Then you should have some empathy for the CNAs. Tell me, what kind of response do you get when you say "Please" and "Thank You"? Is it mostly positive and does it produce good results? Or do things not get done? You know, as a nurse, it's much harder to be humble (and grateful) for the hard work that your CNAs do every day, but if you want to build a strong team (and you are working on a team --- you can't do it all alone), then you need to build good relationships with the people on your team. "Please" and "Thank You" and "I really appreciate what a good job you did with [fill in the blank]" go a long way towards strengthening those relationships. When you were a CNA, did any of the nurses you worked for take the time to praise you? And, if they did, how did that make you feel? And, if they screamed at you, how did that make you feel?

Remember, in LTC, you are taking care of vulnerable people, and, as a nurse, you need to model good behavior. If you are loving and kind to your residents, and you expect that behavior from your CNAs, shouldn't you model it in all of your actions? And shouldn't you be more concerned that the CNAs you work with are good to their residents? That's where you need to focus your attention.

I suspect that you are in for a difficult time. Your DON wants you to be tough, and "write people up." So they already know they have a problem. Why haven't they addressed it before you came on board? If they are unhappy with the performance of the CNAs, they need to take some ownership of the problem and work to correct it. If "sleeping on the job" is not acceptable to them (and that's not a universal policy, since some facilities allow their night staff to take a nap during their breaks), and they know it's going on, why haven't they fixed it?

There are alot of leadership styles. It sounds like you are working for people who are "authoritarian", but that's not your natural style. Authoritarian leadership is only successful in a few circumstances (the military, for example, or the Emergency Room), and almost always fails in Long Term Care. If you continue to work for them, then you will have to learn to toughen up and become more assertive and confrontational. Since this isn't your style, you are always going to be uncomfortable with this facility. Bear in mind, they probably have had trouble keeping nurses because their leadership style is out of touch with the needs of their facility.

So you have a choice. Take the money, and be uncomfortable with the people you work with and for, or try to find a situation that fits your leadership style.

Sounds to me as if you need to find another job that's better suited for you. People see kindness or niceness as weakness and they will try to run over you "most" of the time.
It's time to either toughen up and become a leader or move on to a more laxed job.
Whichever you choose I hope it works out very well for you.

Regards,
Chris

hello. i am a Stna, ohio version of the CNA.
i also work in a nursing home. There is one nurse that calls to my attention every light. in fact, she came in while i was attending to do my "clean and dry" routine for a patient. and she said in an elevated tone. you are spending too much time with this patient, get out and answer these call lights.
i do nothing except attend to the needs of the patients. i even forget to pee, while on the clock most of the time.
that is one extreme.
the other extreme is a nurse that just never pays any attention to what i am doing or what is needed in the facility. sometimes she cant be found so i can relay a need of a patient.
then i have a nurse that is attentive at her job. she is polite to everyone she meets. she always has a smile on her face. when i have something i feel i want to tell her, she stops what she is doing and listens. if she is going to leave the floor, she will let me know where she can be found. she asks for the weights, BP's, etc. at the beginning of the shift so that gives me the chance to try and get it done around everything else.
and i have found out also, there are other CNA's that will work with you and ones that just do not want to do one thing that they dont have to do.
some are lazy, backstabbing, gossipers, the whole gamit.
others are there to work to get the task done. taking care of patients.
my attitude is:
be with the patients, do whatever it is that they need. avoid all the :stuff: that goes on outside of taking care of patients.
if there is lax time, check to see if everything is stocked, emptied, and by golly, sneek away to pee:)
dont worry about what everyone else is doing. watch what you are doing and keep what you are doing great. set a standard. it only takes a spark to get a fire going. maybe what you do will be a new FAD that everyone else wants to follow??
Be nice, but be clear on what you expect. and if your expectations arent followed< help them to know/understand this is what will happen when they are not followed.
hope this helps.
as always, appreciate what you nurses do, dayin and dayout.
Thank you

Thanks everyone for your responses. I enjoyed reading what you guys think on this situation as well and I've been thinking.............I'm going to continue being myself, I'm the type of nurse who is as thourough as I can be in giving directions and always willing to give a helping hand to the CNA's even when I really don't have the time and usually in the past my CNA's have helped me in unexpected ways in my time of need. I think that I'm going allow the CNA's to nap when there is nothing going on and let them in on what management expects of me. I will put it all out there for them to know that if they get caught sleeping on the job by the DON or anyone else that they should be well informed ahead of time not to point the finger to me and say that I let them, I will tell them that they sleep at their own risk and that I will not say anything if they sleep to the DON but if they get caught then their on their own. As for any attitude that I recieve from any CNA's when I do give orders, I will keep my patience and go about my work and if they continue not to obey orders then I will pull them on the side and confront them about the situation and if they want to fight about it after that then I'll tell them that we need to speak to the DON together. I'm the type of person who likes to bake treats for my CNA's and talk to them and not at them, so I probably won't have so many difficulties but if I do I'll just do the best I can and hopefully that will be good enough for administration.

I am a CNA!
Hi, I totally understand what you are going through because I used to be a CNA myself.
In the nursing home where I used to work, people formed in group. They usually grouped together and do something against the nurse. Some CNAs are unwilling to listen to the nurses because they think they know what to do since they've been working in the same facility for so many years. (At least, that's what happened to my nursing home). Also, many CNAs don't like others telling them what to do. The CNAs want to be treated as equal.

In my opinion, the best way to make the CNA to listen to you is to set a good example and be their role model. My mum is a RN and she used to work in a nursing home too. My mum's really nice and friendly. She didn't order the CNA to do things but she assisted the CNA to do things together. For example, when the CNA's busy, my mum would assist the CNA and make the bed. By doing so, the CNA will feel that they are treated equally and it is important to work as a team with the nurse.

Good luck and don't be too nice !

Well, I'm not so sure how to handle some of the CNA's at this job. Some of them just do what they are ordered to do and give you a look, but my last experience was my CNA dissapearing. Yep! No where to be found! It was 12am and I had a few pain meds to give and I was on orientation but my preceptor decided to just give me half her pt load as my orientation. Wasn't that nice? I didn't even know the pt's I was treating except from the info I recieved from report. Anyhow, I was standing at my cart and I was tryting to figure out some very important stuff here right? Well here come one of my pt's wheeling down the hall and parking at my cart asking for ice cold water. I gave her my water from the cart, and of course she asked, "Can't we do better than this?" I know my water wasn't all that cold but I thought maybe I could get by with it, well, here I am asking where the CNA is to whatever staff was around and no one has a answer for me right? I'm fuming because pain meds administration is priority here and I have a CNA who seemed to have a bit of an attitude with me when she started her shift even though I don't know her and she's gone! Well, I had to explain to my pt that I had to pass pain meds and that it was going to be a few minutes and if she saw a CNA herself to ask them for the water, well, of course no CNA was around and appx 20 min later I have a chance to get to the ice machine on the 2nd flr to fill my pt's pitcher with ice cold H2O. It made me crazy though, so when I finally saw my CNA I asked her what her name was and I replied that I didn't want to say "hey you" if I needed her. No I never asked her where the hell she was, I chickened out because she's really tough looking. She looks like a man, talks like a man and shaved her head like a man, she looks like she did some time in the joint and she didn't look like she was about to take any orders from me. By the way, I'm very soft looking and speaking and I smile alot. I'm a little shy but more reserved. Later that am the administrator came in and I had to ask her for my name badge since I'm a new employee. She asked me how it was going and I told her fine and then she went on to make a point of telling me that she runs a very tight 11-7 shift and then she proceeded to ask me if any of the CNA's have given me any trouble? I said no. She went on to say how there is absolutely no reason why a nurse has to ask any CNA twice to do a order and how we can and should write them up after asking one time if they don't follow through and how if I don't want to approach the CNA's myself to go straight to her and she would tell them off because they respect her and are afraid of her. I was really shocked how this was the second time I was told to be really tough with my staff. First my DON at my interview is telling me how to just send CNA's home if they so much as blow a fart the wrong way and now the administrator telling me pretty much the same. I can't help but still feel afraid of the CNA's though. I'm not trying to be discrimatory, but they are black and from the poor parts of the inner city and I'm a white (now) suburban gal who has been blessed in my lifetime. In other words, we are very different in our backgrounds. I do believe however we are the same when it comes to pt care, it's just my authority over them is not something they are taking kindly too. Help.

Tried to tell you that you were in for a rough time. This doesn't sound like the kind of place I would like to hang around in.

The administrator and DON are telling you that this is a rough place. If you want to survive here, you are going to have to be tough, set some clear expectations with your staff, and STICK TO IT. Write people up and CLEAN HOUSE. Help your administrator and DON get rid of the bad apples so that fresh blood can be brought in. Be prepared to teach new staff (that means CNAs) how you expect things to be done.

You have to decide if this is the right environment for you.

i am a CMA at a nursing home. I am new here. I have worked noc shift for 5 years at this home. i hate to say this but some of the aides do need the harsh treatment to get them to do anything. it is like they have no respect for anyone. On the whole most of the people i work with do have respect and do the best they can but it is the few that make it bad for the rest of us. another thing that drives me crazy is the ones that do respect and do what is expected are asked to pick up the slack of the ones who don't. i am in this line of work because i love helping people and am happy to be needed. i get more from these people than i give to them. when they tell me they hate to bother me i reply when it becomes a bother to me then i am in the wrong line of work and better look for a different job. sharon

CNA nightmare
Hi lpnlimbo,
Your story sounds similar to where I used to work before. Well, I used to work as a CNA in the nursing home. (I'm now a RN nursing student yay ) My mum's friend is a LPN, lets called her Kathy. Kathy has so many conflicts with the CNA. Well, I can't blame her since it is true that some CNA are lack of disciplines.

For example, whenever Kathy asked the CNA to do something, they won't do it unless she told them again. Also, the CNA were supposed to follow the assignment and take the patients to have shower according to the schedule. But some CNA never follow the assignment, they just take the patients to have shower whenever they want. As a result, Kathy wrote them up and send some of the CNAs back home. There's one time, Kathy reported to the administrator about how one particular CNA never follow her assignment. Subsequently, the CNA was fired. But one week later, Kathy found out that someone scratched her car !!!

Anyway, my message to lpnlimbo is that, don't get discouraged. Be strong, assertive and yet friendly. If anyone is causing a problem, talk to her personally or report to the administrator. My mum's a RN and she used in the same nursing home too. I think she did a great job in making the CNA to listen to her. Instead of yelling at the CNA and ordering them to do the jobs; she actually helped the CNA to perform the ADLs. The CNA felt that even the nurse had to perform ADLs, we might as well just do it.

Being a CNA in the past, one of the biggest problem that I had was inequality. I felt that some nurses didn't respect the CNA and they constantly yelled and gave us orders. When I was a CNA, I wished that nurses would be more understanding about the burden that we had to cope and the stressed that we had to encountered.

I guess the most effective way to make the CNA to listen to you is to be empathetic. Be able to understand their stress and ask them to cooperate with you in order to work together as a team ^^

I hope this information is useful.
Good night.
Christina.

this is for lpinlimbo, its time to get un soft looking, if u cant handle ur cna and get them to do thier work, maybe its time to talk to ur don about it, dont let the looks or size of people get to u, under all that hard look might be a person softer then u say u are. always remember to look after ur butt first, if shes not doing her cna job, it reflects bad on you. i was a cna once as well, now im a rn , i do sympathize with cnas, but i also make them do thier job as patients are our first priority, gl in ur new field and remember, be strong

CNA's
Been there, done that...sorry but most (not all) the CNA's back home are not worth paying anything and you can expect no help getting them to do anything. That's another reason I travel.
When you allow anything bad to go one without correction it becomes policy. It then takes stern efforts to fix. this may be the case where you are. The DON is trying to turn things around. It's better for everyone when you work together and you know everyone has the patients interests in mind but it just is not always the case. As I travel I find most cna's know their stuff and are good to work with. I don't think blowing up Good Sam. Hospital in Dayton Ohio would make the na's go to work.

I always treated my crew like I wanted to be treated. I worked hard and gained their respect. I tried to not only guide but be a cheerleader. I was polite. I always requested their help instead of demanding it. We worked as a team.

Of course there will always be a few that do not want to be a team player. Without any bravado I would dismiss them and go on. I would never discuss any details with the rest of the staff. This seemed to earn respect. I respected each person that was on my team as a valuable member. I think people will rise to the occasion if the authority figure uses good common sense.

unruly CNA'S
The only way to get their respect is to expect it from them and give them the respect they deserve. When all my CNA'S are busy doing AM care,I answer bells and I make sure they know it. Any time I can ,I help them do care,feed residents,answer bells,and just plain let them know I have their backs. BUT... I also let them know what I expect and what happens when they drop the ball and don't do their assignments. It takes a while for them to realize they do have an ally and after they do things go smoothly and the other CNA'S usually take care of the unruly ones.

I want to be a hospice nurse --need help in finding hospices
8) Well, I've decided that I'm never happy working in nursing homes. First of all my varicose veins are just screaming for me to stop it! Second of all, I'm sick and tired of the unruly CNA's (even though I used to be one myself, not unruly though) and the smart mouthed nurses who think they have something to prove about their intellect. I'm really sick of smug RN's once they notice I'm a LPN, even though I'm going for my RN, not that, that's any of their buisness, start treating me like an idiot. I'm really done running the floor though. I love patient care and medicine. But I want to go into hospice nursing, now that I'm used to doing nights if I have to, I don't hold too much of a challenge there and my family won't care if I'm only gone a few nights a week and I can do what I feel I'm really called to do as a nurse...........hold the hands and bring comfort of the dying. So I might sound hokie to some of you out there, but I think other hospice nurses would understand. It's like this.........I knew early on that I was good at bringing comfort emotionally to weak, sick, elderly people. I wasn't sure what good that would do me, but then I became a nurse for other reasons and in the back of my mind I knew there was a place for me somewhere. Let me tell you, I paid my floor dues, I'm done running like chicken with it's head cut off, I'm done with snobby doctors and other nurses who aren't realistic and on a power high. I'm so done with not feeling I can accomplish all my tasks the best I can simply because I don't have enough time to do so. Don't you think 40-60 pts is a lot in a dementia unit of skilled nursing? I do. In fact.....I know so. I wouldn't be comfortable with one my loved ones in a place that only provided one nurse for the care that my loved one needed when that same nurse is stretched out with 39-59 other people to care for. In fact, I'd feel like she was down right dangerous because she must be exhausted and stressed to the max. Maybe it's just me, but I just feel burned out of the floor and I've only been a nurse for almost 4 yrs. I'm excited at the prospect of hospice nursing though. I know I have a lot to offer in the right conditions to someone who needs special care. I talked to a major hospice H.R. personnel and faxed my resume a couple nights ago, tommarrow is Monday and I'm crossing my fingers she'll call me back for an interview. Can anyone tell me of hospice's that hire LPN's in Illinois? Perferrably in the Western Suburbs. I have only found:
1. Rainbow Hospice
2. Heartland Hospice (Manor Care)
3. Advocate (they only hire RN's)
Any suggestions would be great, it's hard waiting on a wire for only one hospice to call me back.

I have been a CNA for almost 5 years, and I will be an LVN in about 6 months, so I'm kinda in the middle here. When I first came to work as a CNA at the age of 16, there were some nurses who treated me very poorly, and it made my job very difficult. Right now there is a pretty good crew. The way I see it is you get what you give. I do respect nurses, and admire them. I don't like being treated like a slave, no one does. I have had to stand up for myself a few times. I've had nurses who have told me to "shut up" infront of patients, family, and visitors. I have had nurses tell me that I won't amount to anything. I have had a nurse spit in my food when I was out of the lounge, and then brag about it. Those would be a few people that I have no respect for . . . Ha . . Its funny how those people are no longer employed there!
I go to work, and I do my job. I have seen other aides not do their job, and yeah, they do need to be set strait. If some one is intentionally not doing their job, pull them aside and tell them that you'll expect better from them from now on. If some one isn't getting their job done because they're new at it, teach them how to do it right in your natural kind demeanor.
I was always willing to learn when I wasn't doing things right in the beginning, and there is no reason to be snotty about it.

Glad I'm retired.

Hi, I'm a C.N.A currently majoring in Psychology. I'm reading this post and the comments, and its quite obvious to me why you, like so very many others, are struggling to gain the respect of your Nursing Assistants. Let me explain. Nurses develoup a sense of importance within their jobs, it's an important job, they should feel important. However, this comes across with an ere of arrogance to a lot of nursing assistants. Many of us have worked in this position even longer than you may have been a nurse. We know what is expected of us, what is needed, and we strive to do well. Us good ones. Belittling us by reminding us of a light we can see and hear for ourselves is degrading. Some of us are rather intelligent when you take the time to notice. Let your assistants get to know you. If you respect them, take the the to get to know them and their work ethic, you may end up quite surprised. Don't talk down to them, AIDS can feel the condensending tones and attitudes. We know which ones respect is, and if you " put us in our place, "it's not going to go well. Approach your girls, tell them how you are feeling, and if you win over one you are likely to build a good relationship with several. Some of what you are getting was placed by other nurses, AIDS are highly disrespected. If you can see the light, don't walk past it, answer it. It's courtesy. Answer lights and alarms, toilet some easy ones, and you just made s friend with that aid for life.

write them up and report them to your supervisor. Of it you are the supervisor, speak with them and tell them that you have been as nice as you can and if they can not be respectful to clock out and go home until they can comply with your request. Y'all are there for care of the patients and everyone needs to work as a team and team member are not snotty.