Underperforming Employees

[elizabeast7, ADN, BSN, MSN]

I need to vent!!

There is a CNA on my unit who continuously falsifies documentation, leaves the unit and is overall a negative force. I have previously made official complaints about her. The worst being that she would chart on patients that were not in their rooms. We had a group together and a patient was in the OR. She charged hourly rounds on him for three hours while he was off the unit. She was not even walking by his room to see if he was in there!

She is one of those employees that when you check the assignment board and see she has your group you sigh with frustration and know that it's going to be a terrible day.

Yesterday we had a group together at the end of a secluded hall. Six patients had bed alarms. I had to physically catch someone that was getting out of a chair. Multiple alarms went of at the same time more than once. On top of all of that, I was administering a few units of blood so was unable to leave rooms. My aid frequently left the floor. Once to get hotdogs. She never alerted another staff member to watch her group and left me alone on the hall.

I consider myself relatively experienced but I was literally crying in the hallway out of sheer frustration. For all the talk about reducing falls and patient satisfaction, how am I supposed to do my job when I am not given the help I need?

I did reach out to my charge nurse who just shrugged with an expression of "What can we do?" Come to find out, there was a nurse on call!! Two other nurses on the unit had equally frustrating days (though not dealing with the same CNA, just due to patient acuity) and had asked her to call in the nurse on call. However, we were "on our numbers".

About midshift I felt as thought I had to decide which patient I should just allow to fall. I am at a loss!! The other two nurses who's days were similar and I have decided to have a group meeting with our manager. But I don't know what else to do. I have already talked to her multiple times about this CNA and nothing has been done! This behavior cannot be tolerated if we want to keep patients safe!

Any advice????

[Pangea Reunited, ASN, RN]

If management doesn't support you, there really isn't anything you can do but find a new job. Good luck to you.

[thebeccalc, BSN, RN]

There's an aide like that on my unit (but thankfully not on my shift). I would say 99% of the aides I work with are awesome and amazing at their jobs, but this one makes even the small amount of time I'm around her during shift change uncomfortable with her negative attitude and holier-than-thou demeanor.

We reported to each other when I was an aide, and I ended up just taking my patient census list and thanking her without spending any more time with her.

She's run off several nurses with her attitude, and the NM on my unit doesn't do confrontation. At all. So complaints, of which there have been many, just get a nod and a smile. I'll be moving to days soon, and she's a large part of the reason I'm trying to get off this unit before my schedule changes. I can't stomach the thought of working with her for 12 hours.

[tokmom, BSN, RN]

There is power in numbers. If everyone goes to the HN and you get no results, go to HR. Starting completing incident reports for her behavior. They will have to pay attention if you start a legal paper trail.

[amoLucia]

There is power in numbers. If everyone goes to the HN and you get no results, go to HR. Starting completing incident reports for her behavior. They will have to pay attention if you start a legal paper trail.

Sometimes this is what you have to do to start the papertrail. If there's a union, this is esp CRITICAL.

I found that quickly starting disciplinary paperwork in a timely fashion with all the supporting data (dates, times, staff involved, inapprop behavior/SPECIFIC DETAILS (accdg to the employee handbook)etc made it very hard for the higher-upper person to avoid. It's usually the investigatory details that make write-ups so hard for a third-party person to complete. Now, all it only needs is a mgr signature.

The only downfall was that it did require that you sign-off on the report - no way getting past that fact that anonymity is really not possible. But there'll be NO refuting the facts.

[Anonymous865]

You state that the CNA documented hourly rounding on a patient while they were actually in the OR.

The CNA falsified a legal document when s/he did that. It would be pretty easy for a lawyer to prove falsification of the medical record, since the chart would also indicate the patient was in the OR at that time.

I imagine risk management would be very interested in knowing about that.

[LadyFree28, BSN, LPN, RN]

You state that the CNA documented hourly rounding on a patient while they were actually in the OR.

The CNA falsified a legal document when s/he did that. It would be pretty easy for a lawyer to prove falsification of the medical record, since the chart would also indicate the patient was in the OR at that time.

I imagine risk management would be very interested in knowing about that.

Exactly...the falsifying information ALONE is enough to spark an investigation.

[dec2007]

We do have one or two of these who seem to keep their jobs no matter what. I've found that they have connections (indirectly) to management. For instance, one is best friends with the bosses secretary. Complaints fall on deaf ears. I've given up trying to change things.

[HouTx, BSN, MSN, EdD]

Basic rule of thumb in most organizations is to follow the chain of command. So, if reporting it to your immediate supervisor did not work - go up the ladder to her supervisor, etc. Keep accurate records and report the objective data without interjecting your own feelings. Submit incident report(s) because this is a huge patient safety issue/incident. Call the integrity/compliance line - falsification of documentation represents a very serious liability for your organization. Don't try to involve any co-workers, as you can only speak for yourself and protect your own license. They need to do the same.

As licensed health care professionals, we have a duty to act if we know that patient safety/care is being compromised. If you fail to act and turn a blind eye instead, it is the same as being complicit with the 'bad' actions.