Feeling defeated

[GSDlvrRN, MSN]

Hello,

I need advice about being in charge and feeling like people take you the wrong way. I spoke with my manager today about some issues that were brought up about me with students and staff. It completely caught me off guard. Some CNAs I work with said that I make them feel stupid or that I make them feel like they will be nothing but a CNA. I feel like my relationship with the CNAs was developing well. I give them important details after report such as "Mr. XYZ fell yesterday, lets make sure the side rails are up, he is toileted before bed, blah blah blah ". I answer call lights when I am available, I round with them so I can apply butt pastes and change dressings. I always thank them for their help and I always say "Okay thank you" when they report something to me (I actually had a CNA tell me she hates when I just say okay thank you. what else am I supposed to say?)

There was an an incident I do remember when I was coming off lunch a CNA was getting antifungal cream and taking it to a patients room. I know some nurses let the CNAs do the skin treatments, but I do mine myself, and was instructed by the DON that CNAs are not supposed to do creams. I asked him who it was for and he kept walking, I asked him again and he said a resident was itching. I said "Oh I'll take care of it". He then said that the other night nurse (The nurse I was covering for on her days off) lets him do that and I said that I like to do the creams myself. He said "Well I thought this would soothe it because doesn't it start with bacteria?". I said no its okay thank you i'll do it myself. I went to assess the patient and she was fast asleep. When I came back I told him he needed to run that by me if he thought someone needed cream, especially if it is a new skin issue, that i need to document and include in the care plan. I know that this particular CNA is autistic and he is sometimes sensitive. Maybe I said it the wrong way? This resident had not had itching in the past and she did not have an order for the cream either. I want to add that I have only been working at this facility for two months, I had two days of training before I was thrown out there, I am still getting to know the CNAs and how they work and they are still getting to know me. Working for this particular night nurse has been difficult with the CNAs because they have gotten used to certain things and then I come in and I have my way of doing things so I see how change can be hard. I never intended to hurt his feelings and was very uncomfortable with letting him do something just because the other nurse did.

I took this job not knowing, or being prepared for the amount of students that I would be sometimes forced to deal with. There was a day when I met the psych tech students, they came onto the unit chatting about their weekend, they sat on many of my resident's beds and just hung out, there were a few that came up to me to offer help and I declined. I told them I don't know what their skill set is and I would have to talk to their instructor. I searched for her and she was nowhere to be found! There were a few incidents when my CNAs complained to me that the students were hanging out too much and getting in the way and I found 5 of the students hanging out in a resident's room. I explained to them that the rooms are the resident's private space and this is where they live and they are not to hang out and chat about their weekends there. A resident was in there being changed too. I felt the need to stick up for the CNAs that complained to me and to stick up for the resident's privacy. The students twisted my words and told my manager a different story.

There was another incident where I was passing meds to a resident and there were a few students in there chatting with her and braiding her hair. Another student came up to the group and said "Remember the lady you were trying to feed? She died!" And they proceeded to talk about it in front of the resident. The instructor happened to walk by and heard what they were talking about and told them it was not the appropriate place or time to talk about it. And she looked at me and said "You get them for stuff like that!" They told my manager that I was the one who told them not to talk about that in front of the resident and that I "belittled" them.

My issue with all of this is that I am open to working things out with my CNAs, I feel targeted and picked apart and like I am being called the bad guy. I have not been trained to handle students, I should not be in charge of them, it is not my responsibility to teach them, and I am bothered about what they have said. I told my manager all of this. I am drowning every day just trying to learn my job, I can be in charge of 50-75 residents and 6 CNAs, and being thrown 7-12 students on top of that. I have been crying because I love my job so much, it is the only thing I have left in my home town besides my dog, and I feel like I am being sabotaged. I am working my a** off, I know sometimes I don't participate in conversation with my CNAs when they sit around the table and chat because I don't want to be distracted from my overwhelming amount of work. I keep to myself sometimes because I am into what I am doing and am uncomfortable with being distracted, but I am still supervising and I see my CNAs doing their jobs so sometimes I leave them alone. I feel like I try so hard every day to do the right thing and it ends up taken the wrong way. Is it because nurses before me have let a lot slide and now I come and I don't let them get away with things? I felt misjudged from the second I set foot on the floor though. I was told things from the LVNs like "You young RNs trying to outrun us" and some ask me weird questions like "Are you really an RN?" and they ask me how old I am and stuff and say I look too young to be a nurse. There are only 2 other RNs in the facility and they to have told me about problems with staff saying similar things to them. I hate the divide between us, I look up to the LVNs I work with! I am not better! I feel like the lesser one

Idk I feel very insecure right now and like I can't trust anyone or that they don't like me or something. What can I do different? I know I can't change what people think about me. This is a long and emotional post haha I need some wisdom from my fellow nurses who have been in leadership positions, or have been a young new hire in charge of experienced staff.

Thank you!

[ktwlpn, LPN]

You just have find your equilibrium.They are hazing you just like they do almost every other new charge nurse,most of us have experienced this and it really is exhausting.You need support from your admin,you need to continue to be firm,fair and speak up with your staff.Have meetings,make your expectations clear,start progressive discipline as needed.When they realize they can't bully you they will learn to respect you.If your manager is placing more weight on comments from students you are in trouble.Your manager should meet with their instructor and you,that behavior is unacceptable! Wish I could hug you-had a crap day myself.Keep your head up,it will get better.

[GSDlvrRN, MSN]

Thank you for the reply! It means a lot. Can you give an example of progressive discipline?

[ktwlpn, LPN]

Thank you for the reply! It means a lot. Can you give an example of progressive discipline?

In my facility We start with a verbal warning ,next is a written one which includes a plan correction ,third can mean dismissal.If you ask someone to do or not do something and they persist you need to pull them aside and address it immediately,every time,without fail.State clearly what your expectations are,Let them know exactly what they did wrong and what will happen if it continues.Involve your manager now,Let him/her know you have a plan for creating a cohesive team,meet with the staff and outline your expectations clearly.

[Phledd]

My approach was different than those of some supervisors, but likely not right for everyone. I always tried to maintain a friendly, outgoing demeanor with CNAs. I worked as a CNA, myself, during nursing school and saw the effectiveness of that strategy, so I adopted it.

You mentioned the CNA who wanted to apply the cream. I might have, for example, said something like, "You have no idea how much I appreciate your helpfulness. I wish everyone was that willing to help out, but I have a nurse friend who got burned for this exact same thing at another job, so I'm a stickler about doing my own creams. I have to follow the book or I'll be a nervous wreck." Then I'd thank him again.

I also gave a lot of kudos each time CNAs went the extra mile or when they made it through a rough shift. When a shift went smoothly, I gave them credit. If I was swamped with extra nursing duties and couldn't find time to pee, let alone help them toilet residents, I apologized and let them know how rotten I felt about it--and they knew I meant it. I found that the majority of them wanted to please the "friendliest" nurses and hated displeasing them. They wanted to maintain that rapport because it made the workdays less stressful.

Naturally, I did occasionally have someone try to take advantage of my kindness, but it rarely lasted long. I had no problem being assertive when that happened. If someone had ever falsely reported that I was a big meanie to work with, nobody would have believed them.

I'm not sure how helpful this is. I just wanted to share what worked for me.

[ShellysBellys]

I don't know how much help this will be...

I recently switched to night shift myself(in the same building I've been in), and it's always so hard to know what the dynamics are before really working a couple weeks/months on a shift, and even then, there are things that can be missed between all the work that needs to be done, and what the CNA's are doing/not doing and interacting with eachother or not.

Anyway, I inserviced my CNA's about a month after I started. These are the expectations that I have for you, this is what I want completed in a timely manner when we work together. No I don't care what the other night nurse does or doesn't let you do, because she is in charge those nights and it's ultimately her license those nights, not mine. With inservice paperwork, you have documentation that they were insubordinate if they don't complete the tasks you delegate/assign, most aides are more than intelligent enough to figure this out, and will heed your expectations. My DON always tells me to "sandwich" when doing inservices or disciplining (and it's good useful advice)- Start with something supportive and nice, like, I know this is such a hard job, it's emotionally and physically stressful, and I appreciate so much that you all work so hard. Do the inservice. End with something about being a team, and being supportive of one another. Try to be overly understanding, but firm. If they break your rules, follow through with the consequences you lay out.

and obviously before this have a chat with administration and you DON about where they stand on disciplining people, because if there is not follow through from management, it makes your job a lot harder.

I've never had students act that abhorrently, and disrespectfully of the resident's, and that's incredibly disappointing.

[ktwlpn, LPN]

The students need to be dealt with on a higher level,they are jeopardizing their clinical placement,their behaviors are unacceptable.

Be firm,fair and consistent with your staff and they will come to respect you.