How To Handle Nursing Staff With Negative Attitudes Who Won’t Do Their Jobs

Scary nurse (Photo credit: lookstein)
Scary nurse (Photo credit: lookstein)
Scary nurse (Photo credit: lookstein)
Scary nurse (Photo credit: lookstein)

Ever had a problem with a staff member like this?

I love the unit I work on, but I am having trouble with one particular CNA. She attacks the nurses who ask her to do her job. One day when I needed her to do vital signs, I found her eating in the break room, talking to someone from another unit and texting on her cell phone. I waited for a pause in her conversation before I talked. She told me she did not have that patient. (She did because I checked the assignment before I asked her.) She turned her back to me. I left the room and did the vital signs myself.

How do I handle this CNA’s behavior without having a verbal altercation with her? I don’t want to keep picking up her slack.

How to handle situations like this in a positive way:

I feel your pain. I have dealt with this issue many times in my career. This approach has worked for me every time:

Step 1:

Get your mind straight. You are the boss. You decide what work needs to be done and then delegate it to the person with the right skill set and time to do the job. If this person has questions about their assignment or your expectations, then you talk with them.

Step 2:

Adjust your attitude. At this point, you only know your side. Maybe you have done something to anger this CNA. Put yourself in her place. She is on the bottom of the hierarchy and may be uncomfortable bringing anything she is unhappy about to your attention. Instead, she is acting out her feelings with negative behavior. You will have to lead the way and show her how to deal with anger and conflict in an assertive way.

Step 3:

Take action by using your communication skills to talk with this CNA.

Follow this template:

Ask to speak with the CNA privately for about 10-15 min. The end of your shift often works well.

At the meeting with the CNA, follow this outline:

1. Thank her for meeting with you.

2. State the purpose and the goal for the meeting.

3. Give positive feedback about something the CNA does well. For instance, you always get here on time, you leave on time, you follow the dress code, you wear your name tag, you dress neat and clean, you get along with patients, etc.

4. Explain the problem as you see it with a neutral attitude. Be specific about what she is doing. Talk about the effect on you, your patients and the unit as a whole.

5. Get her side. You may have to ask several times.

6. Clarify what she is saying.

7. State the problem as you and she both see it.

8. Get her agreement to what the problem is.

9. Ask for her suggestions for solutions to the problem.

10. Come to an agreement about the solutions. If you cannot, then tell her what the consequences of her behavior will be.

11. Summarize what you have agreed the problem is and the solutions you both have come up with.

12. Be positive about the goal/outcome

13. Thank CNA again.

Step 4:

Make copies of your agreement for yourself and the CNA. Give the original to your manager.

Best case scenario is that you both will agree on the problems and solutions. Then you will both do what you agreed to. She will do her work with a positive attitude. She will talk with you when she has a problem. Your relationship will improve. Good teamwork will be restored. Worst case scenario is that she denies there is a problem or will not talk with you about how she sees the problem. Then you have to tell her what you expect and what the consequences will be for her if she does not meet these expectations.

With 38 years of nursing experience, Nurse Mentor Nancy, Nancy Banfield Johnson, MSN, RN, ANP, gives strategies to nurses to gain confidence, respect and avoid burn out. Be the Best Nurse You Can Be!

Go to http://nancybanfieldjohnson.com to get her new book, “Catching Critical Changes; Six Essential Steps to Effective Nursing Assessment”

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