Delegation

i'm thinking that you might be confusing delegation with insubordination. when you give someone you supervise an instruction and they flat out refuse to do it, that is insubordination. that's a performance and behavioral issue. have you spoken to your supervisor and asked for advice on how to handle this? i'm not talking about the charge nurse, i'm referring to the person who does your performance evaluation.

you also need to be smart about doing your nursing job. you need to stop feeling sorry for the techs and stop doing their work and covering for them when they disappear for hours at a time while you are laboring to get your work done. report their disappearance to the charge nurse, manager or the shift supervisor if you are on an off shift. do you think they'd be off fooling around if they were worried about you and the patients? they can't do your work. and, if they are not getting theirs done, as i mentioned above, it needs to be reported to the charge nurse, manager or shift supervisor and it needs to be documented. one of the realities that a person in a leadership position is able to see is that not everyone is a good employee. do not assume that just because you have always been a good employee that others are also.

i really encourage you to have a talk with your boss and discuss these problems. ask the boss what he/she wants you to do in response to this behavior by these techs so you have clear direction on how to handle it. i think that you are going to have to get assertive with some of these techs and stand your ground with them. right now, they are being very disrespectful to you. your response, however, can't be to go out of your way to do their work that they are dumping on you. that only feeds their disrespect toward you. they're sneering at you behind your back. also, these techs are cheating your facility of the time and work they are being paid wages to perform. as an rn, which is a leadership position, you have an obligation to see that this information gets passed on up the chain of command.

as for delegation, there are principals of delegation that should be followed and i'm listing links to them for you. you might also want to review the principals of assertiveness.

• http://nclextestprep.com/delegation.html - points to ponder when considering delegation and nursing management of personnel.
  
• http://www.leadershipdevelopmenttraininghowto.com/elements.htm - the elements of delegation
  
• http://www.ehow.com/how_3816_delegate-responsibility.html - how to delegate responsibility
  
• http://www.see.ed.ac.uk/~gerard/meng/me96/documents/aspects/delegate.html? - delegation. everything you need to know about delegation presented concisely.
  
• http://changingminds.org/techniques/assertiveness/assertiveness.htm - assertiveness
  
• http://www.dlsweb.rmit.edu.au/toolbox/fmi/content/tutorial/assert/assert00.htm - this is a really nice online assertiveness tutorial from australia. click on the links to proceed through the tutorial. includes sound clips of examples.

all you younguns', listen to me. your problem is partially one of delegation, partially ineffective interpersonal communication, and partially insubordination. when you give an employee an instruction you are delegating. part of delegation involves supervision, following up, getting and giving feed back on the task you delegated. you have to perform that supervision part of delegation too. speaking directly to a belligerent or contentious tech, cna or whatever you call your assistive staff, requires you to have some knowledge of and use some assertive techniques. know what their job description is if they want to play that game with you. in some cases, it's almost like dealing with spoiled children who are masters at manipulation. the way to beat them at this game is to know the rules better than them. we're educated people, folks. put your noodle to work on this problem. it is fixable. when you see the results of the efforts you put into researching and solving this problem, you will be very proud of yourself and begin to feel like the rn you are.

in my early years of working with some really obnoxious cnas in nursing homes i took a few seminars in dealing with difficult employees. every seminar stressed assertive techniques. i've listed some books and other resources that i have that will help you when an insubordination problem comes up, but like any other nursing skill they take practice to learn. i used to reheorifice what i was going to say to one of these difficult people before i even said it to them. your heart will be pounding and sweat may even roll down your back. they won't know that. the important thing is the words you say and tone in which you say them. it establishes your authority. you don't explain yourself, you don't have to, you have the authority to delegate the task to them and it's part of your job. remember the first foley or the first iv you inserted? think about how you do those skills now. well, speaking to difficult people is the same thing. it's a skill that takes some practice. you guys are going to get plenty of it, i can tell. i don't envy you and i do know what you are experiencing because i had to go through this too.

• managing difficult people: a survival guide for handing any employee by marilyn pincus
  
• working with difficult people by muriel solomon
  
• games people play: the basic handbook of transactional analysis by eric berne, m.d. (this little gem is a classic is required reading for most programs in counseling. it defines the various manipulative games people play, and we all play them, to get control over other people.)
  
• http://changingminds.org/techniques/assertiveness/assertiveness.htm - assertiveness
  
• http://www.dlsweb.rmit.edu.au/toolbox/fmi/content/tutorial/assert/assert00.htm - this is a really nice online assertiveness tutorial from australia. click on the links to proceed through the tutorial. includes sound clips of examples.