Tell the CNA to clock out and go home

wooh, BSN, RN · Feb 28, 2013

CNA goes home. Who does the work that they would have actually done if not sent home?

Long Term Care Columnist / Guide · Feb 28, 2013

I'd rather call somebody in early, or work short, than put up with a CNA who's refusing to do her/his job. Over the course of my years as a supervisor, I've sent a couple of them home for that reason, but it rarely needs to happen a second time. Most of my team members are 20-somethings who get paid very little for their work, and I am sympathetic to a point. In fact, I'd rather educate and coach them than have to discipline them. However, if it gets beyond that and I have to resort to written warnings, it behooves them to get on the stick and improve their work ethic.

I am fully cognizant of the fact that they are young, and they are stressed, and most of them are single moms who have a lot on their plates. But bad attitudes have to stop at the door. These folks we're caring for are PEOPLE who are loved by someone, and they don't deserve to play second banana to a worker's eviction or boyfriend drama. Just saying....

allnurses Guide · Feb 28, 2013

CNA goes home. Who does the work that they would have actually done if not sent home?

It gets split amongst the remaining aides, who aren't going to like that and will likely exert a degree of peer pressure to ensure that doesn't happen again.

They aren't going to be happy with the person who was sent home...so there's a loss of peer respect... and that really blows in a setting that requires teamwork.

The action is two-fold: the aide looses a paycheck for the day and has the discomfort of disapproving peers.

I worked in a facility that didn't fool around and we aides even willingly worked short (yes, I mean we actually said we would rather work short) that deal with a bozo who was unable to provide excellent care.

We always made it through and we even had, in the end, an overall better shift because you knew what had to be done and did it right the first time (as opposed to getting stuck cleaning up someone else's poor work)... and you didn't have to deal with the poor attitude.

AngelRN27 · Feb 28, 2013

I was recently told to do the same thing on nights (11-7) if a CNA was caught sleeping. I have very good communication with my CNAs and I feel as though they respect me very much, so when I announced this, it wasn't really a big deal. I haven't had to send anyone home thus far... I agree with above posters, the idea is to make an example out of the first person + scare them out of unwanted behaviors via threatening their livelihood by hurting their pay... sad, but probably effective...

Blackcat99 · Feb 28, 2013

Thanks to all for your comments. When I started working at the "Anything Goes" LTC it was quite different. I was told that the CNA's were in a union and could do as they damn well pleased. I watched the RN supervisor receive constant verbal abuse from the CNA's and nothing was ever done. She wrote no one up and just took the abuse. Now that RN supervisor is gone, and now the new RN supervisor said she is going to get rid of the CNA's with the "bad attitudes." No one had ever told me that I could send a CNA home until now. This is something new at this LTC facility.

Sunny0308 · Feb 28, 2013

Unfortunately CNAs are often underpaid or working two jobs because they are uneducated, or both. I agree with management's strategy up to a point. However, is it possible for all of you to come to the table and agree to work as a team? You need each other. I work in mental health and the Mental Health Techs are not that much different, except they carry no license. I could not survive my shift without their good work, and there are always those who are excellent and those who are lazy. Just weed out the ones who do not want to work, and nurture those who do. You will all be a lot happier. Plus, if you come together as a team perhaps you could approach management for appropriate (more) staffing.

mazy · Feb 28, 2013

I absolutely agree with the point that management needs to be supportive of nurses disciplining CNAs.

Unfortunately, I have worked with CNAs who wouldn't have any problem being sent home, even knowing that they won't get a paycheck. Add in a dramatic confrontation with a nurse in front of everyone and the day is a total win.

If they are allowed to come back, even if they have to jump through a lot of disciplinary hoops to do that, the only thing they understand is that the nurse did the most extreme thing possible to enforce discipline and they still got to come back to work and now what is the nurse going to do?

I have seen this kind of thing happen too many times. And seen good nurses go because of it.

The problem is a CNA with a history of insubordination that has gotten so bad that the only way to get the message across is to have them sent them home. If all disciplinary measures have been exhausted that it's come to this, then it's time to find someone else.

There are plenty of perfectly good CNAs out there looking for work. I agree with sunny, the most important thing management needs to do to support their nurses in disciplining CNAs is to go that extra mile and weed out the bad ones and nurture the good good.

Blackcat99 · Apr 6, 2013

Update: I was set up by management. I sent a CNA home and she was back the next day and spent the whole shift " laughing and smirking at me." Management lied. Nothing was done about the "problem CNA". Now the other problem CNA's are giving me a hard time in retaliation.

SuzieVN · Apr 7, 2013

Update: I was set up by management. I sent a CNA home and she was back the next day and spent the whole shift " laughing and smirking at me." Management lied. Nothing was done about the "problem CNA". Now the other problem CNA's are giving me a hard time in retaliation.

There are issues in that place. The aides are treated awfully by the nurses, the management is incompetent, and you are left holding the bag. I've never had to resort to such drastic action, as 'sending someone home'. Find out the cause of the conflict- there's no way the place is doing the patients any good.

mvm2 · Apr 7, 2013

I am so sorry. i really just do not get why people find pleasure in making co workers lives miserable. Why cause conflict, and play these stupid childish games. They know when they sign their work agreements what a CNA job intales, forgoodness sakes just do your job. If you can't handle it or do not want to do it anymore just go away and allow the spot to be taken by someone who really cares for residents and want to work well with their co workers to make everyones lives more enjoyable. Lord knows everyone has their own set of troubles and woes in this life. I would never want to add to someones misery by doing such terrible things to someone.

I think it is time that management talk to these people and say if you don't want to follow our rules you can go and we can find someone who will. There should be no reason why these CNAs that do not want to do their jobs properly should still be there when there are CNAs lined up that would love the opertunity to have their spots.

CapeCodMermaid, RN · Apr 7, 2013

Management, I'm sure, has better things to do than "set you up".

multi10 · Apr 7, 2013

LTC is a revolving door. The RNs come and go, but the CNAs have been there forever. And they are not going anywhere.

How many times did I want to send a lazy insubordinate CNA home? It was not in my power. In my facility, nurses couldn't "write up" nursing assistants. We had to report them to management and let management deal with them. But Management never dealt with them.

The CNAs were like a pack and felt secure in doing exactly what they wanted to do, when they wanted to do it.