Narcissist Nurse Aides in Long-Term Care: Part 2

Like many nurse aides, I have endured toxic workplace environments created by a particular aide profile for many years. In fact, as terrible as COVID was, there was something good about it; those aides with the profile I am talking about stayed home. Why? Well, why wouldn’t they? The government was literally paying nurse aides to stay home for more money than they had ever made in their entire lives. So, narcissist nurse aides still had the title and subsequent pseudo-respect, more money than ever, and could pursue self-indulgence full time in order to become better narcissists, while getting paid for it. However, what was left on LTC floors was the best of the best, and real nurse aides saved American LTC facilities from apocalyptic collapse, and this assertion is not even close to being an exaggeration. But also know this; quality of care was also much higher with fewer aides.

Then, as COVID ended, these aides started trickling back into healthcare, and more of a terror than ever. They came back deprived of their entitlement to work on their narcissism full time. Therefore, post COVID narcissist nurse aides have more victimhood added to their narcissism, and are therefore of a higher octane.

With everything considered thus far including Part 1, what are the specific elements of the narcissist nurse aides?

1. If you watch them closely, they do not display or express compassion towards residents.
2. They are very big on “This is my assignment, and that is your assignment.” They are NOT team players, but very high on Your job/My job.  
3. They are bullies and attempt to control the work environment through intimidation. Primarily, the goal is making other aides feel unqualified leading to being judged by the narcissist aides. Their objective is to control others through fear and intimidation. They also project intimidation through their demeanor and nonverbal communication.
4. They will attempt to intimidate teachers in the classroom by presenting themselves as somehow more intelligent or knowledgeable. This is usually attempted by posing challenges framed as questions concerning a particular subject.
5. They do not speak life into other aides and encourage them unless they are under their control.
6. They are snapshot aides. They display certain techniques at strategic times that make them appear professional.
7. Unfortunately, they will almost always be in the good graces of unit managers and DONs because they pick up shifts. They are professionals at manipulating weak leadership, which is epidemic in LTC.
8. However, regardless of the hours they spend at the facility, the hours do not deliver high quality of care and are not helpful to nurses or other aides.
9. They are often missing and hard to find.
10. They sit down a lot and are on their phones constantly.
11.  They, for the most part, do not see the nurse aide discipline as having a cooperative association with nurses. Again, they are very dichotomized from contributing to the wellbeing of others and are very big on Your job/My job.   
12. They call off for trivial reasons and will even truthfully state the reason. For example, “I didn’t realize my favorite TV show was on during that shift time.” Yes, to a degree, they are out of touch with reality and how the world works.
13. Very low sense of duty.
14. No respect for authority.
15. They display very few aspects of professionalism.
16. They are rude, and only display politeness while mocking others or for purposes of manipulation.
17. And lastly, they can be dangerous.

This brings us to the real-life consummate example of a narcissist in a public service position. Be sure to project this example onto a healthcare position and consider the like outcomes.

Meet Crenshanda Williams:

 An unconscious woman, a robbery in progress, cars racing on the interstate: All of these incidents led people to call Houston’s 911 system — but not for long. These were among thousands of calls that were cut short by an operator who Harris County prosecutors said simply hung up on the callers.

That former operator is Crenshanda Williams, who has been sentenced to 10 days in jail and 18 months of probation on two counts of interfering with an emergency telephone call.

“Ain’t nobody got time for this. For real,” Williams was recorded saying after ending a call in which a security guard had tried to report two cars driving at high speeds on Interstate 45 South, according to a 2016 report from local KPRC TV.

Williams worked at the Houston Emergency Center for about a year and a half before she was fired in 2016. Her supervisors had realized Williams was responsible for cutting off emergency calls after just a few seconds, often forcing callers to try again — and to wonder why they couldn’t get help.

At the time, Williams reportedly told police that she simply didn’t want to talk to anyone. Her attorney recently said, “She was going through a hard time in her life,” according to the Houston Chronicle.

Prosecutors said the abnormally short 911 calls happened “thousands” of times on Williams’ watch. At court, prosecutor Lauren Reeder of the Harris County District Attorney’s Office said the public needs to be able to rely on the 911 system, the Chronicle reported. When Williams was arrested in October 2016, KPRC-TV recounted several of the calls that she was accused of cutting short. One of the callers was Buster Pendley, who said Williams hung up on him after his wife collapsed — the victim of a blood clot moving to her lungs.

“She was gasping and I could feel her heart beating out of her chest, but I couldn’t get a pulse,” Pendley told the TV station. When he called 911, he said, he held the phone in one hand and kept trying to perform CPR with the other.

“The 911 operator answered the phone, and she said, ‘This is Crenshanda, may I help you?’ ‘Wife’s passed out. I need an ambulance,’ ” Pendley recalled. “She said OK, and she hangs up on me.”

He called back, and an ambulance eventually came. His wife, Sharon Stephens, survived — but she also told KPRC that she “was furious” that he didn’t tell her what had happened, ” ’cause I would have, I mean I would have gotten from my hospital bed and gone to 911 and find out who did that to me.”

That call took place in March 2016. Days later, Hua Li, an engineer, called 911 to report an armed robbery at a convenience store. He had just run out of the store and was calling from the parking lot. On his way out, he heard gunshots.

“They just said, ‘This is 911. How can I help you?’ I was trying to finish my sentence, and we got disconnected,” Li later told KPRC.

“Li called a second time and got a different operator,” the station reported. “By the time police arrived, however, the store manager had been shot and killed.”

When Harris County District Attorney Kim Ogg’s office filed charges against Williams, it accused her of a misdemeanor: interfering with an emergency telephone call. A jury in Harris County found her guilty on Wednesday.

Williams’ defense attorney, Franklin Bynum, says they plan to appeal. According to the Chronicle, Bynum said that the Houston Emergency Center’s problems run deeper than the prosecution’s case suggests and that its phone system doesn’t handle calls properly.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

In addition, we have this report from internet influencer David J. Harris Jr.:

When police came to arrest her, she acted entitled: “I’m working.” Then, confronted with the call logs, she admitted, “I didn’t feel like working.”

This is a living hallmark example of what we are discussing here, and this real-life example can be easily transposed onto healthcare. Narcissists have no place in healthcare; they endanger lives and create toxic workplace environments. Also, her actions put additional burdens on her fellow 911 operators, which is exactly what narcissists do in LTC as well.

With all of this being said, can a narcissist aide be reformed? Pointing to the only example I have to offer, I will say, “yes.”

During COVID, I encountered an aide on the floor who approached me and stated, “Hey, remember me? You got me fired at….” Indeed, I reported her for abusing a resident, and it did lead to her dismissal. During that time, she also displayed all the elements being discussed here. However, on that COVID unit, she was not only there, instead of sitting at home and drawing a paycheck, but delivered exceptional care. So, the best I can ascertain at this time follows: YES, they can be reformed, IF you hold them accountable.

Lastly, I will close with a reminder about the true nurse aide identity:

1. Compassionate
2. Professional
3. Focused on helping nurses.
4. Team Players
5. Focus on what others bring to the table, not their faults.
6. Dependable
7. Practice therapeutic communication.
8. Speak life into others.
9. Trustworthy
10. Hard Workers