Nurses - Leading your subordinates (Nurse Aides, Nurse Techs, Med Aides)

[brotherbear]

With the stressful nature of the field it would be no surprise that nurse subordinates feel the pinch too. Nurse subordinates (those who work under you) are usually Nurse Aides, Nurse Techs, or Medication Aides. Some nurses are successful in leading their subordinates while maintaining good rapport with them, while some constantly struggle with leadership (and with understandable reasons). Here are some tips to help you whether you are a floor nurse or a supervising nurse.

Lead by Example

- If you are constantly showing up late everyday it would be tougher (sometimes even hypocritical) to talk to your nurse aides, techs, or medication aides about showing up on time. Make it a habit to show up at least 15 minutes prior to the end of your shift that way you catch any issues that need to be addressed with the outgoing shift on time.

Follow company policy

If the 70 to 120 is the baseline for normal BS levels (those are my numbers and I'm sticking to 'em!! ), then company policy should be your baseline for leading your subordinates. Let's take something simple as dress code for instance. If your company policy says "no extravagant jewelry" then you should be teaching your subordinates on examples of what the company considers "extravagant" and what they consider normal. The moment you as the nurse lose track of the baseline, you might as well watch your team go structural hyperglycemia

Discourage slander and propaganda

Like a cheap vacuum slander and propaganda (gossip) can suck the energy out of your team. Strongly discourage it by disciplining those who gossip about or slander their co-workers (especially your fellow nurses). This can be easily achieved by confirming information with multiple sources, and then openly reprimanding the gossiper (feel free to use your own creative words for "rumor monger" here). That should stop the others dead in their tracks from thinking about it.

Share credit

This is a great team builder. If your boss commends you for admitting a patient quickly for instance, make it a point to say something like "admissions are always easier with Patrick and Pauline working". That way your boss also recognizes your subordinates. It is a good thing to do (on so many levels)

Be a total leader

Sorry if you thought your leadership ends with correcting a medication aides errors. As humans we gravitate around leaders (be they our older siblings or workplace supervisors). If one of your subordinates has a flat tire and no spare. It would be great for your leadership if you shoulder the load and change out their tires for them. (...and please don't do it so they can get to work on time). That way if a clinical situation calls that they stay behind a few extra hours to help you they do that out of their own free will.

Please share your own war stories on leadership situations or other tips you know that work in a nursing environment.

[Jelli_Belli]

Wow, Is it just me or is the tone of this post extremely patronizing and condescending towards primary care workers?:angryfire As far as I am concerned nurses and techs work as a team to provide patient care. The "subordinates" (a truly poor choice of words) are not the nurses children. They do not need minding or to follow the nurses example in order to understand how to do the job they have.

Those people who work as techs and aides are adults, adults who have probably been working all of their adult life. They should be treated as adults. Co-workers on an equal standing, who just happen to have a different job description.

That is how you foster a good rapport with those you delegate to. Not by treating them like little children that you have to watch over but by treating them as equals.

[HeatherB,CST]

In my previous career, I started as a hairstylists' apprentice in a very busy salon. Now, I know nursing and hair are obviously worlds apart, but the work dynamic was surprisingly similar. Each stylist had primary responsibility for 8-10 clients in a day, while I shampood, swept, mixed haircolor, made drinks, and did blowouts for god knows how many clients. I ran myself ragged, but it worked, and I was happy. Why?

The stylists treated me as an equally important member of the team. They were appreciative of the support I gave them, said please and thank you sincerely, and nurtured me as a future hairstylist....and they didn't use me as a workhorse so they could have it easy. If they got time to rest, they made sure I did, too. I always felt like I had an important part in taking care of the client, which was my motivation for the job in the first place.

In a nutshell, I was treated with respect deserving of an equal. We were all there for the same reason - the people we took care of. I never felt like a SUBORDINATE.

[fleur-de-lis, BSN, RN]

Best advice I ever received about delegating from a nurse manager is "I never delegate anything that I would not be willing to do myself" - on the floor where I am doing my residency, there are no "subordinates", there is a care team made up of individuals with different job descriptions and specialties. When my preceptor and I were caught up yesterday, we changed linens and cleaned the monitors without any hesitancy. I have a great deal of respect for everyone on this unit, regardless of title, and would never consider any of them my "subordinate".

[RNfaster]

To me, the tone of this post is odd. It reads like a brief magazine article that isn't meant to be read by staff. The post assumes authority and dictates without establishing credentials or providing context.

I agree that the tone is odd. I also agree with other posters that say the tone and terms used are demeaning to teammates. I also think the focus of the article is rather demeaning to RNs in leadership positions. Gossip and accessories as focus areas for an RN team leader? How trivial. What about encouraging all teammates with regard to education (BSNs, graduate degrees, advanced certification, additional languages, certification in translation for medical subject matter), pursuit and/or maintenance of Magnet status, etc.?

The OP also uses poor grammar. I think a leader should have good English skills. I know the OP meant well, but this one was a flop for me.

[buddiage]

I had the same thought when I first read the subject line- the word "subordinate" is, in itself, demeaning - almost insulting.

Better than, "people that are beneath you."

I'm a nursing student, with a tech job in tele. I don't find it offensive. What else do you call them?

Just my .02

[Ekklesia]

To me, the tone of this post is odd. It reads like a brief magazine article that isn't meant to be read by staff. The post assumes authority and dictates without establishing credentials or providing context.

Meh, it reads like an opinion essay to me.

While the term "subordinate" may not sound "nice" it is a fact that I, as a tech, am a subordinate to the nurse(s). And, I'm OK with that.

The organizational psychology class I just finished utilizes the term "subordinate" throughout.

[aerorunner80, ADN, BSN, MSN, APRN]

I couldn't not speak up on this one. (like the double negative there? )

I am a tech and I'm proud of it. I do not have the responsibility of an RN (yet, I'm in school) but as a tech on the floor I work, I am the eyes and ears of the nurses I work with and because of that, my job is important.

I am the one who answers the majority of the call bells. I am usually the first one to notice skin breakdown on a bedridden pt and am able to do something about it before it becomes a decub. I am the first one who notices that person X in room xxx is not getting enough oxygen, has high BP, may be throwing a PE (had this happen to me!), is running a fever.

The role of a tech is not just about cleaning and changing people. We as techs should consider ourselves part of the care team. No, we're not RN's but that doesn't mean that our job is any less important than theirs. Tech's can make a difference it a pt's care just by making observations.

I was really offended by the poster who said that they are a subordinate and are happy about it. Hold your head up high and give us techs a good name. We are not "subordinates". Yes, we help out the nurses when they ask us to do things for them but our job goes so much beyond that aspect.

I think nurses (RN's) would get upset when called "subordinates" by doctors because nurses really do run and implement pt care in a hospital.

Nobody is disposable. That is what the word "subordinate" is to me. When I hear that word I think disposable, we don't really need you we just keep you around for the convenience of it. Terrible terrible word.

[Ekklesia]

Nobody is disposable. That is what the word "subordinate" is to me. When I hear that word I think disposable, we don't really need you we just keep you around for the convenience of it. Terrible terrible word.

Therein lies the problem. This is what happens when we start coming up with our own interpretations of what a word "means."

Nowhere in any dictionary do I see the term "disposable" and I certainly don't take it as that. If the original poster had meant disposable...well then, I would be rather upset.

One definition that is in dictionaries is "those of secondary importance" and I DO have a problem with that one.

The main definition is simply "one of lower rank" and it comes from the military history of our country. Yes, it sounds harsh and stodgy and I really don't hear it too much in the actual workplace.

We are all subordinate to some higher "rank" or power.

Frankly, I think we're all on the same page, notwithstanding the semantics of one word.

[TazziRN, RN]

I do not refer to aides or techs or LVNs or people of any level below an RN as "subordinate". They are my team members. I will refer to the aide assigned to me as "my aide" because for the time we are working, he/she is my aide, just as I am his/her nurse/RN.

[brotherbear]

Definition for "subordinate"

- Placed in or belonging to a lower order or rank. (dictionary.com)

Lets stick to this description/definition of the word in our replies/posts.

[vamedic4, EMT-P]

Again I reiterate that you need to use caution when using this word. It's disrespectful unless, perhaps, you're in the military - which many of us are not. We're all on the same team, but divisiveness in language or action in counterproductive to our common goal.

Just do us all a favor and leave out the inflammatory wording. It makes you sound elitist and rude. I'm not your subordinate, I'm your coworker, and I deserve your respect..as you deserve mine. Subordinates generally are expected to follow without question and that is not the case here.

vamedic4

Not subordinate to anyone...except maybe the wife;)

[CRIMSON]

Well now, "subordinate" that sounds like something a dark ages king/queen would term to one of their peasant slaves licking there boots.

I hope for your coworkers sakes YOU are NOT in a leadership role. There is a captain needed for every team but if that team leader isn't down in the mud with the rest of her/his team then they do not deserve the respect of the team they are to lead! It is a team, not big head carried by little ants.

Respect, Acknowledgment and Manners make a good combination.

Nurses are stretched thin as are aides/techs. It is a horrid and sometimes deadly flaw in our system. We need better staffing ratios in both roles. I personally believe it should be a requirement to work as an aide/tech prior to becoming a nurse. It is the only way for a nurse to understand the very large support role of the tech working WITH them. You cannot generally do the job without them!!!! I work in a support role until school is finished. My duties often overlap with the team leader. Like I said mutual respect and acknowledgment and manners can make life a whole lot easier.

Just my opinion!

:rotfl: