Dealing with arrogant staff

SHGR, MSN, RN, CNS · May 6, 2014

I worked at a place like that. How did I handle it? I quit. The place got shut down anyhow. Your sanity isn't worth it.

lumbarpain, ADN, RN · May 6, 2014

what happened to me is that I wasn't working for some time full time...now I am...this place sucks literally.....and they got sited for 12 things ....I knew this the moment I went for an interview , you can TELL how well organized a place is......and this wasn't....but I took the job anyway ...out of desperation to get out of a present situation I am in which I HATE.....thanks for your input.

Sassy5d · May 6, 2014

What would happen if you did just take the reins and did not tolerate the behavior?

Don't do their work.

Give em a report at the start of your shift, and tell them your expectations.

It will be a power trip for them, write down their actions.

Aides are a dime a dozen. Not to down play stna's by any means but they are. Just like nurses are.

I'd rather work short staffed than tolerate out of control behavior.

I've made aides punch out and go home.

Been there,done that, ASN, RN · May 6, 2014

The inmates appear to be running the asylum. This is a privatley owned "rehab" facility, I am assuming.

I WOULD have said write each and everyone of them up per infraction.. but administration already knows the drill. Administration is directing YOU to do their job.

Yep, it's a mess,you cannot change it. Stop beating your head against THAT wall.

BuckyBadgerRN, ASN, RN · May 6, 2014

The CNA's act like that because they can. They've been given free rein to walk all over each other, their supervisors and in the end, the residents. I would document the carp out of what they don't do, nothing happens without a paper trail, get one started. Let them know you will NOT tolerate behavior that puts patient care at risk and then show them you mean it. Chances are, like children, they WANT the guidance and ground rules of what's acceptable, but no one has the balls to give it to them. Let yourself be the one with kahona's so big that you can barely sit =)

itsmejuli · May 6, 2014

There's always a ring leader. Figure out who it is and make that person your priority.

lumbarpain, ADN, RN · May 7, 2014

I am new to this Rehab. Center ...but a seasoned RN of over 17 years.....I have worked in many facilities and have never encountered such discipline problems as this facility.
I am seeking some advice on how to deal with aides that fight amongst each other, they feel there is no teamwork, they do as they please and the nurses get walked all over by them...cause they know that if they get fired....they go somewhere else and work and then OUR facility will be left without an aide working on the floor and shorthanded which Tsunamis into more problems for the staff remaining. Any hints on how to effectively deal with out of control Aides would be helpful.....it seems you have to get peed off at them for them to do something first....and this should not be....asking repeatedly to do one thing is just so frustrating......the nurse takes on more Aide work herself and cannot get her own work done....AND THEY TAKE ADVANTAGE OF IT if they know you will help them out a lot....they depend on you to DO THEIR WORK....its terrible. I have never been a nurse to just DO MY OWN WORK and the heck with everyone else...I always chipped in..but when they start depending on you to answer their call bells..then it gets bad. ps...I have already addressed this to the DON and she says...You got to take charge, you got to hold the reins, you got to , got to. BUT she fails to say how......I find this very upsetting cause I had told her I believe that this facility has had this problem for some time and she affirmed the aices just do what they want on this floor. Its just incredible. I have always gotten along with my aides....their jobs are not easy at all......but this place is Out of this world!!!!!!! I noticed this facility doesn't moniter Bowel movements on their patients....so I asked if I can make up a sheet for that and got the GO from the Nurse Manager......it was simple and I explained to my aides to fill it in so we can get an idea of whats going on with elimination patterns.....the nurse I was working with (a per diem who has worked there for over a year) states to me..."they took your bowel sheet out of the 3-11 book) I said...Why? They need something like this...I never worked in a facility where they didn't have a bowel and bladder sheet? She said....I don't know. they just took it out.......so.......no one told me this wasn't accepted......I had told the DON about the sheet also....but this place is a mess.....I don't know what to do...I worry about my license here.

What generally happens when facility starts to go downhill fast....what is the main triggers? is it hiring staff that just want to do what they want, not the facility? Is it the management? WHERE does it all begin? And who is at fault for most of it?

lumbarpain, ADN, RN · May 7, 2014

yes, absolutely..>.THE RING LEADERS, THE RAT FINKS, the INSTIGATORS, TROUBLE MAKERS

cardiacfreak, ADN · May 7, 2014

Unless you have management to back you up, there really isn't much you can do.

Anna Flaxis, BSN, RN · May 7, 2014

When attempting to change well established patterns, things will get worse before they get better. That is because people think that what has always worked before will still work now, and they will try even harder to get the outcome they have come to expect.

It's like if you go to the same vending machine every day at the same time for a year. You put in your $1.25 and out comes your candy bar. Every day at the same time, for a year this has happened. Then one day, you put in your money and a candy bar does not come out. You might first bang on the machine gently with your fist. You might push the buttons again. You might then escalate your behaviors until you are shaking the machine, mashing the buttons senselessly, or reaching up inside to try and grab your candy bar while uttering words you might not normally use.

What you have to do is set clear expectations with clear consequences. You have to be consistent in applying the consequences over a long period of time. Make it known to the aides what you expect, and follow up to check that they are performing their duties as expected. If not, have a clear consequence that you apply consistently- whatever is within your authority, such as having them clock out and go home, or writing them up. If they do meet your expectations, then praise them and build them up and make them feel good about themselves.

Make an effort to bring in treats for everyone, and give little pep talks every once in a while about teamwork and point out examples of when you see good teamwork happening around you.

Again, you have to do this over an extended period of time, consistently, and expect to be challenged- expect the behavior to get worse at first. Just stay consistent with meting out consequences to those who underperform and dishing out the praise to those who meet your expectations. Take the long term view.

MrChicagoRN, RN · May 7, 2014

Unless you have management to back you up, there really isn't much you can do.

Unfortunately, Theres some truth to that.

There has to be a culture of excellence, and that starts from the top down. As a manager, in that situation, I would selectively hire, even if temporarily overstaffed (yes that can be done if you can sell your case to the top). A good source of employees is nursing students. Then start writing up like crazy. When they see the worst of the worst getting fired, and the new staff picking up the slack, they'll straighten up.