Handling delegation

[canesdukegirl]

I know that most of you have had to deal with co-workers who are not as "on task" as you expect them to be. When I am at work, I WORK. I don't dilly dally, I don't spend 20 minutes talking to my friends in the hall and I don't drag my feet close to quitting time. I have to delegate tasks to some of my co-workers because we work as a team in the OR. There are certain duties that are expected of each member of the team.

In the essence of expediency and efficiency, I tend to work quickly, being mindful that x must be done prior to y being accomplished. I get my tasks done early so that I may help my teammates and thus decrease turn over times between cases. I am ribbed a lot by my peers, "Uh oh, here comes Canes. She is walking fast. Everyone get to work!" They are joking, and that's cool with me. BUT...they are not taking advantage of the extra time that I worked so hard for us to be ahead of the game. They are taking breaks in the lounge, talking to friends, goofing off...you name it. I have tried to not let this get to me, but when my scrub tech scrubs in without getting all of the requisite supplies, I am having to work harder because they did not prepare appropriately. I have spoken to the techs that have not prepared (one on one and privately) and it has made me less than popular. It irks me juuuuust a little that they are taking offense to my asking them to do their duties in a timely and efficient manner.

I have brought this to the attention of my NM. She sees it daily. I don't know if she speaks to the team members or not, but I have seen no change in behaviors. I have a hard time being tough with my peers, however I have no problem being assertive when I need to (like patient advocacy, correct technique, a screaming surgeon). I feel that it is not my place to "crack the whip" so to speak when my peers are slacking off.

Here is what I need from you guys: Should I read some books about being more assertive with peers? Should I try to find out why I am so hesitant to call someone out on being slack? As I said, I have spoken to my NM without result. I feel like I am knocking myself out doing 3 jobs at once so that the surgical schedule can stay on time. I am beginning to feel some resentment, and I know that I need to deal with that feeling NOW so that I can grow and learn. So tell me what you have done in a similar situation. I appreciate your feedback.

[canoehead, BSN, RN]

I read this once and try to remember it, "Imagine what could get done in the world if no one kept track of who got the credit." I just want to get it done so the patient is up and out as fast as possible. Yes, I get frustrated, and sometimes leave a task undone just to see how long it takes for someone else to come along and do it. (Dishes piled in the sink, new charts not made up) I think over the long haul you stand out if you just put your head down and work, and you'll get less resentment/rebellion too.

[canesdukegirl, BSN, RN]

i agree....if i had someone rushing around gathering everything for me, prodding me, speaking to me about what they do not like about my work habits (as long as my work habits are good and it isn't a manager/sup, etc) then i would first be offended.

but see, that is the problem. their work habits aren't good. i talk to them one on one and privately. i would be offended because this kind of behavior of canes could be seen as the mother hen tidying up and taking care of the little chicks (thereby giving the impression canes believes she is better, more productive, more intelligent, more nurse, more whatever that might flit through the mind of the insecure or just plain hateful people).

i don't think that i am better, more productive, intelligent, etc. i just want to get the job done. i am telling them calmly and professionally that they need to get their ducks in a row. so far, this has not helped, hence my posting on this forum for advice.

i am usually the aggressive type wherein i would say something immediately, but i do know of people (and i have been forced in the past to engage in this practice, as well, albeit rarely) who are very passive aggressive and their way of handling this issue would be to sit back and become slower and start to purposely set up canes to go get their stuff, take care of things, etc. their thought would be along the lines of "if she's such a super nurse that does better/faster than me, then let her do it."

yes, i work with passive aggressive people. i cannot wrap my mind around this behavior. i shoot from the hip. i hate playing games because i am totally clueless as to how to play games. i would suck as a politician! i very much believe in the power of positive reinforcement, and want to somehow approach the situation in a positive way. any suggestions on how to do this?

[nyrn5125]

unfortunately everything is the rn's responsibility to get it done and those tech's know it. they also know that if they don't do it that you will.

[Susan317]

I've been in the OR for 17 years,sounds long enough to me.

[greenfiremajick]

yes, i work with passive aggressive people. i cannot wrap my mind around this behavior. i shoot from the hip. i hate playing games because i am totally clueless as to how to play games. i would suck as a politician! i very much believe in the power of positive reinforcement, and want to somehow approach the situation in a positive way. any suggestions on how to do this?

at this point, and from your description, my suspicion is that they are indeed purposely setting things up for you to deal with. so approaching this in a professional/mature manner may not be effective, at all if you're the only one dealing with them or this issue. i would think about going up the chain of command, so to speak and getting things done through another form/source of authority.

also, another poster said something about forcing them to get "unscrubbed" to take care of their own business and making sure that everyone sees why things are running late (techs being unprepared), might be a grand idea! i have a lot of positive discipline/conflict ideas for the business world and in my former world of teaching, but i am not sure they would work in the or room.....also, i've heard that acting like big boys and girls can sometimes escape those in the hospital environment (the way a good number of nurses treat each other, etc......this is from what i've read on this board so please don't all of you start flaming me because you think i have the impression all nurses are immature---that is not my intent to imply such a thing) so my other suggestion of asking for everyone to sit down and have a meeting about this....do you think this could be productive with the team you work with?

[GHGoonette, BSN, RN]

Dear me, Canes, is this the same tech you posted about previously? Hasn't she popped yet?

Sadly, leading by example is not always enough; one of the best theater managers I ever worked with expected the highest standards from all her staff, and had no hesitation in backing her bark up with a hefty bite....

[sistasoul]

The techs know you will do everything so they let you do it. They are taking advantage of you instead of working as a team. Some people have a work ethic and a conscious while others don't. One would think if they saw you running around doing everything they would feel bad and jump in and help. These people may get away with this behavior because they take the time to talk and are seen as "personable" and are well "liked" by the higher ups. Some managers reward these types and let them get away with these behaviors while others see through the BS and see who is really doing all of the work. I know my view is jaded but I have been in many workplaces with the 20/80 rule. Twenty percent of the employees do 80 percent of the work.

It is frustrating when you want things to run smoothly and you seem to be the only one who cares. Maybe sitting down and having a meeting with these people would help. I am fortunate that I work with CNAs that are fantastic.

[canesdukegirl, BSN, RN]

Green-I appreciate your responses. I think that a sit down meeting will do wonders, because then an awareness will be present...the manager will lead the meeting, so everyone will be on the same page. If we talk out our frustrations, then perhaps we can work better as a team. It has simply gotten out of hand.

My NM is aware of those who choose to let the nurses constantly run and pick up the slack. She is so inundated with meetings and other duties that she has delegated much of the responsibility of managing the staff to our team leaders, which is completely appropriate. Our OR is broken up into specialty teams with a team leader assigned to each team. Some of the managers take a very direct approach and do not tolerate the BS, some let it go on because these employees have been dubbed their "problem children" and they have so much to deal with on a daily basis that they don't have the time or the energy to address ANOTHER problem. These managers are aware, trust me. Their advice to us nurses is to crack the whip. I am just dropping my jaw. What? Like it is our place to do so? I thought that was a managerial issue.

So for those of you who suggested a meeting, thanks. That is exactly what I plan to do. I appreciate all of your comments. It has been so frustrating-and the worst part about it is that these are good people in general, they just have stinky work ethic. I feel strongly that if we work as a team, then we can get the job done quickly and efficiently, therefore allowing the staff to go home at a reasonable hour. That is my end goal.

[OCNRN63, RN]

Wow. So here's the way it happens: if our cases are not done on time, we get stuck. Meaning we have to break any plans that we had after work, we have to stay until we get relief...and who knows when that will be. We are understaffed. So you think I should chill? The tech can't drop scrub while holding a retractor. So I am stuck running for things. I agree that the tech looks bad, but the case must go on and yours truly is left holding the bag. It gets old.

BTW, I admit that I SUCK at game playing. When I am at work, I see an objective and a goal. I go from point A to point B. I just want to get the job done. Believe it or not, I am a laid back person in general. But I feel that when I am at work, I need to WORK. I have trouble separating the two. So how would you suggest I play it cool while still moving cases along?

I get where you are coming from. It makes my teeth itch when there is stuff to be done and other people are on the internet doing personal business. I get mad, but I suck at speaking up. So I seethe inside. I know I'm going to wind up blowing out my gut someday. Hey, where do you work? I want you for my scrub if that happens!

[carolmaccas66, BSN, RN]

I haven't read all the comments on here yet, but here are mine.

I'm a bit like u, I try to do things ahead of time whereas others just seem to be lounging at the nursing station, talking to their friends on mobiles or whatever. It makes my blood boil. Also when they do this, I interrupt them with a question, & don't attend to their patients - I tell them they must do it.

Firstly, is it ur job to take these people to task? Or have you elected just to do this?

Secondly, if you keep doing their work for them - they will continue to slack off. It's a simple equation unfortunately - they think such and such is doing the work, I'll just spend a little extra time talking or going to the loo or whatever. They are taking advantage of you.

If it's not your job to keep them in line, don't do the extra work. Leave it, and when the surgeon or senior nurses start complaining (as they will), say that your techs (or whoever it is) didn't do or get this or that, & get them to confront the person complaining. The slack person will soon get the message and there will be complaints starting to pile up against them. Remember u can't do everyone's job, that isn't your responsibility & u will wear urself out & get stressed as well.

If it is your job to take them to task and ur NM won't listen, I would talk to the person who is overall in charge of the OR or someone in senior management. But this can be like flogging a dead horse as managers are too busy to listen about what is really happening 'on the floor' so to speak. But u could try or maybe send an anonymous note.

But I would stop doing their work for them. I know it's hard if ur an efficient person, but if it's not ur job, don't do it. Even if the surgery gets cancelled and re-scheduled, believe me I've worked in ORs and with top surgeons, & they will soon make their concerns known to everyone!

Hope this situation gets better soon.

[GHGoonette, BSN, RN]

I haven't read all the comments on here yet, but here are mine.

I'm a bit like u, I try to do things ahead of time whereas others just seem to be lounging at the nursing station, talking to their friends on mobiles or whatever. It makes my blood boil. Also when they do this, I interrupt them with a question, & don't attend to their patients - I tell them they must do it.

Firstly, is it ur job to take these people to task? Or have you elected just to do this?

Secondly, if you keep doing their work for them - they will continue to slack off. It's a simple equation unfortunately - they think such and such is doing the work, I'll just spend a little extra time talking or going to the loo or whatever. They are taking advantage of you.

If it's not your job to keep them in line, don't do the extra work. Leave it, and when the surgeon or senior nurses start complaining (as they will), say that your techs (or whoever it is) didn't do or get this or that, & get them to confront the person complaining. The slack person will soon get the message and there will be complaints starting to pile up against them. Remember u can't do everyone's job, that isn't your responsibility & u will wear urself out & get stressed as well.

If it is your job to take them to task and ur NM won't listen, I would talk to the person who is overall in charge of the OR or someone in senior management. But this can be like flogging a dead horse as managers are too busy to listen about what is really happening 'on the floor' so to speak. But u could try or maybe send an anonymous note.

But I would stop doing their work for them. I know it's hard if ur an efficient person, but if it's not ur job, don't do it. Even if the surgery gets cancelled and re-scheduled, believe me I've worked in ORs and with top surgeons, & they will soon make their concerns known to everyone!

Hope this situation gets better soon.

Don't know if this would work in an OR setting, where the RN carries the ultimate responsibility for safety and efficiency in OR, but perhaps with a covering formal letter to the NM expressing her dissatisfaction and the intention to do what Carol describes, Canes might just get management to actually do something about it....

[greenfiremajick]

Green-I appreciate your responses. I think that a sit down meeting will do wonders, because then an awareness will be present...the manager will lead the meeting, so everyone will be on the same page. If we talk out our frustrations, then perhaps we can work better as a team. It has simply gotten out of hand.

My NM is aware of those who choose to let the nurses constantly run and pick up the slack. She is so inundated with meetings and other duties that she has delegated much of the responsibility of managing the staff to our team leaders, which is completely appropriate. Our OR is broken up into specialty teams with a team leader assigned to each team. Some of the managers take a very direct approach and do not tolerate the BS, some let it go on because these employees have been dubbed their "problem children" and they have so much to deal with on a daily basis that they don't have the time or the energy to address ANOTHER problem. These managers are aware, trust me. Their advice to us nurses is to crack the whip. I am just dropping my jaw. What? Like it is our place to do so? I thought that was a managerial issue.

So for those of you who suggested a meeting, thanks. That is exactly what I plan to do. I appreciate all of your comments. It has been so frustrating-and the worst part about it is that these are good people in general, they just have stinky work ethic. I feel strongly that if we work as a team, then we can get the job done quickly and efficiently, therefore allowing the staff to go home at a reasonable hour. That is my end goal.

Please keep us posted on how things go?