Hi! I'm a new RN in my third week of orientation. I think I'm doing pretty well overall, & really do like my unit & the nurses I work with. Now I feel like my biggest issue or thing I need to work on the most is delegation. It still feels so weird to me to delegate to nursing assistant (NAs) because I was one for 2.5 years & it feels so strange to be on the "other" side. I think my problem is this: since I know how difficult it can be to do the work NAs do, I tend to either not ask them to do something when I need it -cuz I feel bad asking them to do something-even when I'm busy(I usually do it myself)or I notice I seem to just about apologize as I'm asking them to do something. And I feel like because I'm a new nurse & not demanding in the least a few of them are skipping some things they should be doing-like not totaling up I & O, & one of them last week checked a patient's blood sugar at noon & didn't tell me it was 386!!! I was running around so busy that day that at 12:30 it dawned on me that she didn't tell me the patient's sugar, so I'm thinking to myself "Hmm..I bet it was a normal value if she didn't report it to me." Nope! When I looked in the flow sheet I saw she wrote it there but didn't tell me about it! When I saw her next time I said "Gee, that patient's blood sugar was high-I had to give her insulin." She just said "Yeah" & then said "Oh & I forgot to write down her weight too-it was 250 lbs." I feel like she was just making up that number! Then another NA today was being difficult too. I was very nice to her & helped her clean up & transport patients whenever I could, but then she gave me attitude later on for no reason. Our patient was on every four hour blood sugar checks. So the last sugar was checked at 8 AM today. Then at exactly 11:10 AM I see her just about to check his sugar again, so I went up to her & said "Oh, he is on every 4 hour checks. So his next sugar isn't due until noon." She just gave me such a dirty look! I'm sorry if it's not convenient for you, I felt like saying, but too bad-the doc didn't order every 3 hour checks, so deal! (I didn't say that of course but wished I did!) Then at noon I saw her with the machine, so I said to her "How is his sugar?" And she says to me "I'll tell you it when I know it." And she said it in the rudest voice you could imagine. It really upsets me when I try so hard to be nice to people (NAs) and they turn around and act like jerks. How would you guys handle this? I know I have to learn to be more assertive. I guess I am afraid to speak up in case I offend anyone. Thanks for listening!
If an aide falsifies the record with made up blood pressures, etc. the worst that can happen is she gets fired. If a licensed nurse does it their license is gone with the wind.
With nurses who hang around on the phone while everyone else is busy and their resident's are needing help I go over and stand over them and tell them to get off the phone. I stand there until they hang up (an assertiveness technique). Then, I inform them that the time to make personal phone calls is during their breaks (like maybe they forgot that!). If I catch them at it a second time I do the same thing and also tell them that I am writing them up, and I do--a nice neatly word processed memo documenting their behavior for the DON. If I'm feeling particularly put out with them I'll ask them if they want a copy of it. They either follow the rules and get to work or they are going to go out the door.
I worked with a new (and LAZY) aide who's always watching tv, eating ice cream, and chatting on her cell phone while I'm running around answering call bells, shutting off chair/bed alarms, etc with my other coworkers. She was caught sleeping in the dayroom while a bed alarm was going off across the hall. I heard it down the hall and caught the resident in time from falling off the toilet in his room. My supervisor wrote her up, but she is a softie. Plus that aide had counseling from the DON, and she made up some sobstory about how she is hardworking.
That girl needs to be fired. She's very rude and rough with residents, she's not caring, and a lot of alert residents don't want her doing care on them. Some families don't want her caring for their loved ones. I'm stuck, I don't know what to do. I don't want to appear like a backstabbing tattletale, but I'm sick of doing her work and putting up with her roughhandling and rudeness. I try to correct her positively with the other aides, but she snaps and says I know what I'm doing. Please give me some advice.
Specializes in med/surg, telemetry, IV therapy, mgmt.
Positive correction is not going to work with this little smart aleck. You are going to have to get tough with her. You have the authority to do it. And, for the record you are not going to be a backstabbing tattletale. As a charge nurse you are a supervisor of this worker and it is up to you to deal with her. You reply to her, "Don't talk to me in that tone." If you catch her being rough with a patient or a patient complains of this to you, you take her aside (never correct her in front of the other aides, even if she tries to get an audience) and you tell her (1) "I just saw what you did" or "Mrs. X told me you were very rough when you turned her." (2) "I've told you before to be gentle with the patients. If I hear another complaint or see you being rough I am writing you up and reporting it to the DON." (3) When it happens again you tell her "I told you that I was going to report you to the DON if you didn't stop being rough with the patients. I am writing you up." Do the write up at home where you can put some thought into it. Just like charting you keep it factual. It is OK to document that someone used a snotty tone or raised their voice to you. If she walks away in the middle of your talking to her include that in the write up. That is insubordination. Refusing to follow instruction is subordination. Compose it on your computer, put it in memo form, print it out and seal it in an envelope so only the DON is going to see it. Keep a copy for yourself. The best time to get after this kind of crappy worker is when they are new. If she's been there a long time you will have to keep on finding opportunities to write her up. When the DON sees that you're serious about the crap this aide is doing, hopefully, she will do something about it. Sometimes the DON needs several documented write-ups on a person's same, repeated behavior (shows a pattern) before they feel they can safely fire someone.
Based on what you wrote, I would be writing her up for catching her watching TV, chatting on her cell phone and not answering lights or attending to bed alarms. You write these things down on the back of your worksheet so you have times and room numbers. When I catch habitual phone call abusers I stand next to them while they are on the phone and tell them they need to hang up and then stick with them until they end the phone call. It's immensely intimidating, but it works. Then, I tell them I'm writing them up because they are only to make or take phone calls when they are on break. If the facility doesn't have a policy on cell phone use I would badger the DON about it. I'd volunteer to write the policy for her. In a lot of the facilities that I worked being caught sleeping was automatic termination. Did anyone write that incident up?
Please don't fall into the very easy trap of believing that the DON doesn't care. If she's any kind of manager she is not going to discuss any employee's disciplinary meetings with the other employees (confidentiality). Also, if she's any kind of manager she will value the input from her licensed staff. I would just also suggest that you stay in the hallway as much as you can. It's easier to catch numbskulls like this doing their little nasty things with patients when you are in the patient area. Also, I know the writing takes up a lot of time, but it is the only way they can fire a person. They have to have the written documentation to back up the termination. Guess they forgot to tell you that this was part of a nursing home charge nurses job. I'm sorry you have to deal with someone like this, but she is not going to respond to your being "nice" to her.
Now, before any of you people reading this think I am just a witch, please, let me explain. I've been doing supervision in nursing homes for years. You have to get tough with aides like this. We're talking here about an aide who has been belligerent and defiant. She has not responded to kind prompting and she continues to misbehave. As a first line supervisor you charge nurses are the ones who are in the best position to do that. Don't depend on your "softie" supervisor to do it for you. Take the bull by the horns and do the write up yourself. That way you know it got done. It will be a bit draining on you, but you have to do all this monitoring of her and writing her up. If it helps, think about how this is going to benefit the patients. You have to be as persistent as she is defiant.
Good luck trying out these new supervision skills.
Positive correction is not going to work with this little smart aleck. You are going to have to get tough with her. You have the authority to do it. And, for the record you are not going to be a backstabbing tattletale. As a charge nurse you are a supervisor of this worker and it is up to you to deal with her. You reply to her, "Don't talk to me in that tone." If you catch her being rough with a patient or a patient complains of this to you, you take her aside (never correct her in front of the other aides, even if she tries to get an audience) and you tell her (1) "I just saw what you did" or "Mrs. X told me you were very rough when you turned her." (2) "I've told you before to be gentle with the patients. If I hear another complaint or see you being rough I am writing you up and reporting it to the DON." (3) When it happens again you tell her "I told you that I was going to report you to the DON if you didn't stop being rough with the patients. I am writing you up." Do the write up at home where you can put some thought into it. Just like charting you keep it factual. It is OK to document that someone used a snotty tone or raised their voice to you. If she walks away in the middle of your talking to her include that in the write up. That is insubordination. Refusing to follow instruction is subordination. Compose it on your computer, put it in memo form, print it out and seal it in an envelope so only the DON is going to see it. Keep a copy for yourself. The best time to get after this kind of crappy worker is when they are new. If she's been there a long time you will have to keep on finding opportunities to write her up. When the DON sees that you're serious about the crap this aide is doing, hopefully, she will do something about it. Sometimes the DON needs several documented write-ups on a person's same, repeated behavior (shows a pattern) before they feel they can safely fire someone.
Based on what you wrote, I would be writing her up for catching her watching TV, chatting on her cell phone and not answering lights or attending to bed alarms. You write these things down on the back of your worksheet so you have times and room numbers. When I catch habitual phone call abusers I stand next to them while they are on the phone and tell them they need to hang up and then stick with them until they end the phone call. It's immensely intimidating, but it works. Then, I tell them I'm writing them up because they are only to make or take phone calls when they are on break. If the facility doesn't have a policy on cell phone use I would badger the DON about it. I'd volunteer to write the policy for her. In a lot of the facilities that I worked being caught sleeping was automatic termination. Did anyone write that incident up?
Please don't fall into the very easy trap of believing that the DON doesn't care. If she's any kind of manager she is not going to discuss any employee's disciplinary meetings with the other employees (confidentiality). Also, if she's any kind of manager she will value the input from her licensed staff. I would just also suggest that you stay in the hallway as much as you can. It's easier to catch numbskulls like this doing their little nasty things with patients when you are in the patient area. Also, I know the writing takes up a lot of time, but it is the only way they can fire a person. They have to have the written documentation to back up the termination. Guess they forgot to tell you that this was part of a nursing home charge nurses job. I'm sorry you have to deal with someone like this, but she is not going to respond to your being "nice" to her.
Now, before any of you people reading this think I am just a witch, please, let me explain. I've been doing supervision in nursing homes for years. You have to get tough with aides like this. We're talking here about an aide who has been belligerent and defiant. She has not responded to kind prompting and she continues to misbehave. As a first line supervisor you charge nurses are the ones who are in the best position to do that. Don't depend on your "softie" supervisor to do it for you. Take the bull by the horns and do the write up yourself. That way you know it got done. It will be a bit draining on you, but you have to do all this monitoring of her and writing her up. If it helps, think about how this is going to benefit the patients. You have to be as persistent as she is defiant.
Good luck trying out these new supervision skills.
hi there. I'm not the charge nurse. I'm an aide also, but I'm sick of seeing this aide doing nothing all day and I've been to the charge nurse a million times but nothing is done. I forgot to mention that I'm an aide also when I did my post. The advice is great, if I was the charge nurse, I'd write her ass up and bring it to the DON's attention. But I'll give these tips to my softie supervisor and tell her to get more assertive for the patient's sake.
I have some issues with some of our new tech's as well. One of them was sitting in MY chair talking on the phone, then when she got off I asked her to transport my patient and I saw her 5 minutes later gossiping with another tech, my pt. still not transported. Now, this is obviously unacceptable, but you know what, as a new nurse I need to concentrate on learning all I can and not having a mental break down every day. If I pursue this tech. (also new, started right when I did) and write her up or tell her off, then I will create all kinds of drama that I really don't need to deal with right now. So, while I am still so new, I am going to lay low and be passive (as long as it is not endangering my pt.) Once I am a little more comfortable and I have the energy to be bothered with drama and gossip then look out I will go through the motions of telling her how it is and writing her up if necessary.
I think it just takes a while to earn respect. I am always polite to techs and thank them when they go out of their way and let them know I appreciate them. Most of them have warmed up to me now and are happy to help me, I also try to pay my dues as much as possible. If I am not swamped and I have a code brown I will say, Hey can you help me clean up this pt. and I will do the cleaning while they hold, instead of just asking them to go do it. I think having the aides support on your side is so important. If I get mean and piss everyone off at the beginning then I am going to be screwed when I really need help. Just my philosophy, and it's worked so far (except for the one new girl :wink2: )
Specializes in med/surg, telemetry, IV therapy, mgmt.
I understand your thinking that you want to lay low and be passive for awhile before asserting your authority. However, let me give you a couple of reasons why you shouldn't put off addressing this new tech's behavior for very long.
(1) by not letting her know she's doing something wrong and not calling it to her attention the rule of negative reinforcement applies. In other words, her thinking will go something like this, "no one said anything to me before when I was talking on the phone, so I guess it's OK to do it."
(2) It is easier to correct new employees and get a positive response from them. The longer their bad behavior goes unchecked, the more insolent they are likely to become. They will use that as an argument against you eventually. "No one, not even you, has ever said anything to me about this before. Why are you doing it now?"
(3) The negative behavior escalates. Today the phone; tomorrow it will be taking longer breaks, disappearing while patients are calling for help, using patient's personal items. . .the list can go on and on.
(4) The other aides are also watching and evaluating you. If they begin to think that you are going to be easy and allow one person to get away with talking on the phone all the time, then they will start to do it also. Next thing you know, you'll have several people violating the phone call policy and the problem has then gotten larger.
(5) Some aides will become disillusioned with you for not correcting the renegade aide and will lose respect for you instead of developing the respect you want from them so much. The aides who do follow rules depend on their supervisors to correct someone who doesn't. They have no authority to stop another aide from wrong-doing and can only stand by helplessly while the wrong-doer violates the rules they chose to obey. They will start to say things about you like this, "ah, she doesn't care. She just lets Jane do what she wants."
(6) You never, never, never "tell anyone off". It indicates you can lose your composure and you cannot afford to do that as a supervisor. You always want to give the impression of being strong and in control, but pleasant.
Think about what you want to say to this aide. Compose an assertive sentence and practice saying it to yourself. Be ready to put it into use. The next time you see this aide gossiping in the hallway instead of transporting your patient you say very calmly and without too much emotion, "Jane, I need you to move Mrs. Smith to the dining room now. Come on, you have to get this done right now, please." And, then go about your business. You've given her an order and you've said it in a very nice way. Now, just watch to see what she does. If she is still dawdling you go up to her a few minutes later and say, "Jane, I asked you to get Mrs. Smith moved to the dining room." And, stand there until she moves to do this. The third time you say, "I want you to move Mrs. Smith now." Keep your sentences short, concise and to the point. It gives the aide less room to argue back. If she wants to try to get you in a debate you simply say , "I don't have time to debate this with you, Jane. We both have a lot to do. Just do as I asked you." At this point, stand at your position and don't move until she physically moves to do this task. This is an assertive action on your part.
The write up doesn't come about until this kind of behavior has been addressed a couple of times. You have to give an employee a chance to correct what they are doing wrong before you resort to disciplinary measures.
Just think on what I've told you. Supervision is a skill like any other. The first time you engage in it is a little scary and nerve racking. It helps to think about what you are going to say before you say it. Also, if you get tongue-tied or miss your chance to address an employee at the moment of their wrong behavior, you can still do something. You wait for a quieter, calmer moment later in the shift, take the person aside and tell them, "I want to talk to you about what happened before. I saw you standing around, talking and laughing while Mrs. Smith was waiting to be moved. I didn't like that you seemed to be ignoring my instructions. When I have asked you several times to do something for a patient it is because it is something I feel is important and I want you to do what I'm asking of you." Keep your voice calm, don't shout or get bossy. That leaves the door open for a friendly relationship with this aide. It's hard, I know! For most people, saying things in the fashion I've given you will suffice. If the wrong behavior continues then you know you have a problem employee and that is when you have to start using more aggressive tactics and start the write-ups. After awhile of doing this you will be able to kind of tell who is going to do what they're supposed to and who is going to eventually be going OTD (out the door).
One last thing. . .you can be friendly with the people you supervise, but you cannot necessarily be their friend. There is a difference.
I hope this helps you out. You will have to put your supervision feet into the fire eventually. Just practice and have your words ready for that moment you take the plunge. Good luck.
One of the hardest things about being a nurse is dealing w/ NAs/PCTs w/ bad attitudes.
I was a CNA for 3 years, and I respected and looked up to my nurses, but that is hard to find in a CNA today.
Under no circumstances should you let them walk over you. Stand up to them. I know it can be very hard to do sometimes, but if you don't, you will create a monster. I know, I learned the hard way.
Good CNAs who believe in teamwork are more important to good pt care and a good work environment than are good docs or amin, IMO.
Specializes in med/surg, telemetry, IV therapy, mgmt.
One of the hardest things about being a nurse is dealing w/ NAs/PCTs w/ bad attitudes.
I was a CNA for 3 years, and I respected and looked up to my nurses, but that is hard to find in a CNA today.
Under no circumstances should you let them walk over you. Stand up to them. I know it can be very hard to do sometimes, but if you don't, you will create a monster. I know, I learned the hard way.
Good CNAs who believe in teamwork are more important to good pt care and a good work environment than are good docs or amin, IMO.
I agree. Dealing with bad attitudes is one of the hardest and most challenging things any nurse has to do. It is kind of skimmed over in nursing school and students really don't get much practice at it. Which is why so many new nurses feel so frustrated when they find themselves stuck with one of these problems. There just isn't a nursing instructor around to help them out. It's a sad reality that this kind of bad attitude behavior does go on--pretty much everywhere if it isn't stopped before it gets out of hand.
Bad attitude CNAs are one of the most unfortunate realities facing new nurses, especially ones who have worked as CNAs themselves and were excellent at it. In their innocence they believe that all the other CNAs out there in the working world have the same degree of commitment to reach excellence in their job performance and the same ability to self-analyze and self-actualize. That is the problem that the OP of this thread was having. It's a real shock to come up against these negative attitudes and absolutely horrendous misbehaviors. As an experienced nurse I wish I could hug them all and stand beside them and give them guidance in the learning of leadership skills to deal with these situations, but I am only one person. I know that armed with the skill to deal with a bad worker will improve their own working condition tremendously and lead to job satisfaction. I really feel badly for the graduate nurses going into long term care because there tends to be a concentration of these (what I like to call) renegade aides although some of them are showing up in the acute hospitals too. Good luck to all who are reading this thread and hang in there.
Positive correction is not going to work with this little smart aleck. You are going to have to get tough with her. You have the authority to do it. And, for the record you are not going to be a backstabbing tattletale. As a charge nurse you are a supervisor of this worker and it is up to you to deal with her. You reply to her, "Don't talk to me in that tone." If you catch her being rough with a patient or a patient complains of this to you, you take her aside (never correct her in front of the other aides, even if she tries to get an audience) and you tell her (1) "I just saw what you did" or "Mrs. X told me you were very rough when you turned her." (2) "I've told you before to be gentle with the patients. If I hear another complaint or see you being rough I am writing you up and reporting it to the DON." (3) When it happens again you tell her "I told you that I was going to report you to the DON if you didn't stop being rough with the patients. I am writing you up." Do the write up at home where you can put some thought into it. Just like charting you keep it factual. It is OK to document that someone used a snotty tone or raised their voice to you. If she walks away in the middle of your talking to her include that in the write up. That is insubordination. Refusing to follow instruction is subordination. Compose it on your computer, put it in memo form, print it out and seal it in an envelope so only the DON is going to see it. Keep a copy for yourself. The best time to get after this kind of crappy worker is when they are new. If she's been there a long time you will have to keep on finding opportunities to write her up. When the DON sees that you're serious about the crap this aide is doing, hopefully, she will do something about it. Sometimes the DON needs several documented write-ups on a person's same, repeated behavior (shows a pattern) before they feel they can safely fire someone.
Based on what you wrote, I would be writing her up for catching her watching TV, chatting on her cell phone and not answering lights or attending to bed alarms. You write these things down on the back of your worksheet so you have times and room numbers. When I catch habitual phone call abusers I stand next to them while they are on the phone and tell them they need to hang up and then stick with them until they end the phone call. It's immensely intimidating, but it works. Then, I tell them I'm writing them up because they are only to make or take phone calls when they are on break. If the facility doesn't have a policy on cell phone use I would badger the DON about it. I'd volunteer to write the policy for her. In a lot of the facilities that I worked being caught sleeping was automatic termination. Did anyone write that incident up?
Please don't fall into the very easy trap of believing that the DON doesn't care. If she's any kind of manager she is not going to discuss any employee's disciplinary meetings with the other employees (confidentiality). Also, if she's any kind of manager she will value the input from her licensed staff. I would just also suggest that you stay in the hallway as much as you can. It's easier to catch numbskulls like this doing their little nasty things with patients when you are in the patient area. Also, I know the writing takes up a lot of time, but it is the only way they can fire a person. They have to have the written documentation to back up the termination. Guess they forgot to tell you that this was part of a nursing home charge nurses job. I'm sorry you have to deal with someone like this, but she is not going to respond to your being "nice" to her.
Now, before any of you people reading this think I am just a witch, please, let me explain. I've been doing supervision in nursing homes for years. You have to get tough with aides like this. We're talking here about an aide who has been belligerent and defiant. She has not responded to kind prompting and she continues to misbehave. As a first line supervisor you charge nurses are the ones who are in the best position to do that. Don't depend on your "softie" supervisor to do it for you. Take the bull by the horns and do the write up yourself. That way you know it got done. It will be a bit draining on you, but you have to do all this monitoring of her and writing her up. If it helps, think about how this is going to benefit the patients. You have to be as persistent as she is defiant.
Good luck trying out these new supervision skills.
...Believe it or not this is the same type of stuff that goes on in corporate America where I currently work.
I will go through the motions of telling her how it is and writing her up if necessary.
Kitkat23
63 Posts
I worked with a new (and LAZY) aide who's always watching tv, eating ice cream, and chatting on her cell phone while I'm running around answering call bells, shutting off chair/bed alarms, etc with my other coworkers. She was caught sleeping in the dayroom while a bed alarm was going off across the hall. I heard it down the hall and caught the resident in time from falling off the toilet in his room. My supervisor wrote her up, but she is a softie. Plus that aide had counseling from the DON, and she made up some sobstory about how she is hardworking.
That girl needs to be fired. She's very rude and rough with residents, she's not caring, and a lot of alert residents don't want her doing care on them. Some families don't want her caring for their loved ones. I'm stuck, I don't know what to do. I don't want to appear like a backstabbing tattletale, but I'm sick of doing her work and putting up with her roughhandling and rudeness. I try to correct her positively with the other aides, but she snaps and says I know what I'm doing. Please give me some advice.