Why are some aides so disrespectful?

[onthemark]

This morning I was treated very disrespectfully by an aide. I've been reading the threads on here about disrespectful aides to try to learn how to deal with this particular aide. However, from what I'm reading, it seems that it won't matter what I do or say -- the problem is in the system that allows them to get away with it. It seems that management and administration always side with the aides. Why is this? I feel that if an LPN were disrespectful to an RN or supervisor, they'd get written up.....why not the aides?

It is not necessarily because the aides are part of a union which suppports them because there's no union where I work.

Could it be that they know they won't be fired because they're too hard to replace at the low pay they're earning?

I just wonder why aides are allowed to get away with poor behavior when I don't believe any other level of nursing is allowed to get away with it. Does anyone have any insight into this? I'd like to feel that I could discuss this with my superiors or human resources but if they're just going to turn a deaf ear, then there's no point.

[hiddencatRN, BSN, RN]

LCinTraining said:

I'm still confused, if you had time to stop and ask the aide to take the patient to the service, why not take the extra few steps to just deliver her yourself?

Perhaps it's different in LTC, but when I leave the immediate care area I need to report off to another RN because SOMEONE needs to be responsible for my patients when I'm not there. Even if there is nothing that I am imminently about to do, I need to be available and present in case something comes up. Transporting patients is generally a poor use of my time. There is a reason we utilize unlicensed personnel for certain tasks.

I think it was pretty passive aggressive on the aide's part to not mention she was on break when asked to take the patient to the prayer meeting.

[Been there,done that, ASN, RN]

LCinTraining said:

I'm still confused, if you had time to stop and ask the aide to take the patient to the service, why not take the extra few steps to just deliver her yourself? I do not see you taking any responsibility for this mishap, when the reality is, there is more than one issue to address. How many breaks does your facility give? Ours has a 15 at the beginning and a 15 at the end paid break. We also get a 30 minute unpaid lunch break. Are you suggesting there is not more than one break to your work day? Even an 8 hour shift normally gets a lunch break and a 15 minute (what used to be called smoke) break. Is it not plausible this aide was legitimately on her second break, since you saw her in the break room earlier?

You failed to ask the appropriate question. Then got angry at her for continuing with what she indicated was her break. She failed to tell you she was on break. I see this as nothing more than a communication problem, both of you need to resolve. And before I report someone for insubordination, I'm going to make sure there is actual insubordination occuring.

I understand you said you were busy. However, I feel you wasted time talking with this aide when you could have taken a couple minutes and done the job yourself. Then you would have been applauded by the patient. Now the patient feels like none of the nursing staff cares if her spiritual needs have been met, because both of you have failed her.

I have been disrespected by nurses before. I have seen aides disrespect nurses. It goes both ways. But this is not a disrespect issue. It may be a lazy aide issue, which needs to be documented further. But not one of blatant disrespect. You need to make your needs clearly known. My nurses do it often, "hey, I'd toilet patient X but I'm horribly behind with meds, could you go help?" or "you know Patient Z takes an hour to situate each positional change and I have to get this tube feed started, can you take care of it for me?" SURE! I'm your assistant. It's what I do. Do NOT, however,expect me to stop my break, which may be the only time I sit down for 12.5 hours to do work off the clock. It's illegal, last I checked.

Let's not pretend nurses get a free for all while aides do the grunt work. Treat me with respect, I will be your best friend and you will want to only work with me every shift. Treat me like the dirt on the bottom of your shoe, and I may magically never be able to find help for 2 assist patient lifts except for you.

The OP has already said, if she knew the assistant was on break,she would not have asked her to transport the resident.

If nurses just went ahead and performed the task ,every time they got pushback from a request, we would NOT have time for nursing duties.

Not exactly job security for assistant's, when the nurse is performing their role.

[BrandonLPN, LPN]

Re-reading the description of what happened, I feel the need to play devil's advocate for the CNA in question. First of all, it wasn't time for church yet when the church lady came to get the resident. For all we know, the aide was just about to take her when the church lady came. Why should the aide jump up and take her 10 minutes early? So the resident can sit there for 10 minutes doing nothing?

Also I should point out that when the aide said "oh, she doesn't care

about that service" it may have been the truth. I'm sorry, but we all know that there are some LTC residents who bitter little old people who love nothing more than to get their caregivers in trouble with the nurse. It's like a twisted hobby for them. Maybe this resident decided

to play the "my aide never wheels me to church" card when she knows very well she refused to be taken to church for the past 8 months. Stuff like this happens all the time. I've seen residents purposefully leave out wads of cash as "bait" for the CNA. I've seen residents adamantly refuse to wear Ted hose day after day only to turn around and tell the nurse "my aide won't put them on me". They will refuse their snack and then whine to the next shift that they never get them. These kinds of residents will stop at

nothing to devise ways to get their aides in trouble. And nurses who take every complaint at face value just play into their hands.

I'm not saying this is what happened in the OP's scenario. Maybe that aide really was just lazy. Or maybe she was just finishing her break and was gonna take the resident to church at 1130. I'm just saying give your aides the benefit of the doubt.

[Been there,done that, ASN, RN]

onthemark said:

hurty25, thank you for all your comments. I've worked as an aide and know how hard and stressful it is. Definitely, I want aides to get their breaks. Also, they know that I'm there to help them with whatever comes up, and I let them know how much I appreciate them.

As I said above, I wouldn't have asked her to help if she'd been in the breakroom. However, I'd actually seen this aide in the breakroom earlier in the morning...and she was working away at the cell phone then, too...so I didn't think she was on break again in the dining room.

The refusal to transport the resident was clearly insubordinate . You received several excuses why she wasn't going to perform the task.(Saying the resident wasn't interested in the service is another thread completely).. until she came up with" I'm on break".

The cell phone use is another red flag. Personal electronic devices are NOT used in patient care areas! In this case, the resident saw an assistant, playing with her phone, and refusing to transport her.

Not exactly good customer service, eh?

I work in a large metropolitan facility.. there has been so much cell phone abuse , that a new policy was made.

If you are caught on your phone in a patient care area.. you are escorted out by security... and your job is gone.

[Been there,done that, ASN, RN]

farah1 said:

@onthemark- The way you explained the situation, I don't believe it happened that way. Sounds like you are not telling the whole truth.

@brandonlpn- Even when I was in the military, I did not allow my hierarchy to disrespect me in any way shape or form.

@hiddencatrn- Command? Yeah right. I'd like to see you command me and see how it blows up in your face.

Let me tell you something people.Nurses and Techs or CNA's are suppose to work as a team for the good of the patients. Don't think that becasue you are a nurse, you can talk to Techs/CNA's in any way you choose and no you are no better. Everybody need to respect each other and be professional. Remember, those Techs/CNA"s are your eyes and your ears, they may be able to detect certain things that you do not becasue they have direct patient care and spend much more time with the patients than you do. Where I work we respect each other, and if there is a problem we talk about it once and keep on moving. I am a tech now and will be graduating as an RN in the next couple of months. You all need to start being professional and get out of your stink.

You say WE need to start being professional? (don't know what getting out of my own stink has anything to do with that)

You begin your comment by calling the OP a liar... and continue on with hostile comments to subsequent posters.

"Let me tell you something people." Is not the way to begin an intelligent debate.

Review the OP's comments. She has certainly been respectful ,,, and has given much effort to identify and correct the situation in a professional manner.

[onthemark]

Thank you, Been there, done that, for your many helpful comments!

[MsKeycena/phlebtech]

There's no doubt that she was disrespectful. You have to treat every aide/person different as they all have their own characteristics and personalities. Being in the health field, not only do you have to learn your residents, you have to learn who you work along side too. I so disagree with Nascar Nurse. How can you side with the Nurse if you don't even get the aide side of the story. I think that is really unfair, don't you? I guess Nursing varies from state to state and ltc to ltc because where I'm from Nurse aides get paid fairly well and so do Nurses. But they would rather lose a dozen CNA's for one Nurse.

[JDZ344]

farah1 said:

Let me tell you something people. Nurses and Techs or CNA's are suppose to work as a team for the good of the patients. Don't think that becasue you are a nurse, you can talk to Techs/CNA's in any way you choose and no you are no better. Everybody need to respect each other and be professional. Remember, those Techs/CNA"s are your eyes and your ears, they may be able to detect certain things that you do not becasue they have direct patient care and spend much more time with the patients than you do. Where I work we respect each other, and if there is a problem we talk about it once and keep on moving. I am a tech now and will be graduating as an RN in the next couple of months. You all need to start being professional and get out of your stink.

Nurses and Techs should work as a team, but all teams have a leader. If you (speaking in general, not to the one poster in particular) don't like being delegated to, then being a CNA is probably not the best job for you. And nurses can request politely. Our nurses will ask us to do whatever task they want, they expect us if we are busy or on a break or whatever reason is stopping us to say "I can't do it right now because___". If we just plain don't want to do it for whatever reason then I fully expect to hear "I asked you to do x. I am now not asking you, I am telling you that you need to do it". If we then still don't do it, it gets taken up the chain and we will have to explain to our manager why it isn't done.

[Nascar nurse, ASN, RN]

MsKeycena/phlebtech said:

There's no doubt that she was disrespectful. You have to treat every aide/person different as they all have their own characteristics and personalities. Being in the health field, not only do you have to learn your residents, you have to learn who you work along side too. I so disagree with Nascar Nurse. How can you side with the Nurse if you don't even get the aide side of the story. I think that is really unfair, don't you? I guess Nursing varies from state to state and ltc to ltc because where I'm from Nurse aides get paid fairly well and so do Nurses. But they would rather lose a dozen CNA's for one Nurse.

With all due respect, how much experience do you have in management? I will readily admit, I have my favorite aides and my favorite nurses but when you are a supervisor you MUST treat everyone the same. If you don't you will quickly get eaten alive by someone. You probably have no idea how manipulative some employees can be if they think they can get away with something. Consistency is key.

Also, when faced with a "he said, she said" situation between a nurse and an aide, I stand by my position of siding with the nurse. They are the professional, they are the one with the license and they are the one in charge (in the absence of a supervisor in LTC). If I honestly can't believe what my nurses tell me then I either need to re-educate them on how to deal with aides or I need to let the nurse go. I expect them to behave in a professional manner.

[ktwlpn, LPN]

Nascar nurse said:

With all due respect, how much experience do you have in management? I will readily admit, I have my favorite aides and my favorite nurses but when you are a supervisor you MUST treat everyone the same. If you don't you will quickly get eaten alive by someone. You probably have no idea how manipulative some employees can be if they think they can get away with something. Consistency is key.

Also, when faced with a "he said, she said" situation between a nurse and an aide, I stand by my position of siding with the nurse. They are the professional, they are the one with the license and they are the one in charge (in the absence of a supervisor in LTC). If I honestly can't believe what my nurses tell me then I either need to re-educate them on how to deal with aides or I need to let the nurse go. I expect them to behave in a professional manner.

In your career I am sure you have dealt with problem cna's and nurses,the kind of people that I spoke of-the ones who thrive on conflict and enjoy keeping a unit in turmoil.I have known nurses that engaged in this behavior,it's not just cna's .Borderline personality disorders are everywhere. Unfortunately the nurses that stay at the bedside in LTC are usually not prepared for handling this type of thing. Our education skims right over this stuff. We have to look to our management for guidance.Just as this nurse may be able to mentor this cna and really mold them into a valuable team player her manager can do the same for her and help her learn the skills she needs.

[onthemark]

You hit the nail on the head, ktwlpn, when you said that LPNs were not prepared for handling this type of thing. I need to learn what is expected of me with regard to the rest of the staff. That's why I'm on this site and asking you all for your insights.

[onthemark]

KatieP86, would you please come work with me?! You sound so nice and reasonable, and I like your idea of imagining that patient as a relative.