What tactics do you use with Know All Aides?

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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.

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Specializes in LTC.

This is short term, isn't it? You said she's waiting for nclex. Then she'll go be a know-it-all somewhere else, right?

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Specializes in CV Surgical, ICU.

Yea but seriously?! how dare she speak to the family of a dying man in such a manner!! It's not the family's job to feed and tend to his safety. They need to be there for him as his children, he needs their support, they are not there to care to his physical needs. It's her job! Honestly, what does she think she's being paid to do?! Ugh.. Some people just have no compassion.. I'm with you, I'd just be mortified to have to work with someone like that

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Specializes in Hospital Education Coordinator.

she spoke out of turn to the family. That would be enough reason to start disciplinary action in my facility. Who evaluates her progress as an employee? That person needs to be brought in to the discussion, or talk to your supervisor. Sounds like a bad apple. Hope she does not ask for a reference if and when she passes NCLEX.

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That's the other thing, I spent a great deal of time talking with the family for the rest of the day doing "damage control", ie telling them it was OK to leave their relative with us and I would be keeping an extremely close eye on him. They were a really good family. Edited to add, his anxiety issues were met by about midday that day, and continued on until 10pm when I left the shift.

I think I'll be speaking with the DON so they don't hire her as an RN new grad.

But basically, however riled up I get, I never want to say to someone again "Shut your mouth and get out"

I told a more senior nurse what I had done at work that day and she said "good for you" but I know full well it was not a professional response.

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Specializes in LTC, Disease Management, smoking Cessati.

I would not listen to her incessant yammering. Tell her that you won't tolerate it. If she steps over the line write her up. I had an aide one night who had diapered all her residents on the pretense they were working short. I told her they all had to be taken off. it was against policy... she chose to walk out screaming she had not had lunch.... I let her go... she was back about 15-20 minutes later after reconsidering... asked could she eat first and I told her yes, and I would have anyway..... I just confront about the absurd behavior and if they don't like it.... too bad, there's the door. We are all way to busy to put up with that kind of pettiness. I worked LTC for many years, although I don't now, but I remember the BS quite well....

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Specializes in LTC.

I agree that what she said to the family was out of line, but she was written up for it. Once she passes the test she'll be an obnoxious pain in the ass somewhere else. There's no sense in wasting too much energy over it.

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Specializes in Gerontology, Med surg, Home Health.

Two comments-

I have to disagree about the 'she'll be a pia somewhere else when she passes the NYCLEX"...please don't be foisting off your problem people on the rest of us.

Secondly, it's not always just the CNAs who think they are know it alls. I have a nurse who acts that way. It's always about him. One day he pushed me too far with his complaints about lack of staff (we have plenty) and a meeting being held down the hall...finally I said "Enough of your complaints. You do not run the building. The meeting is 30 feet away from the nurses' station and this is NOT an ICU. Get over yourself or get out the door." He got the message. Every now and then you just have to say it like it is.

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Specializes in LTC.

You cannot change/control everyone, as much as you might want to.

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Specializes in med/surg, psych, public health.
Two comments-

I have to disagree about the 'she'll be a pia somewhere else when she passes the NYCLEX"...please don't be foisting off your problem people on the rest of us.

Secondly, it's not always just the CNAs who think they are know it alls. I have a nurse who acts that way. It's always about him. One day he pushed me too far with his complaints about lack of staff (we have plenty) and a meeting being held down the hall...finally I said "Enough of your complaints. You do not run the building. The meeting is 30 feet away from the nurses' station and this is NOT an ICU. Get over yourself or get out the door." He got the message. Every now and then you just have to say it like it is.

ugogrl.gif :yeah:

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Yea but seriously?! how dare she speak to the family of a dying man in such a manner!! It's not the family's job to feed and tend to his safety. They need to be there for him as his children, he needs their support, they are not there to care to his physical needs. It's her job! Honestly, what does she think she's being paid to do?! Ugh.. Some people just have no compassion.. I'm with you, I'd just be mortified to have to work with someone like that

That's the thing too. The family were so nice and they were dealing with their dying relative, their dying husband and father. All this individual put across is that he was too much trouble for her/us. Without asking and dismissing everything I had said to her.

I'll admit that there are CNAs LPNs RNs and MDs who can all have this heartless attitude, it's not really the fact that she's a CNA that's bothering me, it's the fact that her attitude is totally wrong, and she won't be told that it's wrong.

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Specializes in LTC, Hospice, Case Management.
it's the fact that her attitude is totally wrong, and she won't be told that it's wrong.

We have a written 1:1 education form in our facility. I would probably begin with one of these & would also make sure to write the potential negative impact for both the resident and the family members. I would be very clear when I reviewed this with her that any repeats in this behavior WILL result in disciplinary action up to and including termination.

Despite all her education, you have the license and she doesn't. You are in charge of the unit and she is not. You don't have to be a bully, but don't get bullied either!

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