"Compartmentalized" support staff

[Tait]

So this thread was originally going to be a rant thread, but after a Starbuck's Espresso Truffle coffee, some delicious Tex-Mex and my husbands undivided ear and attention I think I have this broken down into something more productive.

Dealing with "compartmentalized" staff

As a nurse we are trained to look at the big picture. Health, wellness, prevention, stresses, cause/effect etc etc. We strive to take into account all of the many factors effecting our patients, and hope to show up ahead of whatever ailment is nipping at their heels.

We understand the value of stepping outside of the box (I hate that saying but it works) and trying to restructure so we can see every angle of our job. Well at least that I what I like to strive for.

My problem is this. How do we compensate for those who are there to "get the job done"? I am not speaking of nurses, even though I am sure this can apply there as well. I am speaking of techs/secretaries.

Now don't stop reading yet, this isn't another "my tech sucks/my secretary ignores me" thread, I promise. Though it's roots do nestle in these battles.

What my "oh so patient" husband pointed out to me this evening was a case of "compartmentalism". Basically some aspects of health care have people that have a very set idea of what their job is, how to do it, and they don't often stray outside of it.

One such example is the following: Midnight. Patient A changes heart rhythm from 100% A-Paced, SR underlying, 60's to Afib RVR unpaced. MD requests a faxed stat EKG and a set of new vitals since the change. Previous BP 102/71. Tech is requested to take a new set of vitals for the MD on the phone and responds with "I did the midnight vitals." RN responds "I understand, however the MD is requesting a new set due to her HR change, could you please get them for me." Tech refuses stating again that she did her midnight vitals. RN gets them in frustration while trying to write up new orders for labs ets. Pt is 89/54.

Now I have had this situation many times before. I ask for something outside the realm of the normal routine, and I get balked at.

My question is again, how do you compensate/communicate/reiterate to someone who is "compartmentalized" in thier job?

Tait

[chicookie, BSN, RN]

I see this a lot. Along with a secretary that has the same answer for every freaking question "I don't know". Thats her answer.

The other day, the secretary was on that same rampage, I finally got fed up and said I thought you were the brain of this nursing station, and if that is the case we are in some deep doo-doo. She looked at me, surprised and laughed and then answered my question. I hate when she does that but now she answers my questions at least. sometimes.

On my floor I think we have a huge issue with our techs and secretaries. Well at least I do, again they won't listen to me because I am too young/ too new to know what I am doing. -_-

And I agree with you I HATE IT! We are a team and sure don't act like one. Even though our manager is all teamwork! teamwork! We are the most divided people ever and new people like myself are forced to follow the every man for themselves rule and then the cycle continues.

Its more of a culture really. The old tech teaches the new tech the same thing and its gets passed on and on, I think.

I think you did wonderfully and need to talk with whoever is over the tech.

[LilyBlue]

I think that tech should be fired. She is obviously not interested in the well-being of the patient.

I have worked with horrible techs like this. Interestingly enough, when I ignore them and do everything myself, they seem to become more interested in helping me/the patient. I guess it stings to realize that I think their presence there as a worker is essentially worthless.

[lolalolacherrycola]

Trust me, I rarely take work home with me, but I was so mad yesterday that I left an appointment with my chiropractor early because all I could see was red.

I guess it didn't help thatin addition to the tech issue, I waited 2.5 hours for a PA to call me back on said patient (as I checked her BP Q15 of my own accord, called Rapid Response for advice) of whom I found out was waiting on the fax of the EKG from me! Why was she waiting so long? Because after she called back with the fax number, the secretary wrote it on a random piece of paper, NEVER TOLD ME, and then went to lunch. It wasn't until the PA finally called me back looking for the EKG that I realized what had happened. I am glad I charted my butt off on this one, and I kept the patient safe through that time.

By compartementalized I reiterate, sometimes I don't think people realize in healthcare that if a step in the teamwork is missed, people can DIE.

Tait

Again you are so right and seems like we (the nurses) end up getting the short end of the stick...

We couldn't keep our job if our performance was as bad....sad...

[Ruby Vee, BSN]

compartmentalized. with the intending meaning of "someone who can't see outside of their designated role". insubordination is a given in health care. i am trying to look past assumed insub, and look for a deeper core of just someone who can't see the bigger picture.

thanks for the responses btw. just so you all know i have followed the app. chain of command on this specific instance.

tait

not only does this tech fail to see the big picture -- even after it's explained to her -- but she just doesn't care. if she did care, she would have done the vitals after you explained to her the reason for the extra work. while you might be able to effect a change in behavior based on increasing her knowledge, there's nothing you can do about simple lack of caring.