Being direct with co-workers, aides, sitting at the desk, ect...advice please

[beeble]

I recently am so uneasy at my job. I like my position, and the work (I have worked hard for this), but am finding it harder to cope. If anyone could offer constructive criticism or advice, it would be appreciated.

On my shift, after initial assessments, there is a group who sits at the desk. Sometimes I wonder if they have patients. I am usually running around. Last night for example there were three of them trying to decide staffing along with the charge nurse (like who should be assigned with who for upcoming shift). It also usually includes a frustrated grad NA (who cant find a job), and it is hard to ask her for help as she usually argues with you over whether something needs to be done.

There is an unusually good NA, but a couple others are hard to find after their initial vitals. I had to get used to this as a standard.

One RN is back after a month absence after showing up to work drunk/after drinking (x2), and after attending a treatment program, while I admire her tenacity to hold on to her job and get back into the swing of things, she is somewhat innapropriate (interjecting observations when I am getting report on someone that have nothing to do with what we are talking about, asking me if I wanted her to do an assessment on one of my pts as I was busy-- shouldnt we do our own assessments? ect).

The new charge RN will NOT redirect aides, ect, avoids conflict.

During a code on my patient, the staff were all in there watching, and I alone noticed call llghts and had to go (after above aide refused to leave and help) because I was afraid a resident would fall.

When I said to one of the RNs who was watching the code that no one was on the floor and I was answering call lights while my patient was coding (code team was in there along with all staff) she said she felt I was "attacking her".

When I had to call anesthesia for IV stick (pt hard stick), grumpy CRNA told me to hot pack arm. I hadnt sat for 5 hours. I sat for a minute, got up to hotpack, the CRNA was there already said 'it isnt hotpacked? I am NOT doing it" I said I would make a note of that. He asked me to get my charge RN, this other charge rn came and they talked and my charge rn said I was supposed to hotpack that, I said I have been working hard for 5 hours straight, and I am disappointed that you caouldnt support me, he got an angry look on his face and said 'thats what we do. I was SO disappointed and decieded not to trust this charge RN again, also he has reported several RNs for things he could have talked to them about and one was suspended on account of it, but of course he sits at the desk and would never confront the cna that sits there (see above). Sorry its complicated.

Another person is nice, but she gets really hyper, and she started to, at the beginning of my shift, hand out forms to rooms I ordered to be tubed (I needed to fill them out and had to re-collect them), among other things, and creating MORE work for me, and I said I know I am busy but I am fine, this is creating more work for me...and as a result of being paranoid about the other staff and feeling like they are at the desk talking about me as they do to others, I said, 'you just said you dont like when people start doing your work, and now you are doing mine. I know, maybe I was abrasive there, but I was busy, and tired, feeling the effects of the above.

Anyway, this is a nutshell picture. I jsut dont feel that close to anyone, save for one person I call and vent to. Any adive? I am sick of taking mental health days off because it gets to me, and would like things to go better but I guess I am too direct sometimes. And people disappoint me.

[ukstudent]

i recently am so uneasy at my job. i like my position, and the work (i have worked hard for this), but am finding it harder to cope. if anyone could offer constructive criticism or advice, it would be appreciated.

on my shift, after initial assessments, there is a group who sits at the desk. sometimes i wonder if they have patients. i am usually running around. last night for example there were three of them trying to decide staffing along with the charge nurse (like who should be assigned with who for upcoming shift). it also usually includes a frustrated grad na (who cant find a job), and it is hard to ask her for help as she usually argues with you over whether something needs to be done.

i am sorry if this is wrong but you sound like a new grad. when i was new, i too noticed this, however, with expereince i too can sit for periods of time. it comes with learning how time manage. you also need to learn to stick up for what you want. repeat after me "i am the nurse. i am directing you to do.........., if you refuse i will write you up".

there is an unusually good na, but a couple others are hard to find after their initial vitals. i had to get used to this as a standard.

see above, you do not have to get used to other people not doing their job.

one rn is back after a month absence after showing up to work drunk/after drinking (x2), and after attending a treatment program, while i admire her tenacity to hold on to her job and get back into the swing of things, she is somewhat innapropriate (interjecting observations when i am getting report on someone that have nothing to do with what we are talking about, asking me if i wanted her to do an assessment on one of my pts as i was busy-- shouldnt we do our own assessments? ect).

look at it this way. you say no one will help you but when someone asks if the can help you, you refuse and take it as an insult. if you can't take offered help then they are going to let you drown.

the new charge rn will not redirect aides, ect, avoids conflict.

then go up the chain of comand.

during a code on my patient, the staff were all in there watching, and i alone noticed call llghts and had to go (after above aide refused to leave and help) because i was afraid a resident would fall.

i looked at you post about this. not a code, but respiratory distress leading to intubation. however, code or not, you need to stay with your patient.

when i said to one of the rns who was watching the code that no one was on the floor and i was answering call lights while my patient was coding (code team was in there along with all staff) she said she felt i was "attacking her".

part of your job as the nurse of the patient is to remind the code team that maybe all the people in the room are not needed and that some should leave. it is good to have an extra purson in the room to be used as a runner to get supplies not on hand. you stay with your patient.

when i had to call anesthesia for iv stick (pt hard stick), grumpy crna told me to hot pack arm. i hadnt sat for 5 hours. i sat for a minute, got up to hotpack, the crna was there already said 'it isnt hotpacked? i am not doing it" i said i would make a note of that. he asked me to get my charge rn, this other charge rn came and they talked and my charge rn said i was supposed to hotpack that, i said i have been working hard for 5 hours straight, and i am disappointed that you caouldnt support me, he got an angry look on his face and said 'thats what we do. i was so disappointed and decieded not to trust this charge rn again, also he has reported several rns for things he could have talked to them about and one was suspended on account of it, but of course he sits at the desk and would never confront the cna that sits there (see above). sorry its complicated.

don't call for someone to come and help you until you are ready for the help. you called someone to help you that needed you to do some thing in order for them to complete the job. you decided not to do it. think of it this way. one of your co-workers asks you to help with a bed bath. you turn up and they have nothing ready. no sheets, towels etc, no bathing supplies, and they want you to stand around while they go get everything. you would be upset and wonder why they called you over prior to actually needing you.

another person is nice, but she gets really hyper, and she started to, at the beginning of my shift, hand out forms to rooms i ordered to be tubed (i needed to fill them out and had to re-collect them), among other things, and creating more work for me, and i said i know i am busy but i am fine, this is creating more work for me...and as a result of being paranoid about the other staff and feeling like they are at the desk talking about me as they do to others, i said, 'you just said you dont like when people start doing your work, and now you are doing mine. i know, maybe i was abrasive there, but i was busy, and tired, feeling the effects of the above.

again, someone trying to help you that is thrown back into their face.

anyway, this is a nutshell picture. i jsut dont feel that close to anyone, save for one person i call and vent to. any adive? i am sick of taking mental health days off because it gets to me, and would like things to go better but i guess i am too direct sometimes. and people disappoint me.

i don't know that you are too direct. and this is probably not what you thought you would get as a response. you need to be able to ask for help and accept help when given. if you are calling off frequently then you are letting down your co-workers that have to then frequently cover your shifts.

[Katie5]

i don't know that you are too direct. and this is probably not what you thought you would get as a response. you need to be able to ask for help and accept help when given. if you are calling off frequently then you are letting down your co-workers that have to then frequently cover your shifts.

you were being very objective and i applaud that.

as to the initial assessment, if she does the assessments, then she signs her name to it. not necessarily, that you have to do the assessment, if someone sees you bogged down and offers help.

where you need to worry is if she does the initial assessment and expects you to sign off on it.

again, i saw no reason, why you should have left your patient. it was your patient. from what i read, i didn't consider it too direct.

here is direct- you need to sometimes take charge especially when it comes to your patient. you should try asking for help more often and not assume everyone else knows how busy you are.you should get another solution instead of constant calling in- perhaps it has a role to play in how your colleagues treat you. you should stop being so hasty in labelling and judging people per "she hyper", the same measure you use, is being served right back to you. and finally, you should try to be more objectionable when looking at situations. get a pad and pencil and write down some positives about the people you work it. and your positives. write the negatives, tear it, shred it, do whatever but get it in the bin. start again on a new page.

[fungez]

If it were me, I'd find another job. It sounds like you're in a toxic environment and the crazy is contagious. Good luck to you.

[JustEnuff2BDangerous, BSN, RN]

Perhaps the problem is you are not being direct enough.

If call lights are going off and you're drowning in work down the hall and people are sitting at the desk, you need to know how to ask for help. "Could you please help me by answering those call lights because I am down the hall doing _______?"

I assume by your post that you do team nursing, or some variant thereof, where you have an LPN and/or a CNA. In team nursing, each person's role SHOULD be clearly defined. For instance, at my hospital, on my floor, we do team nursing. Each set of pts has an RN, LPN, and a CNA. RNs do assessments, teaching, give IV meds that LPNs cannot, etc. LPNs are predominantly responsible for passing medications. CNAs are responsible for direct patient care (baths, linen changes, etc.). The RNs and the LPNs are expected to step in and help one another where needed, it is not solely the CNA's job to answer call lights and such. If my LPN were to refuse to pass meds, or my CNA were to refuse to do patient care, they are not following their job description and that is grounds for termination.

You cannot expect people to know what you expect of them unless you tell them. If you need someone to do something, you need to tell them in a direct, complete, specific manner. "I need you to _______ because _________."

[classicdame, MSN, EdD]

sounds like a bunch of creeps to me. No matter YOUR attitude there is no excuse for refusing to answer call lights, etc. I would find another job ASAP and give the Director an earful. Maybe even the risk manager for the facility. This bunch is an accident waiting to happen.

[steelcityrn, RN]

Find a new job. This place sounds terrible.

[carebearsRN]

can you actually write them up if they don't do what you say? I'm new so i'm not familiar with this whole delegation/teamwork thing

[sparketteinok]

OP, I think you and I work at the same place!! LOL....

Politics, the buddy system (manager and charge are best friends/drinking buddies) and cliques are predominant in my hospital. My charge nurse is rude, hateful, and most of the time a witch just because she can be. She gossips to no end, announces very personal things about people at the nursing station full of people (such as a person's sexual orientation), belittles and screams at whomever she pleases. Four nurses have quit because of her in the 8 months I have been on this floor. We are very short staffed now because of her, and she constantly complains about how we have no one to work ....ummm...duh??!!

I just try to keep my head down and take care of my patients. I try to stay out of the politics, don't listen to the gossip (stop someone that's about to tell me stuff and tell them I'm not listening to that), and just try to make sure my behind's covered.

The only thing I can say is it sounds like you're trying to be everything all at the same time. You can't. You were made human, not God. I would suggest to pick up a call light now and then, help someone out now and then, but mainly take care of YOUR patients. All these other factors won't matter if you get called before the BON because you were preventing a fall during your patient's code.

I feel for you. I wish you the best of luck.

P.S. to those who were chastising the OP for taking days off, she never said she was calling in. And while no one likes excessive calling in (or at all), I never have understood why nurses throw each other under the bus when a personal day is needed. Aren't people entitled to a life outside of work? Maybe those were scheduled mental health days. I have taken them (scheduled). And any nurse who says she hasn't is either lying or supernurse. It sounds like she needs to in the environment she's in. Maybe she does need a different attitude and/or coping strategies. But that doesn't excuse the behavior of those coworkers. I guess all of yall work in perfect environments where everyone gets along and helps each other. It would be nice if everyone remembered that everyone you see is fighting a bigger battle than what you see on the surface.

[DesertwindRN, ADN, RN]

My heart goes out to you. Toxic unit. Been there. Concentrate only on the patients under your care. This is hard but the only way to survive. At the end of the day ask yourself what kind of nurse you were for your patients. Stay way from the nuts you are working with. Also what kind of employee you were for your employer. You have to limit your scope of vision to only your patients not the unit. You are not working with a team. Do this while you look for another job.

Good luck to you and please keep us updated as you look for another job.

[Kooky Korky, BSN, RN]

sounds like a bunch of creeps to me. No matter YOUR attitude there is no excuse for refusing to answer call lights, etc. I would find another job ASAP and give the Director an earful. Maybe even the risk manager for the facility. This bunch is an accident waiting to happen.

Not being there, I can't evaluate. I tend to think you are working with a bad Charge nurse if he lets others sit around and try to "help" with the assignment for next shift, when this current shift is first starting and lights are going on and are not answered.

Don't go off on anyone, don't burn your bridges. Don't call off. Just work up your courage and tell the aides, "Grab the lights, guys". No please, no help me stuff. They're not helping you, they're doing their freaking jobs.

Try to become friends with the Charge Nurse. Don't suggest to him, don't criticize him. You see that doesn't work. If you can't get him on your side, you should probably go to the next one up the chain of command, maybe change shifts or wards or employers if you can't get anywhere.

I agree you should have done the hotpack prior to calling Anesthesia. And if the boss has allowed the drinker/driver to return to work, that's not your worry - unless she messes you up somehow or you KNOW she is harming patients.

TELL people to go cover the floor if the Charge Nurse won't tell them. Tell them, ok thanks, everybody, it's under control, now go take care of the rest of the patients. Go. Scatter them with your waving arms or something. Treat them like the children they are, nicely but firmly, and close the door behind them.

I know it's hard to find the courage but you must do this in order to survive.

[bostonbakednurse]

I read this in a Readers Digest magazine:

Ten percent of the staff do ninety percent of the work, while ninety percent of the staff do only ten percent of the work.

It seems to be the "norm" in healthcare. Why doesn't management step up to the plate? They are probably afraid for various reasons. Some being the Unions, retaliation, etc.

There is better customer service at McDonald's. And that is really sad.