Dealing with crappy tech/assistant performance

[mitral]

I'm a new grad and still a little shaky on my feet. I've only been set loose from orientation for a few weeks. I have a tech/nurse assistant/pca that is making my job sooo much harder. When she does actually work she does a great job, but it's hit or miss. She's late getting the vitals in, so I have to either track her down or take vitals myself before passing meds. Same with glucose readings. She doesn't always enter. I and Os correctly, last night she forgot to enter them at all. Doesn't always do what I ask (sorry, I'm too busy with this other room). I feel bad yelling about certain things because I know I forget to do a lot too.. But doing 2 people's jobs is really putting me behind. I've also never had to deal with this type of situation before (the other techs are great) so I really don't know how to approach this. She is well liked for personality by management so, you know how that goes. What would you guys do?

[JRDeeRN]

How many patients do you normally have ?

[uRNmyway, ASN, RN]

Well, easy answer is to manage your time so you have to rely on others less. I have never worked in a hospital where a CNA was responsible for taking vitals, BG, I&O, etc for me. Had to do all that, plus phlebotomy, plus meds (you get the point) for 8-9 patients on nights. So yes, it would be an adjustment, but it's possible. And then when you DO get help, you appreciate it that much more.

If that is not an option, then try to address these things with her calmly, not in the heat of the moment when you are upset with her for HER time management.

[salvadordolly]

A lot of the techs test out the new grads to see how tough they're going to be with them. Don't let her walk all over you, or you will find the other techs doing it too. You need to get more assertive with her and bring up what she's missed. Another way is to give report at the beginning of the shift - emphasizing who needs what, so that she knows what you expect. You can do rounds with her about an hour before shift change to make sure everything was done.

[Palma0609]

I have to do all of those myself as well, the Accuchecks, I&O's, but they do get vitals, and for the most part tell me when they aren't WNL's. I do however, have one that told me the other day that she had something more important to take care of at home, while she was on her personal cell phone at the nurses station, and when she was done with that, she would attend to the pt's needs. So, it's everywhere. And this one too is liked for personality, however EVERYONE knows how "lazy" she is. Which is why I don't understand why something hasn't been done about it.

[PediLove2147, BSN, RN]

Well, easy answer is to manage your time so you have to rely on others less. I have never worked in a hospital where a CNA was responsible for taking vitals, BG, I&O, etc for me. Had to do all that, plus phlebotomy, plus meds (you get the point) for 8-9 patients on nights. So yes, it would be an adjustment, but it's possible. And then when you DO get help, you appreciate it that much more.

If that is not an option, then try to address these things with her calmly, not in the heat of the moment when you are upset with her for HER time management.

I am sorry but I hate when people come here and say this. She HAS a tech so she shouldn't have to do this herself. Every other person is doing their job, why can't she? I understand that some days are busy and the nurse needs to help out with vitals and accuchecks but it should not be an every day thing. I would speak with her, in a calm manner. No one likes be told they are not doing a good enough job but she does need to be spoken to.

[Morainey, BSN, RN]

I am sorry but I hate when people come here and say this. She HAS a tech so she shouldn't have to do this herself. Every other person is doing their job, why can't she? I understand that some days are busy and the nurse needs to help out with vitals and accuchecks but it should not be an every day thing. I would speak with her, in a calm manner. No one likes be told they are not doing a good enough job but she does need to be spoken to.

I have to agree - just letting it slide sounds like the fast track to getting walked all over.

[uRNmyway, ASN, RN]

I am sorry but I hate when people come here and say this. She HAS a tech so she shouldn't have to do this herself. Every other person is doing their job, why can't she? I understand that some days are busy and the nurse needs to help out with vitals and accuchecks but it should not be an every day thing. I would speak with her, in a calm manner. No one likes be told they are not doing a good enough job but she does need to be spoken to.

I get what you are saying. Maybe I'm just someone who avoid confrontations when I don't think it will work.

I guess I am just going off what I see time and time again here on AN. Staff that doesn't do what they should, get confronted, and only get hostile and more useless. Then management who covers for the useless staff because they are buddy-buddy. Add to this the clique mentality, other techs and CNAs who end up ganging up on the confronter, and you end up worse than when you started.

[proud nurse, BSN, RN]

I cannot stand a lazy co-worker!!

There's a PCA that runs the nurses. She flat out tells them she's "not doing anything today." You can maybe get a solid 3 hours of work from her in an 8 hour shift. And of course she's got everyone fooled because she's worked there for so long, and I honestly think people are afraid to tell her to get to work. She gets away with so much.

What I need the PCA to do is part of their job. I don't ask them for anything that is out of their scope, so I don't feel bad in the least bit letting them know what needs to be done.

[bahamagirlrn, BSN, MSN, RN]

I would pull the person aside and speak to them about their job performance. If there's no improvement, then I will follow the chain of command. At the end of the day it will be the nurse's ( ) which will be grass and everyone else will be the lawn mower. Remember, we as nurses are there to provide excellent care for our patients.One of my philosophies is that it does not matter who doesn't like me on the outside, but once we get in the facility you respect me, I respect you and we get the job done to ensure that quality care is provided.