Does Inadequacy equal Incompetancy?

Nurses General Nursing

Published

Hiyas guys and gals... heres my schtick...

ok--

I work overnights at a local nursing home. I am an LPN in charge of 1 40 bed floor in the facility. I immediately supervise 2 CNA's and, above me, we have an RN Supervisor.

I am Mandated to make walking rounds Q hourly, which I do without complant. My Nurses aides make their hourly rounds (aside from changes and ADL's) basically in between my rounds. Its a nice system-- we usually pick up problems pretty quickly.(sometimes a resident who's swaddled up to their neck in multiple blankets as a matter of course may *rarely pass away through the night and, we'll discover that on change rounds... but always before the morning)...

My aides are predominantly immegrants from other countries, most have accents, but are easily understandible both in person, and over the phone. I am 'locally grown' :) and speak the English language Very Fluently. I do not use foul language, and encourage other people to do the same when on the nursing unit.

My Nursing supervisor, on the other hand, is an older woman... a very older woman (I do not mean to sound demeaning, as, yes, I am considerably younger than her, but, shes pushing mid seventies.) with a VERY thick foreign accent (I dont know if my co-workers/boss read this, and saying of which country she's from has a good chance of getting me in trouble). She has a habit of 'dissapearing' through the night, into a locked area of the nursing home for several hours in the middle of the shift and is very difficult to obtain on occasion (not all the time, but on occasion.)

While having difficulties on the unit recently (had to send out 2 patients, 1 at 2:30am, 1 at 6:30am for unrelated reasons) I was able to obtain the supervisor with only a modicum of difficulty (I had to send one of my CNA's downstairs to find her, if the residents were less acute, I probably would have done it myself)

and, told her, I wanted to send the first resident out. (the resident was very unresponsive with difficulty breathing and slight facial droop. No DNR.)

Instead of calling EMS for me, and filling out the forms while I was caring for the resident, she basically waited for me to finish my cares and assessment of the resident (O2 administration, fingerstick, repositioning, neuro check, et al) and, then had me fill out all the paperwork and call EMS. (due to a type of insurance, we have to get clearance before certain res. can go to hospital...)

I can understand having me call EMS... I am more easily understood, but, all the info I needed to tell them is on the forms I had to fill out (an extended transfer sheet, if you will) it is considerable more easy and concise to have 1 person do the sheet, 1 person take care of the patient.

then, she asked me to notify the family. which I happen to know is NOT one of my responcibilities... its the RN duty. (its written out that way in the P&P manual) Which I told her, and she very unhappily agreed, and notified the family.

I replayed this event at around 6am--another res had a seizure, without seizure history. Same story, she stood around, barely looked at the resident, and, did not help a lick.

On top of this.... she recently slipped on some ice, and broke her non-dominant arm. I do not mind assisting her with some of her work responcibilities (IE- putting things away in the cabinet) and I do not mind if she does not help with the physical side of problems, but, paperwork necessary before a transfer (that MUST be done before the res. can leave)... now, that she can do, but did not. I can understand having someone in a supervisorary role who is not at 100% working... there are we 'underlings' (I'm so resisting the use of the word 'peons' here) who can, and will do the grunt work.... but c'mon now..... gimmie a break... Goddess forbid... what would happen if both of them crunked at the same time! I think I'd be up an unsanitary tributary without a means of propulsion.

I feel that if you cant do the work, dont come in and make it 9 times as hard on the others (ie: being sick and insisting that you cant work or... in my least fave case-- being sick as a dog and leaving early... you're not benefitting me by coming in and doing a haphazard job that I will have to re-do. Best bet, stay at home, Get well, and do what you need upon returning.)

Now, I feel that if you Can do some work, but not all the work, C'mon in and do what you can, I will try my hardest to make the ends meet....

And... Finally... If you can do the work, and are feeling very apathetic towards the job.... STAY HOME. Apathy is not welcome on my unit. Ever.

*sigh....

also... something else, and, I suppose this continues the above rant...

If you are on my nursing unit, you are an equal. IE... You are responcible for EVERYTHING contained within your State licencure AND your job description, the state being the higher power. Nurses can do bedpans, diaper changes, and toileting. We can even answer call bells...

On a number of occasions, while I was doing very little at the nurses station, while both CNA's were doing changes, a call bell went off... I went to go and answer it promptly (a bell left on unnecessarily for too long to me is the most irritating thing on the planet.) If both CNA's are in other rooms... do you A) Check out the bell, B) Totally ignore it, or C) Scream down the hall for the CNA's to check it out... Supervisor has told me to do 'B' or 'C' until its been answered, can you say, I dont think so.... (actually, I said to her 'There's nothing in my job description that prevents me from answering bells. Now, excuse me while I go check on it')

I get so irritated at anyone in a supervisory position (LPN's over CNA's, RN's over LPN's) who gets into a holier than thou position about doing some menial chore. Heck-- most menial chores SAVE work in the long run-- if you answer the bell promptly, you can toilet the resident, who's now not going to Climb the rail and fall, and not going to break their hip, and, not cost the facility tons buku bucks, and, not take a 3 person transfer after their bedbound w/ a broken hip... SEE.. *sigh...

I believe I'm done venting...

What do you all think about Inadequacy equaling Incompetancy...

Thanks for the input.

--Barbara

Tweety, BSN, RN

34,248 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Sounds like you've got a few issues there. Hope it gets better.

Remember, we will get as much crap as we will take. How much are we willing to help out those who can't perform their jobs adequately and even safely, when our jobs are hard enough? I think a little give and take is in order, but some people take more than they give. It's a tough spot to be in.

I for one believe everyone should pitch in and help. I get irritated with the RN who looks from room to room spending ten minutes looking for an aide to clean a patient up. I used to have a nurse manager that would help make beds when times were tough. That was a long time ago, they don't make them like her anymore. My manager much to my dismay has a huge ego since her promotion. Not that manager's have to make beds, I'm not saying that.

Noney

564 Posts

Specializes in Critical Care.

I've been in the same situation that you're in now Barbara. It is soooo irratating. You sound like are a great nnurse keep up the great work. I always wonder about people like your supervisor... do they realize how others feel about them?.... do they care? .... or they oblivious?

Noney

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

Barbara - You are doing a great job in an unenviable position. If possible - can you change jobs? Have a face-to-face with this woman in private? Go over her head to administration? Just some stray thoughts>)

mattsmom81

4,516 Posts

You are looking at the supervisor and judging her by the standard you are setting for her. Perhaps she has her own standard of what her job description entails and what she is responsible for.

I was a house supervisor in a hospital once. Before I did the job myself I did not fully appreciate the role nor understand how it differed from mine as a staff/charge nurse. I really did not have time to pitch in much the way the staff nurses would have liked...I had other responsibilities.

Not saying what is going on at your facility is the same as my experience, just presenting another POV.

Perhaps you could sit down with her sometime in a nonthreatening way and talk with her....open up the lines of communication a bit. Once we get to know one another it is harder to dump on one another, IME.

You sound like a very caring and capable nurse. It is hard to work with an immediate supervisor one finds unsupportive, I know. Good luck to you and hope things work out the way you want them to.:cool:

CashewLPN, LPN

348 Posts

hiya...

I agree-- management/supervisors shouldnt have to do the grunt work... but, they should do the work assigned to them in the P+P manual... IE-- filling out transfer paperwork, and calling EMS...

*sigh...

I've tried to have the 1-1 heart to heart with her... basically, the gist of the conversations has been (and, I am not joking) 'You be good girl and do work, I be old lady and watch.' no ifs, ands or buts... basically, she does very little, broken bits or not... and, if you suggest otherwise, once she called me a 'bad girl' (need I mention MASSIVE language barrier here!) and, I kinda went off and had some quiet but stern words about how I wanted to be treated... it hasnt happened since... now, she relies on me in every emergancy... basically, I start IV's faster with a greater percentage of first attempt successes, and, God forbid someone stops breathing, I can properly ambu someone(She cannot do that even AFTER being shown by me several times... its not that hard of a task, but, must be done correctly...), and, the staff will listen to me- as they have told me that they can understand my speech better.... ah well.. I'm rambling

now, comparitively, to my old job, (inpatient rehab in a big local hospital) this is a dream job... scary, eh? So, changing jobs is out of the question at the moment, I just got my 1 year in.

staffing is ok(not great), the acuity not too bad, and, my boss is great with giving me the time I need for school...

ah well....

Mattsmom... I thoroughly and totally get you... thing is, this woman literally locks herself into the supply closet with a recliner chair, pillow and blanket... gee... I wonder what she's doing... (PS... she snores. loud.)((PPs... excuse the sarcasm....)

perhaps, if she devoted less time to her well paid nap, I'd be less irritated...

:)

ah well...

I'm around!

--Barbara

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