Unruly CNAs

meanmaryjean, DNP, RN · May 22, 2017

*utmost

kidzcare · May 22, 2017

Be friendly but firm with them. "Please help me turn patient 7B." "Please let me know the fingerstick in room 14. Thank you." If they refuse, roll their eyes, say "Yeah, right" or something like that, ask them once, "So you are refusing to do this task?" If they do, you can document it and provide this to management.

This is good advice. This approach puts you in the position to lead by example. You can only control yourself in the equation.

Friendly but firm is best take away here. I remember having an aide who told me that we were to short staffed for her to give a LTC resident her weekly bath. I told her that I knew we were short staffed but that the bath was a part of her duties and it did need to be done. This resident's family pays 5 figures a month for her to live here and she needs to be treated with dignity. The CNA didn't like being told to step up her game, but she did it (after complaining about me to other CNAs who immediately defended me). Now that CNA and I get along great. I notice that many of the CNAs at the SNF I work at step up their game when they work on a hallway with me. I hold myself and them to high standards and they know it (and like it).

You reacting like this to a fairly innocuous post kinda highlights why you may be having problems with the staff, and really serves well to prove NedRN's point....

#truth

fawnmarie, ASN · May 22, 2017

Yes, OP, I have worked with many rude and/or lazy CNAs in my time. They are in every facility, and the "career CNAs," which KelRN spoke of, are the worst. Rude, lazy CNAs and mental health technicians are one reason why I decided to try school nursing. I figured I'd be better off working alone, than trying to delegate tasks to CNAs who were going to argue with me about their assignments, or just flat-out refuse their assignments.

wrst · May 22, 2017

Now we know.

Maybe you meant "Maybe I should HAVE labeled my article..." and not "...I should OF..."

foggnm · May 22, 2017

'Rude and lazy' aren't really specific behaviors that can be addressed by management. I'd suggest you just let it go since it is a short assignment. Or make a list of the people and the actual offenses that interfered with patient care and report that to their supervisor. That said, my first tact is always to take issues up with a person directly if it is someone you will interact with on a long-term basis.

God grant me the serenity

to accept the things I cannot change;

courage to change the things I can;

and wisdom to know the difference.

Kooky Korky, BSN, RN · May 22, 2017

Be happy you have aides. My suspicion is they all have friends. Thus their rudeness is your inability to relate, communicate, and manage effectively. Perhaps you think you know everything with 2 years of experience yourself. If you instead think 'what could I have done differently, or how I can communicate better, versus what's wrong with these people', you will have fewer of these problems. It is not easy, but far, far easier to change your own behavior than others. If you model best practices and behaviors, others around you will respond positively.

What planet are you on? People will respond positively if she models best practices? Like letting the aides walk all over her?

Kooky Korky, BSN, RN · May 22, 2017

I get that perhaps you were just venting and looking for validation and did not appreciate what might appear to be "blaming the victim" response you got from me. I was attempting to provide constructive advice but you clearly didn't hear it. Probably wasting my time but here are some more thoughts for you.
If you had a problem with a strong personality at work and needed help on dealing with that person, my response would have been very different. What you actually stated is that you could not deal with an entire class of people at work describing them as "extremely rude and lazy". You complained about their behavior to the manager versus asking for advice on how to manage the situation. You may have complained/gossiped to staff nurses as well which could have gotten back to the aides as well. You feel free to label people and call them names (demonstrated by calling me names as well).
By the way, how on earth are the staff nurses dealing with extremely rude and lazy aides without quitting?
Think about how you might react if people treated you like that. You would probably avoid them right? That is likely what these aides are doing with you. At the moment, both your posts make you sound like a terrifying employee from a manager's perspective. Three weeks to go? You may have been lucky to have made it this far.
So yes, I think it is likely you are the problem here. I gave you some advice that is really more future oriented than this one assignment. It is unlikely your situation will improve in the next three weeks no matter what you do, but you have a chance every three months as a traveler to have a fresh start.
I will add one other thought should you decide to so some self examination versus "the world and Ned is against me". Are you of the same socioeconomic class and/or ethnicity as these aides? There could be a vast culture gap that prevents you from understanding and communicating with them effectively and vice versa. Until you make the attempt to understand them, problems will continue. Most of us get raised in a monoculture and don't really become exposed to other cultures, particularly as it relates to work, until we become working adults. Thus culture clash is common and can be huge. I say that with personal experience of discovering certain classes to not have my own work ethic and having to deal with it. You have to learn new communication skills and what they need from you to earn their respect.

Of course God forbid that the aides should actually do their work.

Do you see any possibility that OP is not in the wrong? That the aides really are rude and lazy?

Kooky Korky, BSN, RN · May 22, 2017

How dare you judge me for expressing my experiences with a difficult group of people. Maybe I should of labeled my article "dealing opposition on an assignment", maybe that would have better suited you, jerk!! I noticed you are some type of "All Nurses" troll and comment on on almost every single article. Maybe you should take a tip from you own advice and re-evaluate your own character. I have the upmost respect for "good" CNAs who actually "aide" and not make my job more difficult.

What advice would you give to a nurse who asked this question of you?

Kooky Korky, BSN, RN · May 22, 2017

When I worked in the hospital, nursing students were our best CNAs. They wanted to do a good job because they wanted good references or to be hired as nurses in the future.
It was the career CNAs that we consistently had problems with. They would hide in the locker room all day, vitals would be hours late, Foleys would never be emptied, at night we'd find them asleep in a closet or the treatment room, they'd roll their eyes at you when you told them that a patient was total care and needed to be turned or bathed. The hospital didn't have a transport team but most of the time nurses ended up escorting patients to tests ourselves because by the time we could find the CNA and argue with them about taking the patient to Radiology, we could be there and back already. At night, I just did my own vitals because I was usually waking the patient up for neuro checks anyway and the CNAs never listened when you asked them to do something a certain way- for example, "this patient is 3 months old, please take an axillary temp" and they'd do tympanic because it was faster. For the 5 years I worked there, any time anyone brought up this issue, the response was the same. "They'll never change, the culture was like this before we all came, we can't change the culture." Actually, I remember being warned about the attitude of the "career CNAs" at new grad orientation.
Since I left the hospital, I've worked in areas that didn't employ CNAs.

Why did you let them sleep, not empty Foley's, not hide the tympanic thermometer, do your own transporting while these lazy, good for nothings got paid to not work? Are you out of your mind?

You and all the other nurses who let them get away with this?

Have you ever heard of coaching? Setting rules? Write-ups? Team meetings? How do you ever

expect things to change for the better when you let people walk all over you and, by extension,

maltreat the patients? (as in VS hours late, not turning and cleaning the patients) In case you can't tell, this makes me very angry.

DolceVita, ADN, BSN, RN · May 22, 2017

I don't imagine it is in the CNAs scope to educate patients, right?

Deal with this stuff as it happens, with the individuals involved. You can recognize their time and experience on the floor without crushing them. Ask them not to interrupt when you are speaking with a patient and remind them that education is not in their job description (nor their scope).

No need to be a poop or anything with them. Just firm. Keep your temper in check, if you have one. When they do something well thank them.

Thank whatever you believe in you'll be gone in 3 weeks. Don't burn a bridge.

Oh my goodness I just made that sound like dog training....sorry. Please don't start on me.

NedRN · May 22, 2017

What planet are you on? People will respond positively if she models best practices? Like letting the aides walk all over her?

Modeling best professional practices of course. Did you really think I was suggesting that she mirror the aide's behaviors?

Of course God forbid that the aides should actually do their work.
Do you see any possibility that OP is not in the wrong? That the aides really are rude and lazy?

It is possible, but unlikely. If they were generally rude and lazy, the OP traveler would be in the same boat as the staff nurses who were also getting the same treatment. Thus her workload would be identical to staff, and not being treated differently. The tone of the post was they were rude and lazy "to me" and making her life so intolerable she was considering breaking her contract. I did ask her how staff nurses were dealing with the same aides both out of curiosity, and because the info would yield clues as to the source and cure of the identified behaviors.

I will admit that there can be cliques that are rude to any outsider, including fellow staffers not in the clique, and that while effective communication by nurses may ameliorate the issues, really it is the responsibility of their manager and/or HR to correct negative work behaviors.

OK?

Ruby Vee, BSN · May 23, 2017

How dare you judge me for expressing my experiences with a difficult group of people. Maybe I should of labeled my article "dealing opposition on an assignment", maybe that would have better suited you, jerk!! I noticed you are some type of "All Nurses" troll and comment on on almost every single article. Maybe you should take a tip from you own advice and re-evaluate your own character. I have the upmost respect for "good" CNAs who actually "aide" and not make my job more difficult.

Whoa! Name calling and nastiness doesn't go far here. Once you put the question out there, it is a sure thing you're going to get answers you don't like. Your response to a post that wasn't what you expected gives us all a clue into why you're having difficulty getting along with ancillary personnel.