I find a lack of understanding on the part of some of our aides as to what the nurse's view is on certain things.
The aides think we do too many vitals, weights, I & O, rounds, etc. and decide, on their own, that they are unnecessary and do not do them. One of them was in the habit of removing IV's she thought were unnecessary. I reported her after she continued doing this after I'd told her not to. We had to stick the patient 5 times to restart his saline lock for antibiotics. Family was quite angry and I don't blame them. Another nurse told them the truth, though, which made them livid and they c/o to the DON, who fired the tech.
They want to sleep on duty while they are supposed to be watching to make sure nothing happens to mental patients and have a complete lack of understanding, apparently, that the patients will not wake them up to say, "OK, I'm going to kill myself now, or swallow scissors now, or cut myself now, stop me if you can." They do not seem to grasp that not only are they going to be fired and maybe prosecuted, blackballed, whatever if the patients suffer harm but that they are also jeopardizing my license and livelihood and ability to support my family if some investigator decides I was not properly supervising the aides - although how I am supposed to ride herd on them and still accomplish my own work is not totally clear to me.
I spend a lot of time and emotion on trying to make clear what I expect of aides, one thing being that they need to tell me if they need to leave the floor, other than for a quick potty stop. And if I say that they need to wait until their peer returns from his break, they need to wait. Some are wonderful, some get huffy, I hate all the upset and anger they toss my way at times. They do what I say, though, like it or not, as I have made it clear that I will do the write-up's that are sometimes necessary if they don't. They might not like me but I have earned their respect and they know not to cross me. Actually, I think they like me well enough and I even like them.
How about you? Do you have such troubles? Do you have the respect and cooperation of your techs? Do you like being in charge? Do you enjoy working with unlicensed staff?
