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.

[canesdukegirl, BSN, RN]

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....

I like the suggestions that Carol made. I have tried this tack before with one of the more spastic techs. I let her goof off, I did my own work, she scrubbed in, set her table up...and guess what? I heard my name so many times during the case I wanted to slap something. We were doing a case with the Chief of Surgery that day, and HE even got so aggravated by me having to run out of the room so many times that this is what he said, "Canes, why didn't you have everything in the room BEFORE the case? Are you distracted today or something? This isn't like you. How about you get everything ready next time?" I was throwing mental darts at the tech, who SAID NOTHING. I wasn't about to call the tech out in front of everyone because to me, that seems unprofessional. I hate pointing fingers in front of a group. We did have a chat one on one about it after the case, and when she was still not up to par, I called my manager into the room so she could see for herself what I was experiencing. She had a chat with the tech too. The tech is prepared for FIRST cases now, but not following cases.

So everyone knows that it is a team effort to prepare for cases. However, the RN is the one who bears the brunt of the surgeon's ire when things are not available. THIS is the reason, Susan317, why it appears as if I go overboard.

Green, I will keep you up to date on what transpires during our meeting. Again, I appreciate your suggestions.

[canesdukegirl, 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?

as the circulator, the surgeon places the responsibility of moving cases along squarely on my shoulders. if something is not done, or supplies are not pulled and opened, it is my responsibility to do this because the scrub person cannot or should not break scrub. with most of the scrub techs, we will have a "mini-conference" with the surgeons before they scrub in to review the pref card and make sure we have everything. most of the techs pay attention, but it is the 3 or 4 that i work with often during the week that don't pay attention, resulting in my running like a madwoman.

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.

clearly. i am trying to come up with the best, most effective approach to avoid this. i think a meeting like green and carol suggested is what route i will take.

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.

dude, tell me about it. i am stressed! i have tried to do this, but the techs are very quick to throw the rns under the bus. as stated earlier, i think that a meeting with hard and fast outlines as to who does what and the expectations of each member of the team clearly laid out will be my best bet.

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.

thank you carol! i appreciate your thoughts.