How to deal with nurses who respond they are busy when you delegate - page 2

Good evening, I am a new manager with only one year experience and over the last year I changed my job. Currently, I am responsible for 41 employees, andI can say I have good RN/patient census. One nurse is responsible for... Read More

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    Do you get that by 'following them ' to 'see how they use their time' if worded in that manner is going to forever make you the enemy. you need to be their ally not the 'other side' get out there on the floor answering call lights helping with med passes (doing baths ect.........) while your out there you will get every answer you need to know and then you can streamline that info in to a culture change.........but a culture change means a change in roles which may mean 'taking away' some of their traditional responsibilities so they can focus on these new task. For instance knowing that your don't have a full census all the time i would take advantage of that. instead of each nurse taking 10 pts each could they stay at full capacity and one nurse be assigned care plans? or what if they each have 15 pts and one 'serve' as a float so that she takes each load while they each have a couple hours to soley focus on that task without interruption and not falling behind on their other task? ..... do you have a mentor? It sounds like you have some great goals but perhaps could use some help from another unit manager with more experience in helping find a successful way to present it.
    Orca likes this.

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    Quote from evolvingrn
    Do you get that by 'following them ' to 'see how they use their time' if worded in that manner is going to forever make you the enemy.
    This struck me as well. When you tell them you are going to be monitoring how they utilize their time, that strikes me as micromanagement. I have workled for micromanagers, and it is miserable. I believe that it would be better to say that there are some essential basic tasks that are not being performed, and your expectation is that they will be. Spot check for charting (which you have identified as a main trouble spot), then counsel those employees who are not complying. With charting in particular, I have found it helpful to emphasize that if there is a problem or legal issue over care later on, charting can save you. I was once sued by a patient who made several false allegations. My charting on the night in question refuted everything he said, and the case was quickly dismissed.

    Your employees need to believe that you are there as a resource, and that you will support them in your jobs. The tone that you have set early on, first with handing out the work performance standards and then telling them you are watching, paints you as their adversary and someone to be avoided - which is professional death to a manager.

    None of this means that you cannot or should not set limits on their behavior and performance, or spell out your basic expectations. There needs to be a healthy balance, however. You are there as their supervisor, not their overseer.
    Last edit by Orca on Jan 30, '13
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    I've been on both sides of the fence - staff & supervisor & inservice. What I see as the biggest obstacle to better documentation is the staff's lack of knowledge. Some folk just don't know how to do it any better. No one has expected any better of them and the more senior staff may never even had strong skills to start with (and if you don't use it, you lose it).

    Nsg school care plans are flufy & stuffy things with all the R/T and A/E/B thingies. My LTC/rehab care plans are short, sweet & to the point. I'll never win any school awards!!! Never really cared to do them, but I had to start - rusty at first, but it got easier. I developed my own sample care plans that I would just tweak for each pt. As long as basic CPs were started on admission, they could be refined any time by anyone. And that was the expectation of staff. I would always date & sign off my care plan entries just so I got my credit due.

    My point here is that the staff need really good education with resources, opportunities to practice writing samples, safe feedback, etc. Just like school. IMHO, you need a really fine-tuned education program for care plan & charting improvement. Provide the education, expect to see it in use, gently correct & refine. If they don't know to know to know to know, they can't & won't do it. Sounds to me like they're playing passive-agggressive with you now.

    You've got the disciplinary piece in place - I do like PP Orca's comment of supervisor vs overseer. And there are some good alternative options offered by others. Good luck.
    Orca likes this.

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