you get your DON's support when dealing with the problem at hand? The CNA who refused to care for the resident needs to be reported/disciplined.

Not one of the CNAs do what I ask them too and if they have a question they don't ask me they go straight to the DON.

Again, how does your DON handle this when it happens. If the DON is a competent professional they should be aware of the dynamics that often follow when a young, recent graduate is put in charge over former coworkers. They need to be clearly supportive of you in your new role in the organization.

If you haven't already I think it's time that you sit down with your DON and discuss

the current problems on your unit and work out a plan of action.

You're in a tough spot and I think it's difficult to offer you any good advice without knowing all the nuances of the situation. I think that if it were me, I'd try to tough it out for about a year or so to be able to include this experience on my resume and then apply for a position at a different facility where I'd no longer be the former CNA, but start with a clean slate and some previous experience as charge nurse. I think that once a pattern of social interaction/professional "pecking order" has been established (as it has in your current facility), it can be hard to undo.

If you are to stay I think it's vital that management support you, and work with you.

It's your responsiblity as charge to make sure that the residents get cared for the way they should on your shift, but in my opinion you can't do this alone.

Best wishes!

TheCommuter, BSN, RN · Aug 6, 2015

My solution entails playing hardball: you've gotta hit insubordinate CNAs where it hurts by sending them home.

CNAs are not the highest-paid workers in allied healthcare, and many desperately need a full paycheck to stay afloat. Hence, a short paycheck can mean the difference between staying above water or having the cell phone and electricity disconnected.

The point is to strike the mouthy, disrespectful, disobedient, insubordinate workers where they'll feel the pain (read: in their wallets). After suffering a hit to the pocketbook via a short paycheck, you'll increase the likelihood of the CNA's compliance to rules and obedience of your directives.

A person who doesn't want to do his/her job doesn't deserve full pay for that shift.

Taylorgrn15 · Aug 6, 2015

Thank you all for your help. My DON did stand up for me and told me this would not be tolerated. I do need to work on standing up for myself and not just do everyone's job for them.

macawake, MSN · Aug 6, 2015

Thank you all for your help.

You're welcome :)

My DON did stand up for me and told me this would not be tolerated.

That's good. The reason I asked in my previous post is that in my experience in some units substandard care is part of the culture and is silently condoned by management. Or a clique of employees have grown so strong that they set the agenda and management doesn't have the required skills or ability to combat that.

If that had been the case then you'd have been facing an uphill battle.

If it's one or some individuals pushing the boundaries trying to find out what they can get away with, it'll likely be easier to resolve. It takes determined leadership, but it's definitely doable.

I do need to work on standing up for myself and not just do everyone's job for them.

I don't know you so this may or may not apply to you. What I do know is that at twenty-two people's approval was much more important to me than it is about two decades later. Today even though I prefer being liked rather than disliked I've accepted that not all people will adore you and I'm completely fine with that.

I don't try as hard to please coworkers. The important thing is that the job gets done and happiness and validation of worth is something I get from family and friends, and last but not least, from myself.

When someone is being blatantly disrespectful like the CNA you mentioned, I find that it's often necessary to simply lay down the law. There's no need to cajole or wrap it up in sunshine and rainbows. They are paid to do a job, and they should just get on with it.

Purple_roses · Aug 6, 2015

They sound like that have no business being in healthcare. Who would fail to care for a human being just to prove a point? That's disgusting. I agree with Commuter--send them home. Sure you'll be short staffed, but it sounds like you're doing their work for them anyway. They'll either come back with a better work ethic or they'll quit, in which case your facility can hire people who didn't formerly know you as a CNA, and therefore may not have problems with your age. If you do end up getting new hires in, don't tell them your age. It's not their business anyway.

Taylorgrn15 · Aug 6, 2015

Thank you again!! I have been really frustrated lately and you made me feel better! I love my job as a nurse because of the residents. It sucks when you have coworkers who make you dread coming in to work. I just need to remember I am there for my residents not to make friends. ðŸ˜€

anewsns · Aug 6, 2015

I'm younger and a softie myself but somehow managed to establish myself as a respectable supervisor. An employee from a different department once said she overheard a CNA being mouthy about a task and then she heard me say "Don't question me. Just do what I am asking you to do." And she did it. In the beginning , despite my softer nature , I had to write a couple people up, pull some into the office for a chat , send people to other wings on short notice, or generally shut stuff down. I made sure to stay fair and professional in the meantime (though I'm not a perfect angel ) and try to be understanding of different situations. it's been fine now and I rarely have to correct anyone , just ask politely. People come to me all the time with questions too. To someone not signing a write up, I'd just hand it to the DON anyways and talk to the DON as well. If there's another nurse around to witness , have them sign it too.

OCNRN63, RN · Aug 6, 2015

I had similar problems when I was the manager of a home-health care agency. One of the worst offenders was the chaplain. We needed him to do outreach and assist with marketing, but all he did was sit back in his office and read, sometimes sleep.

I got so frustrated with him blowing me off that one day I stomped back to his office, found him sleeping, woke him up, and told him I expected him to go on a couple outreach visits that afternoon.

In my case, it blew up in my face, because he called corporate and complained; he also got the secretary to conspire with him. I lost my job, but I had my dignity. A better job came down the line, anyway.

In your case, I would have just told her I expected her to get up and go take care of that patient...NOW! No bargaining, no arguing, do it now, or don't come to work the next day. Just because you were a CNA there in the past doesn't mean they shouldn't respect you now.

SubSippi · Aug 6, 2015

I had similar problems when I was the manager of a home-health care agency. One of the worst offenders was the chaplain. We needed him to do outreach and assist with marketing, but all he did was sit back in his office and read, sometimes sleep.
I got so frustrated with him blowing me off that one day I stomped back to his office, found him sleeping, woke him up, and told him I expected him to go on a couple outreach visits that afternoon.
In my case, it blew up in my face, because he called corporate and complained; he also got the secretary to conspire with him. I lost my job, but I had my dignity. A better job came down the line, anyway.
In your case, I would have just told her I expected her to get up and go take care of that patient...NOW! No bargaining, no arguing, do it now, or don't come to work the next day. Just because you were a CNA there in the past doesn't mean they shouldn't respect you now.

He complained that you woke him up from his nap?

That man sounds shameful!