Quote from savoytruffle
Thanks. I have a staff meeting scheduled for next week to talk to all my LPNs about what's expected of them. The off shifts voiced to me their concern of not getting respect from the CNAs. We really have some things that need discussion between the nurses, aides, and myself. These talks need to be honest and fact supported, but I'm afraid of them turning into a fury of defensive actions and hurt feelings. My plan is to lay out my expectations in simple terms. " this is acceptable". "This is not". This is exactly what to expect to happen when my expectations are not met, or your behavior is unprofessional. And then stick to it. I feel most of my efforts for the summer will be focused here.
And sometimes, that is exactly what everyone needs to hear. What is acceptable behavior, and what is not. A review of the duties of the CNA. And the duties of the LPN. If you are a union facility, then what the contract says about discipline, if you are not a union facility, what will happen in the most distinct way possible if someone engages in non-professional behaviors. Make sure to give everyone a copy of their behavioral and professional obligations, and everyone signs it that they have recieved and acknowledged. If you have heard and heard again about such and so doing this and that, no need to rehash and have it become a free for all. What you may have to do is to state outright that you have heard and seen it all, and that the purpose of the meeting is to make expectations clear. You could certainly ask for suggestions, but people will be asked to stay on point, and there will be no name calling, inappropriate points will be redirected. You could even do a white board of "LPN and CNA" called "General Complaints" and have them write at least one suggestion for improvement ie: Lead CNA per shift, rotating. Dividing up CNA duties so that 2 people work together as a team, rotating. That once a week one team of CNA's is on call lights and stocking, and the rest have an assignment, rotating. I can see a "but the nurse is sitting right there and she sees the light, she can't answer it???" WELLLLL, if YOU are sitting right there, and are observing all of this, then what is preventing you from answering it. ???" OR my personal favorite "I shouldn't have to bathe people, the nurse needs to, as she needs to assess the skin, not me" Which then becomes a discussion of CNA's being "in the know" as far as subtle differences in a patient's condition, skin condition "not acting right" and that we depend on them to be eyes and ears for the goal of patient safety.
As far as the LPN's, perhaps a weekly "check in" for any potential brewing issues, and a proactive approach to nip it in the bud before it becomes an issue.
Good luck and let us know how it goes.