Bad management

middleagednurse · Sep 14, 2016

Just FYI, generally speaking, it is better to be nice than to be right, unless it's a life or death situation obviously. I'm not saying you did anything wrong, but it's always a good idea to work on your interpersonal relationships when at work.

AutumnApple · Sep 14, 2016

It is possible to communicate effectively in writing using your cell phone. Unless I'm sitting in Barnes & Noble (which I am now, on my iPad) or Starbuck's, I do all of my internet on my phone. That's because I have one of those old unlimited data plans on my phone and no internet at home. Please don't let your phone be your "reason" for poor writing. Writing on these forums is an excellent way to practice your writing skills. The more you practice, the better you are at writing. If you continue to practice good writing habits while on the forums, it will be much easier for you to write well when it's time to chart or to write an email to your boss. Again, I think a writing class might help you.
I don't think the problem is you being "too nice." I think the problem is that you aren't direct; you don't communicate effectively. I don't doubt that the CNAs are recalcitrant, even lazy. I just think you'd have a better time of it if YOU communicated exactly what you needed, when and possibly why. The CNAs, however lazy and disrespectful, are people, too. If you treat them as valued team members you will have an easier time getting them to do their jobs. (Ask me how I know this. Sigh! I, too learned the hard way by alienating all of the CNAs at my work. It takes a long time and hard work to win back their good will.) Some CNAs are interested in being nurses and if you share with them the importance of turning and repositioning in avoiding decubitus ulcers, they may be more vigilant about turning. Some are just putting in their time so they can take the paycheck home to their kids. Have you ever asked them about their kids? A cheery "Good morning?" And a sincere "how are you" will go a long ways toward making those CNAs more willing to help you out. (Do their jobs.). Some CNAs are just lazy and have poor attitudes and nothing you do will help -- those are the ones you write up. Those are the only ones you write up. If management keeps hearing about how you're "mean" to the CNAs and you keep writing them all up, even the ones no one else seems to have an issue with, the problem appears to be all about YOU.
Almost no one responds well to "I am your superior and you will do as I ask." It might work out well in the military, but there is relatively little asking in the military. You give orders. Giving orders doesn't work well in civilian life.
Yelling is never OK -- not even when you do it. Not even if you're yelling at someone who is swearing at you. Just don't do it.

And part of the OP's journey may involve finding out she just does not get along with CNA's. That's fine. Many nurses I respect and wish to emulate are that way.

When I was a preceptor, I swear I had one GN who was like this. *I* liked him. He was direct, not into gabbing with co-workers but was not anti-social, and probably one of the most polite GN's I ever worked with. He took redirection well and I didn't have to stand over the top of him the whole shift for his duties to be done.

BUT......................

Meh, when he had to direct a CNA or perform a task that required cooperating with them, something always seemed to happen. It was rarely a fight or even a disagreement, although those things happened a couple times. Mostly, there was just something in the air, a level of discomfort. Little jabs and quips. He just simply didn't get along with them.

His orientation ended with high marks and a good rating, with the usual amount of "areas for improvement" things written in. I of course had to include the fact that his relation with the CNAs absolutely had to improve. In fact, that became his "primary" goal to achieve before the next review.

I was called into the manager's office and he was there, long face and looking a bit ashamed. He had informed the manager he did not feel he was meant for the job on our unit. He even emphasized that his review was more than fair and even a little flattering, but he did not feel things would improve as far as how well he managed the CNA's went. He was, in fact, in the office to give his two week notice.

My manager at the time was a very good leader. While I ranted on and on about how hard nursing is the first year and how we can achieve things in little steps............she shocked me with her recommendation to him:

I take leadership very seriously, and a big part of that is managing the aids. I think you are right, this is not the unit for you. Our aids like to test people, some have learned bad habits that are going to take a lot of work to change and there are even a few problem childs in the group. I don't think you can contribute to this unit's goal of improving the quality of leadership over the ancillary staff.

But that does not mean you must quit and give up, walk out of here defeated. It just means you need a setting where your qualities meet the needs of the unit better.

He went to the ICU the next day, and this manager helped get him there. They worked with less aids, and it was just very different there. The aids had very specific, defined tasks and the rest was for the RN. There wasn't as much engagement between the two groups there.

He did well there, was still there when the hospital closed. I lost track of him after that.

Point is: Sometimes we can't overcome our shortcomings. They're a part of us. But we can learn to embrace them in a way that keeps us from being dragged down by them.

Some nurses just can't to the leadership dance with CNA's. So, just find something that doesn't require so much of it.

Ruby Vee, BSN · Sep 14, 2016

Just FYI, generally speaking, it is better to be nice than to be right, unless it's a life or death situation obviously. I'm not saying you did anything wrong, but it's always a good idea to work on your interpersonal relationships when at work.

I remember bitterly resenting that saying, but it is so true!

Kooky Korky, BSN, RN · Sep 14, 2016

Thank you for responding Ruby Vee
I tried to get right to the point without dragging on anyway it statrtes when i had trouble with a cna being insubordinate i had a patient pass away and protocol is for the nurse to call the managerAnyway the cna called and notified manag when i confronted her she yelled at me at the nursing station and said she is my friend i can call her and tell her i tried to explain but she kept screaming at me so i yelled back enough we are giing outside now. She was friens with management and staff so i got a write up immediately for being mean. Anyway almost a year later and i needed help with a resident and asked nicely for a cna to help me real quick and they responded ill be there in a minute so i raised my voice a little in a sense of urgency no now. The manager came out and pointed her finger in my face and said the cnas were conplaining that i was mean and disrespecting them and that i cannot talk to staff like that. So next day i went with the manager to the administrators office as directed and i git wrote up explanation was you have a history of yelling at staff which is completely false. Third incident was when a cna refused to do her job so i reported her and sent her home she got a write up and the next you guessed it i was called in the office with administrator and manager and was told that the cnas said i was mean. So yes another write up and them saying again i have a history. Ugh feeling frustrated i went back to work anyway and ever since management takes every complaint to the administrator she never attempts to do it through the chain of command. They bully you because they know if the nurse says anything we will be written up. The gossip there is ridiculous and the residents are highly neglected by the cnas so staff has reported them and always end up fired so yes i quit i feel i did the right thing as they were lying and the administrator would not let me defend myself instead he would just stop you from talking and talk about what a wonderful administrator he is.

Girl, where is your punctuation? This is hard to read without it.

Kooky Korky, BSN, RN · Sep 14, 2016

Yelling back is still not appropriate, nor is leaving the floor to continue yelling somewhere families won't hear. Sounds like you need to self reflect and work on some conflict resolution skills. The only thing I see bad management wise is letting you get as far as you did. They didn't do anything to nip your inappropriate behavior (yelling) when it very well should have been.

What do you think about the CNA not helping her stat when he knew it was to prevent a fall?

About the aide yelling at the Nurses' Station?

Kooky Korky, BSN, RN · Sep 14, 2016

I get what your saying but i am not going inti extremes to write a novel i am only giving bits and pieces of what happened first off i did not continue yelling i basically talked over her to go outside so she could calm down. There were no threats made ever i removed her from the situation which left 2 other cnas at the station which is our protocol. Second you must have never worked with rude cnas or insubordinate ones at that to leave harsh comments like you are doing. You dont know the whole story as i dont have enough time to write it but i gave her every opportunity to correct herself and she still did not. You see this is my problem i am very nice to them and then they advantage and the second i stand up for myself they claim i am the mean one when i listened for over 20 minutes of her screaming profanity and how she is a nurse because cna has nursing in the initials . I could go on and on as this wasnt a one time occurence this was daily with her. The others dont listen to the nurses because we are not backed up by management so when we try to enforce care we are laughed at. I am not the only nurse dealing with this there are 7 nurses that quit already and 5 more are quitting with me. This is what my post is about. Thank you for your input.

Daily. Screaming profanity for 20 minutes. Calling herself a nurse because CNA has Nursing in the initials.

Sounds mentally ill and in need of serious correction by Management. You might want to consider anonymously reporting to the licensing authorities this facility and this person and the managers who do not correct her. It sounds like a worse version of MASH than the 4077th.

Be glad you're gone. I hope your new job is a better place to work.

Kooky Korky, BSN, RN · Sep 14, 2016

Thank you Qing
I am respectful to my CNAs i know they have a hige workload just like me. I ask them if they need help and they tell me no thankyou we got it then i find out they tell the other nurse on Opposite days that i never help them. The other nurse never backs me up and so i am portrayed to be the mean one. I am just fed up with the insubordination its supose to be a team effort to help the patients but i see that LTC is just for highschool drama and to get away with what you can and still get a paycheck. I have a new job and the staff are phenomenal i dont have to babysit the CNAs they know what their job entitles and they care for the latients. We work as a team not plot against each other. I guess the environment was bad at my old job. All they cared about was a paycheck. This new team cares about each ither and getting each other through a shift with the best patient care we can provide as a team. I just needed an environment i could thrive in not die in.
Thank you for all the responses i do take them seriously and am not offended.

As Charge, I used to ask each nurse how I could help her. Accuchecks? Stock your cart? IVPB's not here, go to Pharmacy and get them? Dressing? Etc. No one ever needed anything. Then the Manager told me she had c/o that I never helped anyone. Huh???

Kooky Korky, BSN, RN · Sep 14, 2016

well, not completely false, you had gotten written up before...
The write-up actually said "for being mean"? More likely it was for yelling at staff.
What do you see as "chain of command"?.... Management -->>administration.... Seems like that was going up the chain to me...
These two descriptions just don't jive with one another....
Maybe it's because you are posting this in dribs and drabs, or because of your train-of-thought, run-on-sentence, no-capital-letters writing style (Or some combination of both, I think) ... But I don't think you are going to get the answers you are looking for. We can't comment on a situation when you've only told us like 1% of it the first time and only slightly more the next post, and honestly, after that I am no longer interested in trying to decipher what you mean, if you can't be bothered to actually tell us.
You don't have to write a verbatim transcript of what was said in order to tell us what happened with enough clarity to get meaningful input. But to expect strangers to give you advice on something that even someone who was there wouldn't be able to figure out with what you've given us (at least in the first post or 2), I think you are asking for the moon.
I will offer this: The interactions you've described here, would result in a write-up or other disciplinary action at any job, nursing or otherwise. You would be doing yourself a favor to seek help to learn how to communicate effectively with co-workers. You need to learn how to say what you mean... Not just, "she should have known I meant....", or raised voice means urgency..., etc. Your communication style is lacking, at best... and likely to end up getting you fired someday, at worst.
Good luck.

I would not write her up. I would advise her to not yell and I would tell her to give me a written report of what had occurred, then I would deal with that.

I have dealt with a number of lazy, terrible, disrespectful aides and know exactly what she was dealing with. I would hire new aides and get rid of these horrible excuses for workers. In other words, I would be supportive of my staff nurses, as long as I was sure they were being truthful with me.

I'd encourage this nurse to become a better leader, less afraid to be assertive.

Jen4nursing · Sep 15, 2016

Well i thank you all for your input and will definitley work on my communication skills as suggested. Just so everyone is aware I am an American born and bred and yes I am bilingual but my first language is English I am a straight A student and English and writing happen to be where I excel. I have been on the Deans List every year. So for me it is hard to type on my cell phone and when I am so full if emotion I do miss the grammar errors. So please don't question my intelligence. I am simply asking how do you handle problematic CNAs when you have no management of any kind standing behind you. I assure you I am a very kind person and all those that know me understand. You all don't know me. I respect your input and will definitely use the advice but when you have gone by the book and other nurses opinions and you still can't get through to your staff and your patient gets injured or falls because the CNAs simply won't do their job because there are no repercussions where I work then wouldn't you get fed up as well????? I am simply asking for advice on how to handle insubordinate staff when no one backs you up.

Thank you all for your input.

Editorial Team / Admin · Sep 15, 2016

What do you think about the CNA not helping her stat when he knew it was to prevent a fall?

OP clarified that later. Still, yelling is not appropriate. There are other ways to communicate an emergency. And in fact, remaining calm and NOT yelling is essential in handling an emergency.

About the aide yelling at the Nurses' Station?

Two wrongs don't make a right. The aide was wrong, but the OP's response did nothing but escalate the situation.

Jen4nursing · Sep 15, 2016

Thank you Kooky Korky,

This is the response I have been waiting for. I know how you feel on not getting recognition for your hard work. This is how I felt at the job I quit. You are also 100%correct I need to be more assertive in my position but I will always have the respect for CNAs that actually do their job its the ones that are there just to socialize that get under my skin and this is where I need to internalize the most. I treat parients and their family like they are my own. I did not want this resident to fall and I was yelled at for changing my tone when I said "No Now" right in front of the CNA this is not okay either. The CNA said he did not feel like I was yelling he said you needed my help that it was okay. I apologized anyway as I did not want him to think I was yelling. The unit manager saud thank you to me for apologizing yet the next day I was called into administration and was write up. When you get attacked daily for being an advocate for your patients it does wear you down.

Jen4nursing · Sep 15, 2016

Rose Queen,

You are correct also I did not help the situation but when your patient is almost on the floor and the CNA told you I'll be there in a minute it is what came out of my mouth I may have been in the wrong but it was not done to demean the CNA it was that I needed help now before he falls. I respect your responses everyone's in fact. Please if there are other ways you deal with insubordinate staff please share with me again thank you for all your responses.