Hi, recently I was promoted to nurse manager/director of subacute unit. On couple of occasions, I've noticed that CNAs do not follow my orders, and I tried to ignore it, I thought maybe I am overreacting, however today I had an incident that I really need to address. I had a pt who was potential for elopement, I asked the CNAs to observe the pt for couple of minutes until I come back and apply watchmate on the pt. All CNAs laughed at me, and walked away, the oldest of the CNAs come back and asked me what exactly did I asked them to do, she walked away and did not listen to what I was going to say. When physical therapy saw what had happened two of them offered to watch the elevator until I came back. A watchmate was placed on the pt. I had to leave the floor for a meeting, when I came back I was told that while I was away, the social worker told the nurse providing care for the pt to take the watchmate off, and they did while I was away. Tommorrow I am going to have a meeting. I need help. Thank you.
Mar 21, '12
Meeting? Meeting? You're going to have a meeting? Tomorrow, you should sit down and write a list of names. Then get out the company policy on insubordination. Write everyone who disobeyed your order up so far and so fast they will feel it in Ottowa.
Write the Social worker up too if you have that authority. If not make out an incident report and turn it in to that person's supervisor whoever that person might be.
You could write them up for endangering a patient too.
You can't fire them all at once. Nobody's staffing would stand that. But you should.
I literally cannot believe this.
Mar 22, '12
Agree with Dixie. I would also speak with the nurse to see why she was following directive of a social worker--you are her supervisor.
It may also be that people are testing you..What are you going to do? This is patient safety so stand firm and write them up, start a disciplinary paper trail.
May also want to let your boss know what happened and how you are addressing it...
Mar 22, '12
You'll want to make it as non-personal as possible when you discipline these staff members (and yes, in your place I'd have a meeting with the offenders, but also document a verbal warning for each of them---you need to start a paper trail). Keep the focus on the fact that your mutual patient was placed in danger by their failure to follow your directives, and that any concerns they may have in the future will be discussed with you in private; they don't get to take matters into their own hands.
It takes time for a new manager to build respect among her/his former peers; as I've often said through the years, people can forgive almost anything,
except for someone who rises from the ranks!
It's really tough to find the right balance between "I am DA BOSS" and "I really don't deserve this position and I know you're going to do what you want anyway, so I'm not going to fight you." Good luck!
Apr 13, '12
Document, document, document. I am furious for you. Being promoted from within is difficult. Sometimes, you can give them an "opportunity" to improve via an action plan. Failure to comply with all elements in the action plan will result in immediate termination. Engage HR on your experience. They can help you get your ducks in a row and keep you from breaking any laws.good luck!
Apr 23, '12
I would write them up so fast their heads would spin, get tough. Good luck
Apr 28, '12
Writing people up is fine and dandy but it does not command respect. It makes people function out of fear and results in lack of creative problem solving, mistakes and constant questions from people afraid to lose thier jobs. Correcting insubordination is a teaching moment. It should take no more than 5 minutes and the person should be instructed that all communication during these events are to be kept confidential. Confidentiality will not be maintained by all but it will earn enough trust from enough of the staff to get their buy in. Buy in is key to successful management. Do not talk trash to you coworkers about individuals performance. No eye rolling, huffing or any crap you don't want your staff to demonstrate. You lead by example and set the pace. Bond with your UAP's/Nurses by working side by side to develop relationships with them. This gets you the inside scoop to crush trouble makers but must be carried out tactfully and with no malice. Fair and even treatment and keep your word. Find a mentor. You need someone you respect and admire to train you. I had a wonderful manager train me. I went from tears and trying to figure out why no one would listen to being highly respect and people fighting to work under my supervision. Remember UAP's have nothing to lose but a low paying job. You have not only your career but also the career of the nurse you supervise in your hands. Feeling go out the window. Beliefs and policies and procedures are what gets laid on the table.
Jun 11, '12
document...document...document. you have to create the paper trail you are going to need to terminate a low performing/problem employee. it takes time to get rid of low performers...unless they are immediately dangerous patient care. I still consider myself rather new to the management position...and I was also promoted from within. they honeymoon is nice while it lasts but when it ends...it ends hard & fast. I would have dismissed for the shift the ring leader of the insubordination on the spot and taken over their responsibilities for the shift on the spot and my other responsibilities be d####ed...your ultimate responsibility is safe patient care...end of discussion. I then would call the offender in for a short meeting before their next shift to privately discuss what happened and show them the documentation you have started as far as the corrective action policy your facility has. the offender will know exactly where they stand and you can be sure they will share the experience with their "followers". Now your paper trail is started and it really is in the employees hands what happens to their job. Be sure to keep HR...have HR present for the meeting, it creates safety for you AND the employee. keep your immediate supervisor in the loop also. it is critical to know and understand your facilities HR policies on corrective action/discipline/termination. I faced a similar situation very early on after the promotion...if I knew then what I know now...I'm still paying, to some extent, for mishandling that situation to this day. know and understand your convictions as a nurse and a leader, then find the personal fortitude it will take to have the power of those convictions. hang in there...
Jun 11, '12
From my own experience, I have found its harder to be promoted in house than to have a new supervisor hired in from the outside. Like someone else said, they are nice at first because they "know" you, but when you have to start acting like a manager, now their mad because "she thinks she better than us". Someone else recommended having HR present during the reprimand, I agree 100%. If HR isn't available, grab another supervisor but always have a witness. At the LTC I worked at, the social worker was involved in the decision to place a wonder guard on a resident unless it was an emergency situation then it was placed first then discussed with the care plan team, M.D., and family. You might want to ask the s.w. how that works at your facility. First management job is always difficult and can be very intimidating. I can look back at my first management job and just wonder, what was I thinking, I sure handled a lot of situations wrong. Hang in there!!!!
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