How to write up a verbal warning for indirect behavior

[SoulSpirit_Rn]

Hi,I am a RN and there is a PCT who seems to want to sabotage everyone. The matter is she does it in a CYA(cover your a$$) kind of way. For instance, she is overly particular and hypercritical about everything. Therefore, she does not know how to assess a situation within her scope of practice, thus she ecsalate everything as a serious issue. Then, I am forced to constantly address or fix the matter numerous minor concerns. For instance, blood pressures that are low/high although the patient is stable and well. A pulse of 115..."OMG call the doctor". Overly critizing co-workers mistakes. Simply, put she is impractical to what it really takes to be a teamplayer. She is self-centered, cannot think outside the box, has no critical thinking skills, and does not have her teammates back. I can go on and on. She causes a heap of petty, irrelevant issues in comparison to my full list of daily tasks as a nurse. And if I was to address EVERY matter, immediately, undividely, I would be burnt-out in a nut house or cursed out each time I call the physician. I would expect this demeanor from a intern/student, but not from an experienced co-worker. FYI- I just got hired in this unit. Everyone else is on board with the change, but she is a pest. She even encourage the patients to contact family with issues she impose on them. In return, patient's relatives call the unit or doctor, overly concerned about much of nothing. This interrupts my task; causing me to focus too much time on one patient versus using my time wisely among all patients...and keeping my sanity. She is exciting the patient and being over critical. My boss told me to give her a verbal warning in writing. But how can I be factual, when she is purposely covering herself with this perfectionist behavior. No one wants to work with her and she is not creating a optimistic, comfortable work enviornment, because everyone feels the need be too particular in response to her hyper-particularity. Help please because I have to get this action corrected, formally, and immediately.Thanks

[lillymom]

I believe I would just tell her she is practicing out of her scope and not a team player. She is not a nurse and therefore is not allowed to do an assesment or give advise based on her personal assesment. I am a CNA and I have a co-worker who has this type of behavior and it infuriates me because she thinks that anything she does is okay and doesn't act like she has a limit to her scope of practitice, all the while belittling all the other CNA's.

[traumaRUs, MSN, APRN]

Dear PCT:

It has come to my attention that you are performing tasks out of your scope of practice. Some instances:

1. It is not within your scope of practice to determine when the physician is called as was seen when you interacted with pt XYZ.

2. Please notify the RN of your patient concerns and she/I will address them.

In order to provide excellent care to our patients, we must work as a team. This is very important. Further infractions or instances where you practice outside your scope of practice will result in further discipline up to and including termination.

[rogue_maverick]

On a similar note, how do you deal with eagerly competitive colleagues? Like the ones who feel and act like they are the charge nurses, to the point that they compete or go against the charge nurse's style of management?

[anurseadvocate]

I agree with TraumaRUs comment and would just like to add something --I have found, during my nursing adminsitration days, that the more detailed information related to situations resulted in more strength if ever there was to be some contesting should an employee be fired. Also, does this staff know what her/his 'scope of practice' is.. When providing written reprimands that lead to progressive discipliine, it is always good to show some type of retraining/re=education -- Many times in dialysis units, staff are not provided thorough information on their scope of practice, as I have been told by many in many units...and, seen myself.

Just always remember that you, as the RN, have a license and can be held accountable. It is so very important for staff to understand their limits. I, once, had a technician (actually several) tell me that they did not want to go to the RN with a question, etc because the RN might think they didn't know what they were doing.. I know that sounds weird, but it is a reality in some units... I also was informed, many times, that RNs often allow technicians make their own 'judgement calls' especially when it was an RN duty and required for the patient.

[madwife2002, BSN, RN]

I would also give her a copy of her job description and go over it with her.

Get her to sign it again and date it for the day you review it with her.

Realistically not many staff members actually read their job description when they sign it.

Highlight the areas which you feel apply to her.

This is not new behavior, and will be much more difficult to get to change but it is possible.

In my experience when you write her up she will either be shocked and make and effort to correct her behavior or she carry on and be terminated.

This will be a pattern of behavior which will be known by most members of staff, but will be badly documented in her employee file.

[rgroyer1RNBSN, BSN, RN]

I agree with traumarus I am a nursing supervisor and work as charge alot and this is behavior that would infuriate me, your the RN she isnt, next time ask her where she got her nursing license and how she knows how to asses a patient as it is not in her scope.

[anurseadvocate]

I agree with the poster who stated give her a copy of her job description --review her training/education and ensure it is all documented in her personnel file - complete.. The reason I state this is because of the following; If someone files a complaint against her and the state enters to do an investigation and her records are NOT complete, often, they are not as evidenced in survey findings, then you as the RN are covered. If she has documented in her file what her job duties are and that she signs to such, as well as training, this is more supportive of your goals.

[anurseadvocate]

Also, something else to think about ---Some states are considered, by law, as ''at will'' states - this means that an employee can leave a job, at any time, without notice, for any reason --- the employer can terminate an employee at any time for any reason -- we recently encountered such (in an at will state) ---in fact, when the person left at will (employee's decision) there was no unemployment granted.

Progressive disciplinary action is important to show esp if an employee goes to the extent of obtaining an attorney, which we have also probably all dealt with.

[Joni's Mom]

Haven't most of us worked with a person that's overly careful, and so s l o w no pt wants to be put on by her? Does anyone know how long it takes to put a pt on the machine such as 10 - 15 min per person? It just seems that there is no way these people can be fired d/t they always cover themselves such as writing everything down, our tech has a little notebook she writes in. So what happens because we are a small unit with 1 RN and 1 tech? I as the RN usually do all the work and that tech just cleans the machine after the treatments are done and that doesn't mean if we have turnover then I will turn over the machine because this tech will take an abnormal amount of time cleaning the machine which in turn makes me behind in the schedule. When we complain, our manager just says write down what the tech is doing wrong and she (the manager) will speak with this tech. Well there is nothing that this tech is doing wrong that can be documented so the tech gets away with being the way she is and we continually have to take it. Short of calling in sick on the days I have to work with her there is nothing that can be done, but grin and take it.