You know one of those UAP's that think they're more knowledeable than everyone including the nurses
So I work with this Tech who practically think he's the best thing the hospital has ever seen, in fact that's exactly what his facebook statuses say, I'm not joking either.
So this tech thinks that because he's learned a thing or too from the more experienced nurses that he knows it all. He also believes that since the higher-ups gave him some praise and recongnition that he's invincible and even better than the newer nurses in the department.
He likes to challenge the newer nurses and other techs. I'm tired of working with him,, and I'm by no means the only one.
Yesterday was the last straw, I had an intubated patient that kept hitting at the tubing, I was on the other side of the room helping my fellow nurse with a patient draw bloods on a patient with SOB. We told him to go to that patient and hold him so he wouldn't pull out the tube, until we finish up this patient and get some sedation. So he starts getting an attitude, saying that he can't stand there forever, I run and get hand mittens, then he says with an snarky attitude of course "Those mittens won't do anything for him" (Without just going off on him) I told him that with the mittens on the patient would not be able to pull the tube out, and he would be getting sedated shortly after we finished up on the SOB patient. I left him right there to watch the patient as I was preparing the sedation, he has no right to challenge me!
Last night was NOT the first of his shenanigans.
He once placed a COPD patient of mine on a non-rebreather because after he took her oxygen sat (which was in the high 80's) he felt she needed it, and took it upon himself to do that.
In his ''know-it-all-ness" he decides that a non critical patient needed to be hooked up to the cardiac monitor, well that's until the manager stopped him and asked him why he was hooking a non-telemetry patient up to the monitor?
He never does what you ask him to do when you ask him to do it. He feels he can do it when he has time.
I once had a lady partsl bleeder, and no lie she was BLEEDING heavy. I needed orthostatics on her STAT, and I had to tell him twice to do it. Then he turns to me and tells me he's doing something.... and guess what he was doing?
putting blankets and sheets on beds, geesh..I didn't know that was more important than stabilizing a patient?
I've told him to take Mr So and So's vitals, before Mrs. So and So's vitals, because Mr. So and So was getting blood and I needed vitals stat, what did he do? He started doing vitals on whatever patient he wanted to, then came back and gave me a sorry a-- apology that he just couldn't do that person's vitals first, because of course in his mind other things were more important to him.
He is a kiss a--, he loves being around the doctors and more "experienced" nurses, and jumps at every opportunity to be among them (staff parties, etc..)
I'm not the only nurse that hates working with him, alot of the other techs and RN's can't stand him either.
I've never experienced a subordinate actually try to show up a nurse. I need to have a discussion with my manager, I don't want to work with this tech anymore, I've had enough.
Sounds like this dude knows how to push your buttons, and its working... I wouldve pulled my "CNA Busy Card" too if I was asked to don anything with a heavy Vagi bleeder..
Write him up, but don't you think blood vitals are your responsibility?
While the RN has to answer for having the task done, the ancillary staff is to help facilitate getting it done. In the ER, clinical technicians positions are to do ekg, phlebotomy, and assist with patient care. If this person does not want to perform these duties; they don't belong there.
Quite simply, the ancillary staff is skilled to do these things-they answer to their assigned RNs. They have a job to do together; if someone is not pulling their weight they are a danger to the patient and the team and they must go!
For those who say skip the preliminaries and go straight to the BON, what do you think will happen next? If they take any action, they will start by investigating the complaint. That will involve contacting the hospital and looking at this person's file. If there is nothing in there to corroborate your accusations--for example, no incident reports from you or your co-workers--what will there be to support your allegations? The guy will skate. And any further complaints may be tainted because the first one was deemed to be "without merit." It could look like he was/is being unfairly targeted.
Lay the paper trail. You and anyone else he has blown off or outright been insubordinate with, need to document this dangerous pattern. The more of you who do this the less it will look like a personal vendetta.
Don't ask this tech to do things. Tell him. This advice comes from other nurses who have learned the hard way that with an uncooperative tech or aide, asking implies a choice. So, tell him what you want him to do and when you want it done. If he gives you any grief (anything other than a valid excuse), ask him if he is refusing to do it. This is the meat and potatoes of insubordination. If he says yes, write him up. If he says no, tell him to get on it immediately.
Don't get flustered or lose your cool. Be matter of fact and calm. It's win-win for you. Either he performs or he hands you a nail for you to build your case against him. Be unemotional when you fill out incident reports, so that you come across as cool and collected. Vent away from the job, and present yourself as capable and in control.
BTW, the meaning of insubordinate is the refusal to put oneself under another's authority. The result is someone who literally doesn't know his place.
Don't "suck it up" and wait for him to hang hisself. You are the professional and you are responsible for your patients and what you DELEGATE. We've all been there. He's testing you (and others). If you're comfortable, pull him aside privately and respectfully tell him that you've noticed a few incidents where his behavior was disrespectful and challenging. Additionally, explain that his actions may have compromised the health of patients on various occassions, so to comply with your directions. Give him his props, say you notice that he's a hard worker and you thank him (that's important, so that he doesn't feel that you don't value his contribution, and it will lessen the tension). Also, you mention that you asked him to vitals and/or draw blood, then he gave you lip. You as the authority must clarify the priority with him. He can always say that he thought emptying the bedpan or giving someone water was a priority, you can be brought up on disciplinary charges if you didn't tell him the priority. Always speak to the individual first! Let him know that you do not want to report him, but because there is a pattern you have to bring it to his attention, so that it doesn't repeat. Ofcourse, if it repeats, then send a message by going to your superior. e.g RN-"Please check the vitals of pt X". Tech- "I'm busy right now, can you ask someone else". Nurse- "What are you busy doing, b/c this patient is priority, we need to infuse blood". Also, earlier, you mentioned that you asked him to check vitals on patient who was about to receive a transfusion, that is why I used this scenarior; however, a lot of facilities require the RN to take the vitals in cases of bld transfusion. (so look into your policy). Don't let him intimidate you. GOOD LUCK. I've worked the ER with some lazy ER Techs and some helpful ones, so I know from experience.
this might sound silly, but i'm an NAI who's on the way to RN...I can definitely see why you'd be so ticked off and annoyed and stuff!! In general, the guy sounds like a grade-A d-bag. However, I wonder if "asking" him to do things instead of "telling" him to do things would have a better outcome? That was just something that stuck out to me in the OP...a lot of "telling." As an NAI, I generally do whatever anyone ever says to me but I much prefer when I am asked as opposed to being told to do things. Just thought I'd throw that out there...good luck with everything, don't rip your hair out!
RN in training you are correct, I thought the same thing when I read that. This guy is obviously full of himself and considers himself at least a "peer." He probably dont take kind to some RN tellin him what to do all the time.
He probably knows exactly what he can get away with and whose butt to kiss & when to kiss it. Going tit-4-tat with him is something he's hoping for because he can make you look stupid.
No advice. We have a rare one or two like this. most don't do anything, beyond their scope or in their scope.......if they are a manger favorite i dont know if any write up will solve anything. but i would still bring up concerns with managment
I wonder if "asking" him to do things instead of "telling" him to do things would have a better outcome? That was just something that stuck out to me in the OP...a lot of "telling."
Ordinarily, and with reasonable people, asking is a great idea. However, we have had discussions about this topic before and it seems that when a complaint was filed, politeness was used against the one who was delegating. It was viewed as implying a choice.
When you are dealing with someone who is well known for insubordinate behavior, for taking their own sweet time to do things, and for knowing when the higher-ups are watching, you dare not leave any room for ambiguity. You don't have to be surly. In fact, it's better if you're not. But you still have to be direct and to the point.
You're probably not the kind of person who needs to be asked twice to do something. :)
Ordinarily, and with reasonable people, asking is a great idea. However, we have had discussions about this topic before and it seems that when a complaint was filed, politeness was used against the one who was delegating. It was viewed as implying a choice.
When you are dealing with someone who is well known for insubordinate behavior, for taking their own sweet time to do things, and for knowing when the higher-ups are watching, you dare not leave any room for ambiguity. You don't have to be surly. In fact, it's better if you're not. But you still have to be direct and to the point.
You're probably not the kind of person who needs to be asked twice to do something. :)
HAH! you are totally 100% right. I am a pleaser in the worst kind of way...it's difficult for me to understand people that intentionally try to tick people off (esp their superiors)?!? I used to manage in retail and I remember a few folks who had to be "asked" more than once to do things...I guess I was thinking why would ANYBODY need to be told to do something twice in nursing, like this field seems to have much more urgency than retail, you know? ...hello, this is not a sweater that needs to be refolded sometime in the next hour, this is SOMEONE'S LIFE?DIGNITY/COMFORT!! GET IT TOGETHER!! if being nice fails, just punch the guy right in the throat!
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79Tango
689 Posts
Sounds like this dude knows how to push your buttons, and its working... I wouldve pulled my "CNA Busy Card" too if I was asked to don anything with a heavy Vagi bleeder..