Real dilemma...help please (long)

[hollyberry678]

I work in a really really busy high-acuity unit, very large, too (60 beds)...and for the past year has been going through some major changes. I started last Sept as an RN, previously has been working on the floor and desk as support staff for 3 years. I do love the area I am in, and the work itself. It has been co-workers who have been my biggest challenge.

Back in Jan or so, a float aide during days "went off on me" in a patient room because I'd paged her about an incont pt. I told her to leave the room- it wasnt appropriate, ect. Later she grabbed my arm and tried pulling me into an empty room. I complained about that I was SOOOO upset.

I also complained about a new aide who didn't help at all and spent her time on the internet. The aide's mgr wanted me to have a 'mtg' with her, and thought it was a 'communication' problem, I said no, it wasnt a communication problem, that I was pointing this out, but that I would approach her and say I want things to go well for her and offer my help (I did and she rebuffed me rudely), so I let that go and got off days to avoid those people. I felt the mgr didnt believe me, and wouldnt do anything. Post script on this, now they know I was telling the truth as there are many more complaints about her.

Now night shift: Lots of new staff, they get pulled to sit alot, or arent there, and we have nothing. When we do have someone, they sigh, ect if there is any work to do. Because of the complaint regarding the aide who yelled at me, she told others and some began having an attitude.

There is an aide that transeferred to night, now at the desk, sho WAS in nsg school, now isnt, and she seems to want to think she runs the show at the desk/unit. She will be really short with me, and if I need her help with something, say changing a routine lab to stat, she will be like 'whattday want' if I call to the desk and say it's me. She also came to relieve a sitter once for my pt, who had had restraints on and now didnt need them, and began ying this pt up, and I said he didnt need them, and she said, he does if i am in the room, and i said no, he dosent need them, ect ( like a power struggle, What is that about, is it because she knew me before I was an RN?)

I believe she has gossiped to others, particularily the new people about me, and if the are walking in the halls, she and them will become silent and ignore me.

So I just tried to interact as little as possible, minimal, and they made me uncomfortable, so I felt tense...

Also, a new aide came to me at 11:05 asking for 'report' interupting me, and I said I wasnt ready, she later came to me and was rudely saying 'i dont appreciate that, ect'

Then the 'ringleader' said one time, oh, can i get report? oh you are too busy, arent you.

Another aide was sitting and we didnt have a floor ade and I literally was running the entire night. At the end of the night I said to her, can you empty the foley (I could see 200 or so cc's in the bag) she said I DID AN HOUR AGO'. I said can you lease do it again? (wanting shift totals. Apparently this was too much, but she did it.

Then the past few nights that aide was rude to a patient, long story, but it was becasue of the tension, i was in the room helping a wobbly pt back to bed (roommate) and she was supposed to get a weight on the other one, becaseu the paient didnt respond to her correctly she crumpled her paper and said 'thats it' and left. Next night I approacehed her and asked if there were something i can do to ease the tension btwn us "what tension?'. i told her the same pt needed a pre-surg shower at 0430. OR called and delayed it to 0630, family was there and offered to do it, i told aide-- who was in doorway-- thats okayfamily will do it and made a waving motion with my hand, like thats ok.

She later in the hall went off on me pointing in my face a ragefully yelling at me. *****

I went to mgr in a.m. and said thats it, I have had enough. I can pass meds, assess pts, but am not believed re: aides. I worked very hard for my degree, and lived on 1100/mos for years supporting my child to do it, ect.

Mgr said I am too sensitive, and 'let it go'. I said I need teamwork to work here, that they somehow dont like me, i am being scapegoated or something, and that they want to run the show. she told me to take a little birdie on the back of my head and have it chiro every time I get too sensitive. She said they invested a lot in me, that I am supposed to be a leader, and that I am a good nurse, and to hang in there, that she would take care of that end. She said I should work through problems, and that this is a good place to do it (BTW lots of RNs quit d/t stress here).

They seem to have a high opinion of the aide who pointed her finger in my face repeatedly, ragefully yelling, but to me that type of behavior is unnacceptable.

I like the ubit, but want to concentrate on my WORK, and devloping good relationships, not on DRAMA that the support staff in their bored lives are thriving on.

Should I just trnasfer or go to a diff hospital?

Another question: should I stay at this hospital/diff unit (and learn to love that area), or go to diff hosp (like the county hosp) and go to a station in the same area (because I love it.

Or stay and "work through" the tension/stress of these part group to aides? BTW when there is a float aide (exceptt for that one) or if I float, I get treated repsectfully, and as an RN.

Thanks for listenening.

[oramar]

Mgr said I am too sensitive, and 'let it go'. I said I need teamwork to work here, that they somehow dont like me, i am being scapegoated or something, and that they want to run the show. she told me to take a little birdie on the back of my head and have it chiro every time I get too sensitive. She said they invested a lot in me, that I am supposed to be a leader, and that I am a good nurse, and to hang in there, that she would take care of that end. She said I should work through problems, and that this is a good place to do it (BTW lots of RNs quit d/t stress here).

.

That "little birdie" comment by your manager is what chaffs me more than anything. If it was me I would go somewhere else. Where would be up to you. You obviously know your options.

[MAISY, RN-ER, BSN, RN]

I know you are venting and are looking for answers, however after reading your post I think you need to work on your assertiveness before you go anywhere or change any job. Until those problems are resolved, you will continue to have problems no matter where you go. People will test you everywhere, how you respond makes all the difference.

It helps if you start off each shift with expectations for your supporting staff. There are always people there who think they run the show, truthfully if your license depends on their actions-they need to answer to you! So, when a directive is delivered-make sure you say something like "I need weights on a, b, c patients and would like them given to be in 30 minutes. That is a direct request, documentation required of an order and should be followed. If not, write them up. Am I saying write everyone up---of course not, what I am saying is don't let anyone walk all over you.

When you address managment-don't be emotional, bring written documentation of what happened, and by reporting it officially you will be doing not only yourself a favor, but the patients and the rest of the staff. Slackers work everywhere....they'd rather argue than do their job.

Maisy

PS yelling? No one can do that unless you allow it? Walk out! No one can mistreat you without your consent!

[leslie :-D]

when i started working nocs, the aides were giving me a run for my money.

they had been reputed to run the show, and the facility couldn't retain any of the nurses on that shift.

first, i told mgmt that if i started working nocs, i was going to have a big pow-wow w/them, and expected mgmt's support.

i started nocs and first observed the behaviors of the aides in question.

within a week, i had that (mandatory) meeting w/applicable persons.

i let them speak their minds and i would respond w/rationales for various actions.

when a couple of them still continued to dominate the session, i stood up, only to put my foot down...

and proceeded to tell them how the floor was going to be run when i was on the clock.

and, if they didn't like it, they could leave.

i literally took the bulls by the horns and told them to knock their crap off- immediately.

one aide ended up leaving, after i had written her up and being put back on probation.

i think it's critical to have these meetings, only to vent and ultimately, communicate.

this way, there are no misunderstandings and we understand ea other perfectly.

and, by the end of the meeting, they know who's in charge, w/o a doubt.

leslie

[hollyberry678]

Thanks for your responses...These people are making me REALLY uncomfortable...it's like they are MEAN (IMO) with their gossip and shunning and attitudes. I feel really terrible! They dont respect me or something, or think they are the boss!

I mean, how again am I supposed to work with that aide who yelled at me? If she dosent get repercussions, she will feel she can do it again, or that she dosent have to answer to me, and that can affect pt care...I hope you get what I mean. It also makes me tense!! as it has all along.

Since it is nights, additionally, mgt is not there to witness or go to...and then it is '2 sides to every story', in which I believe these people, or at least that aide in particular, will embellish...

Yes, thats what my mgr said to me too, to try to work it out there or it will be following me around, and I agree in principle of that, however I also think this particular unit has the worst aides (and so I have been told by others), and they dont show a lot of respect (unless you let them 'run the show', in which case you are buddies, but that is not the scenario I want to get in to).

Anyway, please try and help me understand and 'grow'. thanks

[MAISY, RN-ER, BSN, RN]

It doesn't matter what was, from now on the new you is not going to put up with anyone's crap! Request your protagonist do her job, if she does not comply do what you'd do anyway-do it yourself BUT DOCUMENT DOCUMENT DOCUMENT. Managers don't like complaints without proof.

Example: We had a technician that some of the other nurses hated-stated she was lazy and disappeared. I never had that experience-she was always great with me and that was the side I shared when asked by my manager. Well, one day that changed....she didn't do one thing requested, and really had me in a hole! I went home, and shot off a two page email outlining her total defiance of my requests, attitude in front of families, and how it affected my assignment. The Nurse manager, sat her down the following day-showed her my letter and told her how I'd always supported her and spoke favorably of her work. How sad she had crossed the one nurse who actually liked her. She was reprimanded formally, had to meet weekly with the NM. She was afraid to talk to me....when she did she apologized....I don't hold it against her. I just took the time to explain why her inaction and poor response can wreak havoc on the staff. As part of the team she is important-now she knows why.

Hold your head up-no one can make you feel bad, or out of control unless you let them.

JMO

Maisy

[hollyberry678]

Yes, I get what you are saying, and that is why I am scapegoated now, I believe, because I did initially complain. AND I expected some sort of respect. The other RNs just put up with it, do everything themselves, and everything's fine.

When I was an aide, I worked my tail off, and ALWAYS repected the RN. I considered myself 'support staff' and that I was lucky to be there.

So now it is in numbers that I am the bad RN (if they even consider me that with the way they dont respect it) or something (I dont expect anything now, I have learned my lesson).

Also, the other night the HUC didnt tell me my child called at 0330( he only will call in an emerg), when I later asked (he called back at 0430 and an RN got me-- said he left a msg and why didnt I call), the HUC said 'I FORGOT, OKAAAY?') Then, the next night during my one 10 min break started yelling at me that 'how dare I question her regarding this in front of the person she was training...huh? I said I have a right to recieve my phone calls, of which I hardly ever get, and ESPECIALLY from my CHILD at 0330!! She backed down and said she was sorry, but later I could tell was gossiping about me with the other aide who had just yelled at me...

I mean, they have a clique here, and it is safety in numbers, and I feel they are trying to intimidate me!! And until the other morning, I didnt think mgt would respond, and even now, I wonder what minor thing they will do.

I mean with the aide that yelled at me, pointed her fiinger at me, how can I work with that? that needs definate repercusiions, IMO. Any thoughts on that? thanks

[gonzo1, ASN, RN]

It is very hard to learn to not let people intimidate you. But if you want to continue working in this area you must come to the understanding that the only thing that matters is taking care of the patients.

It doesn't matter that the aides don't like you, or shun you. Are you there to take care of people or win the popularity contest?

Why should you care that these people don't like you or talk about you or shun you. Do they pay your bills, tuck you in at night etc.

Tell them what you expect done and the time frame you expect it done in. If they don't do it write them up. Period.

You said you are a new nurse. You can go find a different place to work (which you should do sooner, rather than later) However, you are in a great learning experience. Use the toxic floor that you are on to practice your leadership skills, communicate with staff and then take what you learn and go somewhere else where the work environment will be less toxic.

It has taken me five years to learn that working is not a popularity contest. It doesn't matter if the aides don't like you because you demand that they do their part of the teamwork.

Never yell back at staff, and always tell them in private or with one other witness what behavior will be allowed and what won't.

Where ever you work there will always be staff like this that show up to surf the net and do as little as possible to collect their paycheck.

Over time you will gain respect of the ones that do their job and the loafers will fall by the wayside.

[whodatnurse]

Building a little bit more on what Maisy started getting at...yeah, I too think it would behoove you to focus on the one thing you have 100% control over: you. As I read your post, it became pretty clear that you're conflict-averse (tons of people are). You 'ran away' from day shift, now you want to 'run away' from your workplace...and I point it out that way not to make you feel badly, but to drive home to you that as long as your happiness in a given workplace is that largely affected by the personalities of the other co-workers, then eventually you're going to run out of places to 'run away' to. Because even if you do find a great situation, people change jobs all the time, so the cast of characters is constantly changing. The one common denominator in the picture will always be...you.

I know you would love to just be able to 'do your work' and not have to deal with any difficult people. Unfortunately, they're everywhere and most workplaces aren't free of struggles stemming from interpersonal dynamics. Your nurse manager is right...you ARE a leader in that your job is going to sometimes require you to direct the work activities of others and get results. That is a skill that can be developed. Try to look at the behaviors of difficult people at work as exercises in applied management. As you grow confident in that aspect of your job, you won't be as inclined to take off the first time a particularly headstrong personality comes aboard.

So...how do you go about growing in this area? For starters, you might ask for coaching/mentoring from someone whose supervisory skills you admire. Ask if you could meet on a regular basis that works for both of you and chat about things that are going on and get ideas for things to try to turn difficult situations around. For inspiration and insight, I would also recommend that you go to the library and check out some of the many books on leadership, as well as biographies of leaders (particularly those you personally admire). You might also consider taking a community college class on supervision.

Nobody should stay indefinitely in a job situation that is truly horrible at which they've exhausted all their efforts to improve. But I think in your case that what's driving you away right now will only find you again if you don't attack this problem from the angle of how you respond to difficult people in the workplace.

[mpccrn, BSN, RN]

holy hockey sticks is all i could think of as i read the saga as it unfolded. everyone there needs to grow up. it's not about you or the level of respect you think you deserve. it's not about them or the power of the click. it's about the patient and doing the job. you earn respect from a no nonsense fulfillment of your job requirements. they learn to give respect by your demand of it by doing the job without getting involved in the politics. clearly state your intentions and your expectations. don't get involved in name calling or finger pointing. that's not the job. i'm sorry you're having a hard time right now but keep going at it. time frames of expected tasks should be clear. formally writing them up if they fail without a good reason should be expected on their part. you're in this together. finding a way to work together surely will make things easier on all parties. having a little fun along the way would be a plus. good luck

[hollyberry678]

Yes, I agree its about the patient, however I do need a 'little' respect because I direct the care. I dont need them debating me about it, disrespecting me in front of the patient, walking off without doing what they need to be doing (like the weights), and WHO LIKES TO BE SHUNNED? THAT is childish. I have to disagree with you on that, I think I put up for a long time (and did everything myself) FOR the patient, but I would like to have a CALM work environment, too!!!!! Wouldnt everyone??

[leslie :-D]

you know holly, i do realize how easy it is for me to spout my mouth off re what should be done/how to handle.

yet i constantly have to remind myself that there are many people who have difficulty w/confrontation.

some of us are naturally more assertive than others (read: big mouths:p)

what i can confidently tell you, is if you hang tough and stand your ground, these people will eventually back off.

once they see that you will not be intimidated, they do back down.

i have learned this time and time again.

so if you decide to take this/them head on, remain respectful and determined.

do not let them ruffle you (or, don't let them know they upset you.)

but if you choose to leave in search of greener pastures, just know there is no avoiding the woes of human nature.

whether we need to deal w/other nurses, aides, md's, families, bosses, we need to know how to deal and how to stay on top.

wishing you only the very best.

leslie