Help: Case study dilemma

Nurses General Nursing

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Hello everyone. I have a case study that I could use your input on. Please give suggestions on what you would do as well as where you think I could look to find more info. Thanks

Study

You are a recent RN grad who has worked for 9 months on a med/surg unit and accept a new position in the cardiac step-down unit. The unit employs only Registered Nurses and Nursing assistants who have training beyond that of a basic NA. They are trained to perform higher level tasks such as blood drawing, telemetry monitoring, and running electrocardiograms. Most of these NAs have been employed on this unit for many years and are very confident of their skills and their role on this unit. You are still feeling somewhat insecure about you technical skills.

On you first day, you are assigned to work with a NA, who is experienced, to care for 5 patients. you discuss the care needed for each patient, set goals for the day, and assign responsibilities to the NA that fit her job description. She interupts and says she will not complete the assignment because you are new and need the experience. When she is sure you are proficient with the work she will then accept the assignment. In essence, she tells you that you must do both your work and hers. Your supervisor has left for a meeting and is not expected back until after lunch. What do you do?:imbar

P_RN, ADN, RN

6,011 Posts

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Hmmmmm. Do you sense "attitude" or honest caring for your education in the new unit? I wonder where your preceptor is.

A telemetry/stepdown unit is pretty strong stuff to be turned loose on your first day on the unit. Sometimes as preceptors we DID assign the new people to work with a PCA (patient care associate-sounds like what yours are) to learn the equipment, supplies, and unit routine. The actual patients were not assigned to a new staff member until their unit orientation was complete. They were the responsibility of the preceptor/new RN/PCA team.

fergus51

6,620 Posts

Calmly explain that you don't have time to do her job and yours at the same time (and her job is not your job), but if there is any extra time you would love to go over skills then.

CATHYW

564 Posts

I think I would do what I could to flatter her (NOT BS her), by saying that you had heard that she had extensive experience on the floor, and had hoped that she would be able to show you the way things should be done. (We all know there is the textbook way, and the REAL way!) I would further say that I would appreciate her teaching me the right way things are to be done on that floor, so I would get them right from the very beginning.

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

Okay - I would try to uncover the motive here...is she trying to get out of work, help you, undermine you or what? Then I would address that end of it. However, I do not accept assignments from techs.

sharann, BSN, RN

1,758 Posts

MCCRAMD,

It sounds as if she is delegating to you. It sounds backwards. I value the job of each person I works with, but this sounds like it has crossed the line here. Some of our orderlies have tried to bully me and I just smile and then tell them what they need to do. They usually get my drift.

Keep us posted.

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