Accused of abandonement

rn/writer, RN · Dec 18, 2007

I think we need to understand the difference between an employee who is having a difficult time and an employee who is being difficult and giving others grief. AND we need to acknowledge that two --no, three--different discussions are now taking place in this thread.

The first topic is what happened to the OP. The second is the employee who is having problems, and the third is the employee who is causing problems. I'm concerned that we're muddying the waters and lumping all of these important subjects together.

As far as the OP is concerned, the consensus seems to be that she does need to be more on top of her responsibilities and to communicate better, but that writing her up for abandonment did seem a bit harsh.

This opened the door to wondering if there was something more going on than just this one incident. I think we'll have to leave this part of the discussion right there as none of us is in a position to know the whole story. Even the OP herself may not have a complete understanding of the issues. There may be factors involved that she is not aware of.

We need to keep the other parts of this discussion theoretical and resist the urge to speculate further on the OP's situation.

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Topic #2 is employees who are having difficulty. I don't think anyone is saying that you open the trapdoor under people who are struggling but who are genuinely trying. These are the kinds of folks you work with if at all possible. You put some effort into trying to discern where the problems lie. Is is a lack of confidence? Do they need better organization? What would help them feel more in control. Often, the time invested in this kind of person is well spent. Once they feel "at home" on the unit, they aren't eager to look elsewhere. One of the biggest issues for such an employee is feeling safe. Write-ups should be used sparingly and only for serious transgressions, and when done, there should be plenty of encouragement delivered at the same time.

Topic #3 is employees who resist being managed. They don't take direction. They don't accept responsibility. They create conflict and tension. And they are not teachable. If a manager has made numerous attempts to connect with such a person and nothing has changed for the better, judicious use of write-ups may be the only tool left in the box.

Managers have an entire unit to run. If one person threatens the rest of the team's ability to function and has resisted efforts to bring about change, guess what? They have to go. A good manager will attempt to work with that employee, but the employee has to be willing to do their part. Sad to say, there are people in this world who are rude, self-centered, vindictive, and cold. Managers can only do so much, and then, for the good of the workplace, they have to say, "Enough." Unfortunately, few P&Ps address bad attitude. All that's left, then, is to write them up on whatever is available, even if it seems like an over-reaction. Is that bullying? Actually, it's just the opposite. To allow one employee to create problems for the rest--that is bullying. That is when nurses complain that management doesn't care because so-and-so gets away with crummy behavior and no one does anything. This is the "anything" that needs to be done.

I would much rather work under a manager that pulls the plug on a truly dysfunctional employee for the good of the unit than one who is so worried about being "nice" that she ends up doing a disservice to the rest of the group by keep a bad apple around.

Managers can try to connect with their people and work out problems, but they can't offer psychotherapy and handholding to resistant and difficult people. Sometimes the troublemakers just need to be let go.

This is one area of management that many would like to ignore. But when they do so, the entire unit suffers and that filters down to the patients. It may seem harsh to give a prickly employee her walking papers, but tolerating uncooperative attitudes and incorrect behavior only gives the message that this is acceptable.

It takes courage to be the "bad guy," but that's one reason why management often deserves the pay increase that goes with the territory.

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Once again, let me remind everyone that topics #2 and #3 are NOT about the OP.

tencat · Dec 18, 2007

I agree that 'bad apples' do need to be dealt with decisively and strongly. A problem needs to be taken care of for the good of the group. However, what is rubbing me the wrong way is the assumption that all employees that have problems are automatically bad, have 'bad attitudes' and deserve punative punishments. Maybe that's not the intent behind some of the posts, but those who are posting these positions sound very rigid and unyielding in their attitudes (dare I say 'bad attitudes'?) Bad performance is a legitimate concern, and is quantifiable. A 'bad attitude' is not easily quantifiable and is in the eye of the beholder sometimes. An employee might perform very well, but not respond to management the way the manager would like. Does that mean that the employee is horrible? Not necessarily. It's not fair to assume that every employee that is having problems is automatically a bad employee trying to get something out of the system. I know that happens a lot, but that's not always the case.

LydiaNN · Dec 18, 2007

In the first place, one particular poster very clearly justified inflating this incident to the charge of "patient abandonment" to enable a write up that could facilitate them leaving the unit. Maybe that flies with some HR departments, I don't know. Where I work, the only person who might end up getting dismissed would be me. You can't go around exploiting the mistakes of others- even big ones- to speed up the process of getting rid of a difficult employee (and I'm not saying the OP is a difficult employee, although someone in this thread did say that, again without having the facts needed to arrive at such a conclusion).

Difficult employees are hard to deal with, yes. That's what makes them difficult. I haven't seen anyone who said a manager shouldn't have the ability to get rid of someone who intentionally tears the morale of the unit asunder, but the fact is that sometimes the reason that doesn't happen is that there are rules in place that protect employees. And just how did they come to be? From lawsuits against employers who did things like wrote an employee up for a bogus charge like patient abandonment. I think lots of managers are working to try to get rid of bad employees, but they're doing it within the rules, which just takes longer. We're also not allowed to tell anyone else what's going on, so it is often perceived we're not dealing with a situation when in fact we are.

Scrubby · Dec 18, 2007

I'm not saying that a manager shouldn't have the power to terminate someone who is consistently doing the wrong thing. However i do believe that all avenues of trying to improve a persons behavior need to be explored first such as anger management, trying to get the root of the problem through counselling, mentoring etc. I very strongly believe any manager who resorts to targeting a particular person by putting pressure on them is doing the wrong thing as it's a negative way to deal with a negative issue. Adding extra pressure (which to me sounds liked sabotage), constantly picking someone up on EVERYTHING no matter how small is considered as bullying behavior and not exactly a positive example from a manager. As someone has already said if someone is going to dig their own grave then let things take their course.

I think it's pretty sad that someone here asks for help and they get all this speculation and heavy criticism in return.

rn/writer, RN · Dec 19, 2007

i agree that 'bad apples' do need to be dealt with decisively and strongly. a problem needs to be taken care of for the good of the group. however, what is rubbing me the wrong way is the assumption that all employees that have problems are automatically bad, have 'bad attitudes' and deserve punative punishments. it's not fair to assume that every employee that is having problems is automatically a bad employee trying to get something out of the system. i know that happens a lot, but that's not always the case.

i don't see evidence of such assumptions. i see reference made to troublesome employees who do not respond to lesser measures, who continue--after efforts have been made to connect with them--to cause disruption and ill will.

rn/writer, RN · Dec 19, 2007

I think it's pretty sad that someone here asks for help and they get all this speculation and heavy criticism in return.

Please read post #49. The OP's situation led to questions which led to further discussion that started mentioning theoretical problems. The statements made regarding "problem employees" do not necessarily apply and that is why I made the distinction in my post.

i do believe that all avenues of trying to improve a persons behavior need to be explored first such as anger management, trying to get the root of the problem through counselling, mentoring etc. I very strongly believe any manager who resorts to targeting a particular person by putting pressure on them is doing the wrong thing as it's a negative way to deal with a negative issue. Adding extra pressure (which to me sounds liked sabotage), constantly picking someone up on EVERYTHING no matter how small is considered as bullying behavior and not exactly a positive example from a manager. As someone has already said if someone is going to dig their own grave then let things take their course.

What if all the problem-solving things have been attempted and the employee's behavior has not changed? Do you continue to let a stubborn and resistant person create problems for everyone else?

Managers need to reach out, certainly, but they can't sacrifice the rest of the unit if the questionable person doesn't reach back and isn't interested in changing anything. It's the kind and decent thing to be sensitive to the needs of your employees--to a point. We are adults, and as such, we're expected to conduct ourselves with some level of maturity. Management is wise to try to work with a salvageable employee, but they are not obligated to hold the hand of someone who is oppositional and resistant to help.

The post that talked about getting rid or troublesome employees like pulling weeds from a garden and putting pressure on them when they continually pressure those around them with their divisive and unfair behavior is not referring to employees who are having difficulty finding their footing and struggling to develop their skills. It is talking about people who remain entrenched in nasty and challenging behavior despite management's efforts to reach them through non-punitive means.

It would be nice if everyone could be a team player and care about the needs of the group. Unfortunately, there are folks who generate tension, conflict, and chaos in the workplace and they need to be stopped.

No one is suggesting that fragile, well-meaning nurses be targeted. But those who will not work with management, who refuse to play well with others, who resist counseling and cling to their unhealthy methods for dealing with things they don't like, they put themselves in harm's way.

Not getting rid of someone who keeps causing problems despite efforts to help them change amounts to letting them hold their co-workers hostage.

UM Review RN, ASN, RN · Dec 19, 2007

Not to throw the discussion off-topic (any more than it already has been--and it's strayed quite a ways ), but my objection to this management tool stems from the way I've personally seen it used.

Fact is, I have seen the technique Daytonite mentions used only occasionally for the stated purpose. More often, I have seen it used on perceived "troublemakers" who actually brought valid concerns to the table. Forcing the "troublemaker" out served to keep all the staff in a subservient, fearful role, and attained the management objective of enforcing policies (such as deliberate understaffing) that undermined patient care.

Suzanne Gordon talks about this so well that I'm really only paraphrasing some of the things she discusses in Nursing Against the Odds. I recommend that every nurse read it.

However, I agree that this particular discussion, brought up by Daytonite, really has no place on this particular thread. Critical information has not been shared. Whether we think the actions of the OP's manager and preceptor is fair or not is a moot point, as we are not part of the process of discipline for this OP.

The most we can do is share, commiserate, suggest, and/or support, no matter how this turns out for the OP. The burden and responsibility of creating an expert practice is on the OP and even though the tone of some of these posts is bursting with some of the more unpleasant realities of bedside nursing today, I want to assure the OP that we all do wish her well, and we all do want to see her make improvements to her practice.

rn/writer, RN · Dec 19, 2007

I have seen the technique Daytonite mentions used only occasionally for the stated purpose. More often, I have seen it used on perceived "troublemakers" who actually brought valid concerns to the table. Forcing the "troublemaker" out served to keep all the staff in a subservient, fearful role, and attained the management objective of enforcing policies (such as deliberate understaffing) that undermined patient care.

I agree that this tool can be misused and object strongly to that kind of application.

Scrubby · Dec 19, 2007

rn/writer-sorry had to edit above post I meant to say that IMHO a manager should have the authority to dismiss someone only IF all other methods have failed.

But i still disagree that a manager should have to put extra pressure on someone as a tool to get rid of them. If the employees behavior is unacceptable and continues this is ground enough for termination without resorting to nasty tactics.

DutchgirlRN, ASN, RN · Dec 19, 2007

But I was greatly bothered by the attitude behind it all. Come on. . .the OP said, "ultimately my preceptor is the one responsible." That's a big problem. Who among you reading this didn't know by the time you finished nursing school that you were responsible for your actions? You don't blame the first available person.

When I was precepting I was responsible for the patients. As the OP stated she was not even on the assignment sheet as part of the team for the day.

Orientation is a time for learning. Learning how to be a responsible nurse and in the beginning of a nurses career is possible to only be as good as the nurse who is precepting you. There are some things we just don't learn in school. Taking a full asssignment and organizing our time is only one example.

Everyone learns from making mistakes (I still do after 32+ yrs) and which new nurse hasn't freaked out over getting reported for something they did wrong that they didn't even know was a wrong thing to do?

I'm just saying that I was thinking this could, or might be, a pattern behavior (not accepting blame and placing it on others). It often is.

Why would we think this? The OP is an orientee who hasn't been there long enough to establish a behavior pattern and also a new grad who doesn't have an established work record either.

My feeling was that someone else at the work place might have used the incident (abondonment) as a convenient vehicle to lay into the employee when the real problem was actually other behavioral issues.

Why would we read into this that someone else might be using this incident to correct the OP's behavioral issues? How do we know she even has any? Again, she is a brand new grad & orientee.

I don't think we need to be discussing anything other than whether or not she really is guilty of patient abandonment.

chare · Dec 19, 2007

i included the following, obtained from the north carolina state board of nursing website as an example of one definition. as demonstrated by mercyteapot in post 10, these definitions can vary greatly from state to state. it was not my intent to imply that i thought the op was guilty of abandonment, but rather to stress the importance of knowing how each sbon of nursing defines it.

oh for heavens sake, i do believe the bon has bigger fish to fry that this new nurse who was still in training with a preceptor.… she may deserve a write up for not telling preceptor, but abandonment?!

i was not implying that i thought the op was guilty of abandonment, but merely providing one definition. i also agree that the bon probably does have “bigger fish to fry,” however if this would be reported to them, they would be obligated to investigate the allegation. had i been the op’s preceptor, and this incident stemmed only from her/him leaving the patient care area for a few minutes, i would have handled it by talking with her/him about the importance of letting your team members know when you will be out of the immediate area for a few minutes.

i went to go speak to a manager about an issue i was having with my preceptor.

i won’t speculate about the issue the op was having with her/his preceptor. however, i will say this. if i was her/his manager i would assign her/him a new preceptor for the remainder of the orientation period. depending upon how much of the orientation period was completed i might also extend the time period with the new preceptor as well. if the preceptor is the problem then it will go away. if the op is the problem then there will be another person’s observations and evaluations documenting the issues. either way it will help ensure that the op will get a fair evaluation during the orientation period.

who wrote you up? if it was the precepter go to your nm.sounds like your preceptor has a bug up her patooty about something.if it was the nm who wrote you up, go to the don.this is not abandonment and she has no business telling you so.

good advice. the only points that i would add are these. if the write up was only done in your orientation progress reports rather than an official disciplinary processing, i would not worry about it much, if at all, as that is probably the only place it will reside. however, if the write up was done via the formalized disciplinary process, the op’s facility should have a policy regarding the disciplinary process and outlining her/his rights in the disciplinary process, as well as her/his avenues of rebuttal. the op should have the right to write a rebuttal either way.

if your hospital is like mine and you cannot transfer for six months without manager approval, keep your head down and fly under the radar for the next few months. who knows, by then everything might work itself out.

i think this is the best advice that anyone in this post has given you. sometimes we just need to accept the fact, for whatever reason, that we are not a good fit in a particular unit/department. this does not mean that you are bad or the department is bad, it just means you don’t fit. do what you need to do to survive and move on at your first opportunity.

please do not take this harshly, as that is not my intent. there are 2 sides to every issue, and the truth is usually somewhere in between. only you know what has happened. ask your preceptor if the two of you can take time to discuss your progress, and if he/she believes there are problems that you need to work on, and if so, what do you need to do to correct them. if your preceptor can not or will not do this, then you need to address this with your nurse manager. do not do this if you are not willing to take a good, hard look at yourself and make changes as needed.

i know it’s terribly hard to do this. i started a new job at a new facility almost 2 years ago. shortly after starting i began having problems and couldn’t wait until my first year was complete so i could apply for a transfer. while i was waiting i analyzed the situation and realized that there were several factors contributing to these problems, most of which i had no control. i could control my behaviors however, and looked at ways to reduce or eliminate negative or non-productive behaviors. since modifying my behavior i have grown to enjoy working in the department, as well as becoming active on 2 unit based committees. looking at and changing your behaviors doesn’t mean that your wrong, it just means that your doing the smart thing and working on what you can control.

again, i wish you the best of luck in your nursing career,

bell83 · Dec 22, 2007

I think that there are some things that need clarification. First off, I had zero previous disciplinary issues on the unit. The write up was a complete shock, especially considering this. I spoke to my manager because I felt that there were lines my preceptor had crossed with me, and tension was very high between us. She had continuously spoke to me in ways that were insulting and inappropriate, and I needed to speak to someone so I asked one of the managers if we could speak in private. I did not want to tell my preceptor that I was reporting her actions as I knew it might spark up a verbal altercation. She later told another manager that I had disappeared without telling her and without hearing my side of the story. I was still on the floor, I had not left it, nor the hospital. I was not "galavanting around". So that clears up anything daytonite may have have assumed with the information that was given. Second, when I said ultimately my preceptor is responsible. I think it was extremely misinterpreted by a few responders. In saying that, I meant that my preceptor has primary responsibility of the patient. Because I am new nurse, who just graduated, I am not in a place in my career position to assume complete responsibility of a patient's care. I never stated that my preceptor is responsible for my actions, I accept total responsibility for my actions. My concern was the extreme to which a mistake I made of not telling my preceptor that I was talking to one of the managers was addressed to such an extreme as a write up for patient abandonement by another manager. This is one of, if not the most serious charge to slap on a nurse, and I don't think that it should be given lightly. I wanted input on whether anyone though patient abandonement was an appropriate way to address this because, it seems far-fetched.