I have a problem with my management skills - page 2

I am such an avoider of confrontation. I would rather stick a needle in my eye than write someone up, but I have a problem with delegating. I hate to do it, but when I must, I do. I was charge of... Read More

  1. by   Tweety
    Alwaysthere: you said: " dont understand attitude of people who wont help wether it be an aide or a nurse...When i walk into my facility my attitude is that ive commited myself to helping pts ...it doesnt matter if their "mine" or not....and i make it a point to have worked with all thirty pts on my unit at least once so i will know how to give them care... " in response to what I said about the CNA who asked me to chart his vital signs.

    There is more to the story than what I posted. But I'm not going to get overly defensive. When an aide insinuates I'm doing nothing and tries to get me to do their work for them, when I'm really busy too, I put my foot down. This aide had 8 hours to chart his vital signs. Anyway, as I said I'm not getting overly defensive.

    I like what you said. I loathe RNs who will look up and down a hallway for an aide to do something they can do themselves.

    It's good to see it from all sides. But I refuse to be put in charge, and not be in charge if you know what I mean.
  2. by   MRed94
    My thoughts exactly. Too many of the aides that I have worked with are getting away with WAY too much, simply because they are as short staffed as we are.

    BUT. I am one of the about 2 nurses in this facility who will actually HELP them, and they all know it. IF I possibly can, I do. And I would NEVER look for an aide to do something I am perfectly capable of doing.

    BUT. I will NOT tolerate attitude from them, because I don't give them any attitude, either. They know that, and respect that. Occasionally I have to be firm with them, but usually not. They work the same kind of hours I do, and much harder than I do most of the time.

    We all watch out for each other, which is a rare situation. And they are all good at helping each other and me. And if there is a new one, and she/he gets out of line, they usually take care of it, cause they know what the team needs and what it doesn't need. Attitude is definitely one of the things we don't need.

    Sounds to me like this CNA has been there a while and has done this for a while, too. So I think firmer measures are warranted at this point. NO, she should not give the aide attitude, but the aide needs to know that she isn't going to get far with that attitude.
  3. by   Teshiee
    Hell, if people did their jobs and things ran smoothly we wouldn't need managers, ceo, and presidents. It is tough especially when you have no support from your staff. Call a staff meeting and stress what your expectations are and see what they expect from you. It is a start!!!!!
  4. by   alwaysthere
    Originally posted by 3rdShiftGuy
    Alwaysthere: you said: " dont understand attitude of people who wont help wether it be an aide or a nurse...When i walk into my facility my attitude is that ive commited myself to helping pts ...it doesnt matter if their "mine" or not....and i make it a point to have worked with all thirty pts on my unit at least once so i will know how to give them care... " in response to what I said about the CNA who asked me to chart his vital signs.

    There is more to the story than what I posted. But I'm not going to get overly defensive. When an aide insinuates I'm doing nothing and tries to get me to do their work for them, when I'm really busy too, I put my foot down. This aide had 8 hours to chart his vital signs. Anyway, as I said I'm not getting overly defensive.

    I like what you said. I loathe RNs who will look up and down a hallway for an aide to do something they can do themselves.

    It's good to see it from all sides. But I refuse to be put in charge, and not be in charge if you know what I mean.

    im sorry i did not make my self clear in the original post...what I said was in support of you veiwpoint...how much time could that have taken him....it wasnt an unreasaonable request..and unlike most NM's you requested it of him. (at least the first time.)

    What ive seen in my own facility and through these posts...is a lack of proffessionalism and individual understanding of standards of care on the part of the aides.
  5. by   BBFRN
    Originally posted by alwaysthere


    What ive seen in my own facility and through these posts...is a lack of proffessionalism and individual understanding of standards of care on the part of the aides.
    I think this is true for some facilities, depending on what the culture of the facility is. I know I experienced a lot of these places when I was an Agency Aide...I think I am blessed to work with an amazing group of Aides at my facility, granted most of them are working their way through nursing school, but nonetheless, they are caring, knowledgeable, and very hard-working. I try to be grateful for the ones like this, because we all know that an aide can make or break our day.
  6. by   BadBird
    This is a gross but true story. Many years ago when I worked on a cardiac step down unit there was a nurses aide who was always taking food off of the patients trays and eating it. I was new there and did not know this at the time. I gave my lunch tray to my patient who immediately vomited onto the plate. I took the tray out to the hall and set it on a cart with the cover on it. ( I was planning on disposing of the vomit before putting back in the tray cart) Now, mind you there was not a lot of vomit, just a little, but definately there. Ok, here is the gross part, are you ready? The aide takes the cover off of the tray and says "Oh, I love baby carrots "and ate a mouthful, I was stammering saying NO NO NO, another nurse said to me she always does that. No one knew that my patient got sick on the tray yet and when I finally found words and yelled out that my patient had vomited in
    the food !!!! That aide turned about 20 shades of green, but she never again ate off of any patients tray. Feel free to share this with the aide that eats off of trays, she may not do it again.

    Sorry if I grossed anyone out but it really did happen and I will never forget the look on her face, OMG
  7. by   michelle95
    I've been having a problem with this, too. Just to let you know a little about the girl I am having problems with...this is what happened this past weekend.

    Saturday night a patient came up to the nurse's station almost crying saying she had to go to the bathroom. Now, mind you, earlier she had been given an enema, sorbitol, and MOM. I told this CNA to do it and she immediately started talking about how this patient is prejudice (the CNA is black, the patient is white). I told her that not everyone is that way. She fussed a little and went to take the patient. Come to find out, the aide had been in the room earlier and while she was taking the patient's room mate to the bathroom, the patient had asked her to go when she was finished with the other patient. This aide told her that she was going to give the other lady a bath first, then, she would take her to the BR. Actually, she waited until the lady had rolled herself up to the NS and asked for someone to do it.

    Then, Sunday night I was in a patient's room..and, another nurse that knew about the situation Sat night called me into the hall. In that same patient's room was that CNA fussing at her. I couldn't hear all of what was said, but, I did hear the aide tell her to shut up. I was appalled. I didn't immediately go into the room, but, I went to the NS. I was too mad. The aide came up there and was telling the other aides what had happened. When she got to the 'shut up' part, I turned around and told her that she IS NOT supposed to be telling residents to shut up. She told me that if I had a problem, I could shut the hell up, too. Now, this was all I could take. I had been with this aide 16 hours on sat and over 8 hours on sund....I had to do her work and mine and could never find her. I had to leave the NS ASAP before I scratched her eyes out! I was furious. I told the charge nurse that evening, but, I don't think she did anything about it....so, I called my boss on Monday. I told her that I would NOT work with this aide again and that something needs to be done....I can't imagine how else she talks to others.

    To top it off she said that the patient was mad because she took the other lady first (the other patient was black)....NO, the patient said it was fine...she just didn't want to wait while the aide gave the other one a bath. Can you blame her after all she had taken?

    And, this CNA is lazy...she won't do her work...she tells the nurses to do it 'themselves' when they ask her to do something....and, get this, she's in nursing school. Eek!

    I've done decided if I have to be a ***** to make sure that my patients are taken care of...well, that's just what I gotta do.
  8. by   BBFRN
    Wow, what a horror story! You should write her up! Who wants someone as verbally abusive as that taking care of patients? Did you have the authority to tell her to clock out and go home?
  9. by   plumrn
    After a recent unit meeting, (CNA's meetings are separate from nurses), we nurses were told the CNA's complained because nurses weren't helping pass trays or toileting pts. enough.

    We have usually the same amt of aides as we do nurses on the floor.
    Really made us angry. During assessments, rounding through the day, etc. we frequently assist pts to the BR, on the bedpan, or whatever. We just don't run out into the hall or to the station and announce it. "Hey everybody!" "I just helped Mr Smith to the bathroom!" We also pass trays, maybe not as many as the aides do, but we do our share.

    We have our own responsibilities that it is impossible for them to realize, plus anything else that needs doing. The aides always leave on time. The nurses are at least 30mins to an hour late finishing up routinely. In a large part because we have so much on our plate to finish before we can leave.

    They don't understand that when I am seemlingly sitting at the station doing nothing important, I am really perusing the chart of the pt with the dangerously low b/p, trying to get their history, recent labs, meds list, family phone number, etc., so that I will have as much information as I can before the Dr calls me back. I also have in the back of my mind that my new admit from surgery will be rolling up in just a moment, needing v/s's, assessment, IV placed on pump, etc., etc., etc, ... and one of my other pts is waiting on a pain shot.

    So, no, I may not put every pt that calls on a bedpan, but I do when I don't have other more serious things going on. Trying to prioritize care, and keeping aides from thinking I'm not a team player can be a real juggle sometimes and bottom line, I am the one that will be held liable for anything that goes wrong.

    Well, that is my little vent. I feel better, now.
  10. by   sphinx
    Hey Carrie.....
    oh yeah, I'm the same way.....hate confronatation, delegation. Too hard for me, unfortunately. As you may recall, I have complained considerably about how my current job is stressing me out, but their are several good things about being a CHN, and one of these is, I don't have to deal with stuff like that anymore. I am independent. As a nurse, I in charge of managing the patients care (meaning, I am primary, then PT, OT, ST......)I do have to do aide supervisions at least every other week, but have never had a problem......if a patient has a problem with a lazy aide, or one who is rude, I find out about it long beforehand, and can go in "armed" with info, and talk with her/him, etc....and go from there). It is way easier than the day to day battle with the aides I used to have: some were great, some were mouthy, some seemd lazy, but managed to get stuff done somehow. I remember one aide from our floor, actually I think he was a tech, so besides doing aide stuff he was also checking BG's, drawing bloods, etc. He would always put me off when I asked him to do something for me, and ooooo would I get so mad. But all the patients loved him and asked for him by name. This past May I found out why. He was working in PACU at that time, and I remember him from after my hyst. I was there a long time d/t pain issues, and he was very attentive and kind, sat by my side and talked to me while I was bawling about how much pain I was in, listened to my babbling, I mean, he was an angel, and one thing I really remember from that whole experience.
    Anyway, I'm just remabling, as usual....no good advice, unfortunatly.....just a "I know how it feels, hun!"......hang in there.
    Heather
  11. by   Sleepyeyes
    I know exactly how you feel. Same thing happens to me.

    Unfortunately I usually don't have time to follow up and make an issue out of it.

    Should you have a prob with an aide, I recommend going to the DON --preferably with all the nurses who've had problems with the same aide, getting together and discussing it, and presenting ideas for how to handle it, so the DON knows what's coming and you all are on the same page.

    One facility that I worked with was very good about "cleaning out" the CNA's who gave people a hard time, and with the disciplinary actions being consistent and getting backup from the DON.
  12. by   michelle95
    lgfla, I called the DON and told her about it the next day. I told the charge nurse about it that night, but, she didn't do anything about it. Personally, if I could have, I would have sent her packing, but, I can't do that. I told the DON that I WOULD NOT work with her again.

    PLUM, I hear you. This ticks me off to no end. I have been there from 30 minutes to 1 1/2 hours after my shift and the CNAs ALWAYS leave on time. Then, they get mad 'cause I don't do more for them after I see them propping the walls up all day.

    UGHH!
  13. by   BBFRN
    Wow, telling a patient to shut up in my facility would be grounds for immediate dismissal. I reccomend taking her to the Med Room and flogging her!

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