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Concerned

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by exit96 exit96 (Member)

exit96 has 3 years experience and specializes in EMERGENCY, ICU,M/S.

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I’m in month 8 of a new position, it’s in a dialysis unit, but this isn’t specific to dialysis.

Last week a new, or newly reinforced policy for the techs to weigh the patients on the way out was reinforced. Seems like an easy enough task to complete without fanfare. Well, on Friday evening, a couple hours into the shift, the 4 techs who were on shift all went straight to the Manager with the story of “ Joe (the RN) wont help us. So, the manager came out to the floor and told Joe RN that “the techs all said that you won’t help.” Joe RN was completely blind sided as he was busy preparing meds, checking patients in and assessing them, and so forth. Joe RN has had zero complaints by staff and patients, and the Manager “knows” that this cannot be true. So everyone went on with their business and completed the shift. However, there was no more communicating between the techs and Joe, the normal, appropriate communication ended. 

Joe has had a great report with the techs he was working with, no issues whatsoever, until now. All the techs involved have always been great at communicating and asking “can I get some help,” and Joe has always been the type to say “I’m glad to help.” The techs are not happy with the reinforcement of having to accept their responsibility of weighing the patients out, and for some strange reason, this shift not one of them asked for help, but all went to the Manager with complaint (lie) that “Joe won’t help us.” 

Joe requested a huddle with the staff before the Manager left for the evening. And the techs all complained and nothing was accomplished. The Manager told Joe that he doesn’t believe the techs story, yet does nothing about it...

The main concern: Joe RN doesn’t feel that the patients are safe, nor is he safe with behavior such as this being allowed. Joe works with this same crew on the evening shift twice per week.

Joe has never seen or experienced anything like this before. It appears that the Manager has no control over the techs behavior, and their ganging up on the RN and all sticking together with the same lie is very, very concerning. 

So, yeah, I am Joe (not my real name), and this has me so stressed that I haven’t been able to get it out of my mind all weekend, nor can I get rid of this headache all the stress has caused. I don’t know what the hell to do about this, seems like the staff is out of control and I am concerned about my upcoming shifts, patient safety, and my own future.

This is truly a messed up situation...

 

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exit96 has 3 years experience and specializes in EMERGENCY, ICU,M/S.

10,084 Visitors; 414 Posts

After putting my thoughts, and reality down here, I guess I know what the right response to this is...😏

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Kallie3006 has 7 years experience as a ADN and specializes in Surgical, Home Infusions, HVU, PCU, Neuro.

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Have you approached the techs in a nonthreatening manner asking what they feel you didn't help with and what can be agreed upon to reestablish your coworker relationship? If not then I would start there. 

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It appears your perception of your working relationship is different than the techs’ perception of it. The truth is likely somewhere between what you are saying and what the techs are saying. Starting a dialogue with the techs is an excellent place to start.  Listen to them.  Do not get defensive or “correct” them.  Just listen.  Tell them, sincerely, that you want to be better and ask what you need to do in order to improve the relationship.  Then do it.  

 

Sometimes, it’s perception.  For instance, if you ask a tech to do a menial task and then you go sit down.  It looks like you are dodging certain types of tasks. They just see you sitting, but they don’t realize that you are, for instances, gathering information to call the MD on a critical issue. So, instead, say, can you do X, I need to do Y.  And use thank you and please. 

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It's a techs world, it's a techs world, in my James Brown voice. I worked for a dialysis clinic and during my training I was told by the nurse and tech that they booted an RN out because she would not help. Now that woudn't be a bad explanation but my boss told me that the last nurse left due to family issues. At the same time, the nurse along with the techs were bullying a tech to, "make her strong". I was told that they don't talk to her or invite her to do things with them outside of work because she isn't that good of a tech. She needs to speed up etc. The manager knew and did nothing about it. It was insane. Due to the fact that the techs do the dialysis mostly, they pretty much run the place in their mind. Just letting you know this to give you a different perspective. If you like the job, you will have to find a way to not allow this to turn into a me against them thing. I left the dialysis position because I wasn't that interested in it. 

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brillohead has 5 years experience as a ADN, RN and specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

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20 hours ago, beekee said:

Sometimes, it’s perception.  For instance, if you ask a tech to do a menial task and then you go sit down.  It looks like you are dodging certain types of tasks. They just see you sitting, but they don’t realize that you are, for instances, gathering information to call the MD on a critical issue. So, instead, say, can you do X, I need to do Y.  And use thank you and please. 

This is a big deal and a contributing factor in a lot of cases like this. 

If I walk out of a patient's room and ask an aide to toilet that patient, get them fresh water, get a set of vitals, or whatever, I make a point of saying what I'm going to be doing instead that prevents me from doing the task myself -- I need to get meds for someone, I have to page the doc for an order, I have to check that beeping IV pump down the hall....  things that need to be done by an RN, so the delegation of the other task is understandable.  And oftentimes it's "can you get her an ice water so I can go get that call light" -- both things that can be done by either an aide or an RN, so one of us does one and one of us does the other. 

Drawing attention to the collaboration helps with awareness. 

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On 5/19/2019 at 10:07 AM, exit96 said:

Last week a new, or newly reinforced policy for the techs to weigh the patients on the way out was reinforced. Seems like an easy enough task to complete without fanfare. Well, on Friday evening, a couple hours into the shift, the 4 techs who were on shift all went straight to the Manager with the story of “ Joe (the RN) wont help us. So, the manager came out to the floor and told Joe RN that “the techs all said that you won’t help.” Joe RN was completely blind sided as he was busy preparing meds, checking patients in and assessing them, and so forth. Joe RN has had zero complaints by staff and patients, and the Manager “knows” that this cannot be true.

 

The techs also know the truth.

 

On 5/19/2019 at 10:07 AM, exit96 said:

[...]for some strange reason, this shift not one of them asked for help, but all went to the Manager with complaint (lie) that “Joe won’t help us.” 

If you possibly made any statements about how "they" (as opposed to "we") need to make sure the weights get done, that probably wasn't the best way to handle it.

At the same time, they have colluded to make things seem something different than what the consistent reality has been.

I would suggest the decent working rapport you believe you had with these people was tenuous in nature.

 

On 5/19/2019 at 10:07 AM, exit96 said:

The Manager told Joe that he doesn’t believe the techs story, yet does nothing about it...

 

Letting the workers accuse each other and/or fight it out when two groups of them have difficulty completing all the required tasks is an effective blame-shifting technique.

Joe needs to learn to respond to accusations with confidence and reason. When the manager comes out and tells Joe what the techs have said, Joe says, "That isn't true. I will check in with them and find out what this is about." Joe will not go on the defensive and starting detailing all the things he has been doing while the techs were colluding and complaining, nor will he get eaten up inside about others' attempt to sully his rep. Instead, he will immediately leave the manager and go to the techs and say, "[Manager] let me know that you are under the impression that I do not help. I hope that isn't what you truly believe about me. I know you all are working hard, and if I'm multitasking and don't notice when you need a hand, feel free to [give me shout/holler/let me know/etc.]

Joe will be sincere and also the tiniest bit conciliatory, and will remain pleasant for the express purpose of not fueling fires like this.

You can take wind out of sails by being genuine and not overreacting.

Good luck ~

 

Edited by JKL33

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On 5/19/2019 at 10:07 AM, exit96 said:

I’m in month 8 of a new position, it’s in a dialysis unit, but this isn’t specific to dialysis.

Last week a new, or newly reinforced policy for the techs to weigh the patients on the way out was reinforced. Seems like an easy enough task to complete without fanfare. Well, on Friday evening, a couple hours into the shift, the 4 techs who were on shift all went straight to the Manager with the story of “ Joe (the RN) wont help us. So, the manager came out to the floor and told Joe RN that “the techs all said that you won’t help.” Joe RN was completely blind sided as he was busy preparing meds, checking patients in and assessing them, and so forth. Joe RN has had zero complaints by staff and patients, and the Manager “knows” that this cannot be true. So everyone went on with their business and completed the shift. However, there was no more communicating between the techs and Joe, the normal, appropriate communication ended. 

Joe has had a great report with the techs he was working with, no issues whatsoever, until now. All the techs involved have always been great at communicating and asking “can I get some help,” and Joe has always been the type to say “I’m glad to help.” The techs are not happy with the reinforcement of having to accept their responsibility of weighing the patients out, and for some strange reason, this shift not one of them asked for help, but all went to the Manager with complaint (lie) that “Joe won’t help us.” 

Joe requested a huddle with the staff before the Manager left for the evening. And the techs all complained and nothing was accomplished. The Manager told Joe that he doesn’t believe the techs story, yet does nothing about it...

The main concern: Joe RN doesn’t feel that the patients are safe, nor is he safe with behavior such as this being allowed. Joe works with this same crew on the evening shift twice per week.

Joe has never seen or experienced anything like this before. It appears that the Manager has no control over the techs behavior, and their ganging up on the RN and all sticking together with the same lie is very, very concerning. 

So, yeah, I am Joe (not my real name), and this has me so stressed that I haven’t been able to get it out of my mind all weekend, nor can I get rid of this headache all the stress has caused. I don’t know what the hell to do about this, seems like the staff is out of control and I am concerned about my upcoming shifts, patient safety, and my own future.

This is truly a messed up situation...

 

Just my opinion here, yep, everyone has one.  LOL.  In a group of people there are always "opinion leaders", I am guessing that this opinion leader has started something up, for what reason, well who knows?  It all starts with one person saying something then others jump on board.  Who is the tech opinion leader in your case?  That is the one you want to keep in mind.  Do you feel comfortable asking other nurses about this?  It can be hard to talk to someone if you aren't sure you trust them.

There is something underlying here.  Try to determine what the motive is.  What is their goal? Additionally, the manager has to give specifics, for instance, a date, time , what was said, etc.  Is this a bad manager?  Do the techs think that they run the place because they can run the manager?  The whole thing seems odd.  Is this being put in your file?  Keep records for yourself.

 

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This is pretty obviously a management issue, not a tech vs nurse issue.  If a manager gets a “tip” that one of their employees isn’t doing their job, the appropriate response is to observe for themselves & take action if necessary.  

The techs don’t have any right to see or participate in any disciplinary discussions - nor does the nurse, if the transgressions being corrected aren’t directly related to patient care.  

Setting up employee vs employee firing squads isn’t “managing”  staff.  

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1 minute ago, rzyzzy said:

This is pretty obviously a management issue, not a tech vs nurse issue.  If a manager gets a “tip” that one of their employees isn’t doing their job, the appropriate response is to observe for themselves & take action if necessary.  

The techs don’t have any right to see or participate in any disciplinary discussions - nor does the nurse, if the transgressions being corrected aren’t directly related to patient care.  

Setting up employee vs employee firing squads isn’t “managing”  staff.  

Sadly it happens...

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LibraSunCNM has 10 years experience as a MSN and specializes in OB.

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This really sucks, but unfortunately there are just some units where the techs truly do rule the roost and the manager doesn't have the guts to discipline them.  It's completely concerning and unsafe, you're correct.  I'm sorry I don't have magical solutions for you, I feel for you and hope that you can find a way to an answer (or a better job). 

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Joe, 

The thing with dialysis techs is that they do tend to have a "gang" mentality in many places. There is also frequently a ethnic divide between techs and nurses. I'm very surprised though that this hasn't been enforced all along. Pre and post weights are so critical in dialysis. Imho- having a staff meeting with all the techs and nurses on that shift with the 💯 support of your mgr- who sounds like a wimp, to educate everyone on how post weights contribute to the patients well-being. Not to providing one more opportunity to reinforce fluid restrictions on the v way out the door. I'm guessing part of their objections is that 15 minute chair turn around and not getting behind, which is understandable. Finding some ways to help them with this concerns world go a long way. Never underestimate this techs though, when they hang up on a nurse, the vnurse usually loses.

 

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