Was I justified in writing up Nursing Assistant?

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Hello All... Hope u can help me with this as I've only had to write someone up only one other time. Worked the 3-11 shift Saturday night with 7 staff and 27 patients. It was 6:00pm and 3 nurses were off the floor at dinner. Myself and another NA were busy showering a patient who had just had a huge involuntary. So this left 2 other nurses out on the floor to answer calll bells. In the midst of showering, this NA comes into the room and states that he took it upon himself to page the other nurses back to the unit b/c it was just too crazy and then promptly left the room without giving me time to respond to him. (Since the assigned charge nurse was at dinner, I was in charge). Just a few minutes later the nurses that were paged arrived onthe unit, madder than hell of course!!! The charge nurse comes to me and asks if I was the one who told this particular NA to call them back from their dinner. I stated that no, I did no such thing. She said that this NA told her that I told him to have them paged back. At this point both of us were fuming mad:angryfire. Especially since there was only one call light ringing when they arrived back on the unit!!! Well..... I asked this NA to meet me in the report room, that we needed to chat. I confronted him and asked him why he said that I told him to call. His reply was this "well, I knew that since I'm only a NA that I wouldn't be able to have the authority to page them back, so that's why I said you told me to do it." I told him that I didn't appreciatte his lying and that he needed to speak with me first before making such phone calls. He apologized and said that "I didn't mean to implicate you." Well, both myself and the Charge nurse were so ticked off at him that we both wrote him up. This isn't the first time he's done something like this either. He thinks that he knows everything and is constantly telling the licensed staff what to do. He will argue with you and demand that you do things his way. He has no respect for anyone that is in charge.!!:angryfire He even was kicked out of nrsg school because he mouthed off one too many times to an an instructor and was fired from his last job for sleeping.

Anyways.... would u guys have written him up also or should I have went abut this differently?? I talked to my boss yesterday(after she received the letter) and she said she would speak to him. I don't like to get anyone in trouble but I think someone like him needs put in their place.

Specializes in LTC,Hospice/palliative care,acute care.
I think he was just trying to help out. 3 people gone at one time for lunch is a LOT. No wonder you were struggling. That isn't fair to the rest of the team. I think that both you and charge were on a power trip. I wish I got to go off the floor at lunch... I never, ever am able to eat uninterupted unless my patients decide to sleep during my lunch time. Must be nice... while everyone deserves a break, and my situation isn't common practice, this nurse should understand that if things are "going crazy" up on his or her floor she should expect to be called back. Get off the trip and get back to work!! :-)
7 staff for 27 patients.4 were left on the unit while 3 took break...I assume this is LTC-the staff dinner breaks have to be scheduled between the patient's mealtimes and the med pass....Usually the only reason for staff to be called back to the unit is for a code or a fire.You have to remember that the cna's ALWAYS get their sheduled breaks-the licensed nurses are often eating standing up in the medroom ......It does NOT sound like a "power trip" unless your view is that of one that has a problem with authority-as this cna seems to have....I've worked with many that just can't accept direction and as someone else posted it's like baby sitting.It is not easly to juggle the needs of the residents while playing the control game with staff.Bottom line-you ARE in control and YOU are supervising this person.....He sounds like the type of person that is totally incapable of seeing beyond his own needs to the needs of the entire unit...That's why he is NOT a charge nurse....You did the right thing.You need to stop his behavior now and you need to start your papertrail.If there are no consequences for his actions he'll never change.Sadly this type of struggle often makes victims of the patients....
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Specializes in Med-Surg.
It seems like this concept of "writing someone up" and "putting them in their place" further seperates the healthcare environment into a regimented military experience instead of promoting a team player module.

There should be a policy of checks and balances in place, however a nursing unit is fluid and changes by the moment. It is important for everyone to be able to rely on one another, be supportive and respond appropriately when disaster happens, whether it's a meal that was not delivered to a patient (this happened on my shift yesterday and the unit director wrote up an INCIDENT report against the unit secretary for failing to enter the order on the computer upon admission!!!) to a code response.

Perhaps the final outcome should hinge on the degree of damage, if any resulted from the incident. Otherwise, we are all put in a position of looking over our shoulders and pulling the knife out of our backs at the end of our shift lest some co worker has an agenda/vendetta against us.

Don't you agree that on any given day all of us could be "written up" for some deviation and called on the carpet? It could be anything, from hanging an IVPB 5 minutes late to failing to answer a call lite fast enough.

If you really are splitting hairs, let's face it, none of us conforms 100 % of the time. If you have a dangerous co worker who does not give a damn and is a hazard to patients or the department overall, then that should be brought to someone's attention, however I feel that the punishment should fit the "crime".

A lot of people confuse incident reports with being written up. Reporting an incident like you describe might have been necessary if it had the potential to cause harm or a problem. My coworkers are fond of saying "she missed her medication and I wrote her up". Sorry, but only a charge nurse and a manager can "write someone up" in this hospital and you did not write her up. It does not go in their personnel file.

But I also see your point. To constantly write up every little thing, starts a tit for tat war and gets us no where. And I certainly agree that anyroom you walk into at any time if you look long and hard enough you'll find something to "write up" someone about.

However, there are incidents, like was described in this case where write ups are necessary for documentation. So when this person really does something bad and people say "he always does that" there's documentation and the person can be terminated.

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It seems like this concept of "writing someone up" and "putting them in their place" further seperates the healthcare environment into a regimented military experience instead of promoting a team player module.

There should be a policy of checks and balances in place, however a nursing unit is fluid and changes by the moment. It is important for everyone to be able to rely on one another, be supportive and respond appropriately when disaster happens, whether it's a meal that was not delivered to a patient (this happened on my shift yesterday and the unit director wrote up an INCIDENT report against the unit secretary for failing to enter the order on the computer upon admission!!!) to a code response.

Perhaps the final outcome should hinge on the degree of damage, if any resulted from the incident. Otherwise, we are all put in a position of looking over our shoulders and pulling the knife out of our backs at the end of our shift lest some co worker has an agenda/vendetta against us.

Don't you agree that on any given day all of us could be "written up" for some deviation and called on the carpet? It could be anything, from hanging an IVPB 5 minutes late to failing to answer a call lite fast enough.

If you really are splitting hairs, let's face it, none of us conforms 100 % of the time. If you have a dangerous co worker who does not give a damn and is a hazard to patients or the department overall, then that should be brought to someone's attention, however I feel that the punishment should fit the "crime".

to an extent i see what you are saying and agree, however i would have to take issue with the fact that the CNA LIED to the other nurses and told them you said something that you didn't. How long has this been going on? How many other times has he used another persons name and influence to get something? What could come of this if he is allowed to continue with no consequences. I don't think it is all about putting someone "in their place" (though the roles do need to be laid out again to this CNA), I think the CNA had no business ordering the nurses back to the floor and certainly had no business telling them that the OP is the one who said they had to come back.

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I think he was just trying to help out. 3 people gone at one time for lunch is a LOT. No wonder you were struggling. That isn't fair to the rest of the team. I think that both you and charge were on a power trip. I wish I got to go off the floor at lunch... I never, ever am able to eat uninterupted unless my patients decide to sleep during my lunch time. Must be nice... while everyone deserves a break, and my situation isn't common practice, this nurse should understand that if things are "going crazy" up on his or her floor she should expect to be called back. Get off the trip and get back to work!! :-)

Maybe I should have made my post a little more clear when I originally wrote it..... For those of you that have agreed with me I thank you, but for those who haven't (espec.jeepgirl) I think it was only b/c I didn't give the entire story for fear of being too long of a post but here goes... I work in a rehab hospital with brain injury patients (ICH, TBI, CVA, Alzheimers/Dementia and some overflow cardiac,ortho patients from other units).... these patients are all basically pretty stable as they are no longer in acute care. I am well aware that it is very rare for those of you who work acute-care to get an uninterupted break/lunch or one at all for that matter, but that is one of the advantages to working in this type of setting. I have worked at this hospital for 13 years and I think I can rem. only about 2-3 times that I was unable to get away for a luch break.

Even though no one else considered the unit crazy at the time he did, I was more ticked off that he lied and "implicated " me. As other posters have already said this makes me wonder about how many other things he has lied about. You would have to have worked with this guy to truly onderstand what he is like. Believe me, I'm not the type of RN who gets off on writing people up, in fact I am very well liked by the other NA's I work with and if ever there is that rare occasion that I have a problem with one we can always discuss it and move on without it ever having to reach the manager. However this guy... you just can't reason with him, he knows everything!!!!! For example... When he first started on our unit in may, we were assigned 10 patients together and were told we had to complete and Ekg on one patient. We both proceeded to complete it , I had to walk out of the room to retrieve a razor, when I came back in he had the leads in different spots than where I had placed them before I left. I asked him why he moved them his reply "you had them in the wrong places, that's not how I was taught in nursing school" I was completely appalled, insulted and embarrassed as he said this in front of the patient:angryfire

I excused both of us out of the room and then said to him as nicely and tactfully as I could" First of all, I'm not perfect and I'm open to learning how to do things a different way but for you to just change the leads and tell me my way was wrong in front of the paitent was way out of line...you embarrassed me and insulted my skills as an Rn!!" It was as if I was talking to a brick wall..... He said I can't help it that's not the way we learned in school and I like tto do things the proper way. I jsut had enough with him so I spoke with my boss and she talked with him and then he pulls this crap.

Another incident........(sorrry for being so long but I want to make myself perfectly clear tihis time) After the lying incident, he had the odacity to leave work and not report off to the aide that was taking over his assignment. He was working 7a-7p, she showed up to replace him at 7p and proceeded to find him to get report from him only to find out that no one could find him. Since his backpack was gone we assumed he left. He has already been warned about this too... that he does not leave until his replacement arrives and he gives report to them. However he continues to repeat the same behaviors over and over again. This is a 24 year old wer're dealing with not a 2 year old!!!:angryfire

The more I think of everything he has done the more it's really ticking me off. I go back to work Monday and I'm going to have a long talk with my manager. I'm tired of being a babysitter!!

And as another poster stated, yes I've made my share of mistakes in my career.. I'm not perfect.......But I NEVER have blamed another person for something that I made the decision to do whether it turned out to be right or wrong!!

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It sounds like this young man has a problem working as a member of a TEAM, and takes it on himself to do things. If he cannot understand his place (as a CNA, not an RN, RNS, RNM, or even DON, lol) as a part of the team, then he should be let go. He doesn't seem to understand where he is on the chain of command. Since he's a repeat offender, I'd say he already has one foot out the door.

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Specializes in Neuro, Critical Care.
his reply "you had them in the wrong places, that's not how I was taught in nursing school" I was completely appalled, insulted and embarrassed as he said this in front of the patient:angryfire

As I remember you mentioning in an earlier post, this individual was kicked out of NS. Now that to me, means that he does not have a degree and really ultimately NO LISCENCE. So, all in all his scope of practice encompasses one of a PCA/CNA...Maybe im misinformed (possibly:)) but I dont think PCAs/CNAs were allowed to place the leads for an EKG...It seems as though this individual has issues with authority.

Im still in school so I have never practiced as an RN, but I have worked other places where teamwork is just as important...its always a shame when one person doesnt realize that when they dont contribute to the team that they are essentially just working against everyone else...

anyway...good luck with your situation.

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CNAs are allowed to perform EKGs at the facility I'm at ELKMin06. What CNAs do can vary from facility to facility or even state to state.

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Boy, it sure does sound like you're babysitting. He might be 24, but he acts like he's 13. I can see why he got kicked out of nursing school. He's irresponsible and possibly dangerous and should NOT be in a care setting. I'll bet he's sure that all of these 'incidents' are everyone elses' fault, not his. People like this don't get it until something drastic happens, and even then they don't see how their behavior influenced the outcome of an incident. He has a lot of growing up to do or he'll find himself working at McDonald's or digging ditches for the rest of his life. I'm not a nurse yet, but I've been an NA, and I would think that a person in a medical field that thinks he/she knows more than anyone else (especially when they don't have the experience or the training) is a VERY dangerous person to work with. Keep up that paper trail so you all can get rid of him and have a safer work environment.

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Well, if it is your facility's policy for the leaving NA to give report to the oncoming NA, then I would say that he left his assignment. I live in NY, NA's and CNA's cannot be charged with abandonment if they leave their assignment, however, the facilities can "nail" them to the wall for all sorts of safety issues.

He can also be written up and eventually fired for failing to properly perform his duties. In this case document, document, document, even if for your own records. You might see a pattern of taking off on the same night, or when certain team members are coming on.

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IMO yes he should have been written up, but by your senior, asking to talk to him without a third party was putting yourself in what is now seen as a dangerous position.

just something to think about.

goodluck

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