Quote from starlisa14
I'm dealing with this very issue. I've worked for 3 years now but, I'm the "new" RN nurse supervisor to the 11p-7a shift. I'm having to stay later to file their paperwork that was delegated to them, I'm having to assess residents (I would do that anyway) inorder to chart on half the unit because they don't, I neglect my supervisor duties to answer call lights because the LPN is discussing where she goes to get her hair done. I'm trying to protect my license, protect the residents, protect their license and protect the facility, but in the process I'm thinking there will come a time I can't do it all which is now. So, I recently asked my DON to orient me to the disciplinary process/procedures more fully because during orientation all I got were the steps but I recently learned there is a form for each step and each step is handled differently (first step is a verbal, second and third written -first 3 DON doesnt need to know about on and on etc...
Bottom line: After stating my expectations as their supervisor, demonstrating those expectations, offering assistance wherever needed, inservicing...It's time to start the discipline process. And for all these LPNs/CNAs that have been at this facility for so long, and those that know their job, my question is, "Why are you acting like you haven't and don't."
If you are assessing the patients, then you would have to do the paperwork anyways--another nurse can not document what they do not assess. If you delegate, then be sure to check throughout the shift that what you delegated is being completed.
You could also assign someone to lights for the shift, along with chart checks or whatever else you may need them to do.
If a nurse is discussing hair issues, then you need to interrupt that and ask that the nurse answer the light. Seems obvious, however, some employees need to be directed and tasked, which I would think would be part of your supervisory duties to begin with.
If you are stating your expectations, demonstrating, offering assistance and inservicing, make sure that each nurse signs off that they are aware and understand same. I would also be clear on assignments--(you are to assess, medicate, treatments for the following patients.....) Another idea is to have a "main brain" that has all of the assignments on them on a clipboard at the nurses station. When a nurse completes what is assigned to them, they sign it off. So mid shift if things are not done, you can bring that to the attention of the nurse.
And make use of your CNA's and team them if it is easier for patient care. They could also be in the mix of the call bell anwerer for the evening.
In some facilities if a supervisor doesn't have a patient assignment, they are at the desk answering the call lights while doing paperwork, then delegating appropriately. If you have LPN's that are refusing to do as asked, then a disciplinary process does need to occur. (and again, be sure that all of your stated expectations are also written expectations, and signed off by each nurse that the understand them and what will occur if they do not perform to expectation).
Your supervisory style may be far different than someone else's was. Another thought is that each LPN is assigned to a team concept model--one gives all meds, one does all assessments, one does all treatments, one supervises all the CNA's, and one answers all call lights. Then it would be up to you to rotate around and be sure that each nurse is doing what they need to be.
Look to your NM for approval for any changes to the norm that you would want to enact. Just so you are further sure that the NM is on the same page as you for patient safety and efficiency.