What to do???

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Hi all! hope I can get a little bit of advice from those of you who've worked in long term care. I have a BIG problem. At night, there isn't an RN on staff, and when i attempt:mad: to give report to the CNA's they literally walked away while I was talking. I had to ask them to stay and listen to me finish giving report. They complained about everything I asked them to do and gave me a list of reasons why they wouldn't do them. Then they began talking about the pt's meds and stuff(which they had no idea what they were talking about). They wouldn't even look at me while I was talking and told me that I shouldn't give report on every pt. (which i wasn't, only telling them 3 things that were issues that day with the pts!!). So MAD, tried to assert my place but found it INCREDIBLY difficult!. any help??

Specializes in LTC.
When giving CNAs report, I say it once. I don't have time to repeat myself. Its their job to get report, they usually listen in, if not.. then that's their problem"

Actually, everything the CNA's do or don't do can become YOUR problem. They don't transfer properly and the pt gets hurt, your problem. They feed someone who is on thickened liquids regular food and they aspirate; YOUR problem again. If you are the charge nurse everything that happens on that floor, you are ultimately responsible for.

True, many CNA;s have HUGE attitudes and just don't listen or do the things they are supposed to do. I feel like I am constantly telling them the little things they know. They want to get away with doing as little as possible. Some are like that, not all.

Just remember you are the nurse and the pass or fail of your floor is your responsibility.

Right but when they are flat out not listening to me, and report was given to them by me, .. its their job to listen and apply that information to their jobs. I say report once, give them the opportunity to ask questions. They need to have some responsibility also.

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Specializes in Psych, LTC, Correctional.

Don't be so quick to turn it over to the DON. You will have to learn how to deal with this at some point in your career so why not now?! One thing I have always liked to do to get a "difficult" CNA to cooperate is to let them see me on the floor helping, going above and beyond my duties shows them I don't think I'm better than them and teaches them teamwork by example. Once they start respecting you they will do everything for you from giving a extra shower to buying you a pop when your thirsty and broke. Seriously they will. There is usually one CNA who is riling up everyone else....this is the one I write up so the others will see this and know that I'm serious. After I write the one CNA up I am still friendly and professional with her to show her we are putting this behind us and moving on. It's all about respect and showing them you are not above doing what you are asking them to do. Good Luck!

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Specializes in Geriatrics, Ambulatory Care.

"Don't be so quick to turn it over to the DON. You will have to learn how to deal with this at some point in your career so why not now?! One thing I have always liked to do to get a "difficult" CNA to cooperate is to let them see me on the floor helping, going above and beyond my duties shows them I don't think I'm better than them and teaches them teamwork by example. Once they start respecting you they will do everything for you from giving a extra shower to buying you a pop when your thirsty and broke. Seriously they will. There is usually one CNA who is riling up everyone else....this is the one I write up so the others will see this and know that I'm serious. After I write the one CNA up I am still friendly and professional with her to show her we are putting this behind us and moving on. It's all about respect and showing them you are not above doing what you are asking them to do. Good Luck!"

Well said. No one has to respect you because you have a title. This is something you have to earn. If you turn this over to the DON then she has the power and you will still not have any. She can not make them respect you. Just continue to give report and set expectations. I am impressed that you want to give report to the aides. Maybe you are the first nurse who has felt this is necessary and the aides do not know how to respond to it. Try doing an in-service and explain that you want to give the report because you respect them as aides and the more information you give them the more information they can give you.

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It's odd though because there is NO RN on the shift that I am handing off too. So if I can't get the CNA's to listen to me then there is no one else over seeing the care of the patients and I find that to be unsafe.

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Specializes in Geriatrics, Ambulatory Care.

Only 7 states require 24 hour RN coverage in LTC -- California, Colorado, Connecticut, Hawaii, Maryland, Pennsylvania, Rhode Island. Although outcomes for the residents are better with more RNs it is not mandatory.

I have many LVNs/LPNs who are much better supervisors than the RNs. Just because you give report to a nurse who is not an RN does not mean the CNAs do not listen to her.

Sorry you are having difficulty but the more fixated you are on the fact that you are the RN the less the staff will care.

As the saying goes:

"People do not care how much you know until they know how much you care." ~John Maxwell

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Specializes in Gerontology, Med surg, Home Health.

I agree with the poster who said you need to deal with this yourself. If you go to the DNS with every problem, YOU will never get the respect you need to run the unit.

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Only 7 states require 24 hour RN coverage in LTC -- California, Colorado, Connecticut, Hawaii, Maryland, Pennsylvania, Rhode Island. Although outcomes for the residents are better with more RNs it is not mandatory.

I have many LVNs/LPNs who are much better supervisors than the RNs. Just because you give report to a nurse who is not an RN does not mean the CNAs do not listen to her.

Sorry you are having difficulty but the more fixated you are on the fact that you are the RN the less the staff will care.

As the saying goes:

"People do not care how much you know until they know how much you care." ~John Maxwell

I should have clarified. There is NO RN OR LPN on staff after my shift, so its the CNA that I'm reporting to.

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Specializes in Gerontology, Med surg, Home Health.

What kind of place is this? Certainly not a skilled facility if there aren't licensed people there 24/7.

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