Disrespectful Nurse aids

[holdensjane]

I am a new grad RN that started in October. Overall people on the floor have been supportive. But I'm having trouble with some of the assistants. I work on an oncology floor so weights and I/O are important. alot of the times they will chart numbers that are way off and when I ask them to do it again they will give me attitude. I always say please and thank you. Well just three of the assistants there are like that. They're all regulars on the floor and have been there many years and are many years older than I am. I'm only 22 and look like i'm 16. Today one of my patients have been having high BP for several days so I gave a bp med and at nine and asked if the PCA would check it again in an hour. Nine is around the time she gets the vs in the chart and reports to me a higher than normal bp. anyway, she says "well I just took it right now...." with attitude. then in the afternoon comes around and comes up to me and tells my patient's bp is 135/87, then she says she got confused between patients and its actually 178/90, and then after another second she says "no wait, rm 09 its 157/75". I say okay not thinking anything and casually just asked her to record it in the chart. She was standing right there next to it and chatting with someone next to her. The next thing I notice she's going into another room to take another bp and says to me "oh no, i got the wrong patient again, 09's bp is 135/87". This time I was thinking "okay which is it" but i didn't say that I just say "okay can you just record that in the chart please" and she says "YES I WILL LATER, I am taking vs right now, I cannot do that". Ok so i figure she's busy so i say "well could you just read me off the vs and I'll record them just so I have something to work with", then she got irritated and said okay and left to continue her vs. and nothing happen. So i got frustrated and took the dang bp myself. The reason I wanted her to write it down was because I knew she was confused so I figure if she writes it down, I will be getting the right BP since she'll have to decide which BP it was and it will be official for me. Oh yeah and earlier in the morning she was emptying out stool and asked me to come see it (i was in the room) she had already flushed it at the time but there was still some red tinted fluid left. I asked her if there was urine mixed it and she said that there was not because the urine was dark but normal. Well I didn't see the urine so I was trying to assess the situation her dark but normal can mean something different that me right? so I asked her again "so there was no red in the urine at all?" and she said "OF COURSE NOT" to me in front of the patient. Like I had just asked her a stupid question, I just wanted to know if maybe the urine spilled over to the stool. anyway, she proceded to say "maybe you want to get an order from the dr. to check blood because let me tell her the smell of the poop and the color I think is blood, it does not smell normal". she said that to me and the patient. Of course I'm just starting out but I was also a PCA before I starting working as a nurse there and sometimes would float to that unit. The patient said she had tomato soup last night. Then the PCA just said "well I'm just telling you". I personally didn't think it was that big of a deal because tomatoe soup sounds reasonable an answer but I figure i'm a new grad and was willing to hear what the pca had to say, but I just felt really disrespected. when I was a pca I NEVER acted that way. I went and told my preceptor the situation (just with the patient, not the pca) and she said that it was probably the tomatoe soup too. I feel like i shouldn't bring this stuff up as a new grad cause I don't want to get black listed. Somtimes I'd rather just suck it up and do things myself. I don't get this from many of the other PCAjust the older ones who have been on that floor for many years. a big part of me is saying just to suck it up, what would you do if you were in my situation? btw, the three assistants that do this are also big gossipers. i keep thinking maybe its something I'm doing, but I always say please and thank you I just feel like they get annoyed when I ask them to do something. when i was a pca i always her how pcas are lazy but i never understood because I always tried to do what the nurses told me. and now more and more i'll hear from nurses that pca are unreliable and will find an excuse to keep from doing something.

[mom4josh]

I too have been yelled at, argued with, and disrespected in front of patients. I know how frustrating it can be.

I don't know if it is a resentment thing, a power struggle (especially when you are younger than they are), or if it is just a sign of the times (good help is hard to find these days).

Don't anyone :trout: me for this next comment, but there have even been times when I felt that they took their frustrations out on me because they had not succeeded in nursing school (for whatever reason). That is not something we have control over, so they need to just do their jobs while they are there.

Anyway, my advice is to just keep doing your job, keep being nice and respectful to them (even if they aren't in return), and keep documentation of problems you have with them. If it gets too bad, go to your charge nurse or NM. And, if you can, get on the good side of at least one of them so maybe she can influence the others.

Best of luck!

[holdensjane]

mom4josh said:

I too have been yelled at, argued with, and disrespected in front of patients. I know how frustrating it can be.

I don't know if it is a resentment thing, a power struggle (especially when you are younger than they are), or if it is just a sign of the times (good help is hard to find these days).

Don't anyone :trout: me for this next comment, but there have even been times when I felt that they took their frustrations out on me because they had not succeeded in nursing school (for whatever reason). That is not something we have control over, so they need to just do their jobs while they are there.

Anyway, my advice is to just keep doing your job, keep being nice and respectful to them (even if they aren't in return), and keep documentation of problems you have with them. If it gets too bad, go to your charge nurse or NM. And, if you can, get on the good side of at least one of them so maybe she can influence the others.

Best of luck!

I'm still on orientation which is why I don't want to cause any waves, you have to sign your name to the documentation forms. I don't want to cause trouble I just want to get work done. I've worked with 2 of the three disrespectful aides when I was an aide, the one in my post actually oriented me my first day as an aide a year and half ago. The other one I didn't mention used to try belittle me because I would only float onto that floor once in a while so she would always try and make me feel bad about not doing things a certain way, it was the wrong way, just a way different from hers.

[CaLLaCoDe, BSN, RN]

I too as a new nurse had to contend with orientation (which to me was way harder than nursing school!) and the resentment, the not following of orders, chatting up the handsome phlebotimist when she should be helping me with daily weights, getting my four o'clock vitals in at 0600, and all the like. I definitely have sympathy for you! Remember this: things will get better. Agreed, they are jealous of you and your success. However, you are of a different social economic order and things will change over time. I try to see the aid as part of my team and help them out when I have a chance. Lately with the requirement that we clock out at 0730 that's difficult to do with all the charting required of us!

PS. I too was an aid for 3 years prior to becoming an RN. So I definitely can relate to your tale of woe.

[FireStarterRN, BSN, RN]

It sounds like it's jealousy and resentment. It doesn't help that you look 16. I've encountered this problem in the past. It's very frustrating. Sometimes they have social clout on a floor and can cause a person grief. It's dicey and there is no one answer. Be assertive and busnesslike with them and if they do or say something inappropriate in front of a patient, call them on it, in private. They should not get away with challanging you in front of patients, or anyone else for that matter.

[smk1, LPN]

Sounds like she is trying to assess as well. You need to actually see the urine color and the poo in order to assess for a problem. She can't just flush it and then tell you it was bloody or whatever and ESCPECIALLY not in front of the patient. The BP confusion is serious business too! What if you are giving medications with parameters? 135 systolic to 178 systolic is a big leap. She needs to be more organized. I wouldn't be comfortable with her just deciding which one was which if she was that confused either. She shouldn't just randomly assign BP values to different rooms because she can't stay organized. They should be retaken if there is that level of confusion.

[babbz]

Aaarrrggggggggg!! My eyes!! Use enter button please!

Just a little sillyness on my part ignore, was just trying to read your post

I have worked in several hospitals and I do not like observing the cna's, tech's or any other so called professional medical staff member behaving in such a manner; using bad attitude, etc. It's childish and silly coming from older folks (or really anyone in a professional setting actually).

Like mom4josh said, it may be part of a power struggle or it may be envy. Those envying you could really make your life miserable especially if they felt they had the power to do so.

Remember being taunted in school for doing the right thing? The "Bad" students were just envious of the "Good" students and so in the spirit of misery-loves-company, they would try to dissuade others from doing the right thing by taunting them and making them feel like they were the ones doing the wrong thing.

Don't let them get to you, continue doing the right thing:up:, do your job and hang in there!

Hold your head up high, be proud of all you achievements and just know that somewhere, you are being applauded ?

[nyapa, RN]

Did you say that you worked with these staff previously as an aide? That they orientated you?

It does sound like sour grapes! Suddenly you have gone to the next level, and they don't like it!

Question...Were they like this to you before you became a new grad?

[Scrubby]

Kaeky-I think you really need to speak with this person about it and even take it further. It's a concern that she doesn't even chart her vitals properly, is she just relying on her memory? Not good enough. As the RN you are supervising this person which means that your accountable. IMHO you really need to talk to her privately and tell her that your concerned about the way about the way she is charting.

If your concerned about causing problems just remember that YOU are the RN. You are supervising the aids therefore you are accountable. If there is an incident because someones BP wasn't charted properly then you may be held responsible. They are getting away with this because your letting them. My advice here is to stick up for yourself and tell them to take that BP again NOW. If they carry on about it report them to your supervisor and document everything. Their incompetence is putting the patients at risk. If they are jealous that's their problem not yours.

[mom4josh]

kaeky said:

I'm still on orientation which is why I don't want to cause any waves, you have to sign your name to the documentation forms. I don't want to cause trouble I just want to get work done. I've worked with 2 of the three disrespectful aides when I was an aide, the one in my post actually oriented me my first day as an aide a year and half ago. The other one I didn't mention used to try belittle me because I would only float onto that floor once in a while so she would always try and make me feel bad about not doing things a certain way, it was the wrong way, just a way different from hers.

Actually, in my original post, I was thinking about your own personal documentation... kinda like a work diary. It can help you in the future if there ever is a need for dates, times, incidents, etc.

Over the last few years, I have done this at my job. When our floor got a new NM recently and tried to do progressive disciplinary action against one such UA, she didn't have much to go on... until I pulled out pages of memos to previous NM and notes I had written about this UA. She was gone within a couple of months.

[Jo Dirt]

I had an aide once call me to get up from my charting to come stand at the shower room door to keep an eye on her patient. I thought she had something important to do. She went and sat in my seat and called her friend to see if she wanted to go out that night.

It didn't happen again.

[FireStarterRN, BSN, RN]

motorcycle mama said:

I had an aide once call me to get up from my charting to come stand at the shower room door to keep an eye on her patient. I thought she had something important to do. She went and sat in my seat and called her friend to see if she wanted to go out that night.

It didn't happen again.

That is just toooo brazen. Thanks for the laugh!