I'm the manager but UAPs are undermining me

[Nurse Beth, MSN]

Dear Nurse Beth,

I work in a dialysis center. We have an RN facility administrator (FA). I am the nurse manager over patient care. I had worked at the center for 8 years and followed company policies, state and federal regulations.

The FA told me the first day that I was doing everything wrong. I needed to do things her way even if they didn't follow regulation. As time has gone on she has hired unlicensed assistive personnel (UAP) friends. After they were hired they started to criticize my decisions as a nurse. They ratted to the FA and I would be called into her office because I undermined the UAP decision. The UAP started to make clinical decisions, giving midodrine for low BP, asking physicians for orders.

There were many patient safety issues, improper delegation. The UAP were in charge of the center. I have been to the FA supervisor and HR. Nothing has been done. What can I do?

Dear Nurse Manager,

In title you are the nurse manager over patient care but in reality you are subordinate to the UAPs. You are not allowed to exert your authority and do your job. It causes great moral distress when you want to do the right thing but have no ability to stop unsafe actions.

Midodprine is a vasopressor and antihypotensive drug. UAPs should not be administering drugs, receiving orders, or making clinical decisions.

You have followed the chain of command, and they are backing the FA, not you. If something goes wrong, though, would you be held responsible?

You have not given one reason why you should continue to hang onto this job. It's clear that the situation is not going to change, and your license is at risk every day. Look for another job while you are still employed and plan your exit.

Best wishes to you.

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[JKL33]

These actions you are describing by UAPs are considered to be delegated, whether you agreed with them or not.

Anyway, that's beside the point. Quit, yesterday. Report them.

[beachbabe86]

Have you been through a state survey? Have you read the Federal COP? Do you know what your responsibilities are in that area. It is no joke and you will be left out to dry.

[LPN Retired, LPN]

RUN, run like Forrest Gump, get out. You worked too long and hard for your license to lose them over an UAP and a supervisor who won't back you up. Disaster waiting to happen and they will lay the blame on you.

[caliotter3]

The OP should not have needed anyone to tell her/him what they should have done in this situation long ago. Every day they remain there is a day of borrowed time.