Different Approaches To Nursing

mtgirl63 · Dec 15, 2001

Wow, that's a tough call, but I guess if she's wasting her time doing things that aren't assigned duties (we have an RN on day shift that spends time labeling things and rearranging cupboards), I would tell her, I will help you if I have time after my work is done. I'm like you and believe in getting meds out on time. Do what has to be done and deal with the other stuff as time allows. On the other side, I don't agree with nurses that start passing meds 2 hours before they're due just to try to get done early either, but that's just me and how I was taught. I think of this people that "wander" into other duties that aren't theirs, are trying to avoid their job for whatever reason, and are just waiting for someone else to pick it up. I know that when I come on shift there is one day shift nurse that is continually saying she didn't get so and so's 2:00 med to them, she has it in the cup ready to give, and would I give it. NO, I won't give it --- I do not give meds that have been set up by someone else. Sorry! I've said no enough, and told her why, that she finally stopped asking me!

MontanaRN · Dec 15, 2001

At our facility we have an hour before and an hour after to get meds out. I start on time-not before-and sometimes have trouble getting them all out. I can't understand why she believes she has so much free time, enough to do everybody's else's work. I have to work with her again on Monday and I'm really dreading it. I live in Montana too. So I end up driving over an hour each way plus we do 12 hour shifts. I just really don't need the hassle of the drive, and her too.

night owl · Dec 15, 2001

I couldn't imagine working with someone like that. If It were me, I'd take the bull by the horns and confront her. Ask her why she thinks housekeeping is a priority. Some people are just compulsive about cleanliness... :rolleyes: Explain to her that her work is a priority and that getting involved with other time consuming things such as sec'y jobs, housekeeping only sets her back timewise, and takes her away from the necessities. Tell her you're not criticizing her, just helping her with some time management tips. Most of the time, effective communication goes along way.

Ask her why she feels the need to supervise your work? You are an adult, she's not your mother. In order for her to get respect, she needs to give some. People will appreciate her more if she's not breathing down their necks all of the time and that she needs to get her own work done. Sounds as if she has some personal problems going on at home. You need to keep the working relationship on good terms because you're right, you'll probably need her assistance during a crisis and how bold of someone to refuse their assistance when you need it...Take it from there. It's either going to make or break the relationship. As I see it, to be open and honest is the best thing for both of you right now.

~Michele~

PS-GOOD LUCK!

hoolahan, ASN, RN · Dec 15, 2001

Yup! You have to confront her. Just simply say that you prioritze differently, and you leave housekeeping tasks for last, since that is not in your job description (I assume.)

Suggest that if she leaves her housekeeping tasks for last she may not need as much help getting her work done.

I think mtgirl hit the nail on the head, she seems to be trying to avoid her own work.

Good luck!

willie2001 · Dec 15, 2001

Sounds like this person needs to get off their high horse and learn to prioritize. Maybe you could tactfully suggest this to her. You certainly don't want to antagonize her since you have to work with her. I hope it all works out for you.

Mijourney · Dec 16, 2001

Hi. Wonder if this nurse has a problem with direct patient care? Sounds like she would be better off working in administration.

Montana, the good thing about home health is that the patient can be a little more lenient about his/her routine med time and still maintain adequate blood levels. Hoolahan, correct me if I'm wrong, but there isn't there a two hour span of time in which the patient have to take their med and maintain drug effectiveness. I know that on many of the med counters my patients use, the span of hours is on the box. For example many manufacturer's will put 7am - 9am on the morning slot.

The hospital is a controlled environment, so you do have to be very vigilant about prioritizing your nursing care. I definitely feel that meds should come before picking up the trash.

grouchy · Dec 16, 2001

I wouldn't say she has a "different style of nursing", I'd say she's an idiot! Actually, I'd say something stronger than that, but I'd get censored off the board. Yeah, you can talk to her, but will she listen to you? Can you get a different job? Can you and the CNAs she has antagonized collectively make a case about her behavior to management? I guess talking to her would be a good start, but I'd be reading those want ads.

nightingale, RN · Dec 17, 2001

Power is everything...... Has she been there forever and everyone just thinks she is the perfect nurse... hmmm.... It is impossible to say what your options are from this post.

You have probably developed your own style of confrontation. Remember, you get more bees with honey... but you do want to be clear with her that you do not need to be helping her when she herself has her priorities askew!

Step back (as best as you can emotionally) and assess where the power is (with her). If everyone is lauding over her to get there needs met (doctors, administration) then you have quite a mountain to overcome (and I would talk with human resources about transferring and be checking the want ads if this is where she is); If on the other hand, she is viewed as the inefficient nurse that she is, then you will not have that much to worry about with a strong confrontation.

It is sad we are so hard on each other (sometimes). I think it is a human nature thing with people and especially between women. I have viewed this so much in the business world (I have years of business backround) that I do not think it is a "nursing thing" but somehow it would be a nice assumption that nurses treat each other with more kindness, dignity, and worth (but sadly soemtimes ... we do not).

Go with your gut... Remember... the cream rises to the top.. B.:)

WriteStuff · Dec 17, 2001

Hi. You're definitely in an uncomfortable situation. Sounds like she has trouble seeing the "big picture" when she gets to work.

It also sounds like she has a whole lot of other stuff on her mind, that really has nothing to do with you. Whatever it might be it's coming out sideways and disrupting the work environment for everyone.

Would you be comfortable discussing your concerns with your DON, or Supervisor? You don't sound like a judgemental kind of person, you just really care.

Your Supervisor, or DON might be able to shed some light on things that help you decide how to approach her.

There's certainly nothing wrong with just asking her to have a little one-on-one chat with you so you can both be on the same page in all of this. And is doesn't have to be confrontational, although you have no guarantee that she will not see it that way. At the very least it will be out in the open for you.

Keep us posted as to how it all turns out........these are the kinds of scenarios that help us learn from each other.

Good luck.

Stargazer · Dec 17, 2001

I would agree, from the original post, that it sounds like the nurse in question has poor triage and organizational skills. To play devil's advocate for a moment, though---what kind of housekeeping duties is she doing, exactly?

I ask because I am admittedly somewhat of a neat freak at work. I was always the one who went around the nursing station picking up coffee cups, stacking magazines, throwing away old newspapers and discarded shift notes. (However, I did this only when done with my own work or while waiting for a doc callback.) Many times, while walking into an ICU patient's room, I would find such a godawful mess that I HAD to clean up and organize the room first because I knew I would never be able to find anything if the pt crumped. This was not the way I chose to begin my shift; in fact, it ticked me off because it put me behind. But I cannot even THINK in a chaotic, disorganized atmosphere.

Most of the time, however, I didn't say anything to the day shift nurse who left the room that way. This was because the handful of nurses who did this were also the ones who would get their patients out of bed, despite ventilator, PA catheter, chest tubes, multiple drains, Foley, etc. and would shave their pts, wash their hair, change all their lines, etc. I figured my having to take 20 minutes to clean the room was a fair trade for all the work they'd done.

I'm not saying this is what your co-worker is doing. But I thought I'd offer a different perspective. I do think it is possible for people with different workstyles to get along, but there has to be mutual respect of each other's viewpoints. A colleague started arguing with me once about the way I recorded my I & O's, because it wasn't exactly the same way she did hers. Neither of us were wrong, but she was a girl who could never back down. I finally just told her we would have to agree to disagree on this point. We got along fine after that.

Long and short of it is, I think the first step is talk to this nurse and get her to recognize that A) There ARE differing yet equally correct styles of nursing; B) You don't believe she would require so much help from you, or need to work every minute, if she organized her time differently and didn't take on so many non-nursing tasks in addition to patient care. Then offer to show her how you plan you shift. If she completely resists any of this, gets pissy with you and continues to come to you for help while simultaneously accusing you of laziness, then you need to document the chronology and events of a few "typical" shifts and go to your supervisor wioth it. Good luck!

NancyRN · Dec 14, 2002

Co-workers? What co-workers? The only time I see another nurse is when I get report, or when we pass each other on the run down the hallways! We smile as we run.

It's hard to imagine having trouble with another nurse when I so rarely get to interact with one.