Broken Spirit from boss

LadyFree28, BSN, LPN, RN · Mar 17, 2016

OP,

I have looked at a few of your past posts concerning working with others and your concerns when needing instruction or direction-from the PA in Urgent Care in 2014 to now this job and your supervisor's "nitpicking".

Based on your post here, you have done a few missteps that could've had yourself disciplined or your site cited for some of the actions you have, especially for someone who has "experience"; you may not want to hear this and based on your "feelings", I think a bit of a sharpening of your practice and thick skin is in order, especially when there have been situations that you have to take some accountability as to how some of your actions are valid for discipline, as well as advocating for yourself when you feel "bullied" as far as based on the delivery of your superior's reprimand's; this was evident in your posts when you worked in urgent care, and it has yet to be resolved at another position; somewhere the common denominator is YOU, and you have to make a decision on correcting your practice and swallowing your pride/dismissing delivery over obtaining the message to better improve your practice.

Now, I am going to respond to your OP and give you my analysis:

Given meds in dining room
Dropped narc and instinctively threw it in sharp box, immediately went to ---- and told her I needed her help and explained what I did, she called ---, came back to me saying ---- was really mad and she could not sign off what I did because she did not fiond the medication, finally found in sharps box but told me she could lose her job, this was an ambien, yet made me feel like I could lose my job, finally signed off med that it was wasted.

Your coworker seems to be emphasizing the importance of witnessed wastes; something that nurse should take seriously.

Clean gloves worn at the nursing station for a second
Called other staff member regarding resident meds while in hallway

As far as the clean gloves; most LTCs frown on wearing clean gloves outside of residents rooms; not sure what the last issue is.

CNA asked where ----was, told her she was at nursing station, was told she could not leave CNA has fall that I could assist and that they could not leave resident alone if there is a fall, told ----I knew this but did not know at time there was a fall before telling CNA that ---- was at nursing station

This is confusing; did someone fall and you did not intervene in starting the process of checking the resident and an incident report?

Told by ----I had to do the pharmacy deliveries because she never sees me doing it, told her I would do it but was in middle of narc pass, she still insisted on me doing pharmacy from now on, again told her I have done it before, insisted I still do it even after other nurses are not busy or say they will do it

Why are you going back and forth about this? So what you have "done it before", if someone is suggesting that you share the responsibility of doing the pharmacy checks, a prudent team player would at least say sure, or "I'll do it odd days I'm her and you can do even days while your here", or something where it's being shared.

CNA asked question if a residents family causes skin tear do we still have to do a report? Told her to go see ----, later ---- told me I should have went and assessed the situation and find out about skin tear, I did not know who resident was or if we do a report, later after RN saw skin tear decided not to do anything regarding it

Once the CNA approached you, you have a duty to do an assessment and follow the protocol as a nurse, depend on facility policy-you knew about the skin tear; the onus was not on the RN who decided not to do anything about it, although that is the RNs error, but you failed to report an event-that can be seen as neglect.

I found a place on mar that no one was filling out from the 9^th and it was the 13^th, pointed it out to ---- and she made point to tell me I should have been responsible for this even after I had not been there a day or two either and was not the only one on the cart at that med pass

You are only responsible for your own documentation-that's black and white for that matter.

Didn't lock the med cart, keys on top yet I was standing right there where I could see the cart the entire time yet got into trouble with this.

You may not like what I am going to say, but YES, you should've gotten into trouble; meds are supposed to be secured at all times; that is not negotiable. :no:

The issues I list has happened to me, yet they have or may have happened to other nurses, yet I was the one that was in trouble for it, they never got in trouble by the same supervisor...and its being done by others, yet I am the one that hears about it.

How do you know this? Are you privy to what the supervisors are doing to other coworkers? How about the possibility that your coworkers do get disciplined, take the criticism and keep it moving; either modifying their behavior or continuing their bad habits?

They are pointing out your missteps so that you adhere to best practices; unfortunately, not everyone knows tact.

This is some things that have happened. I feel my spirit as a nurse is breaking and I want to cry all the time. I love my job as a nurse, but it really has gotten to where I am sick physically and mentally due to my supervisor. She has it out for me and here I am. I feel alone. I feel like crying all the time. I feel like I am simply being bullied.

I hope you don't feel bullied by me; I have pointed out and have examined some of the issues that you are having as a nurse; these issues will continue to follow you if you don't modify your nursing practice to the best of your ability, and focus on being the best nurse that you can be instead of worrying about others; you also need to keep in mind that some of your missteps can be reportable where your place can be sited or have grounds for legal action.

Being a prudent nurse isn't easy; when your supervisors is giving you the chance to correct your missteps, despite a better delivery on management's part you could be out of a job, suspended, or worse; some of your missteps you don't have a leg to stand on-the oh solution is to make less missteps, take each correction with a "thank you for telling me about my misstep, I'll be sure to practice safer," and DO SO; competence wins over EVERYTHING else in this business; don't put yourself in the position for them to give you any more ammo.

Best wishes.

betweenus64, LPN · Mar 17, 2016

Oh my gosh....I just want to say thank you. I needed to have all that broken down just as you did, it totally gave me a new perspective on things and I had no one tell me this. Thank you again. Maybe a little thick skin with better nursing is what I need and I will do better. I just needed to have it all broken down for me. I need to not worry so much. I am nervous now at work, but I need to be, guessing I need to step it up. I am so new to working in this type facility, I work in long term skilled care and never worked in a facility like this, yet they knew this when hired on, so I am learning but some tact would be great, huh? But a huge thank you to all this, by the way, how do you learn how to be a better nurse other than experience it? Is there anything on reading about being a nurse on a skilled unit and how to handle falls etc? I really just need to get my head in the game....thanks again....

allnurses Guide · Mar 17, 2016

betweenus,

I have a similar situation where I have had to learn and grow. I had been off the floor for 9 years and last year returned to floor nursing in one of the few places that would hire a somewhat rusty nurse. LTC was where I ended up. I embraced the situation in order to review my skills and prepare for returning to the acute hospital. I have made many of the same mistakes you had mainly because I didn't know what I was doing was wrong. I guess what is different for me is that I have co-workers and a DON who make up a great team. Having been through a diversion and monitoring program I am super anal about how narcs are handled. So I don't think that I would have dropped a pill in the sharps box bit I was putting small trash in there like needle caps and alcohol wipe wrappers. When it was pointed out e it was. "We can be fined up to $1000.00 for each non-sharp item in the box." We as employees actually police ourselves I am now the Title 22 compliance officer - and we police ourselves. The reason I say this is that most of the things you mention would cause the facility to be cited under Title 22. If we see a cart unlocked we lock it. etc - we also help each other out. No member of our staff walks by a room with a call light on. It's natural to feel defensive or picked on when put on the spot by a supervisor - but what most supervisors are looking for is personal accountability not excuses. What they want is that you own it and try to do better not "Well so and so does it too." If we find a documentation error or omission we either fix it of we can legally do so or take it up with our co-worker. This way we keep the boss out of it. That being said not all groups of employees can do this as some groups do not have the cohesive relationships we do. So don't take it so hard just resolve to do better and take action.

Peace and Namaste.

betweenus64, LPN · Mar 22, 2016

Thank you for that comment. I really don't get it, why have supervisors that don't want to get off their asses to help when we ask for help? I could not find a vein and poked like 3 times before going to the sup which by the way did not get up off her fat ass and come draw this blood, another RN did. I feel she is just lazy and tries to do her best to pick on someone. I am getting angrier by the day and hoping not to blow up on the wrong person. I really am trying, I do a great job, I have learned my mistakes, yet when I need the additional help my supervisor will not help out. I get responses that are nasty, and really uncalled for. I asked a question last night and the response was really nasty in return, not that it needed to be. I won't go to her any longer, I will do whatever I know and not let this person steal my happiness. I know I am learning, yet, being ugly to people is not the way to be....its just not necessary and she truly needs to blow some air out of her fat cheeks and be nice for a change....

MedChica · Mar 25, 2016

Well, I dont know if youve been bullied.

Giving meds during mealtime? Depends on the facility. If your facility doesnt allow it, dont do it.

Dropping narcs in the sharp box? Meh. I can understand why she was bothered if she had to hunt for it. But, if she wasnt the relief (sounds like your coworker), what was the problem? If I were the relief, I wouldve just 'correct counted' and gone home. YOU could explain that crap to the DON when they pull you in the office in the morning. Theyll look to me and say, '----, you know anything about this?' Ill just point in your direction and say your name. Yes, i would dime you out. In a heartbeat. LOL Lets not downplay the seriousness of a screwed up narc count. If youre lucky, you will only lose your job. BON doesnt screw around when it comes yo diversion. I dont know how throwing a narc away without a witness is instinctive but it's time for you to develop new habits. The end.

You dont wear gloves in the hall. That's ltc 101. The fact that you argue about them being clean...? It's besides the point, really.

Dont leave keys on the cart. Get into the habit of keeping the keys on your person. You could just as easily get sidetracked and leave the keys unattended. It happens.

You shouldve assessed the skin tear...and documented. The CNA informed you because you were their nurse, Im assuming. Your direction was to tell the aide to go ask someone else about it...? I dont understand. The CNA will document about the skin tear. The buck stops with you and you didnt do anything.

If you didnt fill in your holes, the supv was right to correct you.

It doesnt matter if other nurses are sitting around when pharm comes in. They know how tp recv meds. You dont. Thats the point.

I didnt really understand the other 2 scenarios. I guess its one of those 'you had to be there' situations but I dont sense bullying. Youve made mistakes that deserve correction. You seem to have an excuse for every mistake, though. I can see how thatd be annoying. You dont seem to take durection well AND it seems like someone would have to tell you about something several times before you complied.

"...but everyone else is --" What does that have to do with you and your mistakes?

"...but they were clean gloves --" There is no room for a 'but'.

You dont have an argument. What are the rules? LOL DONT WEAR GLOVES IN THE HALLS, IN THE DINING HALL, AT THE NURSES STATION, etc...

Period.

Youll live, OP. You're receiving correction for your own good.

allnurses Guide · Mar 25, 2016

I have to admit that I have a hard time giving you much credence when you refer to your supervisor as not getting off her "fat ass" to come help. If you want to be taken seriously the first lesson is that you yourself must be beyond reproach. You can't cry that you are being bullied while in the same breath referring to someone else in such a way.

I am sorry you are struggling and I hope it gets better. I can promise you that "going off" on someone isn't going to help your situation.

MedChica · Mar 25, 2016

Apologies if that came off roughly. It's way easier to hear my words in person. I always come across harshly in print, I think.

JustBeachyNurse, LPN · Mar 25, 2016

Thank you for that comment. I really don't get it, why have supervisors that don't want to get off their asses to help when we ask for help? I could not find a vein and poked like 3 times before going to the sup which by the way did not get up off her fat ass and come draw this blood, another RN did. I feel she is just lazy and tries to do her best to pick on someone. I am getting angrier by the day and hoping not to blow up on the wrong person. I really am trying, I do a great job, I have learned my mistakes, yet when I need the additional help my supervisor will not help out. I get responses that are nasty, and really uncalled for. I asked a question last night and the response was really nasty in return, not that it needed to be. I won't go to her any longer, I will do whatever I know and not let this person steal my happiness. I know I am learning, yet, being ugly to people is not the way to be....its just not necessary and she truly needs to blow some air out of her fat cheeks and be nice for a change....

Your anger seems displaced. You are bullying here not being bullied. You've made significant errors and as a result she must watch you before the facility gets cited such as tossing unwitnessed narcotics in a sharps container (pills do not belong in a sharps container). No walking around with gloves on. You claim they were clean but how is an inspector to know? You need to alter your perspective. If a coworker assists why can't the supervisor continue with administrative work?

It can a HIPAA violation to discuss a patient & medication by calling out to another nurse in the hall. If witnessed by family, administrator or an inspector you could have been suspended, terminated or fined on the spot. The most that should be called out in a hallway is "I need help in room XX".

Plenty of complaints but no self corrected action or introspection. You've decided to demean and despise the supervisor charged with observing and calling out/correcting your errors. Despite being spoken to before you post that you continue to make errors. Maybe ask for policy orientation ?

JustBeachyNurse, LPN · Mar 25, 2016

No one can make you feel inferior without your consent--Eleanor Roosevelt

Fireflynurse · Mar 25, 2016

To the OP, maybe you want to slow down your med pass to ensure every step is accurate and everything followed procedure? I am new so I don't have much useful advise for you. The only thing that I can offer is that don't take people's advice and managers' correction personally. Most likely they aren't attacking you personally if their focus is on your job performance.

I want to share with you my own personal experience that I think it was personal attack. Two months ago, when I was at the training of first job, an experienced CNA attempted to open my med cart and tried to take narco to one of the resident without asking me for it. I stopped him and reported him to the nurse that trained me. When the nurse asked him why he did it, his response was that I was from a different national origin in Asia ( different from his and hers) so he didn't think that I could be trusted. So there, that's personal attack. It wasn't my performance but his action was purely base on me as a person. I don't get offended when others correct my mistake because of their attention to my job, it makes me a better nurse. I hope my personal experience help you a little bit.

JustBeachyNurse, LPN · Mar 25, 2016

I want to share with you my own personal experience that I think it was personal attack. Two months ago, when I was at the training of first job, an experienced CNA attempted to open my med cart and tried to take narco to one of the resident without asking me for it. I stopped him and reported him to the nurse that trained me. When the nurse asked him why he did it, his response was that I was from a different national origin in Asia ( different from his and hers) so he didn't think that I could be trusted. So there, that's personal attack. It wasn't my performance but his action was purely base on me as a person. I don't get offended when others correct my mistake because of their attention to my job, it makes me a better nurse. I hope my personal experience help you a little bit.

That's not an attack. That's blatant racism borderline discrimination. Plus fully exceeding scope of practice and likely illegal in most states