I'm afraid on my unit I have a know it all aide. She is from a foreign country (actually so am I) used to be a nurse in a foreign country, has her degree, is waiting to go through NCLEX, yada yada. She's the person that is never wrong. Nope, if I ask her why she is fifteen minutes late from her break, it is my fault for asking and not understanding why she was late. She's then asking why I don't pull up another aide whose child was sick was talking for a few minutes on his cellphone during the shift.We had a patient who is for now Med A but likely to go hospice with a lot of anxiety, he was already in a low bed with tabs and mats on the floor. He kept trying to get out of bed. Whilst I was on the phone getting orders for anti anxiety meds she told me "You need to get private sitter for him. I can't be there all the time" I understood the situation. I told her we were in the process of getting new meds ordered and that it would take some time for him to settle down.About twenty minutes later after my med pass, around 9am she finds me inhaling my breakfast and said "Didn't you call the family yet? They need to find someone to sit with him" I told her I was taking a five minute break and then I got "Look, this is your responsibility! Why don't you understand? You're just interested in sitting and eating" At this point I got really mad, told her to leave my office. She didn't...... I ended up saying "Shut your mouth and get out". I shut the door on her and I feel I lost it. Firstly, I run around like a mad woman most of the time. Secondly I was dealing with the matter in hand. Thirdly, I hadn't eaten since 5pm the day before..............I have to eat some time and normally spend each meal time on the baylor shift inhaling my food within five minutes. And fourthly, I do not barge up to the CNA's and talk to them in the same manner that she spoke to me in.Then the family came in. She spoke to the family and said she didn't have time to keep putting the patient in bed or feed him. She said someone from the family needed to do this. When I heard she had done that, I went absolutely ballistic - she's written up. I guess the point of my post is this, how do you deal with know it all CNA's that want to run your unit without going ballistic or losing your temper? I think I would have done better if I'd employed a zero tolerance policy with this one from the start, but of course then she'd have been coming to me with issues about the other normally hard working CNA's.