How do you handle difficult team members?

[lexieanders]

I am a recent grad working my first position as team lead and I am having difficulties with a fellow nurse. She doesn't participate in the change of shift report. She only reports to the charge nurse who is her friend and talks about the patients with a few other nursing friends on the floor. She also has told me that I should inform her first before going into her patient's room because I aggravate all her patients, which I don't understand because I only assess her patients one time and enter the room only as necessary. (My facility requires team leads to complete at least one assessment per patient.) I am missing a lot of patient updates because I have to try and eavesdrop when she discusses the patients with the charge nurse or her other friends on the floor. I am unsure about reporting her because I feel that the supervisors will side with her because they are friends.

 

 

[SmilingBluEyes]

Well not much you can do from your position. IF she is friends with influential people, you are at a distinct disadvantage. Can you move on?

[lexieanders]

No, I need this job so finding another is not an option. 

[JBMmom, MSN, NP]

Perhaps your position puts you at an inherent disadvantage. You say you're a recent grad and you're in a team lead position. Did this nurse potentially want the team lead position herself? And even if she didn't, she may resent that a nurse with potentially less experience is in a lead position. Or, she could just be a jerk.

No matter what lead to this situation, it sounds like she's not likely to make the position easy for you. I'm sorry that you have to deal with this, but unfortunately, it's not unusual in nursing. You're right that there a risk in trying to deal with this above her because of her friendships. I have a tendency to be relatively straightforward, so if it were me I might consider just approaching her one day and asking what the problem is and see where she goes with it. But sometimes that's more frustration than it's worth. Good luck!

[canoehead, BSN, RN]

I would have this conversation.

Heads up to her, you are required to assess each patient once a shift so you will be in there for that, and if their light is on and you are free. You'll notify  her if you give meds or have questions. It's no reflection on her care, you HAVE to do it, and you'll help with little requests while you are there. Make sure you don't committ her to tasks ("yes, Ms Smith, we will get you up after lunch.") just say you will let her nurse know that she wants to get up then. And of course, don't point out things she should be doing, except in private.

In return, about an hour before the shift ends you need her to give you an update on their condition, or if their condition changes enough to affect her workflow. If she doesnt update you, you won't be able to help her, so tell her to please update YOU, not others.

 

[Emergent, RN]

My impression is that you are working in a long-term care facility where an RN must be the team lead? Nothing else makes sense since you are a new grad. New grads are wet behind the ears and really shouldn't be a team lead.

Of course, in the long-term care world, RNs have a special status. That is inspite of the fact that the LPNs know a lot more about patient care in that specialty than a brand new RN. But supposedly an RN is the only one capable of being a team lead.

My advice is for you to recognize this and defer to these LPNs who know a lot more about the business than you. I know all about that because I went into long-term care as a new grad myself. Definitely those LPNs knew a lot more about patient care than I did.

[JKL33]

What is the make-up of the team (I.e. is this person an RN or LPN) and how are responsibilities divided in general?

 

[lexieanders]

JKL33, this person is an RN who is also a recent grad. Our facility rotates team leads weekly, so she will also act as team lead for some weeks. The team leads are responsible for conducting at least one assessment per week or more with significant patient changes. 

[JKL33]

Interesting. I haven't participated in a set-up like that. It doesn't sound like a great practice or a necessary one, but then I don't know what the specific philosophy or motivation was behind it.

Admittedly there are several different ways your problem could be handled. A couple that seem most viable to me are:

- Initiate formal discussion (e.g. at staff meeting or by bringing to manager's attention) regarding how teams are supposed to function and what the expectations are. This would hopefully be a round-about way of reviewing/reiterating that we need to participate in shift report, we need to let the team lead know of significant patient changes (if that is an expectation), etc., etc.

- Be professionally cordial with this other new nurse. Not trying to become BFFs or anything like that, but performing your role in a way that serves as an example and also interacting with her in a manner of general kindness and professionalism especially when it is her turn to be team lead. It is possible that she will see things differently and will try to respond in kind when it is your turn to be team lead.

Beyond those suggestions, just realize that what she is doing flows from insecurity ultimately. Her behavior is suggestive of someone who isn't sure how they will fare without illegitimate advantages such as latching onto the charge nurse, or without the illegitimate advantage of being able to sabotage your attempts to do your role (e.g. you must notify her if you're going in her patients' rooms). That is insecurity.

Perform your role the best you can as far as you understand the expectations. Don't do anything to compromise your professionalism. This will shake out sooner or later and things like this generally don't go in favor of those who make large compromises to their integrity as she is doing. These people do create discomfort and sometimes chaos, but their motives and activities are usually able to be discerned by others around them.

Good luck ~

[Guest 1152923]

While it's still early in your career, I would learn early how to deal with difficult coworkers as it's been my experience that the nursing profession is full of toxic personalities.  It's also best to really understand the dynamics and power hierarchy at your workplace because confrontation with the wrong person, however justified, may only make your life more difficult.  

[lexieanders]

Thanks everyone, this is all great advice!

[mimibrown, ADN, BSN]

I would ignore the crappy behavior. Work around her as much as you can. Don’t report her because you will have a target on your back. Eventually, she will find some other stupid thing to waste time on.