I'm just a PCT, but our facility has been going through this for quite some time, and the FA might be starting to fix it.
But the FA needs to figure out who the low performers are. Our FA basically started by monitoring the floor and started counting how many patients did each team mate put on and take off, especially during turnover. Then she would look at how many vitals each team mate was signing off on the computer.
We have an LPN who would slow down to a crawl during turnover, and would put on no more than two patients during turn over, and take off maybe three. Most of us really didn't notice it, because we were all busy with our patients, and all I saw was the patients who were ready to get on.
When you have someone like that, it doesn't take much for everyone to be pointing fingers at each other: Without attentive leadership, the best defense against an allegation is a counter-allegation, and it's hard to complain because you are going to rely on these people for possibly years on end.
Kay714: Sounds to me that your techs are being insubordinate. They shouldn't be refusing to do anything within their scope of practice. Also...no one should be getting an hour-long break. I keep hearing about people taking extended breaks at my clinic but I don't time anyone's breaks. But if you're taking an extra 30 minutes for break, well you might run out of time to stock and do other chores.
I don't know what assignments that nurses have at your clinic, but the only time I ask for help from RN's is during turnover. Turnover can either flow smoothly, or turn into madness. I'm generally busy non-stop during turnover, and what I need is someone to help with alarms, vitals, and patients who are cramping. We are a 12 chair clinic, and there have been plenty of days where I easily put on five or six patients, and that's not counting the patients who I just took off, cleaned the machines, and set up for the next shift. I don't take short-cuts either, so I wait for the three minute Heparin dwell time, etc.
But I always saw it as a jump in, assist the patient, and jump out of the pod kind of thing. I don't expect the charge nurse to take my patients and put them on for me or anything like that. But no body should be spending a lot of time at the desk during turnover. This is like the most vulnerable part of the day, for us and the patients. Patients are most likely to crash at the end of their treatments, and that is typically while I'm busy taking off or putting other patients on. This is when patients are most likley to cramp. Also, RN's are supposed to be doing assessments in the first half hour of treatment, right?