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?
That's a great idea to work side by side with her and show her how to do it. Rudeness should not be tolerated, door slamming, cursing, shouting, none of it belongs on the job, especially toward our bosses.
I wonder, forgive me for thinking it, is it possible our memory has faded a little, Noryn? Maybe you really did do it all and get out on time but did you do it all from the start or was that after doing the same assignment for a while? Did you get a meal break and/or rest breaks or did you donate an hour a day to the job for free? Just asking, no insult intended. I find that some of my own memories are beginning to develop some fuzzy edges. I noticed it with my parents and in-laws when I was a new mom and they were telling me how to be a good parent. Their memories of how they raised us just weren't so clear.
Your post confuses me . I dont think I ever posted I was able to do it all and get out on time. But to answer your question, I think, like I said it was just too much. I couldnt give the care I wanted to give, I was behind once I started. Did I get a full 30 minute break? Depends, right before I quit no I didnt as there was noone to cover for me. Did I get rest breaks? No.
Some nurses are making twice that much. Your pay is way too low, but if you are happy, right on.
My point is, regardless of who are you in long term care--aide, lpn or rn your work is hard. But at least as a RN you get paid halfway decent. In my state though the median pay for RN I think is around 21-22 dollars an hour.
Specializes in ICU/CCU, Rehab, insurance, case manager.
CCM I have read thru all the posts on this tread. With each responce that you were given you have come across rude and condescending. While you may have handled 30+ patients years ago. things are not the same anymore. You seemed to have escalated the situation rather than listen to the nurse when she spoke to you. Your superior attitude is not going to win people over either.
I've read this thread with great interest. To give my background before I get onto my soapbox, I'm in a leadership role, at night, in a busy emergency department. In my past life, I served in all sorts of leadership roles in the ems world. So, for the past 19 years, I've been leading people.
You may have noticed that I choose the word leadership over the word manage. People hate being managed. People like being led. Part of being a good leader is knowing the difference between the two and allowing people to develop.
Managing is focus on what the person is doing wrong and how to punish for what has been done wrong. Leading is having the employee make the right choices based on the framework that you have provided for them.
The folks that work with me do the right thing because it is the right thing to do. They take exceptional care of the patients, they make sure the families are informed, they explain delays, and they are always looking to go the extra step to make sure that everything is taken care of. Why? It is the culture that the leadership team has created. Our leadership is never too busy to talk to a staff member. If we cannot answer the staff member's question on the spot, we make sure that we get the right answer and let the staff member know what the answer is.
As for doing clinical work - we do lots of it. When an rn went home sick last week, who picked up her assignment? Who watches over patients when the primary nurse gets a real sick patient? If a staff member has a question about a procedure or an assessment finding, who do they call on?
Yup, it's our leadership team. I'll admit, it's fun to watch the department director transfer patients to the floor in a talbot's suit and heals, but it's what we do. It is how we lead.
Part of leading is developing staff. Our charge nurses are probably the most empowered group of charge nurses that I have ever run into. When they come to me with a question about how to deal with a situation, the answer is usually "What do you want to do about it?" rather than a concrete "Do this". Why? It continues their empowerment and makes them able to replace me one day.
It seems that capecodmermaid is managing. It seems that rather than lead, she is looking to motivate through negative reinforcement. This was typical of the "Head nurse" type of management that is still epidemic throughout healthcare.
I've never heard "I used to do that and more" or "I don't see why you can't do that" at my job. We focus on what can be done and fixing what needs to be fixed.
Does your staff have the equipment that they need to do their jobs? As silly as it may sound, our folks had problems finding thermometers. How did we handle it? We got more. There were reliability problems with our transport monitors. How did we handle it? Biomed now replaces the batteries quarterly.
Yeah, you may have taken 50 patients every night, with one hand tied behind your back, and had to do multiple dressing changes, tube feeds, and even answer the phone. Your staff doesn't want to hear that.
You can't start motivation and leading with the big things. You have to start with looking deep inside yourself and realizing that you may not have been doing things the best way.
I've heard many of my peers from other departments laments on the current state of the nurses. Many of them sound like capecodmermaid. They blame the lack of respect, lack of caring, lack of work ethic on the newest employees. We don't have the same problems. It is our culture - the staff members hold each other to standards - and their standards are much tougher than the hospital's! They come to our department and watch the staff and how they interact with each other. Usually, the comment is something to the effect of "My staff isn't like that". Then I will generally say something like "Do you lead them to be this way? We do."
But, what do I know. I've only been a leader for 19 years.
I know I don't need to defend CapeCodMermaid, and this is really not a defense , BUT she has some REALLY great and innovative ideas when it comes to patient care issues, BUT when the "I am the DON and do not have to get my hands dirty anymore" attitude come out, thats when one loses alot of respect by staff nurses .A unit runs so much smoother when there is MUTUAL respect.
Specializes in Gerontology, Med surg, Home Health.
Zowie..a lot of opinions out there. First of all until any of you deal with the nurses I'm dealing with you won't get it. They have contracts and can do what the please knowing there really is nothing that will get them fired (don't scoff...it's unbelievable but true)
Secondly I am neither rude nor condescending when speaking to my employees. You are NOT me so you don't know what I am capable of and I am telling you that I could handle the 30 patients she had that night and take a dinner break and get my notes done and help the CNAs. As far as the not getting my hands dirty part...think again. I answer call lights every time I walk down a hall. I take people to the toilet. I do the treatments when the nurses are busy. I mop up the spills before someone falls...the staff nurses, I might add, usually walk by and call housekeeping.
Flame away but I am seeing it more and more that nurses are not as prepared to deal with things as they used to be.
I started out as an aide...I've been a staff nurse, a nurse manager, a supervisor, the MDS coordinator, the SDC, the assistant DNS and now the DNS. I can't help it if all y'all can't do what I do. I can't help if all y'all want to tolerate rudeness. The nurses do not want to listen to anyone. I try and try to teach them the best, safest way to do things and their attitude is "yeah....right....we already know that" Well if you already know why is it you can't write a skilled note? Why is it you can't use proper clean technique for a dressing change? Why is it that you check someone's blood pressure for a Metoprolol parameter find the pressure is 70/50...hold the Metoprolol but give Lasix and HCTZ. Why is it you demand that the CNAs treat you with respect but you feel no qualms about being downright rude to the ADNS and DNS? Why? Because everyone else has allowed you to treat them that way and they let you give the excuse "I'm busy"
I don't really expect any rational answers from any of you. Most of my staff tell me I'm the best DNS they ever worked for. Why? Because I'm out there every day helping them...trying to get their salaries raised...treating them like profession people with brains...
Specializes in Director of Nursing Long Term/Subacute.
Well down here in Alabama we don't have contract nurses so I don't really know what they do or where they come from.
Maybe they do have an attitude.
Just do the best you can for your facility. But if it were me and someone talked to me that way--I would start the paper trail, hold them accountable and fire them the next time they did that.
Down here in the South we don't put up with such shenanigans--we got work to do.
I know nothing of being a supervisor, I in fact am a new nurse a LPN in fact, I too get tired of the DON or ADON telling us nursing what we are not doing. However I would never tell my boss to just try and do my shift and get out on time. I know that she would never do it for one and but no that is really disrespectful. The DON at my LTC facility is not as expeirenced as most but none of the nurses would talk that way to her. I think that in your position you could have done something a little more drastic than sending this nurse out of your office. My opinion and I know it doesn;t amount to a hill of beans but sometimes you have to do something to let that staff know how aerious you can be.
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?
CapeCod, how did you ever do that? Did you have good support staff? I find our 7-3 shift fairly manageable with 20 patients on our sub acute unit with all the help, like PT OT, recreation,unit clerk etc. 3-11 is always crazy, with all those people going home, admissions, lab results, doc that just wrote orders, or just returning calls finally,sun downing residents... Those same amount of people seem much more difficult to me. Plus it does seem like often times the CNAs are not as attentive on this shift. I work 16 hours and more times than not I struggle with the 3-11 shift and I am an experienced nurse. Sometimes people are just looking for some validation. Maybe her not 'sick' and 'stable' people are time consuming and needy in other ways? The LTC floor often I am speedier with their meds because I have a routine, however on 3-11 many family members come in and occupy my time. Also the sundowners can be out of control sometimes. I have been known to take them down the hall with me if they are w/c bound fallers. We also have some psych patients now that keep our unit pretty stirred up. The police have been to our facility in the last month 4 times, because of psych patients acting out or calling 911 themselves, acusing us of keeping them hostage. All on our beloved 3-11 shift.
I think it is best to try and find some empathy and try to relate rather than say "you have it easy". Ask how you can help. A lot of people won't take you up on it, but they will appreciate your concern.
Also, even if you could do all her patients with one hand tied behind your back, riding a unicycle and on a tightrope to boot, doesn't meen you should say it. (I am convinced that you can and are an excellent DON as well. ) This nurse sounds frustrated and demoralised (sp and is it even a word?)The last thing she needs to hear is that you can do her job and better than her, which is exactly how I would interpret your words. So she came away feeling worse about herself and with no solutions other than this probably isn't the right job for her then. Maybe she has unrealistic standards or things she can work on to make it more manageable for her. I know LTC 33 is pretty normal and can be worse. But I've been fortunate enough to have 17 patients and trust me they get much better care no matter how good the nurse is with the 33.
Hey everyone, slow down here. For one thing, this thread is listed under the "LTC DON & ADON", meaning those of us DON/ADON's that would like to discuss issues with other DON/ADON's that have knowledge of the same things we go through on a daily basis are able to. It seems like the majority of the responders to this particular thread are not DON/ADON's.
I would like to know how many of you know the state & federal laws that we are responsible for complying with when it comes to LTC, employment law, wage & hours, etc. This is what we deal with on a daily basis. CCM was asking for help.... not to be attacked and criticized. Her problem is the nurse is under "contract". That means this nurse can stand around and do pretty much nothing, barely squeaking by and CCM has her hands tied when it comes down to doing anything about it.
Specializes in Gerontology, Med surg, Home Health.
noc4senuf said:
Hey everyone, slow down here. For one thing, this thread is listed under the "LTC DON & ADON", meaning those of us DON/ADON's that would like to discuss issues with other DON/ADON's that have knowledge of the same things we go through on a daily basis are able to. It seems like the majority of the responders to this particular thread are not DON/ADON's.
I would like to know how many of you know the state & federal laws that we are responsible for complying with when it comes to LTC, employment law, wage & hours, etc. This is what we deal with on a daily basis. CCM was asking for help.... not to be attacked and criticized. Her problem is the nurse is under "contract". That means this nurse can stand around and do pretty much nothing, barely squeaking by and CCM has her hands tied when it comes down to doing anything about it.
Thank you! I was going to say the same thing but figured I'd get flamed. And,as an update, that same nurse has had the floor by herself for the last few days and is doing fine.
Noryn
648 Posts
Your post confuses me
. I dont think I ever posted I was able to do it all and get out on time. But to answer your question, I think, like I said it was just too much. I couldnt give the care I wanted to give, I was behind once I started. Did I get a full 30 minute break? Depends, right before I quit no I didnt as there was noone to cover for me. Did I get rest breaks? No.
Did you mean to quote me?