advice needed

[nm2bns1986]

Hi*all*

I have been qualified now for a few years and work as the nurse in charge on nights on my ward, usually as the only registered nurse with a few health care workers. Recently a HCW has come onto nights who is generally good at her job, good with the patients and works hard.*

I do have a few concerns though, and unsure on how to approach this in supervision with her.*

Firstly is we have a patient in long term segregation (i work at a mental health hospital), and the MDT have written an in depth care plan to reintegrate him back onto the ward, and part of that is he can come onto the main ward 3 times in 24 hours for 20minute periods at the nurse in charges discretion. One night we had out in the communal lounge and she blatently said "this care plan is rubbish, he should be able to come out whenever he is settled, the doctors and nurses dont know half as much about him as i do". I did challenge her at the time but she wouldnt listen.*

Another issue is she makes a lot of sexualised comments about her personal life, making our other colleagues feel uncomfortable, and engages in 'banter', more often than not in the office, but sometimes on the corridors where patients can hear.*

My last issue is she tries to take control of the ward, i feel like she undermines me a lot of the time, and forgets that she isnt a nurse.

one time she complained to the night manager that we were short staffed, and he told her that he had already discussed staffing with the nurse in charge, and it was nothing to do with her.. i got pulled in for that.*

Other times she will contact the night manager and say he needs to attend the ward, without telling me, and then when he arrives on my ward i know nothing about it...usually it is about something trivial that could have waited, or about taking time owing etc... so im made to look and feel stupid.*

Basically i think she likes to feel she is the registered nurse and tries to run the ward.*

I am more concerned with her comments about the MDT and that the care plans are "rubbish".*

I am dreading going in tonight but i feel these issues need addressing.

[GrumpyRN, NP]

Yes, this needs to be addressed. Talk to the night manager so they are aware and then talk to the Senior nurse who has 24 hour responsibility for the ward - s/he would have been the person to interview/appoint this person. At some point you are going to have to stand your ground and tackle this behaviour - it will only get worse. As a student I worked in mental health and some of the HCA's ran the wards - not a good environment as there was aggression and just poor care.

Sorry, but as you said yourself - you are the nurse in charge. That means you have to be the nurse in charge.

Good luck with this as it is difficult but when YOU are dreading going into work it is time to call a halt.

Added as a PS, document, document, document. Even write down things verbatim as it may go to HR and then you could be accused of bullying.