Frustrated w/night shift aides

[davidndenise2001]

I know I've read several postings about night shift aides, and it's like I'm reading postings about the facility I work at!

I work at a LTC facility that has three "halls". We have one hall that is like assisted living, our medicare hall, and then our, what I call, full care hall.

I've been bragging about how the night shift aides have been doing such a great job lately doing their bed checks, passing ice water, reporting anything unusual when they find it, etc.

Well, the other night, an aide that had been off all weekend came in for her shift. There was myself and another LPN that was working at the time. Other than that there were 4 aides total. Well we realized that they didn't do their 10p bed check. We didn't give it much thought though, because evening aides had just got done w/their bed check about 9:30 or 9:45.

Well as the night went on, we realized that the 2 aides on the "full care" hall didn't do their midnight bed check either.

Like a few other postings I've read, we gave these 2 aides the benefit of the doubt that they were going to do them in a few minutes. Myself and the other nurse went on doing our duties - mainly passing breathing tx. The other nurse realized that one resident had an awful odor coming from her. She didn't say anything to the aides, because "benefit of the doubt" ya know. Well, at 0500 we started doing our early morning med pass and accu checks. We went in that room and it had an even stronger odor coming from it. The resident was soaking wet! We said something to the aides and they just mumbled something about she had gas all night and she always pee's that much.

Well about 1400 yesterday, this all happened sunday night, I got a phone call from another nurse that was on duty, that I'm friends w/. She told me that her advice, since she has been there longer than myself or the other nurse I was working with, was to write them up and send them home if they're not doing their bedchecks when they're suppose to. If we were to have sent them home, the we would have had 2 aides total in the building and have to try to get ahold of somebody to come in and replace those holes at midnight.

What should we do next time this happens?

[CoffeeRTC, BSN, RN]

Well...I wouldn't let it get that far again. I would mention it to those two that you've had quite a few complaints and you noted that they did not do x,y,z. Tell them that this is unacceptable and if you need help, ask for it, but if you just don't want to do your job then go ahead and go home and call the DON. Simple and easy. No arguments, just state the facts. I always throw it out there that if they need help, they need to ask for it. I will always lend a hand when I can, so they know that that isn't an excuse that will float.

[anonymurse]

Do you want to avoid conflict or do you tend to martyrdom? Find examples in your past. Do you more prize harmony or ideals? How difficult or impractical do you find communication with your superiors? What are their drivers? Construct scenarios. What's the likely outcome of every scenario you run with your friend? Would the other workers straighten up if you were to send home only the worst offender/ringleader? Or would they "teach you a lesson"? Do you already know the answer but you haven't "found the time" to secure interviews with other employers? When you ask a bunch of strangers something, you probably already know the answer you want as well as the answer that's real, and the human thing is to hope someone will feed you the answer you want. The harder and better thing is to choose the answer that's real.

[Weeping Willow]

do not wait for it to happen again. be proactive. first, you need to realize that you are the nurse. you're the boss. this does not necessarily mean your boss has given you the authority you need to deal with this type of thing. find out. tell your supervisor what happened or just ask a vague, general question about what she would do in this situation, how she suggests you handle it. no doubt, whether or not you have the authority, you do have the responsibility of making sure the patients are properly cared for.

you probably need to just take miss a and miss b aside, separately, and have the talk. let them know what you saw and smelled the other night and get their version of it. listen and then decide whether they are truthin' or lyin'. let them know, in a courteous, professional way, what you expect and need from them. don't be haughty or condescending. let them know that you value them and cannot do the job alone but that, if they are not going to keep the patients clean and turned and cared for, they might as well go home.

if they are rude, don't be the same in return. keep your emotions reined in and don't lose your cool. let them know you are saddened by their response and hope they will realize that their work is very important and immediately begin to clean the patients every 2 hours as they were, presumably, taught to do. let them know that, if they cannot meed expectations, they will be forcing you to take this to the supervisor. let them know that they are in charge of their jobs and they are deciding what your next move will be.

don't worry too much about not having them there. they sound pretty useless anyway. i hope they will see the light. it's doubtful but miracles do happen, so give them the opportunity to straighten up. if they don't, though, you must, as a professional nurse, take steps to get rid of them. their neglect of the patients is possibly criminal and it is definitely not accepted professional conduct. they're not doing their jobs - why pay them? how can you let the residents be exposed to the likes of them? they are jeopardizing your license by neglecting/abusing the patients.

you might want to have a witness so they can't accuse you of anything illegal or rude.

how old are you? how old are they? how long have you and they been there? are they just lazy? are they working 2 jobs and are exhausted? where are they and what are they doing if they are not making their rounds?

[suejara]

First, do you think these aides can change for the better (was it a one time thing) . . . . . . . . talk to them about it ....or are they repeat offenders. I know you want to give them the benefit of the doubt but patient care that needed to get done didn't and as a nurse you are going to be held responsible.

Tell your supervisor. It seems that your co-worker had some good advice if that is the protocol your facility follows. You say only two aides would have been left but when you think about, it was really only two aides that were "working" in the first place.

It is also not fair to your nurse aides that do work hard to see fellow co-workers slack off and get away with it. They may resent you for not speaking up, when it is really you who has more authority to get something done about it.

I have been an aide in the hospital and I worked hard. We had one particular aide who walked around intimidating other staff, frequent smoking breaks, long lunch breaks, refusing to do work, neglecting patiens etc. It took almost 3 years to get her fired, part of the reason was that her behavior was let to go on. Nurses and aides complained to each other, instead of documenting the behavior and reporting it to our supervisor.

Again tell your supervisor, if the aides get a warning good, it is up tp them to change their work ethic. Perhaps the role and expectations of the aides needs to be clarified, written clearly on a piece of paper and handed to them. Maybe the supervisor needs to make suprise visits at night. It sucks to be the whistle blower but DO something!

Good luck.