What to do about tech refusing to get VS?

Specialties Med-Surg

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I have a tech at work who I'll call Sarah. She is a really good tech. The problem is that she has an attitude with me. I have reported her at least twice and nothing ever gets done. It goes like this:

I always get my own admission VS, post-op, post cath, and blood VS. I very rarely ask a tech to do anything for me. They know what they are supposed to do and they do it. Yesterday I had a new patient that the physician had sent up from his office, he wasn't even allowed to stop at admitting, dx: viral meningitis. He was 80 years old and I was told that his temp was 103 and that I was to immediately start an IV, order labs, give IV Phenergan, get VS, etc, etc..... At the same time I had another admit come up from the ER. I asked Sarah to get the vital signs on the first patient while I was starting the IV. She brought the dinemapp in the room and said "since you're in here you can get them" I said no Sarah get the VS, she said " do you want me to show you how to operate the equipment, is that the problem?" and she promptly left the room. I was not only furious but embarassed in front of the patients family. I told my assistant nurse manager and she didn't say much.

This is the 3rd such similar incident with this CNT in about 3 months time. I have spoken to her directly also with no results. Any suggestions? What I'm thinking about is asking for a confrontation in the nurse managers office.

I would like to tell her that I think she does a good job but do not appreciate her reluctance to do something that I ask her to do because I only ask when it's really needed. I would like to tell her that she needs a refresher on what her job description entails. Should I mention that I am her superior, well that's not the word I want to use but you know, I'm over her, in charge......?

I want to tell her that if she wants to give the orders that she should go to school and get her nursing license. Thanks for any advice you can offer. We both work tomorrow and I'll let you know how it goes. Thanks.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
All I need to do is to tell her to her face, with a witness present in the room, what her job description is and what I expect of her.

I would have thought this was info that her orientation would have covered?

When I was a CNA (during nursing school), when I was asked to do something by the RN, I would not question it.

HOWEVER.......as a CNA I also know when I am being "abused" by my RN....

1. The RN comes OUT of a patient's room as I am walking in, and she asks me to empty the urinal/take out the patient's food tray. GIVE ME A BREAK!!!!!!!!!!

2. The RN asks me to take the vitals when she is giving blood to a patient. OK so I have 6+ patients to bathe, do I/O's, take vitals on etc and YOU want me to stand in the room and take vitals q15min x 1 hour?!?! I can understand you wanting me to take the pre-transfusion vitals and maybe the post, but come on......

Only a couple of reasons why I decided to go into ICU (where its my patient that I have total care of...no CNA to do my vitals!)

In this particular situation, I think the CNA was out of line for acting so unprofessional in front of the patient and family. If she had issues w/the RN "bossing her around" she should have talked to the RN afterward about it.

I've always done my own vitals on my transfusing patients - I noticed recently a pm nurse asking the CNA to do them . . . that really confused me as the nurse should really take over that little job for the CNA, who is busy enough. Plus you need to be in the room anyway for awhile.

steph

I have had this situation with an aide before. I simply set them down at the nurse's station with the other night shift nurses and told them I would have none of it. The aide said, " I'll just quit." To which I replied, " Go ahead. It makes no difference to me, because you are replaceable." (You also have to take into consideration that the night shift has worked more nights without an aide than they have with one) The aide didn't quit and she didn't get the picture either. The night shift nurses made her life a living hell. The nurses read the CNA job description and there was a line in it about cleaning the unit.She was not allowed to sit down or take a break except for her 15 minute break per shift and her supper break for which the nurses timed them to the exact minute. If she was a minute late, she was wrote up. After a week of her cleaning the counters, walls, and equipment of our unit, the night shift nurses had no trouble with her again and the unit never sparkled as much as it did. I know it seems mean, but sometimes as a charge nurse you have to do what you have to do. There is no room in our profession for back talking, lazy people(CNA, LPN, or RN) who can care less about giving patient care and is only there to get a paycheck.

Schroeder

At my job I have been told that if a CNA has a "bad attitude" towards the nurse that the nurse should send her home immediately. He said nurses don't have to put up with any bad attitudes from the CNA's at any time.

At my job I have been told that if a CNA has a "bad attitude" towards the nurse that the nurse should send her home immediately. He said nurses don't have to put up with any bad attitudes from the CNA's at any time.

I'm finishing nursing school this spring and work as an aide on a very busy unit. Nursing is a second career for me so I've been around the block a few times.

I am constantly amazed at the fact that I can work my butt off helping to care for the nurses' patients, but yet very few nurses care to help me. It doesn't matter what I'm doing, the nurse (one of seven on the floor) wants me NOW, regardless of where I am or what I am doing. Healthcare is a team effort folks, and respect is a two way street. If you find that your CNAs have attitude, perhaps you should examine your own before pointing a finger.

Classicaldreams

Specializes in OB, M/S, HH, Medical Imaging RN.

Well, you won't believe this! I did charge today and we were so busy that I ended up taking 2 patients myself. Sarah happened to have those 2 rooms. She was in those rooms taking VS before I ever had a chance to get in the room. She was so pleasant, asked if there was anything else I needed her to do. I was in total awe. I was told that she had her yearly evaluation on Friday. I'm assuming that something was said. I couldn't believe it! I hope that is the last chapter in this book. Thanks to everyone for letting me vent.

That's great news!!! At my LTC most of the CNA's work hard and do a great job!!! I don't know why but it seems that at every job there is always one CNA who want to make the nurse miserable and will do so unless they are written up or someone has a talk with them. I have lots of respect for most of my CNA's because they do work their butt's off and I am happy to help them out when I can. :)

Well, you won't believe this! I did charge today and we were so busy that I ended up taking 2 patients myself. Sarah happened to have those 2 rooms. She was in those rooms taking VS before I ever had a chance to get in the room. She was so pleasant, asked if there was anything else I needed her to do. I was in total awe. I was told that she had her yearly evaluation on Friday. I'm assuming that something was said. I couldn't believe it! I hope that is the last chapter in this book. Thanks to everyone for letting me vent.

Well, let's hope that this new attitude doesn't last until Friday is over, but I don't know...

You know, you sound like you are a very fair nurse-- for crying out loud, you prefaced your anecdote with "Sara is a very good PCT."

You did nothing wrong by asking her to get vitals and I would be very frustrated by the fact that the tech seems to operate with impunity. New nurse manager needed, perhaps?

What some aides just do not understand is that sometimes we can do their jobs (meaning all the tasks that are delegable to them), but they can never do our jobs. If we are doing the stuff that should be delegated to them, then we are not getting to the non delegable tasks. Admissions are a lot of work for RNs! Especially outside admits.

And yes, I often do aide jobs. I will ALWAYS empty a urinal, I often take trays away, I will get vitals sometimes (and a lot more often than not blood vitals), and other sundry tasks. Hey, guess what: I always get out later than any aide.

It sounds like you help out whenever she can (and probably sometimes when you really don't have the time.) This aide is taking advantage of you. She knows it too.

Specializes in OB, M/S, HH, Medical Imaging RN.
sometimes we can do their jobs (meaning all the tasks that are delegable to them), but they can never do our jobs. If we are doing the stuff that should be delegated to them, then we are not getting to the non delegable tasks. Admissions are a lot of work for RNs! Especially outside admits.

Thanks, I never thought of it in that way but you are absolutely right. I like my nurse manager but I do think she is way too linient!

I'm glad something was said in her yearly eval...and I hope she does not slide back into bad habits. Keep up the good work Dutchgirl...it is not 'bad' of us to expect others to do their jobs. CNA's who think they can mouth off to the people they were hired to 'assist' (its in their title even) need to be dealt with.

I had a float CNA come to my unit once (I was in charge at the desk) She had a bad attitude from the start...loudly complaining she had to come, didn't like our unit, proceeded to tell me how I should run the unit. I quietly told her ' You may go home now'. then picked up the phone and told the supervisor I had an insubordinate CNA and she needed to be sent home, I would rather do her job AND mine rather than put up with her nonsense. And (in front of her) I told the supe a written complaint about her behavior would be sent to her manager AND HR. She was totally cowed, left the floor only to return later with the supervisor to apologize. I made it clear I would have preferred she be sent home, that the complaint forms would still be filed, and if she did not do her job to my nurses' satisfaction, this would also be dealt with.

What is wrong today is people don't want to do their jobs, do not want to work as a team, and bad managers/charge people don't insist this happen. OK rant over now...LOL!

I'm glad something was said in her yearly eval...and I hope she does not slide back into bad habits. Keep up the good work Dutchgirl...it is not 'bad' of us to expect others to do their jobs. CNA's who think they can mouth off to the people they were hired to 'assist' (its in their title even) need to be dealt with.

I had a float CNA come to my unit once (I was in charge at the desk) She had a bad attitude from the start...loudly complaining she had to come, didn't like our unit, proceeded to tell me how I should run the unit. I quietly told her ' You may go home now'. then picked up the phone and told the supervisor I had an insubordinate CNA and she needed to be sent home, I would rather do her job AND mine rather than put up with her nonsense. And (in front of her) I told the supe a written complaint about her behavior would be sent to her manager AND HR. She was totally cowed, left the floor only to return later with the supervisor to apologize. I made it clear I would have preferred she be sent home, that the complaint forms would still be filed, and if she did not do her job to my nurses' satisfaction, this would also be dealt with.

What is wrong today is people don't want to do their jobs, do not want to work as a team, and bad managers/charge people don't insist this happen. OK rant over now...LOL!

Way to go!

Specializes in Nursing assistant.

Just wondering. In a LTC facility, what would you consider an ideal CNA? Do you mind questions?

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