Your in Charge of the staff and things go Bad!

Trauma Columnist · Mar 9, 2005

Easy solution - they've been told before to go through the boss on-call - they didn't, they get written up. Good luck.

UM Review RN, ASN, RN · Mar 9, 2005

What's your chain of command there?

I'm a little confused.

happthearts · Mar 9, 2005

What's your chain of command there?
I'm a little confused.

The chain of command is The manger is in charge of the CNA's.Then I am Director of services and I am on call every other week-end with the CNA's.But this week I was on call for this week while manger was out of town. which happens quite a bit latley .When the Manger is gone I do her job as well. All the CNA's know this.

We are a Non medical Home health company.

My job intails That I do the assessments, set up care ,train CNA's on each job with the Client ,Market for the company . Handle the phones fill in where needed.

Manger handles the secudule of the CNA's takes the phones does the book work.

PBAJS · Mar 9, 2005

Is there a policy/procedure?

A CNA was told to call you, not to call the boss.

The CNA did call the boss. A verbal reminder.

The CNA calls the boss a second time.

The CNA gets written up.

The CNA calls a third time.

The CNA gets written up along with a suspension of x amount of days.

The CNA calls a fourth time.

The CNA is no longer employed.

Just my two cents ... :twocents:

DDRN4me · Mar 9, 2005

there should be a written protocol in place. if they choose not to follow the protocol, they should have 1 a verbal warning (sounds like this was done) 2 a written warning and then # 3, suspension with termination if it happens again. This kind of manipualtion happens frequently in my company, and it is so important to present a united front against it!

happthearts · Mar 10, 2005

Thanks For all Your help The manger and I discussed this and we will be writeing up the CNA'S This was the second time and we also will be diccussing this in the care meeting this month. To refresh all the CNA"S memories . After talking to you all it was very clear we need a united front. I feel like this is something your kids would pull run to dad if you don't get your way with Mom.I just don't play that game .

I Really appreate your help

Thanks Happthearts

renerian, BSN, RN · Mar 10, 2005

I agree with the solution. Follow P&P..

renerian

Home Health Columnist / Guide · Mar 10, 2005

I agree with the solution. Follow P&P..

And if there is no P+P, then create one and inservice them to death.

When I started with previous agency, HHA ran the show when I first arrived, changing their schedule at a whim, calling their "favorite" oncall person too. New RN HHA Manager came and we worked as united front and after 9 months of hard work, management was running the place again.

Helped to develop raport and authority that everytime I did a home visit with the aide present we would discuss a "significant HHA clinical issue" and give out a 30 min to 1 hour continuing education form -- duplicate form one to aide and 1 to office. Boy did the 12 hour yearly CEU credits add up quickly!

I had 2 "topics of the month" that I kept in by brain---sometimes had a one page topic outline handout to give aide (along with family member if present), place in CEU book as "proof" of inservice. Info beyond the fire, safety, infection control typical inservice, like "signs and syptoms of CHF to report to RN", "Diabetes: understanding a diabetic diet", "Nail and hair care in the home", "Prevention of skin breakdown in client with limited mobility" and my favorate as rarely documented/taught but so important: "Emergency evacuation of the bedbound client" --looks good to JCAHO and state surveyor. It was easy for office to always pull my clients charts to show HHA inservice documentation too as included one line statement under "Teaching done": inserviced Mary P HHA and caregiver in ______________.

Good Luck in the position!

fredrix · Jan 5, 2006

i totaly agree with every 1 else. what ever happened 2 cnas respecting charge nurses? i guess im old school. yes im a cna and would never think of going over head of my charge nurse ,unless it was life & death! write them up!!!! good luck with your decision.

happthearts · Jan 6, 2006

Just to update you We did write the aides up and did do ton's of inservices about this.

One thing we added right at the interview time was. We inform the CNA you deal with who's on call. If I the director deems it necessary to call the Manger I the director will do that, but the aide is not to do that period ,when she the manger is not on call.

Now if I can just have an inservices on not what to say to clients and patients in the home .I sometimes wonder if people were ever taught social skills at home. (I know I did my son when he was at home .) What ever happen to having manners. I really feel weird having to teach adults this.

Thanks for all the help Happy

TopazStone · Jan 8, 2006

Another method to block the manipulation is to use a single cell phone/ pager for the manager on-call. This gets rotated to the person on-call and is the only number provided for CNA (heck-- and nurse) contact. No exceptions, substitutions or refunds :)