ejsmom. . .one of the things you learn about being a charge nurse is that doing med pass, treatments, calling mds, answering the phones, taking off new orders, answering family questions, and making sure that each resident is safe is a big part of the job. but, if you look at your job description it also says something in there about supervising the nursing assistants. it may not say it in those exact words, it's there and you are expected to do this as well. the problem for most new lpns and those who are new to the job of being a charge nurse in a nursing home is that nursing school doesn't adequately prepare you for call lights going unanswered for 20 minutes or more, requests of yours that get ignored or "attitudes" such as rolling of the eyes, ignoring you or giving you the silent treatment, muttering under the breath or deliberately muttering things for you to hear their dislike, public displays or tantrums, deliberate weird behavior, using rude or insulting language to you, deliberately behaving to make themselves unapproachable, insisting on doing something their way, or for aides who politely listen to you and then don't do what you ask anyway (this is procrastination and/or passive/aggressiveness). it's a real slap in the face when it happens at first because up to the first time it happens we've all pretty much worked with people who knew their jobs and were eager to do them. well, welcome to the world of ltc and the difficult employee!
i learned so much about dealing with difficult people in ltc. i owe most of what i know to all the hard to work with aides over the years who i had to learn from. there are two books that i keep in my home library that i found very helpful:
managing difficult people: a survival guide for handling any employee by marilyn pincus and working with difficult people by muriel solomon. books like these will help you to identify what is going on with people who are doing these kinds of things.
on a practical level, however, you have to address and confront the behavior immediately just as a parent does with a child who misbehaves. banditrn is correct. you should first have a talk with your don. let her know what is happening. ask about what you can do. you need to know that you have the support and backing of your don. you should also look at not only your official job description, but the job description of the aides as well. one of the things that manipulative and/or intimidating employees will try to do is cite rules or regulations at you. many times they are wrong, but you won't know that if you haven't done your homework yourself. you need to be confident in order to say something like, "that's not true. there's no such rule." and when the employee jumps up and says, "i'm telling the don," you can confidently respond, "and you're going to get the same answer from the don. now i'm telling you again, this is what you are supposed to do and if you aren't going to do it then i am writing you up for insubordination." it's very difficult to actually say these kinds of things the very first time(s). you get very emotional yourself. that comes from a fear of the unknown reaction on the part of the other person as well as an unfamiliarity with the skill of doing this kind of confronting with people. always remember to be respectful and not to get angry. you are merely enforcing rules the facility has laid out. blame the facility if you have to blame anyone. we all have rules we have to follow.
i don't subscribe to this smile and be kind and the aides will come around theory. yes, smile and be kind. but if you don't confront and correct them, they will continue to walk all over you. at first, you may have to take the time out of what you are doing to hunt down missing people to find out where they are hiding. once they know you are willing to come looking for them and follow up with discipline if they keep on doing it, they'll either stop doing it, or they'll have to be disciplined. in one facility i had a problem with employees going to a sitting room where there was a big screen tv that they would watch. if i caught them doing that i would routinely pull the plug on the tv and send them all back to their assignments. that's another thing you'll have to find out about and follow facility policy on. another place had wall phones in all the halls as a convenience for the charge nurses, but the aides would make personal calls on them. when that happened i took the phones off the walls and wrote the employees up. the ones who end up being arrogant enough to continue being disciplined either quit or refuse to work with you. either way, they're no longer your problem.
what i found over the years is the good aides who do their job and follow the rules are usually very grateful when you catch on to what the crummy ones are doing and do something about it. all most people ask is that everyone be treated fairly and that work be distributed fairly. when the good aides see the crappy ones getting away with murder it really ruins their morale more than you can image.