How to handle a coworker who is giving poor care

Caffeine_IV · May 26, 2015

Do you have any examples? Is it something you can prove?

I have worked with slack nurses but never had to report anything. One I recall got fired for neglecting to hang chemo.

TigerGalLE, BSN, RN · May 26, 2015

I have been keeping a log with specific examples with times and dates. Not soothing crying infants mostly. Rough with the babies. Neglecting to put babies on the monitor. Sticking babies multiple times before asking for help. Poor technique with heel sticks that lead to significant bruising.

Momma1RN, MSN, RN, APRN · May 27, 2015

A patient just showed me this video that apparently was loaded to YouTube of a nurse In a nursery actually shaking and hitting the newborns. Obviously that is an extreme example but neglect can turn into abuse if she is truly just burnt out and not enjoying her job anymore. Worth getting fired? Maybe not. But patients deserve better, right?

OrganizedChaos, LVN · May 27, 2015

If you have a log & you have already been to your nurse manager I would go above her. Something should be done before she *really* hurts a patient.

If the nurse manager talked to her & she hasn't changed, I would go to the DON.

prmenrs, RN · May 27, 2015

Keep documenting and reporting. Consider an "incident/quality variance" report (i.e. official paperwork that HAS to be passed uphill). Be patient. It takes a lot of documentation, sometimes. If other co-workers agree w/you, ask them to document as well, and independently of your documentation.

TheCommuter, BSN, RN · May 27, 2015

Not soothing crying infants mostly.

Although soothing crying babies is optimal and something that would be accomplished by a caring nurse, failing to soothe crying babies is not something that would violate policy or procedures.

Rough with the babies.

'Rough' is purely subjective.

Neglecting to put babies on the monitor. Sticking babies multiple times before asking for help.

These things might point to issues with the nurse's quality of care.

Poor technique with heel sticks that lead to significant bruising.

Many people execute poor technique when performing heel sticks, IV line starts, venipuncture, and other invasive procedures. Poor technique is not synonymous with poor care.

As someone who was accused of providing poor care by a CNA many moons ago, I find that many of these accusations are subjective. Just because one nurse gives 100 percent of herself and another nurse gives 70 percent, we must be mindful that 70 percent is still 'passing.' 70 percent might not fulfill our personal standards of care provision, but it is what it is.

MatrixRn · May 27, 2015

Although soothing crying babies is optimal and something that would be accomplished by a caring nurse, failing to soothe crying babies is not something that would violate policy or procedures.
'Rough' is purely subjective.
These things might point to issues with the nurse's quality of care.
Many people execute poor technique when performing heel sticks, IV line starts, venipuncture, and other invasive procedures. Poor technique is not synonymous with poor care.
As someone who was accused of providing poor care by a CNA many moons ago, I find that many of these accusations are subjective. Just because one nurse gives 100 percent of herself and another nurse gives 70 percent, we must be mindful that 70 percent is still 'passing.' 70 percent might not fulfill our personal standards of care provision, but it is what it is.

Totally agree ^^. I was just going to post the same thing.

I would add.....how often is your group in serviced on proper technique for sticks etc. That is certainly a class she, and maybe others could benefit from. It might be worth suggesting to the NM.

As to the 'rough' I had a saying when I was interviewing hires...."I can teach you the tasks, but I cannot teach you to be nice.'

wanderlust99 · May 27, 2015

I would let the nurse manager handle it. And also consider separating poor nursing care with her personality you don't care for. If she was a nice woman giving poor care would you still be keeping a log of her every activity? Or are you just looking for ways to get her fired because she is a *****?

jadelpn, LPN, EMT-B · May 27, 2015

First off, it is highly inappropriate to gossip about your co-workers. What is or is not going on in her home is none of your concern. "She's always been a bully from what I have heard" is something you have HEARD, not that you know. It is interesting how when nurses talk smack about other nurses they somehow are surprised when the nurse in question gets defensive. Equally as stunning is that after all the gossip, one wonders why the nurse has "an attitude".

So, when the babies in her care are crying for lengths of time, does any other nurse go and pick up the baby? When one notices that the baby is not on the monitor, does any nurse just put the baby on the monitor? Maybe some re-education for everyone on the proper heel stick technique? (which in my years I have seen 100 different ways). And rough is suggestive--as a pp pointed out. If a nurse is being inappropriate with a patient (regardless of the age of the patient) then I would think the charge nurse could step in and ask if said nurse needs assistance, is overwhelmed with the patient load, however one would like to phrase it.

I just find it perpetuating the "throw one under the bus" issue when ya'll have plenty of time to gossip about your co-worker, but not one other nurse is willing to step in and help--instead, the baby is left crying/off the monitor for "proof" of this nurse's apparent shortcomings.

And that she has "been there for 20 years" is a non-issue. Next time, I would think about how you could help this nurse for patient safety, as opposed to discussing her personal life and/or nursing practice.

With all that being said, if said nurse is borderline (or not so borderline) abusing infants, shaking them, otherwise being entirely too rough (and again, this has been allowed to continue?) than this is another thing entirely. And that does need to be handled immediately by the charge nurse, and followed up on, your policy regarding this, the whole nine.

TigerGalLE, BSN, RN · May 27, 2015

There are only two of us scheduled per shift. So yes I do go soothe her baby.. What is completely unacceptable is that I have to walk past her playing solitaire in order to get to her screaming baby. It isn't like she is busy doing something else.

And since there is only 2 of us it isn't always possible to stop what I am doing to make sure she is doing what needs to be done. I'm not neglecting to help in order to get "proof" for my log.

I think she is a bully because I have been bullied by her. I have been told that she has always been this way. I don't think being rough with a baby is subjective. I left details out. But leaving bruises from tying tourniquets so tight and slamming babies face down into the bed is rough.

I'm not trying to throw her under the bus because I don't like her personality. I'm concerned about the babies under her care and I would never let her care for my own child.

Honestly I am offended by the responses I have received.

And as far as what is going on in her home; she openly talks about it. We don't gossip about it.

TigerGalLE, BSN, RN · May 27, 2015

And there has been education recently regarding poor heel stick technique. My manager has addressed this multiple times due to staff's concerns. She continue to stick the arch of the foot and bruise the infants despite education.

She also knows how to start IVs correctly because I've seen her do it. The problem is she will stick a baby 4-5 times before asking for help. We have been educated to only stick 2 times per person and then contact the NNP or MD. She neglects to do so.