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?
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.
Wow! What a great example you are to all nursing management!
Hi I'm new to this site. I have been a nurse for 25 years now. 9 years in the operating room and the rest as a geriactric nurse. When I had first became a geriatric nurse I had between 18 to 22 patients. I now average between 37 and 40. Most of them were alert and oriented and took their medication and they didn't have much medication to take. I have seen that through out the years as the medical field has progressed with more labs, new labs, more medications, new medications, more diabeties, all in progress as in the number of doctors and the different tests that are now run, how many doctors that you know will put a geriactric patient on a new medication and take them off of one, they will put them on one but very seldom take them off of one. these new companies that have taken over have cut back staff. Nursing homes are not just nursing homes any more. Nursing homes are taking drug abusers, psych patients, more acute patients and because of modern technology geriatric patients are living a lot longer. They are variety homes. Some patients now you have to crush their meds and then practically stand on your head to get them to take them. The drug abusers are always wanting to fight to try and get more medications, and they are screaming and causing turmoil on the units. In 8 hours time you have 37 to 40 patients to give meds to times 2. State wants you to do it in two hours. One hour before and one hour after. You have to chart on your medicare patients, you chart on your patients that are on antibiotics. What geriatric patient that is now 92 or older bed ridden who doesn't have pneumonia. Weather yearly or aspirated. You have to chart on the abusive patients every shift to regulate their medication for the doctor. Then their is the monthly charting and you have your skin assesment. Your also expected to follow up on the lab reports. Usually lab reports don't come back to a nursing home until after second shift has started and the doctors office is closed. Then you have to try and reach the on call doctor for any change in medication. You are also expected to help your C.N.A.'s when they need it. Any fall or skin tear has to be written up, families notified and also doctors are notified. Familys usually call when they get off work to ask about a loved one or they stop by to see them and talk to you. You help feed patients at meal time. There is nothing that I have mentioned that is hard to do. Even taking care of my trach patients. It is however time consumming. I am on the job for 8 hours. They say I have a thirty minute brake and two 15 minute breaks. So in seven hours I'm to get all this done. When a patient is placed on antibiotic's you have your infection controll form to fill out. Your doctors orders, fax the orders to pharmacy, write them on the P.O.F.'s and on the mars. How much can I do in 7 hours. The new nurses are almost always thrown out onto the floors and it's sink or swim. They get scolded, put on three days suspensions, and usually in front of other nurses. Take 37 or 40 and divide it into 7 hours and tell me how many minutes I have to spend with each patient. Just my two cents worth.
Specializes in Gerontology, Med surg, Home Health.
So apparently all y'all think it's okay for a nurse to stick her finger in her supervisor's face and say "Act professional" before they both walked into my office to discuss staffing? I think not.
I am a new nurse and I understand how it feels to be under pressure but one must still act professionaly, anyone nurse or not knows not to speak to their boss like that! she could have addressed her boss in a better fashion! She definetly must be disciplined, this type of insubordination left unchecked is contagious and rapid growing! if she talks to the boss like that imagine how she treats staff, patients, patient families?? horrendous!
So apparently all y'all think it's okay for a nurse to stick her finger in her supervisor's face and say "Act professional" before they both walked into my office to discuss staffing? I think not.
No I do not think it's o.k. to stick a finger in any bodies face. Respect should be given to a boss and or employee. I would probably fired her or him on the spot. I feel if maners and respect were used more often people wouldn't get in so much trouble. What happened to the good old days.
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. I am not blaming you, it is just the way it is. 33 patients I think is too much with med passes and all the paperwork involved. I dont care what a matrix or the state says, that is just my opinion--and I have been wrong many times
She could be acting out of frustration but again she could just be that type of person. Unless your nursing home is different, every one that I have seen is extremely hard work, in my honest opinion too hard, especially for the pay. Maybe not for the RNs, but the lpns and aides, wow they have to work their butt off to finish.
Just wanted to add, that is how I have always supervised. Gotten in the trenches with the troops, allowed them to vent, agreed with them and gave them support instead of nit picking.
I agree with everything you said except for one thing-
I'm an RN in LTC. I take a hall of 20 pts, do all meds & tx, plus do incontinance rounds, turn & lift pts, wipe butts (not just occasionally, but several times a shift), take v/s and I am responsible as charge for 40 other pts. My 0600 med pass is overwhelming with 200 meds for 20 pts.
It may be just my facility, but as an RN, I work harder in LTC than I did as an LPN.
Whether you are a CNA, LPN or RN, LTC is grueling work.
Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.
Well Cape Im sorry you had to deal with that bad attitude, Im the NM of the SICU at barnes, and if it was me she should have been written up, I would have written her up, she deserved it, or you could just send her over here to barnes to the SICU and Ill work the he** out of her. LOL
I agree with everything you said except for one thing-
I'm an RN in LTC. I take a hall of 20 pts, do all meds & tx, plus do incontinance rounds, turn & lift pts, wipe butts (not just occasionally, but several times a shift), take v/s and I am responsible as charge for 40 other pts. My 0600 med pass is overwhelming with 200 meds for 20 pts.
It may be just my facility, but as an RN, I work harder in LTC than I did as an LPN.
Whether you are a CNA, LPN or RN, LTC is grueling work.
I think you missed my point. I didnt say it wasnt hard--in my other post I even admitted it was too much for me and I am a RN. My point was the work/pay ratio. These aids work for like 8 dollars an hour and bust their butt, RNs around here get about 20-25 dollars and also bust their butt. Lpns about 13-15. So yeah us RNs do have hard work but at least we make a decent amount of money.
Okay.....I get all of the post, but back to the original issue. The fact remains she was rude and out of line. I don't care if she was a lpn, rn or cna..that was her superior and she didn't need to talk that way. As far as having compassion or empathy for the work load. Yeah...LTC stinks sometimes and we have a million and one things to do, but guess what....no one forced us to pick that job. There is no gun over her head. She could leave and get a different job. Thats the aweful truth.
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
CapeCodMermaid said:
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?
My . I don't know the nurse in question or her tone of voice, but personally I don't think she needs written up.
From my perspective-I worked in a position not too long ago that was impossible. Now I'm not a complainer, so when I went to my boss about it, it was serious. I work hard, but what I was up against was not possible, I had done everything I could and had got to the point that I was at the end of my rope. I went to her and got the brush off. Kinda like your answer above. I tried on two seperate ocassions to get her imput/help. Again got nowhere with her. So guess what, I left. Got a great, wonderful job with a fabulous boss that I totally respect and that respects me. And my last boss, she tried and tried to get me to stay....but by that time I was just done. Like I said, when I get to the point of taking my problems to the boss they are serious and I expect to be listened to and helped.
Perhaps the nurse that came to you was truly at her wits end, your answer to her was belittling. She came to you for help and you brushed her off, telling her that her job wasn't too hard, that you could do it easily.
Just my two cents worth.
pepperann35
163 Posts
Wow! What a great example you are to all nursing management!