HELP!

[supervisorhatchet]

Hello fellow nurses. I have recently accepted a staff development position in an 80 bed SNF. I have been at this facility for about 3 weeks, the DON has been here about 7 weeks, administrator about 5 months. Most of the staff that was here 6 months ago is now gone. There are a handful of long timer CNAs and a couple of LPNs & RNs. My new position's priority assignment is to assist in getting staff ready for state survey which is expected in the next 2 -3 months.

1: the established staff that knows better, have already made sure that they let administration know that they are not going to be pushed around (I was even sent home 1 day for "bossing people around" and a couple of CNAs said that they would "quit on the spot" if I was not removed from the situation. Now, all charges were dismissed against me, and I got the day off with pay....but the staff does not know that I got the day off with pay, they just know that they threw a fit, and I got sent home. Upon my return the next day, the admin asked me to take position of staff development, because I have skill and am not afraid to say "DO YOUR JOB" to staff.

--------> here is the problem, how do I reach these ladies that are drama queens and have been effectively running the show (prior so much staff turn over). Personally, I would be pleased to no end if they all "Quit on the spot"...however, the facility really can't afford to lose the bodies on the floor.

-----> how to I get them to change bad habits/create good work habits...I know that I will have to make them believe that "change" is their idea....but how do I out smart them? LOL!

2: we have a lot of very new CNAs and NA that were not able to pass test, they have been oriented by the above mentioned slackers/drama queens and really have no idea what they are supposed to be doing. How do I effectively get these gals to where they need to be skill/knowledge wise?

It is a small facility and my position as "staff development" is only budgeted for 2 days a week (I'll be floor nurse for the rest of my 40hours). Please help!

3: One of the drama queens, is a black lady that has been with this facility for 10+ years, and has already tried to play the black card....ie, "I am being singled out because I am black" ...and honestly, she is so caucasian in appearance that I could not have even guessed that she was "black". How do I correct her actions and keep myself out of a law suit?

Thanks for any advice offered!

[classicdame, MSN, EdD]

you are fighting an uphill battle since mgmt made the mistake of keeping the low performers and letting go of the higher performers. There is a group of people who REFUSE to be involved in anything unless motivated by loss of job and it sounds like your employer is not using that motivation.

Otherwise, be politically correct, do not raise your voice, always keep lists of who DID attend inservices and mandatory education so at some point if you need to prove that person is not competent it won't come back on you. Do not worry about them liking you because they won't. It has taken six years but now the staff knows I am honest with them and try to treat everyone the same. I go by the book and expect that of them as well. Some people resent mandatory education for any reason but I now know they will eventually slip up and make a mistake that will get them turned over to BON or fired or both. I try not to let that bother me as I am doing my part.

[supervisorhatchet]

lol! I got called into office..and first thing the administrator said was....dang you're getting NOT popular FAST ! I said good. I didn't come here to make friends....

Thanks for the advice.

[TeachingeveryoneRN, RN]

Having walked in your shoes, one of the first things I did was to remember what the staff complained about when I was not "admin-*****", the RN's and LPN's were both upset about IV's piggy-backs etc. The RN's would have to take time from their patient's, med rounds, charting to hang and check IV's for LPN's. I contacted our Pharmacy vendor and arranged for and LPN IV medication certification class. This was really appreciated. Next, I conducted a skill's lab, but with the CNA's being the patient's. The one's who were most difficult in assisting in team work and patient care were able to be the patients in:

• "wet diapers" and "lumpy diapers" (tennis balls and water to imitate.....),
  
• cloudy plastic cups over their eyes trying to feed themselves, or be fed by staff who were speaking to one another and not "paying attention to the patient",
  
• securing one in a wheel chair with 1-2 cinder blocks being dragged behind so they could see what it felt like to want to get somewhere and have to struggle.
  
• The proper positioning in bed to prevent bedsores. I had teams of two place each other in bed as they would a patient, then position them properly.
  
• I even had them perform oral care, face washing etc on each other so there could be instant peer feedback.
  

Though not all change was instantaneous, the biggest that I saw was empowerment of staff who were oriented the wrong way vs right way, and they would apply the "right" knowledge. As for your drama queens who will quit on the spot. Fine, but remind them pt neglect is against the law. Always keep a paper trail of the infractions and conversations had with the employee. If you type a summary of the conversation ask the employee to sign if they agree. Remind them it is not a warning, or goes against them, it is to "remind" you that you've discussed this with them and won't need to repeat information to the same people twice wasting their time! I hope all of this helps and wish you to enjoy your new adventure.