I dont handle lazy aides well

Nurses General Nursing

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Maybe I am not cut out for hospital nursing, I dont know. I cant seem to handle lazy aides well. Again I was assigned to the other side' on my unit, night shift, 2 rn's with one aide, 12 pts (6 patients each rn). If there is not a good aide, you drown at some point, usually later in the shift.

This float aide we had last night did his vitals, sat down in the hall with a portable computer for an hour or hour and a half. I got an admit, he balked at doing a sling weight (she is asleep, that can wait for days') (me: no it cant). Then he took over an hour break, when it is posted that they can take 2 15 min breaks and one 1/2 meal break. But that is the standard.

The night charges dont care. They dont give support. They just dont want trouble'. I told the aide upon his return of the above policy on our floor.

Then he started 0400 vitals, didnt answer call lights. I was trying to chart. I asked him to answer a call light. He did not, finally I went to answer it. I asked him why he didnt answer it, he said I could have answered it instead of coming to tell him to answer it. I told him I was charting, and that he was on the floor. He said he was in an iso room'. It seemed to me he took 15 minutes of so in that iso room to get VS, and was just waiting for ME to answer the call light. He got loud when I asked him this (about not answering) and argumentative. Then he went to the charge nurse to complain about me.

The chrage nurse said he's generally been a good guy'... I wrote my nurse mgr stating I am frustrated dealing with certain aides who seem to want to do only the minimum. I called insick for tonight. I am thinking of requesting not to be put back in this section especially if there is a marginal aide.

I left this morning with not enough time to do notes, ect. I just was so upset and wanted to get out of there.

I dont know what to do. Please advise.

I feel bad for so many of you because if your management backed you this wouldn't happen. The nurses work hard as do the aides where I work. We don't really even have to delegate because the aides know their job and they do it. We all try to work as a team as much as we can. If I know someone is a tough bath I'll try and run in to help. They know if I'm in with an emergency to keep an eye on the other patients. We have very few issues where I work because it is structured and everyone knows where they stand. If anyone didn't do their job they'd be fired. Plain and simple. Most of our aides are in NS and we all try to educate them as much as we can to prepare them for their clinicals when possible.

Specializes in Cardiac Telemetry, ED.
Please don't take offense. I never said that it works with every aide. I simply making a suggestion for the OP that she may not have already thought of. She did ask, after all. I am speaking from personal experience and what worked for me. Obviously, there are some aides that will only listen when disciplinary action is taken. My experience has been that they are few, though. If that is not your experience, then I am truly sorry. That is very difficult and I would not want to deal with that day in and day out.

Well, it's not a bad suggestion, and it is a good starting point, I think. It's just kind of a touchy subject for some, because speaking for myself, I do not "give orders". I always ask nicely. Nine times out of ten, I'm the one in there turning, changing, toileting the patient and if I need help, I try calling the aide on their phone, which they don't answer, then have to try and track them down, only to find them in a corner checking their yahoo account or looking at patterns for that next piece of needlework they're planning. I tell them I tried to call them, but they didn't answer their phone, and they say "Oh, it must have gotten shut off somehow." or something equally lame.

I do give some of them the benefit of the doubt that they are just inexperienced and need some help, but on my unit it is undeniable that there is a long standing culture of noncooperation that has not been adequately addressed by management that is at the root of all of this. That is why it's so irritating to be told, or have it implied, that this is a problem with the nurses not knowing how to promote teamwork. We've promoted teamwork til we're blue in the face, and it has done nothing to make things better.

Specializes in Cardiac Telemetry, ED.
I feel bad for so many of you because if your management backed you this wouldn't happen.

That is exactly it in a nutshell.

Specializes in LTC/Behavioral/ Hospice.
Well, it's not a bad suggestion, and it is a good starting point, I think. It's just kind of a touchy subject for some, because speaking for myself, I do not "give orders". I always ask nicely. Nine times out of ten, I'm the one in there turning, changing, toileting the patient and if I need help, I try calling the aide on their phone, which they don't answer, then have to try and track them down, only to find them in a corner checking their yahoo account or looking at patterns for that next piece of needlework they're planning. I tell them I tried to call them, but they didn't answer their phone, and they say "Oh, it must have gotten shut off somehow." or something equally lame.

I do give some of them the benefit of the doubt that they are just inexperienced and need some help, but on my unit it is undeniable that there is a long standing culture of noncooperation that has not been adequately addressed by management that is at the root of all of this. That is why it's so irritating to be told, or have it implied, that this is a problem with the nurses not knowing how to promote teamwork. We've promoted teamwork til we're blue in the face, and it has done nothing to make things better.

If management is not on your side and and the aides know this, then they have no reason to change. It must seem like an impossible situation.

I really wasn't trying to imply that every nurse who has this problem is due to her own lack of trying. I simply read the OP's post and since she didn't mention any other strategies she had tried, I gave a suggestion. I have the pleasure of having management who supports the nurses in creating an environment where the aides must do their work. I shudder to think what it would be like if that weren't the case.

In any case, I hope the OP finds something useful from all of our posts and I sincerely apologize if I offended any nurse here .

Do those of you with ongoing problems write the aides up and get a paper trail started? I haven't had to do this with our aides but I have started paper trails in other areas because I know management can't turn a blind eye so readily once they have it in writing. I would write it up to start to draw new boundaries and continue to do so every time there is an act of insubordination.

Specializes in Flight, ER, Transport, ICU/Critical Care.

2nd POST on this thread.

I went back and re-read my first post and I left something out.

There are LAZY aides and LAZY everything else. No one job title is worse than another - there are also lazy bank tellers, paramedics, factory workers and every job in between.

I have encountered LAZY and DIFFICULT support staff and fellow RN's as well. There are queens (and kings) of the nursing station and smoke break "huts" and even the land of the "lost" (because they seem to be missing all the time). I get it. And it drives me mad at times. However, as I do not have first person knowledge of the situation that the OP describes - it is not possible to fully understand the right/wrong view of the OP.

I have had experiences with support staffs that are - GREAT and others that were merely COMPETENT and some that were flat out DANGEROUS.

Commonsense, respect and kindness goes a LONG WAY with having synergy with any staff. Treat others the way you'd want to be treated.

In the cases of clear behavior that harms any patient - the caregiver involved would be immediately relieved of duty. Abuse a patient (verbally, emotionally, physically) and there will be consequences --- many, many consequences. The fact is that we are all accountable for our professions - I have stuff to get done and support staff has their stuff to get done. Sure, as the RN I am responsible for everyone's stuff regardless - but, I will promise anyone on my "team" that failures will have an impact.

And I have been talked to and treated in a very condescending manner at times by "aides" and I have had a few encounters that have been so so bad that disciplinary action was immediate. There have been others that will "push the buttons" of anyone they can.

There are RN's with high and mighty attitudes and there are "aides" with the same. I have seen bad behavior out of both sides. To any RN out there - if you think you are "better" than any other staff or that you have "paid your dues" so that you are exempted from "cleaning poo and scut" - well, you are as much of a problem as any "LAZY AIDE."

And for you aides out there that are miserable because you are not "the nurse" or resent being asked to do anything because you think the nurse "makes more/doesn't know as much as you/thinks he or she is so important" well you are a problem as well. Also, if you get some glee from deliberately making the "nurse" upset by ignoring them, refusing to do something, being slower than necessary or smart mouthing any/all requests with the ever present "I'm busy and I've got other things to do, so it will be a long time before I have any time to ________ " - well, that is a problem that should be reviewed will all (supervisor, manager, other RN's) - maybe there really is too much "dumping" on you from too many. In the end - the RN can/should/will direct your work - it may suck, you may not like the RN or whatever - but you have a job to do.

This is it folks - your station and role is what it is. If you are an "aide" and do not want to be fully present and accountable and do your job, then find another. If you are a nurse and find any nursing task too mundane and "beneath" you or the work load has you analyzing the activity of others all the time - then you too need another line of work.

Geez folks - just do you job. Show up and be prepared to work for what you are paid to do. I'd make certain that staff meetings reminded everyone of what they need to do - there are many tasks and they have to be done. Know your role - do your job - be respectful - remember that patients are impacted by all of us.

Practice SAFE!!

;)

Specializes in Not specified.

Thank you Scrubby for your support. Yes, I will honestly agree that my wording was harsh, perhaps ugly in an ideal world. But the fact of the matter is that at the end of the day, MY work as an RN is judged by other RNs who make comments to each other and to nurse managers based on the work of those I delegate to. I'm sorry that Chocobean failed to quote my willingness to bend over backwards to help my overwhelmed aides. I'm sorry, but making a bed that was going to be empty for the next four hours does not take priority over cleaning a patient while I have to go another patient's bedside and intervene while her BP is dropping and her tele strip is out of whack. I want my patients clean, well hydrated, their rooms organized and I need aides who are willing to work with me as a partner. I cannot tell you how many times I have said to an aide, "Don't worry about Mrs. So and So, I have her" and personally cleaned, taken vitals and fetched icewater. But in the end, my aide and I are a team and if they fail then I look bad and my license is on the line. If they fail me, I lose. If I fail, then we both lose, not to mention our patient, who is, after all, the reason I exist. I will not let my patient marinate in her feces because an aide said " I just changed her, I'm making a bed." I will personally clean my patient and reprimand my aide as harshly as I reward them. I'm sorry if that offends anyone. My state practice act clearly defines delegation. I highly reccomend "Nursing: Scope and Standards of Practice" by the ANA as well as "Code of Ethics for Nurses with Interpretive Statements" also by the ANA. And I agree with Darkangel that nurses should have some experience as an aide of some kind before becoming an RN. I was an aide for 10 years before I became an RN.

Specializes in Cardiac Telemetry, ED.
Do those of you with ongoing problems write the aides up and get a paper trail started?

Nurses do not have the authority to "write up" aides where I work. We can write incident reports, but incident reports are not disciplinary in nature. They are used for the purpose of process improvement.

Nurses do not have the authority to "write up" aides where I work. We can write incident reports, but incident reports are not disciplinary in nature. They are used for the purpose of process improvement.

That's part of the problem right there.

I cherish the aides that I have had that are wonderful. But for the most part, I sadly have to agree. It seems as if they have "their own" priorities and they may or may not match up with the priority of the moment. I have literally had an aid tell me "that is not a priority for me" and walk away. Yes, many times it "appears" as if we "could do it ourselves", but #1, it isn't our job, it is theirs, and #2 we are usually on our way to do something else, and they fail to grasp that concept. We shouldn't have to stop and explain why we can't do it. If I am not busy, I will help - but if I am, no, sadly I will not. THe aides know that they "have us", and it is rampant. In one hospital I worked in, RN's had the authority to send them home. That worked. I dont think "relieving" of the responsibility of that one patient is helpful - they probably think "great, now I don't have that one to worry about -you do it all"......at least that has been my sad experience. The few that were great, I thank up and down all day long!!!! Kudos for pride in ones' work!

While I was in school there were no classes in "management" or "leadership in nursing" specifically. I wonder (and this isn't a blaming message or a "point the finger" message) if these types of courses would be beneficial...or if they were offered in other people's programs?

Specializes in Trauma & Emergency.
While I was in school there were no classes in "management" or "leadership in nursing" specifically. I wonder (and this isn't a blaming message or a "point the finger" message) if these types of courses would be beneficial...or if they were offered in other people's programs?

The last year of my four year program has a 3 credit nursing class on Leadership/Management in Nursing. It focuses on the transition from a student to a professional. It educates the new nurses on time management, how to handle problems among coworkers (obviously generalized as all facilities have a different P&P), how to accept your new role as a leader in healthcare. I am just starting the program but one of my friends who graduated said that it was extremely beneficial to her. It reminded everyone that even though they were Graduate Nurses they were not above certain tasks, that patient care was their number one priority and strategies for communication among patients/doctors/coworkers. I can imagine that would be extremely helpful. In no way am I implying that the OP had/didn't have this type of class--just was responding to the question above. :wink2::wink2:

To add to this thread--I work in LTC with a 60 patient med pass. I never go out of my way to find an aid to get ice water/toilet a patient of course I can handle that myself. What I can not handle is Charge Nurses who are friends with a certain group of aides shooting the breeze at the nurses station with 12 call lights going off and nobody saying anything about it. I am trying to pass meds on 60 patients..I'm glad that you have time to sit there and do ABSOLUTELY nothing and then have the audacity to look up at me and ask why I'm not answering the call lights. Hmm..of course I will answer as many as I can but if 10/12 need to be changed (which usually is the case) I just don't have time to change 12 people. I understand that patient care is my job..but changing twelve people could take an hour and then what? Is the aid going to help me with my med pass? Obviously not. If you are busy I can understand not answering call lights/not changing patients. But when your sitting at the nurses station for the last hour pretending to do I&O's at 6 pm for a 3-11 (which I still don't understand & continue to ask how they can possibly fill them out so early) I do have a serious problem. It enrages me actually. What makes me even more insane is that the charge nurses don't say a word, supervisor walks by it like its nothing, even the DON will watch as the callboard is lit up with 10+ lights and all 4 aids are sitting at the nurses station doing nothing.

Now to be completely blunt and honest. I do the best I can to care for as many patients as I can while I'm trying to finish all of my responsibilities but I do expect some help. If I ask you to get up from eating your donut and coffee after you just took an hour dinner break and are proceeding to take 4 15 minute smoke breaks I don't need anyone to roll their eyes at me or say some off the cuff comment about how lazy I am. I worked as an aid too and I have absolutely no problem helping to do as many tasks as I possibly can but comments like that make me want to burst into tears because it is all just so frustrating. :banghead:Nobody wants to make any problems because if management isn't taking care of it now..they certainly are going to throw you under the bus with any complaints.

To make a long story short--If you don't have to support of the management in your building..there are probably not a whole lot of changes that you can make by yourself as one nurse.

Previous posters have stated to try to read into the way you are handling certain situations and maybe to try a different approach. Sometimes personalities come off strong to other people--maybe they are completely misreading you.

I think we all face this problem to a certain degree but like many have said before me, we must remember that we are all employed for one purpose: To take care of our patients. We must remember that no job is to menial for us to take care of.

To end this: I do agree that nurses should work as aides before they become nurses. Sometimes it is hard to walk in their shoes if you never truly have.

Lots of luck to you!:redbeathe:redbeathe

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