Brand new RN, 2 weeks into job, made charge nurse....difficult staff!!!!

[KristinaDuBois]

So, I am almost two weeks into a new job I started as an RN at a drug rehabilitation. I am still picking up on things here and there on how things are done, protocols, etc, which makes things a bit more difficult. I am on overnights with two LPN's, which makes me the charge nurse. I think there is a power struggle between myself and the LPN's! As my job entails, I have been asking them to let me know when they are finished with their work, and I will check afterwards to make sure it is all finished. The problem is, one LPN I work with will straight out lie to me about what work was done. Care plans on newly admitted clients must be done the night of......I was called out by my supervisor because the LPN lied to me about finishing his care plans, and I made the mistake of believing him the night before when he told me he was finished!!! So last night, I literally checked everything he did, and he lied to me several times about being finished with work when he was not. When I brought it up to him, he replied with hostility. He said, "Don't you ever question my ability as a nurse again!!" And stormed away. I told my director of nursing, and she said she'd talk to him.....but I don't see the situation improving. What makes things worse, is sometimes I have to ask him for help on situations since I am new and don't know how to do every little thing yet......Whenever I have a question, he makes disrespectful comments like, "WOW,you don't know that? I should be charge nurse!!!!"

I don't know how not to let this get to me. Has anyone experienced anything like this?

[green34]

In my area, granted we're an ER, we have new hires orient with a nurse full-time for at least 2 months and the new RNs we made orient for 3 months with experienced RNs. Meaning 3 shifts a week for 12 weeks.

In the rival hospital, they make new RNs go through a new hire program. They have a 3 month orientation onto a unit and then the rest of the year they are closely monitored with continued support. That hospital system will not hire new hires except into the orientation program. I think my hospital is trying to do something similar.

The only thing that I would be worried about is that you are workin somewhere that has a high turnover rate. At least on nights.

I worked in an ambulance company where 2 months into it, I was the fifth highest basic out of 20 or so basic EMTs. It said a lot about the company when you lose people so quickly.

[swansonplace]

Seems frustrating. When I was a techie, I use to post questions to specific professionals and get guidance as needed. This gave me a strong support system though I was out in the field alone. Now, I was wondering if this exists for new nurses. What do you think? Would it help?

[swansonplace]

Seems like a tricky situation. Is it possible for you to get assistance else where. (procedures manual, another charge nurse, etc.)

You seem to need a procedure document. If one does not exist, can you get someone that is competent to write one up.

When I use to go on a new job, I would target learning those simple tasks that are done 80% of the time. This is not everything I should know, just the stuff that I do most. I generally would learn from the best most competent person. This way I learned a good method. So I would cram these items in fast so I was proficient at my job. I would make a list, and just get these items down fast.

Now as a charge nurse, you could have someone who is extremely competent write something up for you. This would be a part of the documentation for procedures for the floor so you don't always have to sit and explain to someone what to do every time. It would be a written standard, and would be a living document. Or, you can get the schedule arranged for a little bit, so you have someone available that will assist you with that 80% for the first little bit.

A new charge nurse or person in charge is always a mental challenge to those that are currently in a position. It's kinda like a turf thing. You know. Someone of lower rank knows the area better, but does not get the position. The new boss not only does not know the position, but must be trained by the lower ranking person. This causes upset. Not only that you are new, but new and must be trained. I am not sure of the handling.

Generally this will all pass in a couple of months when you have learned the procedures of the place you are at.

[jadelpn, LPN, EMT-B]

It is difficult when you are an experienced LPN and just because you are an LPN you are not able to be charge "in theory" however, an new RN is put in that role just due to title. BUT, with that being said, we are all one team with the goal of everyone being alive at the end of the shift--so we need to just all get along.

There are states that the practice act specifically speaks to LPNs and RN's in a facility and the "charge" role. In my state, an LPN can in fact be a charge nurse with RN's (and most common in LTC). It is an ADMINISTRATIVE role, and not specific to directing RN clinical care of patients. However, most non long term care faciities do not embrace this concept. This is for Massachusetts:

The Licensed Practical Nurse in the Charge or Supervisor Nurse Role

I would be hesitant as a new nurse to take a charge nurse role, however, when making out the assignment, I also would not assign the LPN to new admits. (and there is language that is state specific that the RN has to do the initial assessment and care plans). Is team nursing feasible on your unit? Meaning you do initial assessment and care plan, the LPN then does the rest of the admission? I would seek the NM's guidance on how you can make it work--in a meeting with the LPN in question for his thoughts and input. The LPN needs to hear that the facility at present doesn't embrace the concept of a specific charge role for LPNs but that his experience is valued. Perhaps a "title" such as "lead LPN" would suffice? That way, you could concentrate on specifics of admissions and he could be reference for policy issues and general questions? I know it sounds as if one is coddling the LPN, however, as an LPN it is very frustrating to "act" as charge (meaning answering policy issues and questions) but not be in a position to do anything about it--if that makes sense. Or, an LPN that gives direction that they can't follow through on themselves is difficult.

Never the less, no need for attitude on the part of the LPN. It can be worked out so that your team is seamless--just needs to be talked out.

[Georgia peach RN]

I too am a new RN but also have 12 yrs experience as an LPN. I also have been in situations where the Charge Nurse (RN) was unable to perform all of her duties because they were new to the facility and/or they were lacking in experience. I have encountered LPN's who exhibit hostility as a result of them feeling unappreciated and the expectation to "baby sit" the new RN. I have watched how many of these new RN's responded to this hostility that they did not deserve and the one response that has worked the best is to kill that hostility with kindness.

For example I knew a new RN who was Thrown into the Charge Nurse Role just because she was an RN and a particular LPN was very hostile and rude. she would do some of the things you have described in your situation and more. This particular RN decided to help her with her patients at any and every instance she could and she committed to find out every thing she could about the this nurse, what she had passion for (she loved wind chimes and sitting out on her porch enjoying them and the birds) and then the opportunity arose it was the LPN's birthday so she went and found the most beautiful wind chime, bought it and gave it to her, the LPN broke down into tears it was a beautiful time of healing for them both from that day on they were a team.

Now Im not suggesting you go buy him a present, but I am suggesting to return his rudeness, hostility with kindness. This RN told me "I just decided, no matter what she does to me I am going to be kind and helpful to her" Im not sure why she decided to buy her a present for her birthday.

just a suggestion, there are many other good suggestions on here too.

[IRF-Nurse]

As an experienced charge nurse, leader, DON, and now Chief officer of a nursing unit... I would SERIOUSLY recommend the note above by Georgia Peach RN....

You have a choice here... move forward in your "righteous indignation" with the disciplinary process... sure, you probably can. Likely you will build more distrust with others as that fosters a punitive environment. Did he lie? You say you caught it, and I believe that... but in his mind, he was responding dismissively to a question that could be seen as dismissive/disrespectful of his experience.... (the old "stupid questions" and "stupid answers" adage).

OR,

YOU can choose to grow as a professional and rebuild the relationship... find COMMON ground with this guy, apologize (yes, apologize) for appearing to insult him... assure him that was not intentional and that as a new nurse, you're still learning... including learning that SOME LVNs are far more capable and qualified than our RN peers... now after you've done the above and begun to earn a little of the necessary trust (above and beyond the damage you've done to it already)... start to pay attention. You ARE still learning, but you are also observing patterns. Including patterns such as skill weaknesses you can help him develop under the guise of sharing something you learned (fully implying that you are sure he knew already).

ALL nurse leaders will tell you "Providing feedback without creating undue conflict is an ART! Leadership is about building relationships." And unfortunately you shouldn't be tasked with that so early on... but it appears your choices in that matter are limited, unless you want to seek a new employer already (not so easy to do, as leaders look for those kinds of "red flags" on short term employment dates).

Good Luck!