what do you do

indigo girl · Jun 6, 2006

What do you do when you try to educate pcws in regard to documentation and following procedures and policies and a complaint is put in as one pcw feels that she is being bullied.Still feel slighted and quite put out by it actually.Has anyone else been in that position and if so how did they handle it.?And what was the outcome of the complaint process?Also how did your facility handle the situation?

Never heard of pcws. What does that mean?

knockandhello · Jun 7, 2006

Never heard of pcws. What does that mean?

personal care workers,assistant nurses

buildingmyfaith57 · Jun 7, 2006

how much training is this person getting? does she ask for more training,and two does the manager or lead person tell them they don't have time to train them?

knockandhello · Jun 7, 2006

there is an educator on site and available for all staff but this person does not think she requires assistance although frequently requires further direction eg uses own method instead of that in place for documentation.Which makes it difficult when despite being asked to fill in things like bowel charts she uses her own abbreviations instead of those on the form.

Daytonite, BSN, RN · Jun 7, 2006

in the past i've had employees accuse me of being nasty or speaking to them in a condescending way. you can't really be fired for something like that, but i tried to watch the way i said things after that. i learned to be aware that i can sound very authorative and that some people take that to be bullying when it is not my intention. it was a hard reality to come to, but after a number of incidences of people complaining about me i had to acknowledge that i was the one with the problem. i quit a couple of good jobs over incidents involving this because i got mad when managers tried to help me understand my problem. it took a few years to get myself straightened out. now, i'm very aware of how i'm speaking and the effect of every single word and how i say it has on the other person. i haven't heard any of those complaints against me for a long time.

only you and the pcw know what went on between you, i assume. if there were witnesses then you have only to call upon them. if you want to grow and learn, then be honest with yourself no matter how painful it is. it's unlikely this pcw is so nuts that she would accuse you of doing something without good reason, wouldn't you say? i've found that it really is rare to find people who are really dishonest, even when they want to hurt others. it's takes a lot to deliberately hurt others without provocation.

so, if you did do what the pcw is accusing you of, what do you do? apologize to her and mean it. do it in front of your manager. you have to make this right and acknowledge your fault or you will never get any respect from this worker. it's the fair thing to do. your relationship with her is already in jeopardy and you don't want it to get worse. what will happen is you will end up interpreting everything she does that you don't agree with as being specifically done by her to aggravate you. eventually another incident will happen between you two that will really bring things to some kind of crisis and conclusion that you may not like. i know this situation. i lived it--more than once.

knockandhello · Jun 7, 2006

I have never encountered this before and there have been no complaints from the others on shift when I have gone over paperwork with them or talked to them about issues arriving at work.It seems that if asked to do something she becomes defensive even when it concerns all of us changing our routine when new duty lists were left for all of us.One consoling factor I've been told is that I'm not the only one she has put a complaint in about.Anyway there have always been witnessess .

Daytonite, BSN, RN · Jun 7, 2006

i would ask her why she isn't charting the way she has been asked to. i would instruct her again, probably with another witness present, and if she gets testy i would go out of my way to ignore her behavior and focus on teaching her what she needs to be documenting. i would tell her that i want her to bring her charting to me to be checked over for the next week for correctness. i would work very hard to make sure she gets the idea that i am trying to help her, not punish her. if she complies then i will work with her on her learning to chart correctly. if she refuses to do this, i will write her up for insubordination and refusing to do as asked and keep writing her up until the don does something about her.

before going into any disciplinary action you have to give her every opportunity to be educated. i will go the extra mile because this is an employee with very little power and authority and i want to make sure she feels that she is being treated respectfully. but after enough patience on my part and enough insubordination on hers, i pull out all the stops and start the write ups.

you can only deal with the problems that she causes to you. problems she causes with other charge nurses are theirs to handle.

knockandhello · Jun 7, 2006

Thank you all for your responses.It has given me some food for thought and a better perspective on things.A problem shared is a problem solved as the saying goes.

indigo girl · Jun 7, 2006

in the past i've had employees accuse me of being nasty or speaking to them in a condescending way. you can't really be fired for something like that, but i tried to watch the way i said things after that. i learned to be aware that i can sound very authorative and that some people take that to be bullying when it is not my intention. it was a hard reality to come to, but after a number of incidences of people complaining about me i had to acknowledge that i was the one with the problem. i quit a couple of good jobs over incidents involving this because i got mad when managers tried to help me understand my problem. it took a few years to get myself straightened out. now, i'm very aware of how i'm speaking and the effect of every single word and how i say it has on the other person. i haven't heard any of those complaints against me for a long time.
only you and the pcw know what went on between you, i assume. if there were witnesses then you have only to call upon them. if you want to grow and learn, then be honest with yourself no matter how painful it is. it's unlikely this pcw is so nuts that she would accuse you of doing something without good reason, wouldn't you say? i've found that it really is rare to find people who are really dishonest, even when they want to hurt others. it's takes a lot to deliberately hurt others without provocation.
so, if you did do what the pcw is accusing you of, what do you do? apologize to her and mean it. do it in front of your manager. you have to make this right and acknowledge your fault or you will never get any respect from this worker. it's the fair thing to do. your relationship with her is already in jeopardy and you don't want it to get worse. what will happen is you will end up interpreting everything she does that you don't agree with as being specifically done by her to aggravate you. eventually another incident will happen between you two that will really bring things to some kind of crisis and conclusion that you may not like. i know this situation. i lived it--more than once.

thank you for sharing your past issues and that you worked on yourself. i have enormous respect for you for this. i had an issue just a few days ago which i could have handled differently. it is so easy to wound others even unintentionally. your response makes me think i could do much more.

Antikigirl, ASN, RN · Jun 7, 2006

I taught SOAP to my caregivers, and told them why it is important to use this technique while charting! Most of them, once they realized that that documentation kept them out of trouble, or would serve as a reminder if they ever had to go to court...they would comply no probelm. And the SOAP was easy to remember.

It was rather easy and I put it on paper and each med room had that paper to explain SOAP in each MAR book for easy reference!

S: subjective. Use quotes to explain what the patient is telling you happened. This section is what the patient says.

O: objective: This is what you see, and you can put a brief on what happened.

A: assessment: Make sure you chart things AS YOU SEE IT in detail. For instance, you don't just say "patient was complaining of pain"...say "patient had teary eyes and a red face pointing to their abdomen when asked where the pain was located". Use simple words and no diagnostic terms at all...leave that for the RN's! Just write down everything you witnessed in simple and throughough terms. Vital signs go here, as well as anything 'medical' you saw like a distended abdomen, blood, unresponsiveness, gasping for breath (don't use SOB).

P: Plan: This one is rather easy actually, this is your plan for helping the patient. It can be as simple as "gave pts PRN medication for pain, Tylenol 325mg 2 PO...as ordered and notified nurse. (our caregivers passed meds). Or even "provided for patient safety by staying in the room with the patient, and will use my walkie to call the RN on duty to come assess the pt." Always make a remark on what you did to provide pt safety!

That is a jist of what I wrote for the caregivers, and they used that a lot! :).