Ready to start writing up techs

[ABQLNDRN]

I was wondering what you all think about something: many of the RNs and LPNs on my floor are fed up with our lazy, bad-attitude, rude techs. Many have complained to our manager, who is said to simply shrug her shoulders and not do anything. I talked to one of our permanent charge RNs about how disappointed I was, and she told me why nothing was being done.

Our techs here have a union. Their union has a protocol for disciplining which management must follow. The RNS/LPNs have to officially write the techs up in order for management to be able to do anything.

I am not by nature a big "writer-upper" so to speak. I like to talk to people, nip things in the bud, be understanding, help out when I can, etc.

I work on a mother/baby unit. Before I became an RN, I worked as a tech on a med/surg unit; not for too long, but for long enough to appreciate and understand the work that techs do. There is very little butt-wiping, turning pts. in bed, helping pts. ambulate, assisting pts to the bathroom, sponge-bathing, etc. The majority of our pts. are self-sufficient with ADLs. The bulk of our techs job is to take vital signs, pass food trays, and pick trays up. Once in a while they have to go to blood bank or something to do a small errand.

Our techs literally sit at the nurse's station and surf the web all day long. They get SO mad when you ask them to do their jobs. They ROLL their eyes and crab and complain amongst each other saying, "why doesn't the nurse just do it?" I do know for a fact that ALL of our techs receive paychecks; not a single one of them is on our unit on a voluntary status. I do believe no one held a gun to any of their heads when they walked in and applied for a job.

The other day, a tech did not take Q4 vitals on a baby that was on Amp and Gent and just told the nurse (while laughing), "Oops. I must have written them on the wrong chart." NOT FUNNY for so many reasons! I would've been on that tech's behind like white on rice for that! Naturally, it is the nurse's responsibility to make sure all delegated tasks are actually being done, but I know that I don't have a whole lot of extra time to babysit my techs.

So, to sum it up, I'm not being a nice guy anymore. Since write ups are the only way to get their attention, I'm going to start doing it. Do you all think I'm being mean?

[SuesquatchRN, BSN, RN]

I think you should write them up, but be prepared: everyone, including the other nurses, will get mad at you for rocking the boat.

[SCRN1]

Don't even get me started. Where I used to work, we would have 4 techs on night shift and about 6 on days. They had the same attitude and any complaints fell on deaf ears to the NM. She would come back with, "well, they don't make that much and I'm sure it's not any fun to always be wiping someone's behind". HELLO?? Didn't they accept the job knowing what the duties are? My other point is, they make more than a teenager working minimum wage in fast food (around here) and as long as those teenagers are on the clock, they're expected to do their work. So why shouldn't the techs be any different? If you don't want to make them do what they were hired to do, get rid of all of them, use what they're paid to hire an extra nurse or two each shift so we won't have as many patients each, and let us do total care of the patients which it usually turns out to be anyway.

I worked as a tech my last year in nursing school and we were not allowed to have the attitude techs get away with these days. We were also held accountable for our work. I didn't get to use my time on the clock getting paid to sit there and study, sleep, talk, play on the computer, etc. And I sure as heck didn't give the nurses the attitude so many do today.

[jennyfyre]

When I was a CNA (both in LTC and hospital settings), I sure didn't have a moment to spare to surf the net or do anything else. Potty breaks were a big deal.

On the unit I work on now (as a Health Unit Coordinator) we have 18 beds, and 3-5 RN on day shift... only 1 CNA. She is expected to do a LOT! Sometimes the RNs assign her 3 out of their 4 patients to bathe... but she's still expected to be available to help with discharging patients, settling surgicals, helping with admissions, all vitals. She gets griped at when a discharge takes her longer because of a hold up in pharmacy, etc. I feel bad for her alot... so I do as much of the "running" as I can... specimens to lab, IV poles to CSR, etc. She usually handles everything with a good attitude, but it does wear her down sometimes.

On the other hand, we also get a lot of 1:1 CNA patients... and sometimes the ones that float to our unit are lazy and rude. I'd say if they have bad attitudes and are lazy and not doing their jobs, write them up. If it's not documented, there's nothing that can be done that will be effective. It's not being mean... and just maybe a few of them will straighten up and get busy.

[TazziRN, RN]

Yes, it's true, to have a unionized position disciplined you need to follow a process, and the first part is to document. Verbal complaints do little. For write-ups to be the most effective all of the nurses should do this, but just one person can do it too.

One thing I did once, when my then-NM did nothing to resolved a sticky situation, was to cc a copy to her manager and the DON. It worked. And while it's not the best thing to do, if you have dates you can write up several incidents at the same time.

[ABQLNDRN]

I think you should write them up, but be prepared: everyone, including the other nurses, will get mad at you for rocking the boat.

Yeah, I'm kinda expecting that. It's ridiculous to think that one has to resort to writing people up to get them to do what they originally agreed to do, isn't it? I'd rather not have to...hopefully it won't come to that.

[TazziRN, RN]

Yeah, I'm kinda expecting that. It's ridiculous to think that one has to resort to writing people up to get them to do what they originally agreed to do, isn't it? I'd rather not have to...hopefully it won't come to that.

If complaints to the NM have done nothing, do you expect it to change any other way?

[Daytonite, BSN, RN]

i was a nurse manager in one hospital where the cnas were unionized and had to be present at a number of grievance hearings. this is not a big deal and the union will actually be on your side as long as you follow all the rules. so, look at the job description for the techs because that is the first thing the union looks at. then, look at the steps of the disciplinary process for the facility and see if there is anything that is different for the techs. you might even talk to someone in personnel about how to go about this so you cross every "t" and dot every "i" to make sure you are doing everything correctly. then, when you write someone up, you just make sure that you are addressing specific written rules that they have broken and make a cross reference to them in the memo you are writing (your write up). you actually did a very nice job of describing insubordination by the techs. in my write-ups i always included that i had spoken with the person before about this same behavior and told them they would be written up if they did it again, and this is now the write up because they've done it again. i also do the write-ups in the form of a memo (to: from: date: subject: and then the text), keep them factual and i always keep a copy for myself. i address them to the boss. that would probably be your manager, i would think. you might get some response from these goof offs if you come in being able to spout off union rules/regs as well as facility rules to them. maybe they'll figure out you've done your homework and they better not cross you.

and, keep writing them up. what used to go on in the unionized hospital where i was working was that any decision to formally discipline or fire was made by a consensus of the personnel department, department head (the director of nursing in this case) and a lawyer. this is so the facility was already prepared with documentation in case the employee decided to go to the union for help. that doesn't always happen. many employees who got fired, actually realized that they were being fired because they screwed up and did something wrong. it was the dummies and troublemakers who insisted on exercising their union grievance procedure. what insolent union employees don't realize is that the union is obligated to follow the rules of the contract with the facility. the facility lawyer will see to that. if the union employee has broken the rules, there is not much the union can do to protect them from whatever discipline the union contract calls for. by documenting how they are consistently breaking the rules, they look like real dumbbells when they get into trouble and insist on a grievance hearing. even their union stewards won't have much respect for their shenanigans once they see the documented evidence against them.

now, the only problem i think you will have is that these write-ups that you will have to do will probably have to be on your own time. i never was able to find time to do write-ups at work when i was a staff nurse. i would jot down the facts i needed on the back of my "brains" though. i do like composing on a computer, however, because my auto checker often corrects spelling and typing errors immediately. also, those other memos that i saved came in handy when i was having difficulty trying to figure out how to word something.

[ABQLNDRN]

Tazzi--who knows if it will ultimately make a difference. It's a gamble, and I'm weighing the options right now. We've had excellent workers leave our unit because of the techs, so it may be time to act. I am going to talk everything over with our manager, and as Daytonite recommended, make sure that I have all my ducks lined up before I begin. Foremost, I want to make sure that I have the support of other nurses. It's never fun to upset the status quo, but I know that life dictates that doing so is the catalsyt for change. I know where you're coming from, though. My manager may not want to do anything at all. We'll see.

Daytonite--thank you for your advice! I will make sure to do the things you have recommended! Great advice.

[BrnEyedGirl, BSN, MSN, RN, APRN]

Maralenn,.. this may seem sooooo obvious, but be sure to write down all the facts in writing even if you don't do an official "write up",..I had a aide on my unit just like this,..we all complained to each other, no one liked to work w/her etc,..one night she came to the nurses station in front of everyone and said to me "I opened up your blood in 423, it didn't look like it was running at all",..I honestly thought she was kidding,..I had just been in the room 20 minutes earlier,..I decided I should go take a peek and sure enough, she had dumped an entire unit of blood into an 85yr old, 80lb pt w/ CHF in less than an hour,...I could not believe she really did this,...to make a long story short,..I wrote her up,..my NM said that in all the years that everyone had been complaining about this lady no one had actually given her anything in writing!!! She couldn't do anything w/o the proper documentation,...so write it down!! Good luck!

[vamedic4, EMT-P]

As with any other occupation, the quickest way of getting your point across is to CREATE A PAPER TRAIL!! This allows your NM as well as HR to be aware of what is going on.

I'd say just fire 'em all, cuz they make more work for guys like me.

[outcomesfirst, BSN, RN]

There was an excellent post on dealing with union workers. The only point I can further stress, is the must of initially communicating with the individual (privately)- before starting the write up process. Try not to be offensive, they will just play defense. Explain your concerns. "No one wants to eat cold food" "Vital signs can provide early warning of potential problems" etc. Be clear in your communication and let the person know, this is not personal, and follow up. Be sure to communicate that it is your responsibility to ensure the job is done, if not you will have to document the issue. Good luck!