I'm a relatively new DNS, but I've been a nurse for 25 years and have had every nursing job there is to have in LTC and then some. How do all y'all deal with disrespectful staff? I don't mind a spirited discussion but I am mighty tired of nurses saying "How do YOU know?" Mind you I've been a nurse longer than they've been on the planet. They complain about everything, feel 'entitled' as new nurses, and are so rude it's unbelievable. One of them today was complaining and said she was over worked because she had 33 patients on a 2p-10p shift. I explained to her that she had no sick people, no IVs, no trachs, no dressings...she said 'Why don't YOU try it'. I told her that I had worked on a true sub acute floor and had 30 patients for meds, treatments, 5 IV's with antibiotics every 4 hours, 2 fresh trachs, 3 central lines for TPN, 2 people at life's end from AIDS AND I had to do my own MDSs. She said "You did that and got out on time?" Yes I did I told her. "Then you must be a better nurse than I am and besides it was probably 20 years ago." I was speechless. I wanted to tell her I AM a better nurse than she is and it wasn't that long ago. Instead I told her if she was going to speak to me in that tone of voice, she could leave the office. She slammed the door on the way out. I am at my wit's end on how to deal with these totally unreasonable fresh nurses. Any advice?
Specializes in Gerontology, Med surg, Home Health.
The company I work for a family owned and operated and for profit. Believe me, no one in that family is making a lot of money. We lose money giving all sorts of free care. We all need to be respectful of each other. And, just as an aside, for all of you who thinks it's so easy being in administration....I've worked 7 days straight...did my regular time and was in the facility yesterday all day. Got called this morning at 5:45 and told there were 3 nurse call outs. I got up, hopped in the shower and went to work. Did one person there say thanks? No...they get paid for every minute they are there. I get paid for 40 hours even if I'm there for 80.
Capecod...I've read many of your posts and have to agree with you.
It is so frustrating. I would write her up or at least give a warning. You let one person talk to you like that and the rest will follow. I definatetly give my DON a thanks when she works the floor. This new one....eh. I'm not sure. They tend to moan and complain and she will leave tons of stuff undone, yet complain when we do. Being respectfull is a two way street.
I'd stick to my guns and just let the staff know that we don't do things (being disrespectful and not working as a team, etc) that way here. Word will get around and people will respect a leader like you!
Good for you CCM for coming in and working at your facility. Not one time in any of the LTC facilities that I worked at did the DON or ADON come in and work when we were critically short. I had an emergency in the middle of the night once and could not even reach my boss by phone for help. She had her phone off. You are setting a great example. Too bad more in management don't act as you do.
Coming in on the weekends to work? I thought all DON's did this when needed. Not only weekends but evenings and nocs too. If it is my turn to take on-call then that's what I do. I just have to adjust my own work load to accomodate it.
I posted earlier that I do write up the nurse(s) for rude behavior but, i also allow them to come to my office to vent. This means, any employee is welcome to come in, shut the door and say what they need to. And believe me I have heard all the language over the years. But, there is a line between venting and being rude and having conduct/insubordination issues. It is when they cross this line that they receive disciplinary actions.
It is sad to say that there will always be staffing issues in LTC. I as a DON will be out on the floor along with my managers passing meds, doing treatments and feeding/toileting each time that it somes up if we are unable to find replacements. I don't expect the floor nurses to do anything that I wouldn't do myself.
I always liked and respected my managers and supervisors who lead by example, just my preference. I personally feel and I dont think I am alone that nursing homes in general are horribly understaffed.
Ditto.
You have to earn respect as a supervisor.....it is not handed to you. No matter how many years that you have in, you still have to earn. Because while one person may be sayingto your face, there plenty of others probably saying it behind your back. And that spreads like a plague.
The best way to nip this in the bud is to come in and demonstrate that it can be done. Then give the employee a chance to improve. If ishe doesn't go ahead with the discipline.
(My experience is often the supervisor doesn't know how things currently are going in the floor....no matter what they did 2-5-10-20 years ago. More patients/visitors/new aides are becoming more entitled and difficult to deal with. Technology often makes nursing's job harder rather than easier)
I always work harder and respect more those supervisor that work the trench occasional. And while you can "require" people to respect you, it really doesn't work that way.
Why dont you work that shift and show her how easy it is to finish up your work on time? It will only take 1 time, just have her shadow you. You will get more respect that way in my opinion.
Nursing homes are hard, having 33 patients really is difficult in my experience. That scenario you gave would be much more difficult to work but in my honest opinion it would also be extremely unsafe and end stage pts would likely not be given the care and attention needed.
New nurses are under horrendous pressure, especially with a large load of patients. Their lack of experience really take a toll. We all have been there but what seems minor to you could be pretty intimidating or scary to a new nurse.
I quit the nursing home after about 10 months, I will be honest--it was just too much for me. Never had a problem in the ICU or ER but bad memories of those long med passes.
Again just me 2 cents (which isnt worth much) but as a supervisor and older nurse you should give more support before writing someone up. I think you would get better results and more respect.
I agree, you have to gain respect before you will get any back. 33 patients is a lot of responsibility and we all don't work at the same comfort level. I have been a nurse 18 yrs and I am now a LTC nursing supervisor for night shift and I would not want to work with the patient load you described. That nurse was probably just venting. Your response was not helpful at the moment. I hope you don't take this wrong, I really am just trying to get you to look at it from another perspective. Good luck!
Specializes in Gerontology, Med surg, Home Health.
I'm glad the last 2 posters don't work for me. And to the poster who thinks it's required for the DNS to fill in shifts...think again. Maybe you have a small place and you can adjust your work schedule. I can't. I have deadlines to meet every day and when I'm not doing MY work I have to stay late. I don't mind helping out but I say walk a mile in my shoes before you think I do nothing all day. Listen in to the conversations I have with corporate when I am telling them we need to increase the staffing ratio.....stand by the phone and listen when I am telling them we need to increase the pay for the staff...sit in my office at 8 oclock on a Friday night when I am trying to finish a report to DPH about an incident that happened when I wasn't even in the building and that no one who was in the building bothered to do a complete enough incident report so I have some information. No wonder so many DNSs stay in their office all day. It's hard to come out and get treated badly for things you have little to no control over.
PS. It was a foregone conclusion all season, but.......
To be honest I think that statement is rude and disrespectful especially considering your major gripe is about rude and disrespectful employees. Those posters took time our of their day to give you their opinion and they seemed to post their opinion in a pleasant way.
I am sure your job is challenging, I am sure you have paid your dues but I would also remember that your job, regardless is much better than theirs (and it pays a heck of a lot more too).
Sometimes instead of blaming people we do need to look in the mirror. I will say it again, I honestly think 99.9 percent of the nurses could not handle the load you did safely and adequately. You may very well be the exception to the rule but your expectations also are likely too much for the average nurse.
To be honest I think that statement is rude and disrespectful especially considering your major gripe is about rude and disrespectful employees.
I find it bizarre that a senior nurse in a position of authority has to "prove" herself to her subordinates. No matter my position, in straight office work or a health care facility, it has never occurred to me to demand, in effect, "Yeah? Let's see if YOU can pass this typing test!"
The respect is due, period, by virtue of the hierarchy and her place in it. If at any time she proves that she does NOT deserve the respect that's another story. But I certainly don't want subordinates with gigantic chips on their shoulders who require me to prove myself to them. That's been done, hence the position of authority.
If you noticed, I stated I worked the floor when needed, or when on-call and no one else could be found. We do not use pool in our facility. I put in over 40+ hours per week but, also know how to delegate some issues to my managers. I do not spend my whole workng day out on the floor but, each day is also different.
I still get my reports to the NHA and CEO and board in a timely manner without working into the evening hours. I do start my day around 6A to ensure I see the noc shift and leave around 4P after i have seen the evening shift. I believe each shift should be acknowledged on a daily basis by me as this does cut down on the majority of any complaints.
I feel for you CapeCod. Each building has their own issues and daily crisis. Back to the origianl subject... if the nurse you spoke of has been trained and others can do the job, set her straight and tell her the "attitude" will not be tolerated. Hopefully her behavior does not show to the residents.
I'm glad the last 2 posters don't work for me. And to the poster who thinks it's required for the DNS to fill in shifts...think again. Maybe you have a small place and you can adjust your work schedule. I can't. I have deadlines to meet every day and when I'm not doing MY work I have to stay late. I don't mind helping out but I say walk a mile in my shoes before you think I do nothing all day. Listen in to the conversations I have with corporate when I am telling them we need to increase the staffing ratio.....stand by the phone and listen when I am telling them we need to increase the pay for the staff...sit in my office at 8 oclock on a Friday night when I am trying to finish a report to DPH about an incident that happened when I wasn't even in the building and that no one who was in the building bothered to do a complete enough incident report so I have some information. No wonder so many DNSs stay in their office all day. It's hard to come out and get treated badly for things you have little to no control over.
Let's see my NM at Johns Hopkins, in her late 50s, published multiple times, co-author of CE booklets for them, consulted regarding a national aired program on preventing med errors, and has been quoted in AJN (or was it Nursing 2007) twice in a year, regarding unit research projects on the effects of noise reduction devices and and developing scales to predict delirium in cancer patients. When she had a problem employee, even if it was a traveler, she would work the night shift with them to assess the issue. She also came in when there was no charge on nights, and she took patients.
But then, being the top rated hospital in the nation consistantly for several years doesn't mean that much. And we all know that being published doesn't take that much time......(sarcasm intended)
I have worked with NMs at Thomas Jefferson and Hospital at UPenn, at New York Presbyterian and at Beth Israel Deaconess in Boston. All excellent facilities, with low turnover and good to superior reputations. And the manager put in occasional shifts on the floor. At TJUH, she did one to two per month, taking the same load as staff. And despite having lousy ratios at the time, there was less turnover and the staff had a lot more respect for management.
I would go to the mat for any of these women, as would many of the staff. And the fact they are consistantly ranked excellent in the nation has a lot to do with these awesome managers.
On the other hand, there was the community facility where the manager refused to meet with any staff at a time that wasn't convenient for her. She explained no policy changes to anyone not on days, because, well, she doesn't need to because she is "management". People may not have been openly rude, but they certainly said plenty behind her back. After she had substantial turnover, and refusing to come in to safely cover the unit in the aftermath, because it wasn't "convenient", she quickly her future time "freed up"....by demotion.
Many staff would not come extra, which would have prevented her needing be called in.......because they had no respect for someone who won't dirty her own hands.....and would just not answer the phone.
While we know LTC is different, management still has to earn respect.
You cannot force respect....you must earn it. And what is being said to your face, well...the buzz behind it is generally much worse.
CapeCodMermaid, RN
6,092 Posts
The company I work for a family owned and operated and for profit. Believe me, no one in that family is making a lot of money. We lose money giving all sorts of free care. We all need to be respectful of each other. And, just as an aside, for all of you who thinks it's so easy being in administration....I've worked 7 days straight...did my regular time and was in the facility yesterday all day. Got called this morning at 5:45 and told there were 3 nurse call outs. I got up, hopped in the shower and went to work. Did one person there say thanks? No...they get paid for every minute they are there. I get paid for 40 hours even if I'm there for 80.