Being treated like dirt from the aides...

Slobgob · Oct 23, 2006

"A bad aide with a bad attitude doesn't change."

I guess I just haven't run into any of those... but then again, I'm workin in the Aloha State.... =)

Sunflowerinsc, ADN, RN · Oct 24, 2006

I have been an aide for almost 10 years, and am about to finish my RN. Every time an RN gives me a "thank you" or a "I appreciate your help" goes a long way. It is nice to know that the nurses appreciate me running my butt off all night long. There is no excuse for disrespect on any level whether it is RN to aide, or aide to RN. We are all there for the same reason, for the patients.
One thing that I think I will carry with me from being an aide is that if an aide tells you that something is wrong with a pt, the RN needs to high-tail their behind into the room and check things out. The aide may not have the skills or critical thinking to know what is going on, but they know that something is going on. The aides are the ones who spend the majority of the time with the patient. They can recognize if there are any changes. I dont know how many times I have sensed that something was wrong, and indeed there was when the RN came in to room to assess.

I was waiting for someone to say this, if a aide tell you something is wrong with a pt or so and so "doesn't look right" GO RIGHT THEN to check. They are the ones who spends the most hands on. If they know you are a RN that will go and assess what they see,then they will let you know other things like a change in skin condition,some one is not eating,ect. Also if they know you will get someone ice,pass a tray and feed someone and do what you can when you can, you will be ahead in their assisstance. And we are all there to take care of the pt and it takes a team.

pagandeva2000, LPN · Oct 27, 2006

So frustrated after this 12 hour shift. It was a horrible day.. and I got so much attitude from the nursing aides I worked with. SOOOO much crap. I ask a simple question, and get the roll of the eyes or a face.. . or have one warp around what I said and repeat it back to all the others in a form completely different than what I actually asked. I know this is a process a lot of people go through... especially in the beginning. Even my supervisor asked me how I was doing with the aides on the floor.. because she sees some of their attitudes, too. For RNs... does anybody have advice on how to work better with nursing aides so that there's a mutual respect and understanding? I try to offer my help as much as I can... whenever I can. If any aides are reading, as well - I'd love to hear both sides. I've worked alongside many great aides that are incredible at what they do. It's so hard sometimes to appreciate your own work or theirs when there's that much tension... thanks for letting me vent.

I am an LPN and had been an aide for some time. It is backbreaking work...much more physical than what a nurse does in comparison in some cases. They perceive nurses as 'the enemy' because we come to them with more work (again, this is perception...does not mean they are correct). You will always meet rotten apples in the bunch, and if you are new, they may be trying you. I hope things get better for you.

Dempather, RN · Oct 27, 2006

Hi Guys - It's been a little over three weeks since I started this post (and ultimately, when I started on the unit). I've tried everyday to incorporate as much of the advice given to me in replies as possible... between saying, "thank you", acting when they tell me something's wrong, and pitching in when I have a free moment. All of this has been very useful to me, for I can feel even the toughest aide warming up (even breaking a smile!). So thank you for all your help - it's definitely helped me on the job.

:lol2: :monkeydance:

blueyesue · Oct 30, 2006

i was bothered when i read your original post and saw "even my supervisor asked me how i was doing with the aides on the floor.. because she sees some of their attitudes, too." that set off red flags for me! you can give all the respect you want to people and treat them as nicely as you want, but the bottom line is that there is no excuse for rolling of the eyes and childish behavior. that doesn't come from disrespect. that's just flat out misbehavior and acting out in a very unadult way. they make that choice and it has to do with their own control of their behavior. over the years i've had to learn that the management of subordinates, and that's what this involves, is a skill that you have to learn. unfortunately, nursing school just doesn't prepare you for this. or, for childish reactions. one of the books that was required reading in a class on group behavior that i had to take in my bsn completion program was by eric berne, m.d. (a psychiatrist) called games people play: the basic handbook of transactional analysis. in it he defines a lot of this kind of behavior and what people are trying to accomplish when they are doing these kinds of things. hint: making themselves feel superior to you in a lot of cases, or taking control of situations. now, for his purposes of therapeutic treatment, it's handled one way. for the purposes of an employment situation where we have to accomplish tasks in service to our patients, we have to handle it another way. i have two other books that i also used over the years as guides to help me: managing difficult people: a survival guide for handling any employee by marilyn pincus and working with difficult people by muriel solomon. don't get me wrong. you always assume that this behavior comes first from ignorance or your own inadvertent disrespect of someone else's feelings in a situation and correct that first. however, after reading the comment your supervisor made, i doubt that the problem lies exclusively with you. your supervisor sees the problem. it bothers me a bit that she didn't make any suggestions to you as to how to handle these clowns.
the way is through assertiveness and learning to speak in an assertive way. when you delegate you must make your instructions clear and leave no room for doubt. you must then follow up on the instructions you gave. in my quest to develop my leadership skills over the years i've taken a couple of classes in how to handle difficult people, basic communication skills and basic management skills. in the end, i always had to plan out what i was going to say to one of these clowns and then just get up the nerve to say it. your heart rate goes up, sweat beads pop out on your forehead, you get butterflies in your stomach, and i found myself having to concentrate on not yelling or screaming, but you do survive. it gets easier each time you do it, too. you only have to make an example out of one of them and the rest usually fall into line. if they want to act like children, then you have to treat them like a parent treats and disciplines a child. they get that. the trouble is, they often revert right back to their clown behavior with other people when they can get away with it or when your back is turned. my feeling on that? ok. just don't do it with me anymore or you know exactly what is going to happen. i'm not complicated to work with and the aides who worked with me knew exactly where i drew the lines they could and couldn't cross.
you have to blame part of this on the leadership of your unit. you are not the only person they do this to, i guarantee it. who ever is in charge has permitted this to go on without taking effective action to stop it. they could pull these clowns in and give them good talking to's or give instructions to you rns on how to handle them. sounds like they are doing neither. that's sad! this is one reason facilities lose their nursing staff. it's easier to just quit and walk away from a troublesome problem like this. however, you can also look at it as an opportunity to learn a really valuable skill. what's left is for you to take the reins and drive this buggy by yourself. you'll end up feeling a lot better and that you've accomplished something.
i'm giving you some links on delegation. when you give people tasks remember to tell them specifically what you want them to do, when it should be done, if you want feedback, when you expect them to report it back to you, and most importantly, follow up on it. just like you evaluate all your nursing interactions on a care plan, you do the same with all tasks you delegate out. when you give an instruction, practice the actual words you want to say in your mind. i used to write them down on the back of my "brains" so i wouldn't forget them. if they fail in any of your instructions, you have to get on them right away about it. i used to write those words down on my "brains" as well! "i asked you to tell me what that blood sugar was, now what was it?" and "when i tell you to do something i expect you to do as i asked." after a few times of this, they get the message that you mean business, or else you start telling them you are writing them up, and you do just that. never give a warning (that sounds better than a threat) that you don't fully intend to back up. and, don't be a wimp about it. these clowns deserve every bit of trouble they end up getting into. you will have done your part and given them plenty of chances to do the right things by giving them clear instructions on what to do and how to do it. doing this with difficult aides often resulted in them not wanting to work with me (can you image that?) or in them quitting. either way, my problem was solved. and, i never had to roll my eyes once! the first case of this that i encountered was an lvn who rolled her eyes at me, was very insolent when speaking to me, and did all kinds of things she knew i wasn't going to like. and, as a newbie rn and a milquetoast, i helplessly stood there and let her run this act on me. i would handle that situation much differently if that happened today.
i wish you well. just keep in mind that dealing with these clowns involves a skill that like any other nursing procedure involves practice in order to master.
http://www.leadershipdevelopmenttraininghowto.com/elements.htm - the elements of delegation
http://www.ehow.com/how_3816_delegate-responsibility.html - how to delegate responsibility
http://www.see.ed.ac.uk/~gerard/meng/me96/documents/aspects/delegate.html?http://oldeee.see.ed.ac.uk/~gerard/meng/me96/documents/aspects/delegate.html - delegation. everything you need to know about delegation presented concisely.
http://www.indiananurses.org/education/principles_for_delegation.pdf - principles for delegation. a 24-page document from the american nurses association. this is really a scholarly paper on the subject and should only be read when you are relaxed and able to think clearly.

definetely worth repeating. excellent advice and links. thanks.