Delegation vs. Mistrust

[CoffeeHead]

I'm a fairly new nurse. I started as a nurse on dayshift in the same hospital/unit that I worked as a CNA on nightshift. I'm having problems with delegation. From telling the patient to call a CNA to get help to the BSC to collecting a specimen to ambulating a patient in the hall, I don't feel like I can rely on them, if I can find them at all! It takes me so long to track them down to get their help that it's easier to just do it myself, and half the time if I do tell them what needs to be done, I'm scrambling at the end of the shift to accomplish it, because they never got to it. Outside of bathing the patient, and changing the linens, I feel like I'm doing total patient care, which normally I would love, but I'm getting home after my kid is already in bed each night, and because the other nurses are getting out on time, I know I must be doing something wrong.

I was given fair warning: "If a new nurse works the same unit that he/she did as an aid, there is a chance that he/she will have difficulty adjusting to his/her new role, or that others he/she works with will." This is so true - at least for me. I tried talking to the CNAs and explaining the problem, but while they acknowledged it, nothing changed. I tried being more firm, more specific, more/less authoritative - I'm at a loss.

[JB2007, ASN, RN]

I am sorry that you are having this problem. I had some of these difficulties as a new nurse also. I sat down and had a talk with some of the aides that I worked with while I was a CNA. I just explained to them what my expectations are and explained to them what would happen if they were not met. Most of them straighten up once they knew I was not going to put up with the BS. I have a really good relationship with most of the aides I work with now.

[diane227, LPN, RN]

I agree with the above. Your role has changed and you have to let them know that your duties have changed and how you are relying on them to work with you in your new role so that you can all be successful at getting the patients what they need. I think that you will find that they will be very responsive to this. And then, about a week later, follow up with a thank you card. That small gesture goes a long way to reinforce positive behavior and team work.