This unit has had many leaders in a short amount of time, older nurses bully young nurses, night shift vs day shift constant bickering.
We finally have a new leader and staff is SLOWLY catching on that these old behaviors have to stop.
I need tips for ways to handle somethings such as...
"Why am I getting the first admit?"
"It's not my 'turn' to take an admit"
"I don't have time to do xyz so go do it for me" (then nurse sits and pulls out cellphone)
"I need you to page Dr Soandso and tell him .... Very long list of needs..."
I've been a RN for a few years, held multiple supervisor positions in the past. Problem is these nurses I work with are not happy that I received the FT charge position being "new" to this unit despite my experience. So sometimes I think they see an opportunity to challenge me and jump on it.
Overall, seeking pointers from more seasoned charge nurses how to handle these behaviors & negative remarks.
Perhaps just getting the house supervisor to back you up, just once, to send someone home who is being insubordinate, would help your situation. At least they'd know you meant business. It might mean working short that night with you taking patients, but at least they'd know you were serious. As for the attitudes, I'd start giving those people the hardest assignments every day - maybe they'll quit, maybe they'll complain, but your answer can always be - well, you have time to sit around/stand in rooms all the time - I figured you needed more work to do!
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Part of this is me being facetious but part of it is serious. Sometimes you have to come up with ways to push out the bad apples. It might make your life "heck" for a few weeks, but maybe, just maybe, it will encourage them to shape up or move on.
This is why I love my crew on weekends. We work together, help one another, and we're fair with each other.
When I'm charge, and we have equal teams, I generally always volunteer myself for first admit, just because it helps everyone, and I don't mind admissions. Otherwise, we all work together to figure out a fair way to distribute the workload.
This doesn't always work out during the week, but the weekend peoples I work with are awesome. During the week, if someone doesn't like their assignment that I made, they can just change it... Makes no difference to me, as I still get paid my differential. Everyone's happy.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Unless you and your manager are able and willing to change the entire culture of the unit, nothing will change. Questions well may be, do you have it in you to do that, do they have it in them to change, and does anyone have the time to make it happen?
Answer is likely no to all the above
Now you have to decide if you should move on......and I would in your place..
I think that the questions you are asking are very good ones. It sounds like you are a good charge nurse- one that can see issues and wants to deal with them appropriately.
I have seen similar situations as a charge nurse, also on a med-surg floor. I too, have wondered what the best way for handling some of these situations are.
I have to admit, it sounds like these are some entrenched issues.
I don't know if any of these suggestions will help, but I have a couple...
1. It sounds like what you did with the new nurse and the BB was really good. Discussing the rationale. If you can get the younger nurses on board with critical thinking and appropriate rational instead of "We NEVER, or we ALWAYS," I think it might help. Sometimes 'older' nurse thinking is correct-there are some things we NEVER do, like push IV K+. But a nurse has to be taught to see the whole picture-and reassured that it is ok to call the MD if any questions. But still, think about the situation, I always say...there are grey areas. Try to get the nurses excited about critical thinking instead of being so task oriented.
2. Dialysis patient-again, sounds like critical thinking is lacking here...common 'new nurse' statements I have heard is: "They have been pretty tachy, HR 106"...or, "They have been really hypotensive, BP 98/60"....again, I try to discuss it with them, like "Well, they take 5 BP meds regularly, they have had a hx of cardiac surgery,they need to stay a bit on the low side..." etc.
3. The CNA watching the other...sadly, we just can't fix lazy. Hopefully there is a disciplinary system in place or bad behavior just continues...
4. Can't re-access port/start IV- it helps to just start saying straight up, "Did you try?" And then be accessible to help but make it clear that you will try only if the bedside nurse has tried at least once.
5. Nurse doesn't comprehend this IVF at 30 problem-again, sounds like a lack of critical thinking. And maybe not even caring if the correct information is presented.
I have realized that a nurse (including myself) HAS TO BE engaged in learning something new daily, open to change and realize that you have to critically think and use your head when caring for your patients. If a desire for any of this is lacking, and your nurses are just task oriented instead of using their heads-it makes being in charge and keeping a unit running smoothly very difficult.
I hope maybe this helped even a little. It sounds like you are doing great.
If you could get the nurses on board with being excited about nursing-and learning new things and THINKING-and eliminate the lazys...you'll be doing good.
And try to keep your own sanity and enthusiasm intact in the process...:)
Specializes in Certified Med/Surg tele, and other stuff.
I'm a FT charge on a very busy medsurg unit.
This unit has had many leaders in a short amount of time, older nurses bully young nurses, night shift vs day shift constant bickering.
We finally have a new leader and staff is SLOWLY catching on that these old behaviors have to stop.
I need tips for ways to handle somethings such as...
"Why am I getting the first admit?"
"It's not my 'turn' to take an admit"
"I don't have time to do xyz so go do it for me" (then nurse sits and pulls out cellphone)
"I need you to page Dr Soandso and tell him .... Very long list of needs..."
I've been a RN for a few years, held multiple supervisor positions in the past. Problem is these nurses I work with are not happy that I received the FT charge position being "new" to this unit despite my experience. So sometimes I think they see an opportunity to challenge me and jump on it.
Overall, seeking pointers from more seasoned charge nurses how to handle these behaviors & negative remarks.
Thanks!
At the beginning of the shift everyone is assigned a line in admit. And I go down the line. That way I get no arguments.
I also tell the other nurses NO when ask for help and I see them texting. I have my own work too do and I help them prioritize, but refuse to fall into that enabling trap.
I had the same problem you do with respect. We finally have a manager that backs us, so the staff now listens to us.
Task oriented vs critical thinking = NAIL ON THE HEAD!!!!
Interrupt me during helping a nurse with a serious pt situation to help you restart an IV that you have not tried yourself on a patient with only PRN zofran IV ordered just because you're in the middle of your 9a meds? Nope. Try after your meds and I will after you try and am finished in here. She missed the AC. Wonder if she even really looked/felt. I went in and got a beautiful IV on the forearm with no issues. Again, I try to teach them to FEEL not just LOOK for veins -- falls on deaf ears.
I'm sticking it out a little while longer. I'm actually considering changing specialties (aaaaalways wanted to do L&D) or just go for NP school. I'm at a crossroad. I'm leaning towards NP school.
I appreciate you all! Hopefully this thread helps someone else too.
greenerpastures
190 Posts
Perhaps just getting the house supervisor to back you up, just once, to send someone home who is being insubordinate, would help your situation. At least they'd know you meant business. It might mean working short that night with you taking patients, but at least they'd know you were serious. As for the attitudes, I'd start giving those people the hardest assignments every day - maybe they'll quit, maybe they'll complain, but your answer can always be - well, you have time to sit around/stand in rooms all the time - I figured you needed more work to do!
*
Part of this is me being facetious but part of it is serious. Sometimes you have to come up with ways to push out the bad apples. It might make your life "heck" for a few weeks, but maybe, just maybe, it will encourage them to shape up or move on.