New charge nurse, overwhelmed and underappreciated

[keepcalm_carryon]

Hi everyone, I don't post here often but I don't know where else to turn. I am an LPN and have been for about 4 years now. I've just started a charge nurse position on a shared long term care/short stay unit in a nursing home.

This is my third week on the floor on my own (after a very rough orientation, our NPE was also new as well as the day shift charge nurse and the unit manager! Talk about the blind leading the blind...) and I'm feeling completely overwhelmed.

The facility I work at is disorganized at best. A lot of the management are new to the facility as well so there's a lot of stumbling for the new team to find its feet. There's so much work to do that I generally end up leaving at 1-2 am on a nightly basis (I work 3-11).

And the floor nurses. Jeez. I don't know if I'm just hypersensitive to these things because I'm in direct contact with all of them nightly, and have to clean up after them, but it seems like most of them are poor team players. A lot of work is left over that I end up having to tidy up at the end of the day (adding to my 1 am departure time). I am getting pulled into the unit managers office on a daily basis and getting reamed because of certain things not being done. But then when I bring these problems to the floor nurses, I get the brush off or they get annoyed that I'm daring to point out errors. Most of them don't listen to me or get angry and defensive when I point out things that or due or not done. A huge problem is nurses not ordering narcotics in a timely manner and then I have to call the on-call doctor at 11 PM and ask for a C2 to be faxed over because we're out of meds and need the OK to pull from the Pyxis. Needless to say, the doctors don't like this and I've had my share of angry doctors tearing me a new one.

Today a nurse yelled at me when I asked if she had administered a PPD that was due according to the "dashboard" on our online charting system. She told me that the patient didn't need a PPD, because she was here a few months ago and that's company policy. She made me feel like an idiot. I also got a CNA call out and when I asked anyone if they'd be willing to stay over, some of them laughed in my face or got down right angry that I asked. I was given the OK from the unit manager to offer a small ($30) bonus to anyone who stayed over and one CNA laughed in my face told me the bonus was a joke and got angry that the offer was so low. I'll admit, I went into the bathroom and sobbed for a while. I feel like I'm a joke there.

I get that nobody likes to be micromanaged, so I definitely try to avoid seeming like a pain, but on the flip side, when things aren't done, *I* am the one who gets pulled into the manager's office with a laundry list of things that were not done. I'm just trying to do my job, too.

I'm feeling a definite "us vs. them" mentality and I feel like I'm a 'them'. I don't know if it's because I'm new and need hazing, or young (I believe I am the youngest nurse on the unit) and not yet earned the trust. I don't know if it's because I'm an LPN and some of the floor nurses are RNs. I don't know what the problem is, but I can't take it anymore. I am exhausted all the time from the amount of stress and the late nights, and I dread going to work. I find myself in the bathroom trying to hold back tears more often than not.

Now that I got the rant out, is it just me? Am I taking things too personally? I know that you need a thick skin in nursing, but I've never faced had anything this hard, even when I did hospice. Do I just have to push through this hazing and come out the other side as someone to be trusted? Am I doing something wrong? I will admit to being new to leadership, so any hints or tips for doing that are welcomed as well. Or is this place just not a good fit and maybe it's time to look elsewhere? I hate the idea of leaving a place so soon, I'm really trying to get a nice long chunk of employment on my resume so I can show stability. And I also love the busyness of the desk, it's just the teamwork (or lack thereof) that's really wearing me down.

[HouTx, BSN, MSN, EdD]

Hmm - where to start?

To me, the most obvious issue is that you, an LPN, are expected to supervise RNs. You don't have the legal authority to supervise/direct their clinical care so you are limited to only 'supervising' administrative and operational functions. Your organization has put you in a horrible no-win situation.

Nurses don't just magically 'become' managers without additional training. Not every organization can provide formal classroom training, but at the very least you should have been provided with on-the-job-training (OJT) with a qualified mentor until you are ready to function independently. Again, you have really been shortchanged & IMHO, set up for failure.

Do you have the authority to discipline/counsel staff for performance problems? If so, you need to have a staff meeting and establish clear boundaries - what will and won't be tolerated. Then, begin to consistently discipline (using your organization's progressive discipline process) staff who break the rules. It's important to have the meeting first to clarify expectations because staff apparently have been doing their own thing for a while... they need to know that the situation has changed.

If you do not have authority to discipline, then the situation is not fixable.

[applesxoranges, BSN, RN]

Did you work there before? If people start refusing OT and staying longer (even without bonuses), I think there is something wrong.

[OnlinePersona, LPN]

Hmm - where to start?

To me, the most obvious issue is that you, an LPN, are expected to supervise RNs. You don't have the legal authority to supervise/direct their clinical care so you are limited to only 'supervising' administrative and operational functions. Your organization has put you in a horrible no-win situation.

Nurses don't just magically 'become' managers without additional training. Not every organization can provide formal classroom training, but at the very least you should have been provided with on-the-job-training (OJT) with a qualified mentor until you are ready to function independently. Again, you have really been shortchanged & IMHO, set up for failure.

Do you have the authority to discipline/counsel staff for performance problems? If so, you need to have a staff meeting and establish clear boundaries - what will and won't be tolerated. Then, begin to consistently discipline (using your organization's progressive discipline process) staff who break the rules. It's important to have the meeting first to clarify expectations because staff apparently have been doing their own thing for a while... they need to know that the situation has changed.

If you do not have authority to discipline, then the situation is not fixable.

Totally agree.

Also maybe you can redefine your relationship to them by not only being the boss but a confidant and trusted sounding board. Maybe they are also stressed too.