I am in the process of writing up a patent care associate.Through a computerized form the hosptal uses to report issues.
When asked what the nature of the incident is.. I had to choose a category. Insubordination does not quite cover the nature of the problem.
I am an R.N. with a very heavy assignment. My PCA is supposed to be working under MY direction. #1 on their job description is...
"Under the direction of a registered nurse.".. and so on and so forth. I am ultimately responsible for the care they deliver.
This PCA consistently refuses to collaborate with me regarding patient care. I asked for an EKG and a troponin to be drawn. I was "talking to the hand". She flat out refused. It is her JOB! She will Not take any direction, rather give it.
Patients note her rude, loud and hostile demeanor.. and share their observations/ concerns with Me!
Yes, as you described it, your CNA is insubordinate.
My only suggestion is that when you write her up, be VERY specific about what she refuses to do. Managers have a very hard time disciplining when the complaints do not address the actual complaint. "CNA Mary refuses to complete her tasks" vs. "On March, 1, 2011, PM shift, Mary was asked to complete tasks x,y, and z and she refused to complete them. When asked why...."
I am a brand new CNA, looking for my first job. I would NEVER be rude to my supervising nurse! My scope of practice is, first and foremost, to take directions and instructions from my supervisors in order to support the nurse in the restoration of my patient's health. Without a supervising nurse, I am not allowed to provide care. I am a certified healthcare worker, not a licensed healthcare worker. Write her up. That is definitely insubordination and the time and energy that you spend on that PCA's issues take away time from your patients. No one has time to waste on spoiled, difficult colleagues who refuse to take instruction. She could learn a lot from you if she would take advantage of the opportunity to work with a great teacher.
Aren't you a sweetie! I wish 2% of the PCTs I work with had your attitude. I started out as a CNA so I know what the job entails. I always always say thank you and appreciate the help I get in caring for the patients. Keep that attitude up and you will be a blessing to the profession.:redpinkhe
I am in the process of writing up a patent care associate.Through a computerized form the hosptal uses to report issues.
When asked what the nature of the incident is.. I had to choose a category. Insubordination does not quite cover the nature of the problem.
I am an R.N. with a very heavy assignment. My PCA is supposed to be working under MY direction. #1 on their job description is...
"Under the direction of a registered nurse.".. and so on and so forth. I am ultimately responsible for the care they deliver.
This PCA consistently refuses to collaborate with me regarding patient care. I asked for an EKG and a troponin to be drawn. I was "talking to the hand". She flat out refused. It is her JOB! She will Not take any direction, rather give it.
Patients note her rude, loud and hostile demeanor.. and share their observations/ concerns with Me!
"why is she tallking to you that way?"
Any insight will be greatly appreciated.
This is NOT insurbordination. Let me tell you why. When ever you ASK the PCA to do anything you leave her the choice of saying YES or NO. Now if you said" I need you to do an EKG" or "Please do an EKG" and she didn't comply then that would be insurbordination. I had attempted to write up a CNA who did not want to help another CNA transfer a heavy patient. I asked him to help her he said NO and I immediately wrote him up for insurbordination. Then I was told my managment that I could not legally do this because I asked him to do something rather than telling him to do it.
Insubordination definition:
Willful failure to obey a supervisor's lawful orders. So I learned this the hard way. For now on I don't ask my CNAs do anything but I politely tell them to do. I give clear and direct directions that way if they still insists on no then they can be written up for insubordination.
I really hope to bless both my patients and my nurses! I want to start nursing school next year, but I want to work as a CNA first. I want to get experience with patients and when I am (hopefully!) a nurse, I don't ever want to ask someone to do something that I haven't done myself!
Aren't you a sweetie! I wish 2% of the PCTs I work with had your attitude. I started out as a CNA so I know what the job entails. I always always say thank you and appreciate the help I get in caring for the patients. Keep that attitude up and you will be a blessing to the profession.:redpinkhe
This is NOT insurbordination. Let me tell you why. When ever you ASK the PCA to do anything you leave her the choice of saying YES or NO. Now if you said" I need you to do an EKG" or "Please do an EKG" and she didn't comply then that would be insurbordination. I had attempted to write up a CNA who did not want to help another CNA transfer a heavy patient. I asked him to help her he said NO and I immediately wrote him up for insurbordination. Then I was told my managment that I could not legally do this because I asked him to do something rather than telling him to do it.
Insubordination definition:
Willful failure to obey a supervisor's lawful orders. So I learned this the hard way. For now on I don't ask my CNAs do anything but I politely tell them to do. I give clear and direct directions that way if they still insists on no then they can be written up for insubordination.
When I ask my CNA's to do something, it is understood that I am being polite and not ordering them around. This does NOT give them the right to refuse. I will ask twice if they still haven't done the requested task, I then tell them I want it done. If it still is not done I write them up. I believe we are all adults, we should not have to become a "bully" boss who goes around ordering everything. Politeness goes much further than a straight out order (except in an emergency, then orders are shot out as fast as they need to be and no refusal is tolerated)
This is NOT insurbordination. Let me tell you why. When ever you ASK the PCA to do anything you leave her the choice of saying YES or NO. Now if you said" I need you to do an EKG" or "Please do an EKG" and she didn't comply then that would be insurbordination. I had attempted to write up a CNA who did not want to help another CNA transfer a heavy patient. I asked him to help her he said NO and I immediately wrote him up for insurbordination. Then I was told my managment that I could not legally do this because I asked him to do something rather than telling him to do it.
Insubordination definition:
Willful failure to obey a supervisor's lawful orders. So I learned this the hard way. For now on I don't ask my CNAs do anything but I politely tell them to do. I give clear and direct directions that way if they still insists on no then they can be written up for insubordination.
I think NurseLoveJoy has a very good point here. I am not a nurse yet but I am a former manager of a large medical facility (for many years) and although when you are "asking" this CNA to do something you really are not "asking" you are just being polite, and trying not to come off as bossy. Am I right? I know that is how I felt when I first started in management, after awhile I learned (the hard way) that I needed to politely "tell" the girls who worked for me what I needed them to do. BTW, I think you are a wonderful supervisor to ever be concerned enough to post this, many managers wouldn't even care. I hope once I being my nursing career I'm lucky to have someone like to as MY supervisor! Well, that just my 2 cents... good luck!
This is NOT insurbordination. Let me tell you why. When ever you ASK the PCA to do anything you leave her the choice of saying YES or NO. Now if you said" I need you to do an EKG" or "Please do an EKG" and she didn't comply then that would be insurbordination. I had attempted to write up a CNA who did not want to help another CNA transfer a heavy patient. I asked him to help her he said NO and I immediately wrote him up for insurbordination. Then I was told my managment that I could not legally do this because I asked him to do something rather than telling him to do it.
Insubordination definition:
Willful failure to obey a supervisor's lawful orders. So I learned this the hard way. For now on I don't ask my CNAs do anything but I politely tell them to do. I give clear and direct directions that way if they still insists on no then they can be written up for insubordination.
I too, have been known to ask, "Can you get me a BP/pulse on so and so?" The reply was, "No, I'm really behind," I simply said, " What I meant was get me a BP/Pulse on so and so, thanks." I don't like sounding like I'm bossing them around, but I want them to know that telling me no is not an option. I had words one night when a CNA came back to me with, "You could say please." I simply told her, no I am not going to ask you please do YOUR job.
Start "ordering" CNA's to do things, and see what kind of response you get. I wouldn't say "Susie, would you please draw some labs for me?" But I would say, "Susie, please draw labs on patient Jones in 201. Thanks so much!" It's not asking, yet not necessarily "ordering."
Semantics, I guess, but sometimes those go a long way.
When I ask my CNA's to do something, it is understood that I am being polite and not ordering them around. This does NOT give them the right to refuse. I will ask twice if they still haven't done the requested task, I then tell them I want it done. If it still is not done I write them up. I believe we are all adults, we should not have to become a "bully" boss who goes around ordering everything. Politeness goes much further than a straight out order (except in an emergency, then orders are shot out as fast as they need to be and no refusal is tolerated)
My post never stated to be rude or nasty when giving directions to a CNA. I have a very small, "baby" voice so I can't sound bossy even if I wanted to. All I'm saying is that when you ASK a CNA to do something you are giving them an option rather than a clear, concise, and direct task to complete. Once again I learned this the hard way. The nurse should always be polite when delagating. Just because I'm a nurse does not make me superior to CNAs I need them as much as the patients do so I always treat them with the upmost respect.
Start "ordering" CNA's to do things, and see what kind of response you get. I wouldn't say "Susie, would you please draw some labs for me?" But I would say, "Susie, please draw labs on patient Jones in 201. Thanks so much!" It's not asking, yet not necessarily "ordering."
Semantics, I guess, but sometimes those go a long way.
Well said. There is a difference between ordering and delegating in a polite way. Once I learned to stop asking I have come so much further.
All I'm saying is that when you ASK a CNA to do something you are giving them an option rather than a clear, concise, and direct task to complete. Once again I learned this the hard way. The nurse should always be polite when delagating. Just because I'm a nurse does not make me superior to CNAs I need them as much as the patients do so I always treat them with the upmost respect.
msn10
560 Posts
Yes, as you described it, your CNA is insubordinate.
My only suggestion is that when you write her up, be VERY specific about what she refuses to do. Managers have a very hard time disciplining when the complaints do not address the actual complaint. "CNA Mary refuses to complete her tasks" vs. "On March, 1, 2011, PM shift, Mary was asked to complete tasks x,y, and z and she refused to complete them. When asked why...."