How to deal with nurses who respond they are busy when you delegate

[biju27]

Good evening, I am a new manager with only one year experience and over the last year I changed my job. Currently, I am responsible for 41 employees, andI can say I have good RN/patient census. One nurse is responsible for maximum of 15 patients. Here I can say that we are not always full. I find my CNAs very compassionate, and caring. They listen and look for my opinion and advice. The problems I am having is with the nurses. I constantly find their lack of knowledge. I offer to teach them, however I feel that they do not care, and do not want to improve. I gave to all their job description, the only thing they are concerned with is to pass their meds. They lack critical thingking, do not know how to prioritize. One of their responsibility is to create care plans for their patients. When I remind them what else is needed to be done for their patients, the response I get is, "I am too busy or No, it is too much." I did written verbal warnings, however somehow this does not work. As a result, I do all of thier paperwork. It is overwhelming for one person to do all, especially when I have families that are very demanding and expect from me to update them about their relatives on a daily basis. Please, help me. I am willing to do what it is needed to be done. In addition, I do not have the support from HR who made me aware that the facility is not in the position to fire anyone.

[nurseprnRN, BSN, RN]

If you do their work, they will have no incentive to change. You might just have to follow your facility's disciplinary decision tree (with support from your boss, not HR)-- verbal warning, written warning, performance improvement plan, suspension, firing. Document, document, document. If their poor care is affecting patient welfare, the facility cannot afford to say, "We can't afford to fire anyone." Sure they can. One or two good terminations will open some eyes. Also try AONE, American Org of Nurse Executives.

[ktwlpn, LPN]

Good evening, I am a new manager with only one year experience and over the last year I changed my job. Currently, I am responsible for 41 employees, andI can say I have good RN/patient census. One nurse is responsible for maximum of 15 patients. Here I can say that we are not always full. I find my CNAs very compassionate, and caring. They listen and look for my opinion and advice. The problems I am having is with the nurses. I constantly find their lack of knowledge. I offer to teach them, however I feel that they do not care, and do not want to improve. I gave to all their job description, the only thing they are concerned with is to pass their meds. They lack critical thingking, do not know how to prioritize. One of their responsibility is to create care plans for their patients. When I remind them what else is needed to be done for their patients, the response I get is, "I am too busy or No, it is too much." I did written verbal warnings, however somehow this does not work. As a result, I do all of thier paperwork. It is overwhelming for one person to do all, especially when I have families that are very demanding and expect from me to update them about their relatives on a daily basis. Please, help me. I am willing to do what it is needed to be done. In addition, I do not have the support from HR who made me aware that the facility is not in the position to fire anyone.

Can you work with your staff development dept? Maybe they need to step up the education,then you can counsel your staff and present each one with an individualized plan of correction.We can't move forward unless we are willing to learn.

As for the demanding families-isn't it more appropriate for the floor nurse to give the up to the minute update? Then if there is a problem they can then be referred to you.Maybe you can start this progress with communication.Your staff can learn how to handle most of these people.And set limits-is a daily update really neccessary? That's why team meetings are scheduled.Utilize your social workers,too.Most of our more difficult family members seem to focus their displeasure on hairdressing appointments and PT,OT.

[dah doh, BSN, RN]

I agree with GrnTea. You need nurses who will do the work as described in their job description. The dead weight has to go! There will always be nurses to take their place that actually does the job as described.