Why am I so terrible at delegating??!!

Nurses General Nursing

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Ok so I may be a bit of a pushover and am known for being extra extra nice, but I must admit I am horrible horrible horrible about asking people to do things and not feeling bad about it or hesitating. I have been a nurse for 2yrs in pediatrics and everytime I ask a nursing assistant or a resp. Therapist to do something, they make me feel like I'm totally out of line. Not to mention its just the ones who arent' very friendly as it is. There are some CNAs and RTs that are super awesome and super nice but then there are those who just won't do diddly squat for you without complaining, giving you attitude, or just down right being mean about it. I ask nicely all the time and most of the time I just do things myself that aren't in my job description just b/c I dont' feel like asking or I much rather do it myself. But there are times when I really do need CNAs and RTs to do their job b/c I am swamped and do not have the time to do their job and mine.

Tonight For example, I had 4kids. I had gotten an admission at change of shift, I had to finish up another admission that was left over from day shift, and I still had my 2other kids that I had from the previous night who needed their meds. There is always a RT on this respiratory floor so they usually hang out by the nurses station waiting around for their Q3 neb treatments due or whatever. We had no CNA tonight to do vital signs so I was busy trying to run around doing that, finishing up my admission, my other kid needed an IV so I had to call the supervisor and help her hold that kid. Meanwhile, my new admission 02 sats were not that great and he obviuosly needed to be suctioned. So I kindly went up to the RT and asked him, "excuse me but do you think you can Suction the baby in Room 20? I have to finish this up and I just really can't get to it right now." His response was "Do I not look busy to you?" and with his meanful stares he says "Why can't you do it". I again explained to him that I had a million and one things to do all at the same time, I was being pulled in every direction, and I really would appreciate his help. After all he is RT and that was his job and job description. I never ask people for anything and I just feel like when I do ask I get crap for it. It really sucks.

I try being a hard *** sometimes but with my personality it just doesn't work. lol I feel like I get walked all over, picked on, and people are just so easy to be mean to me. How do you others handle situations like this? And how do you become a hard*** b/c maybe I need to learn and try it. I am tired of being treated like crap when I am so nice to people.

:angryfire:icon_roll:bugeyes:

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Specializes in LTC, Wounds, Med/Surg, Tele, Triage.

I used to feel the same way about 'asking' people to do things, and feel those same 'guilty' feelings when the person did not want to do it. Not anymore. First of all, delegating is not simply me asking someone to do me a favor. It is an important step in the care of the patient, and the other staff are members of the health care team, right? Now my approach is much different. I do not ask, so and so will you do this or can you do this? I say, so and so, the patient in room 81 needs their VS rechecked, turned, breathing treatment, suctioned etc, etc. I allow sufficent time for the task to be done, time permitting that is. Then I check to see if it was completed and take it from there. Remember, delegation is not simply you asking someone to do you a personal favor, it is their job.

If I get that "why can't you do it response?" I remind whoever it is that it is a convenience that the nurse can switch roles and do EVERYONE else's tasks, how many of them can switch my direction and pass/push meds, hang IV's, monitor drips, flush lines and draw blood off them. When I start asking those questions, I usually get blank stares. Hang in there!

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Thanks you brought up a good point.

So how do you think I could have worded my situation tonight a little better. Should I have said to RT "the patient in room 20 needs to be suctioned?" Instead of asking him "can you suction room 20?" I still would have recieved gripe and grimmle from him and he still would have asked me why cant I do it. I suction all my patients but I know RT can do it too and they should do it. Now I know we were all busy tonight and I have been told that the way he responded is "just his personality" but I find it very unfortunate that he is that way b/c there is no teamwork here. Thank God I don't normally work on this unit! lol. And I am a traveler so I will be leaving this hospital soon.

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Specializes in LTC, Wounds, Med/Surg, Tele, Triage.

I updated my original post to hopefully address that issue. The next time he asks you if you can suction the patient instead, say "sure, if you are able to go hang these three antibiotics, draw this pt's blood, and the patient in room 79 needs assisted to her BSC, and oh yeah, make sure to collect a sample and measure that urine, she's on strict I & O's" The RT (or whoever is resistant) should get the point then.

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hahah good one! I am going to try this next time. Thanks so much. I'm having a "why didn't I think of that" moment. Really appreciate it.

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Yes i am the same way. sometimes its just easier to go do it yourself. But i am getting better lol

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Specializes in Med/Surg, Ortho, ASC.

Don't beat yourself up too much over this. I think there are just certain of us (and it always seems to be women) who have this 'need to be nice' ingrained in us. It's very very hard for us to be directive and assertive without feeling the need to sugarcoat everything you say as you say it. I always found that the assistive personnel with attitudes quickly figured out my weak spot and had very little respect for me.

Good luck in learning this skill. I found an assertiveness training class to be very helpful.

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Specializes in Hospital Education Coordinator.

RT was probably taking advantage of your lack of confidence in delegating. I agree with above posts. Tell them what is needed and, if appropriate, indicate when it needs to be completed (next 15 minutes, next time you take VS, etc). Followup, then if not done ask for a reason so you can explain to your supervisor. The idea is to take care of patients, not win popularity contests. Interestingly enough, nurses who put patients first are generally held in high regard. This does not mean you have to be hateful, but be firm about expectations.

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Specializes in Hospice, Palliative Care, Public Health.

I find it helpful to ask "would you go do X, Y or Z" as opposed to "Can you" or "Could you". Can you is a question about are they able to. Would they conveys the expectation that they know how to do their job. It also makes it harder to say no, in my experience. Politeness goes a long way, but its the polite expectation that they are there to do their job. My response to his questions would be a pointed but very very confused question along the lines of 'oh im sorry, arent you RT? why would you refuse to do your job? Then look at them for an explanation of why they would refuse to help a child who needs help with breathing... Especially if they are just hanging out and talking.

An other phrase that i find helpful are 'I know you are right in the middle of something, however I need you to do X for patient Y when you finish that up (especially if "that" is flirting with the secretary or whatever)

Part of the problem is in the expectation that they will railroad you or that you cant get what you need by being extra extra nice. Being extra extra nice, but not getting what you need means you are being a pushover. The people you work with will likely take advantage of that, leaving you in the weeds.

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As with many things in life; it is all about your delivery - both verbal and body language. Also, it is important to have rapport with those whom you will delegate to. It is important that you have conversations with them other than the times you delegate to them. Often I will "ask" someone to do the job I am delegating to them rather than making it sound like I am "telling" them to do it. Such as "hey, would you do me a favor and do (job) when you get a second, thanks!"

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Make it about the patients.

When you do that, the intimidators pretty quickly know they should NOT 'mess with a momma bear'......I was like a momma bear protecting her cubs(although they are my patients in this instance)-keep that visual if needed.

otessa

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They are taking advantage of you because to date you have let them. They know you are afraid to delegate and abuse you because of that. Once you get some confidence in this area things will change and they will respect you more. Don't worry about who likes you and who doesn't. It is all of our jobs to provide care so don't let them guilt you.

"Please suction the baby in Room 20. Thank you." Firm but polite. If they come back with a remark repeat the request in a firm but polite way. Don't be afraid to come back with a crack either. Once they see you have a backbone they will stop questioning you so much.

The CNAs are there to do a job as well. Hold them accountable. If they don't like it too bad. Patients need care.

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