What would you have said to this CNA

[zofran]

I was almost done posting this but it went away? Sorry if it comes up twice???

Anyway, I am an RN on a busy day shift med-surg/onc floor. The other day it was crazy. It was about 1400 and I had not eaten or peed. I was starting to feel a bit sick. I told the HUC that I was not feeling well and that I was going to take a quick break to pee and eat something real quick. I told her to tell the CNA I was working with that I was not feeling good, would be back quickly, and to give her this note.

The note said - Take temp in 502 and get water for 507. Thanks

Well when I got back, the CNA working with me was livid. She demanded to talk to me in private. She says (and I quote) "I am not your N-word" (but she says the word if ya know what I mean) "You can't just leave me notes and expect me to do what you say"

I was just so shocked! First that she would use the N word (we are both white) and second, that she seemed to not care that I had to get off the floor for just a few min.

So I end up apologizing to HER, explaining why I left the note, and telling her how bad I had to take a quick break. She really didn't care, didn't even give the water or take the temp, and just talked trash about me for the rest of the shift. I heard her later telling the other cna's that 'she put me in my place"

this type of behavior is so dishearting for me, We should ALL be there to support eachother and the patients. What would you guys have done?

[leenie123]

Where I worked we were told to always follow chain of command! I wrote the responsible party up and did take and give it to the DON, and was told by her it would be taken care of. Someone did come after awhile and inspect, and go thru charts, etc, but by that time I was hurt in a fall and on disab myself and never did go back to work for them! Prior to my injury though 2 diff family members had approached me about poss questionable injury to their family member, and they had hidden cameras set up in those Rms, but I don't know how that all went. As I said the NA that I wrote up, and reported; that I know of the DON said they questioned her, but she was still working there when I left. Right about that time also my own mother in a nursing home up North died suddenly and I was later told that she had poss been abused and why she had heart attack! Of course there was no proof of it. We were tought in nursing school to look at all pts as if they could be our own parents laying there those beds, and give the best care to them, and I did that. A pt once told me if there was a stairway to heaven that I would be walking up it. I often felt if you can't be humble, and caring all your pts you might want to look elseware for work! Another example of issue was I heard a pt ask who her nurse would be that day, and the NA telling the pt that she was her nurse that day? Seeing as how we all wore white uniforms pretty hard for the pts to know who was what. As I entered the Rm to give that pt her meds, and Tx's, and she wanted to know why I was bringing her meds as so and so told her she would be her nurse? I informed the pt that the other person was the NA that would be tending to other duties for her, but that indeed I was her Nurse that day! I felt that if a NA wants to be a nurse then she needed to go to nursing school, pass her boards, and then she would have a right to say she was a nurse, and not before that! I was told by a nurse that worked there long before I had that the corp had got sued in the past so why they gave NAs the wide birth, and a slap on the wrist. I did what I thought was right to do, but the ball was dropped further up the chain of command. There was big write up in paper couple yrs ago though about several places investigated, and authorities closed some of the places due to abuses, and neglect, etc. I think they got enough reports, and proof that finally something was done about it all! Its a great profession, but you are only as good as the staff you work with; one person can't do it all!

[Katnip, RN]

. There is NO, not even ONE excuse for not taking a moment to eat a bite, such as a cracker. It awe's me also that I've been attacked for suggesting to eat a cracker... In reality...if you can't find 2 seconds to stuff a couple crackers in your mouth while your checking out your meds, washing your hands, getting a patient water, charting, etc... then you DO have time management ISSUES.

Nurses (or anyone for that matter) better not be caught eating in a med room, in the hall, or at the nurse's station. Ask your infection control person about that one.

Nobody is denying your job is hard. Nobody is denying it's not healthy to skip breaks, etc., but you're obviously not a nurse. I always loved it when techs and CNAs complained about how nurses have it so easy and could just use better time management...until they graduated and became nurses and experienced the reality of it. There's a lot more liability on a nurse than on a CNA and the nurse has to do her job as well as make sure CNAs do theirs as well.

[Amira1978]

I know its hard to be a nurse I have two sisters that are nurses one is an LPN and the other is an RN. I see what nurses have to put up with at my job and I know there is no picnic in being a nurse and the same goes for being a CNA or a tech as well. Well for the CNA's I guess it depends on where you work because every facility is different I can only speak on the facility I work with and believe me there is no picnic working as a CNA where I work.

[Merlinsmom]

Personally I would have written up this CNA threes times. First, The CNA did not follow her instructions. Second, She refused actually refused to follow instructions. Third, Later in the day she was underminding your authority within the department.

Where I work I would have been allowed to fire her on the spot without cause or no reason offered. A record in her file would have followed her future job apps.

This behavior could cause unsafe patient care which is TOTALY unacceptable and could very well be a liability in the future !

Totally agree. I used to work medicare/rehab. I actually had to write a nun up once. Pt was in a broda chair, no alarm (even though the cna/nun knew she was supposed to have one, had one for well over a year and the CNA worked with her almost daily) and pt fell, no alarm on (CNA said she didn't see one on pt's bedside table so did not put one on:nono:), hit her head (was ok but still). I was an LPN at the time (now RN) and I talked to my boss about it (the DON) and she said she knew there was problems with this CNA/nun but she did not feel like she could write her up...she just felt wrong because she was a nun. I told her that when she is here, she is a CNA and held to the same accountability that any other CNA I work with is and this is a patient safety issue therefore something that needs to be addressed. She agreed and I offered to give the CNA the writup myself instead of making my DON do it. My DON was greatful, when I talked to the CNA/Nun I explained that I had to do this because it was a pt safety issue which had to be addressed and she understood and did not have a problem with it. She always had the appropriate alarms on people after that.:nuke:

[greeniebean]

As a CNA I can't believe the audacity of that girl! Not just her launguage but being rude to her nurse is unacceptable. If she had a problem with the tasks you assigned her (which seem like basic CNA tasks) she should have pulled you asside and voiced her concerns in a polite way. That's insobordination and at my LTC she'd be lucky to still have a job. She may think she knows the job of an RN but she doesn't. RN's and LPN's manage the aides for a reason!

[cherrybreeze, ADN, RN]

This entire thread has so much to comment on, but it's gone on so long I'll bite my tongue (or sit on my hands?) on the vast majority of it. I will ask about this though:

paying attention to demands such as the CNA made, gives that kind of thing too much attention which could result in repeat behavior of that sort.

Ignoring the behavior gives a silent answer that it is okay to act like this to the CNA. Silence is not the answer. Remember we teach people how to treat us...:)

First, you say paying attention to the CNA's demands/behavior calls too much attention to it, which may cause a repeat of the behavior. THEN you say ignoring it will also encourage the behavior. Exactly what, then, do you suggest in order to "teach people how to treat us?" You're saying whatever action is taken, it's going to make that person repeat the behavior.

[caliotter3]

This entire thread has so much to comment on, but it's gone on so long I'll bite my tongue (or sit on my hands?) on the vast majority of it. I will ask about this though:

First, you say paying attention to the CNA's demands/behavior calls too much attention to it, which may cause a repeat of the behavior. THEN you say ignoring it will also encourage the behavior. Exactly what, then, do you suggest in order to "teach people how to treat us?" You're saying whatever action is taken, it's going to make that person repeat the behavior.

A good way, whether intentional or not, of saying that you're blank if you do and blank if you don't. People like this CNA act the way they want to in spite of everything and everyone around them. They are the centers of their own universe.

[cherrybreeze, ADN, RN]

Oh, I totally hear you there. But I'm pretty sure in the post that I quoted, the poster was completely serious, and not meaning what you are saying. I think they truly were offering 'insight', and since it doesn't make sense, I had to ask.

I could be wrong, but that's how it read to me.

[morte, LPN, LVN]

Oh, I totally hear you there. But I'm pretty sure in the post that I quoted, the poster was completely serious, and not meaning what you are saying. I think they truly were offering 'insight', and since it doesn't make sense, I had to ask.

I could be wrong, but that's how it read to me.

the way i read it, was to allow the behavior , ie to give the complaint credence..remember the OP appologized....was not good, and ignoring it wasn't either.....

[kbrn2002, ADN, RN]

Several issues here. First, the task note seemed a bit much and you probably should have told her in person. Secondly, I think you should talk to her in private. Explain to her that her patient abandonment could have been a cause for harm and that you are not there to worry about her feelings but that you are both there to work together in the best interest of the patients. Explain to her that you want to work as a team and that part of team building is trust. Tell her you will try to talk to her personally or hand over task lists personally (since that seems to be her issue) but that you do expect her to do her part just as you should. I would give her a break and tell her so..."I have every right to write you up for abandonment but I am not going to because I think that this was just a misunderstanding." Let her know that she can make it hard or easy but that you like easy. Why even say all of this? Why not just write her up as the others suggested? It is very important that you get out of adversarial mode but you must also make it clear that you will not put up with dangerous behavior. I would go with team building and writing her up at the first problem is not conducive to team building. It is passive aggressive behavior that flourishes in the female nursing community. We need to learn how to respect each other, work out issues together, and quit back stabbing.

Sorry but I can't agree. Regardless of the method of communication this CNA was given a duty that was within her job description to perform. The refusal to perform that task would be and should be grounds for dismissal, as is the insubordination this CNA showed to her direct supervisor. Another point...the use of a derogatory racial slur should be grounds for immediate suspension pending investigation, which would certainly result in dismissal. I can't imagine any facility keeping anybody on staff that would leave them so wide open to litigation! This situation in my opinion did not call for any effort on the RN's part to foster teamwork and mutual respect. BTW, it shouldn't matter but for the curious I started as a CNA, worked my way up through tech, RN and RN supervisor. I wouldn't under any circumstances, no matter how stressed , EVER speak to anybody that like much less my supervisor.

[misswoosie]

It was a bad day, thats why I waited so long to get a break. I know that waiting until you feel sick is not a good.....And usually take a break sooner. This CNA has been a problem for a long time. And I believe she is in the process of getting fired. Not for what she said to me, but for many other comments overheard by managment. I just could not believe she told me "I am not your

N-word." Who even says this anymore? It just shocked me so much, I didn't really know how to handle it. I did report her to the NM and will not have to work with her again. Thank God.

Most concerning thing would be how she speaks to patients and the quality of her nursing care.We are supposed to work as a team to deliver quality nursing care. I would not want this person looking after my patients or me!

I don't understand why she hasn't been suspended pending investigation.It's Ok saying she won't be working with you again, but what about the patients and other staff?

[dhinson45]

I couldn't have said it any better!!!!!