Chain of Command

[javajaydon]

I have been a nurse for over 20 years, and I have been a DON for the last 3 years. What I am noticing, is it seems staff do not follow a chain of command anymore. I have instructed staff, if they have a concern they need to go to the charge nurse. If the charge nurse is not able to answer or take care of the staff members concern, then they should be directed to me the DON. If I am not able to answer, or take care of the concern, then it should go to the Administrator. What I am seeing, is that many staff members go directly to the Administrator, and then the Charge nurse or me look like we are stupid or incompetent because the Administrator is asking why we didn't take care of whatever the concern was. I'm like how can the Charge nurse or I take care of what the concern is, if we don't know there is a concern? Has any other DON had this same type of thing occur?

[Nascar nurse, ASN, RN]

I would kindly ask the administator to ask the complainer "So what did the charge nurse & then DON say when you took this concern to them"?

Unless the administrator is going to back you up on this and redirect staff to the chain of command, you will be playing a losing game. Stinks doesn't it?

[TopazLover, BSN, RN]

This used to drive me nuts. Administrators claim they have an "open door policy". This is misinterpreted by staff and they are only partially to blame. I agree, go to the administrator and ask that they encourage staff to follow chain of command. Nursing is a hierarchy. It is similar to the military. You don't go to the general with petty problems. If the general were to deal with these problems nothing else could get done. We are in a similar situation. If we don't know what the problem is, we can't correct it before it becomes huge. Then we all look bad.

An honest conversation with your boss may be all that it takes. If that is not completely successful, I would suggest you meet with your staff and address the problem with them and let them know clearly what COC is and what you will do if it is ignored.

[NurseExec]

This happens to me occasionally, and fortunately, I have an administrator who just looks at them and says "and you're bringing this to me why?", then tells them to go see their unit manager.

I think the line staff (CNAs, in particular) think that if they generate drama with the administrator, that whatever they want will get done. Not happening, at least in my building.

Hope you and your administrator can get on the same page about this.

[achot chavi]

The question is why are they doing this? I would have a general meeting with your staff and explain that there is an accepted chain of command for problems and ask if anyone has a problem with this. Be fair- listen with both ears open and take notes. If anyone wants to criticize you , let them and dont get defensive- in fact don't answer anything that same day- say you will get back to them..

The unwritten and unspoken goal of the meeting is to reassert chain of command in order for things to go smoothly and not to complain to your staff that they made you look stupid,

Take minutes and record attendance (which should be mandatory) Add other topics of interest such as continuing education or staffing problems etc. so it wont look like your whining.

Good Luck

[Hinnahwill]

This also happens in our facility. I agree with the previous posts. You need to keep emphasizing with the Administrator the importance of "chain of command". Our Administrator knows they should go through the chain...but often gets caught up in the drama of the situation. We remind him that the DON and I (ADON) are fully competent to handle the problem, but he MUST do his part in asking the employee if they have followed the chain of command before they go to him. THEN your employee needs a personal inservice bout proper procedure and reminded that is the ONLY way problems will be dealt with.