Hostile work environment

[britmansf18]

Ok, I have not been able to get any sleep over this situation. I just feel like maybe I could have done better. I am a nursing supervisor in a LTC setting. I am a new nurse and I have never held a supervisory position before. With that said, I haven't had to deal with staff issues. Here was the situation.

I came into work expecting that I was going to have to do a med pass because we were short an LPN and no one was going to come in. I get there and another RN is on. I figured they brought her in in an LPN capacity. She comes over while I'm getting ready to get report and she says I was told I was charge today. Well, my name is on the schedule and I am full-time. It was my night to work, and no one told me they were moving me onto a hall (I think I should have at least been notified, but maybe I am crazy). She got really mad and got me and the other charge nurse alone and said we embarrassed her and made a scene. The only thing I said was I would have like to have been notified that I was coming in under a different role and that my name was on the schedule and I didn't want to end up being responsible for something because I allowed her to be charge that night.

Meanwhile, I have another LPN that came in because she was called in. She said she wasn't feeling good and didn't want to be here. I was trying to accommodate her as much as possible even though she willingly came in on her own. I was sitting at the desk and I heard her screaming at an aide. She said, "This is the second effing time I've told you."I got up and said, "What's going on here? Are we being hostile toward one another?" The LPN said yes I am because I am tired of everyone telling me how to do my job. Just leave me the hell alone. I said, excuse me, but the language and the tone you are using is inappropriate and if you had a problem you should have come to me.

I would have taken care of it. I went to talk to the two aides involved and they were visibly upset. I went back to the LPN and said I think we all need to sit down and talk or I am going to have to write you up for your behavior. The LPN didn't believe she did anything wrong and the aide changed her story when we all sat down to talk about the situation. She said she knew she was joking and she was fine with it. The other aide was not. She said the language was disrespectful and totally inappropriate.

At that time, she was around the corner on her assigned hall. I was telling the LPN that she needed to apologize to both of them. The other one comes around the corner yelling at the top of her lungs that were talking about her (mind you its like 1am and the residents are sleeping). I asked her to lower her voice and she ignored me. Another aide comes down after hearing all the commotion saying we are disturbing her residents. The aide that was raising her voice told her to mind her business and go back down her hall because it didn't concern her. So the other one starts yelling. Now, they're both cursing at one anther. Finally, the one left and went back down her hall. I settled the situation with the first incident and then I went to go talk to the other aide. She said if the one yelling at her came back down the hall she wasn't going to be nice. I said if either of you start a fight in the middle of the hallway I will write you up. This is my warning to you. Everyone else already got one.... I just feel like maybe I should have.

For the sake of being short staffed, I didn't want everyone to walk out. This place is a mess. People walk out all the time. I'm just beside myself that I am even being treated like this. I can't ask anyone if this or this was done without getting an attitude from them and they report me saying I'm being overzealous about their work. All I am trying to do is make sure their work is done. Can someone advise me on this situation? I think its getting out of hand and because of it my work is suffering. I cant think straight and I am afraid I am going to make a bad mistake.

[icuRNmaggie, BSN, RN]

I would have been tempted to call the police and have all of them charged with disorderly conduct and removed from the building.

[ponymom]

I was going to post the same as icuRNmaggie. I have threatened staff I would call 911 before, and then gone ahead and done it. I don't have time to play games, and woe be to the inconsiderate boob who disturbs my residents' sleep.

Swell place you work at, not.

[LRTeducator]

I wish I had an answer for you, but after spending one year in long-term care a few years ago, I don't feel very optimistic about your situation. I had never seen such a low level of professionalism as I observed in LTC, and I could only attribute that to a lack of leadership. I know it was hard to recruit staff to the facility and it seemed to operate on one of two extremes: they would totally ignore bad behavior or they would suddenly fire someone who seemed to be doing a good job.

Perhaps you might seek guidance from your DON, but don't wait around until the environment destroys your love for nursing. Although I went into LTC with a very positive outlook and hoping to be able to make a difference, I finally left after a year. You may discover that is your only option, as well. I wish you the very best and I hope to hear an update on how things are going.

[OnlinePersona, LPN]

Oh geez that sounds like a hot ass mess. You have three options.

1. Move on

2. Flip out on those fools

3. Don't care and go home.

I'm all about 1&2

[bluegeegoo2, LPN]

I would have written everyone up that was involved. The obvious point behind writing them would be to put them on notice of what type of behavior is expected and what type of behavior will not be tolerated.

Case in point. I was recently working with a nurse new to our facility who had some "anger management issues" if you will. For whatever reason, this nurse liked to throw her title around to the Med Aides and CNA staff. She would also get loud and disrespectful with them. She was spoken to about her behavior (by management, but not documented from my understanding and her story), but chose not to heed the warning. Moving on, it came to a head one evening when she got into yet another verbal altercation with a CNA. She was yelling and cursing loudly in front of family (visiting in a room close enough to the nurse's desk to hear) as well as EMT staff who were on our unit transferring someone to the hospital. I had to intervene and make them both leave the area to shut down the argument and restore order. Because I am a peer of the other nurse I did not have the authority to write her or send her home, but I certainly called management and wrote a statement for HR to follow up on and the nurse no longer works at my facility.

The moral of the story is this: If nursing staff are not held to a standard of behavior then things can quickly go south. If there is any amount of bickering between nurses and CNA's, it becomes an "us vs. them" mentality which erodes the team structure. The same thing goes for CNA's who bicker amongst themselves. They begin to resent each other, often causing "this group" to be against "that group" which further erodes the team structure. And who suffers the most when the erosion of the team goes unchecked? The residents. If "Sally" refuses to help "Tammy" because of whatever, then Mrs. Smith has to wait that much longer to go to bed. And since "Susie" rides to work with "Sally" she won't help "Tammy" either. It's madness, really, when everyone gets so caught up in drama and taking sides that no one realizes that it's the residents who are being left out in the cold.

So, in my experience, quickly addressing behavior issues by whatever means necessary usually derails the polarizing of the team that leads to less than stellar care. After all, it truly is all about them.

[CapeCodMermaid, RN]

I'm stuck on the part that says they brought an RN in in an LPN capacity. What in the world does that mean?

[NutmeggeRN, BSN]

CapeCodMermaid said:

I'm stuck on the part that says they brought an RN in in an LPN capacity. What in the world does that mean?

I'm willing to bet that it was a scheduled shift for an LPN but the RN was the only one who was available/willing to work? Regardless, she is an RN.

I have run into some issues when an MNA is scheduled and there is also an RN or LPN and they are then required to be be an LNA, (ie personal care and ADLS and not pass meds)

They get some kind of ugly because they would rather be doing meds than PM care