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

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    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.

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  2. 37 Comments...

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    I work as an aide on a very busy cardiac floor from 3-11. The floor is usually full to capacity meaning their is 32 patients on any given evening. There is only 2 aides on evenings. From the moment we step ont o the floor till we leave we are running ragged. I physically shake some nights from trying to get all pm care done plus blood sugars, people who need help with feeding, I's and O's, vitals on 16 patients as well as answering bells for toileting, snacks, blankets, etc. We also need to track down the nurses when patients are in pain or have questions the aides can not answer. We are also transport for patients to other floors, x-rays, etc when transport is not available. We also move the patients to other rooms when need be. Plus we change attends, and turn patients from side to side. This does not include when the nurses request us to do vitals every two hours or blood sugars every hour plus whatever else they need help with.

    I really like all of the nurses and enjoy helping the patients but I wish the nurses would realize the aides are responsible for all of the patients on the floor while they are responsible for only 4. I know they say please and thank you and are nice about it but we run like crazy women. And yes, it does upset me when I hear the nurses laughing and talking about ordering dinner and ice cream for later when bells are going off. I do not have time to take a break to eat ice cream.
    I do not think being an aide before becoming a nurse will make you a better nurse but I think it makes you a better leader. As a nurse you would know exactly what the job of an aide is like.
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    Aides need better working conditions too, the ones on my floor have 18-20 patients at a time, I try to help out as much as I can - its amazing how much you need them - I would like to see them included in report so that they know what is going on with each patient
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    On the floor where I precepted last quarter, The aides would gather and have a report session to pass on report to the aides working the next shift. This was at the same time the nurses were also finding each other for report. I really liked to see the interactions on that floor. It truly seemed to be a well oiled machine (so to speak..). I think the communication and respect factors go a long way toward making a great team.
    Mikey31079 and pagandeva2000 like this.
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    perhaps it's just me, but referring to people as "subordinates" is a good way to alienate yourself. i realize this is good for the heading of the post, but i've seen nurses do this and use that specific terminology when talking to others --that's a huge no no.
    i'm not trying to start a fight- quite the contrary. but whether you're a nurse or an aide, your goal is the provide the best care for your patient. and just because the nurse is the only one with the legal responsibility for the care doesn't mean she's the only one who deserves the credit for it.
    rule number one: if you need something done...ask. "can you get a stat cbc on 436 and then take him down to xray? sure, i'm all over it. not: you need to do a stat cbc on 436 before taking him to x ray. that will automatically have your aide headed for a long trip to the bathroom. respect goes a long way, and remember...we can't read your minds.

    rule ii: remember, as others have pointed out, that while you may have 5 patients (or more depending on your facility), the aide may have 2-3 times that many. and having all that responsibility is a lot, that's a lot of manual labor that you're not having to attend to, so patience is a must.

    your recommendations ring true - especially the one about sharing credit. make sure you thank those who help you - you never know when you'll truly need their help again. and believe me when i tell you - if you just "expect" people to show up when you get in the habit of not thanking others for help - you're going to be left alone, doing whatever it is - by yourself.

    going to nap soon
    MedChica, mc3, MedicalLPN, and 1 other like this.
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    This is a personal thing, and maybe it's a regional thing but I don't use the term "aide." I also don't say "my aide." I don't own them, they go home and live a life without me when the shift is done. I say "the tech I'm working with." Maybe it's semantics, but I feel it fosters more teamwork.
    pattycakeRN likes this.
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    I had the same thought when I first read the subject line- the word "subordinate" is, in itself, demeaning - almost insulting.
    MedChica, MedicalLPN, pagandeva2000, and 2 others like this.
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    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.
    Last edit by Multicollinearity on Jun 22, '07
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    Here is another suggestion for people who delegate: "Do unto others as you would have them do unto you".
    husker_rn and Simplepleasures like this.
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    Quote from multicollinarity
    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 thought that, too.
    if what you say is true, at least the op could memorize the contents and watch it play out on the floor.

    what seems to be common sense to some, takes a bit more education for others.
    the intent is in the right place.


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