Micromanaging

brownbook · Apr 9, 2016

I will now micromanage you now, ha ha,....I had a charge nurse like yours, luckily I moved, I never solved the "problem".

I have to say (I know this is not your point), but we routinely draw up normal, "watery", IM meds in whatever gauge needle is on the syringe, then switch it out to a 25 gauge for the injection. But I don't know if you can give the IM when the solution is thick?

Perhaps you could kill her with kindness, (lie). When you and she have a minute to talk tell her how helpful whatever "advice" she gave you that day was, that you really appreciate her clinical knowledge and how much she helps you and the rest of the staff. (If you can do with without gagging!) Do this several times a day or week. I know it sounds soooo insincere and a "normal" person would know it was insincere...but some people do not get the sarcasm, insincerity, she might, will hopefully, eat it up. Hopefully once she sees you as an ally she will find someone else to micromanage?

As to not helping, long breaks, doing crosswords, has management addressed this. It seems very black and white...take a picture of her sitting with her crosswords, document went she left for her break and returned. If you present management with facts how can they justify her bahavior?

I learned this on Allnurses, from my frustration with a CNA who wouldn't help. Don't ask someone like her for help...."will you, can you"....say "I need". " I need you to give Mr. X his PRN now, I have to catch up on my charting." It is not a magical solution, but it may work, you may need to be a broken record....."yes I do need to get better organized...but I need you to give Mr. X his PRN".

CrunchRN, ADN, RN · Apr 9, 2016

I feel for you and thick stuff is even better with an 18g. You are right also about not putting 2.5 in the deltoid. I think you need to print out material that states that and give it to her and keep doing things the right way.

MMC.RN · Apr 10, 2016

I feel for you and thick stuff is even better with an 18g. You are right also about not putting 2.5 in the deltoid. I think you need to print out material that states that and give it to her and keep doing things the right way.

That's so true! I should print stuff out although she would probably say I didn't get it from a, "reputable," source. I wish we had 18 gauges, but we don't so I'm stuck with the 20. It works alright. Not to mention that with psychotic agitated patients do you really want to put injections in the deltoid anyway? If they're stable and I know this and if they aren't getting that much I will use the deltoid, but most of the time it goes in the gluteus with at least two people there in case things go south.

MMC.RN · Apr 10, 2016

I will now micromanage you now, ha ha,....I had a charge nurse like yours, luckily I moved, I never solved the "problem".
I have to say (I know this is not your point), but we routinely draw up normal, "watery", IM meds in whatever gauge needle is on the syringe, then switch it out to a 25 gauge for the injection. But I don't know if you can give the IM when the solution is thick?
Perhaps you could kill her with kindness, (lie). When you and she have a minute to talk tell her how helpful whatever "advice" she gave you that day was, that you really appreciate her clinical knowledge and how much she helps you and the rest of the staff. (If you can do with without gagging!) Do this several times a day or week. I know it sounds soooo insincere and a "normal" person would know it was insincere...but some people do not get the sarcasm, insincerity, she might, will hopefully, eat it up. Hopefully once she sees you as an ally she will find someone else to micromanage?
As to not helping, long breaks, doing crosswords, has management addressed this. It seems very black and white...take a picture of her sitting with her crosswords, document went she left for her break and returned. If you present management with facts how can they justify her bahavior?
I learned this on Allnurses, from my frustration with a CNA who wouldn't help. Don't ask someone like her for help...."will you, can you"....say "I need". " I need you to give Mr. X his PRN now, I have to catch up on my charting." It is not a magical solution, but it may work, you may need to be a broken record....."yes I do need to get better organized...but I need you to give Mr. X his PRN".

Thanks for the advice! I will definitely try the killing with kindness as well as the asking for what I need. I've never been exceptionally rude back and always just taken her criticism and walked away, but maybe if I overcompensate she will just let me do my job! I've never had any complaints about the quality of my work so I don't know what she's going on about. Although it's not just me, she does this to everyone else as well.

Her attitude and conduct are actually a huge problem. No one wants to apply to work on our unit and our float staff abhor coming over by us and it is mostly because she creates such a tense hostile working environment. HR and management just don't see it or just don't care.

Apparently management has addressed the not doing her work and doing the crosswords or at least they've been told several times by many different people. I would take pictures, however being a psych facility that would be a huge faux pas and could get me terminated for having my phone out. Our unit manager walked on the unit and she was doing this so I know she is aware. Meanwhile, I am working my butt off doing both of our jobs while she sits and does nothing. Her excuse that day was, "I just wanted to see if she could do it alone."

jadelpn, LPN, EMT-B · Apr 11, 2016

If management is not responding, but know what is happening it is on them. They could be creating a paper trail against her, who knows.

You do not have 18 gauge blunt syringes? Perhaps that is something that you could ask for to remedy this problem going forward. Then you could change out the needle for injection. That could certainly solve that issue.

Is it just you and her, or are there other nurses? I know everyone's patient load can be overwhelming at times, but if you make it a point to help each other out when you can. And try to chart as you go. Very frustrating for sure.

But until you have the backing of the powers that be who are in a position to do something about it, DOCUMENT and CYA. "Charge nurse made aware, 1800 hours" or something of that nature. Because the only way this may (may) change is when all heck breaks loose and you document "sought assistance of charge nurse at 1800 hours" and charge nurse says she was doing crosswords at the nurses station, I would think there would be no choice at that point.

Thank you for the work you do in a difficult specialty. Best wishes and let us know how it goes.

Been there,done that, ASN, RN · Apr 11, 2016

Thanks for the advice! I will definitely try the killing with kindness as well as the asking for what I need. I've never been exceptionally rude back and always just taken her criticism and walked away, but maybe if I overcompensate she will just let me do my job! I've never had any complaints about the quality of my work so I don't know what she's going on about. Although it's not just me, she does this to everyone else as well.
Her attitude and conduct are actually a huge problem. No one wants to apply to work on our unit and our float staff abhor coming over by us and it is mostly because she creates such a tense hostile working environment. HR and management just don't see it or just don't care.
Apparently management has addressed the not doing her work and doing the crosswords or at least they've been told several times by many different people. I would take pictures, however being a psych facility that would be a huge faux pas and could get me terminated for having my phone out. Our unit manager walked on the unit and she was doing this so I know she is aware. Meanwhile, I am working my butt off doing both of our jobs while she sits and does nothing. Her excuse that day was, "I just wanted to see if she could do it alone."

Killing her with kindness is a passive- aggressive move that is not only ineffective, but beneath a professional to implement.

The fact is "It is unbearable and I dread going into work daily." Management is aware and choosing to ignore the many complaints. Even if they ARE creating a paper trail.. you state it is unbearable.

Time to say when.. you have the experience to move to a non-toxic environment.

Onward and upward!

Lucy1798, BSN, RN · Apr 16, 2016

This sounds like a dreadful situation to be in. I wonder why they are not reprimanding her? Her behavior is very unprofessional. If she seems to treat other people the same way, you know it's not anything you're doing that's rubbing her the wrong way.

Unfortunately, if management is not correcting the situation and you love the job, you have nothing to lose by trying to get inside her head. Maybe there is a way to casually, but sincerely, ask if she's ok? You just sensed maybe she needed an ear to listen. She may give you a puzzled look or ask why. I would casually say, "Oh no reason. I just got the impression something may be weighing on you. If you ever need to talk or just vent, I'm here. I know how tough this job can be sometimes." And leave the ball in her court.

The kicker is we ALL have things weighing on us. Maybe she's got issues we don't know about. You said she's originally from another country. Maybe she's missing someone, or she feels lonely, or someone is ill back home and she feels helpless to comfort them. Also we have to take into account the possible culture differences between her original place of birth and America. Maybe they just act differently and she honestly doesn't mean any harm.

Ok that last statement is pretty far-fetched. Lol I don't know any country where the culture is to call your co-worker or employee stupid. I'm not taking her side by any means. I just feel sad for you in your situation. I hope maybe this will get her talking and then she will trust you. Maybe she will start acting right. Sometimes people just need that one person to show they care.

I hope you can enjoy going to work. It's not fair other people can try and ruin our day. I wouldn't let her win without giving it everything you have. When you've had enough, and if management still doesn't cooperate, you'll know it's time to move on. Good luck to you! Please keep us updated! :)

MMC.RN · Apr 20, 2016

If management is not responding, but know what is happening it is on them. They could be creating a paper trail against her, who knows.
You do not have 18 gauge blunt syringes? Perhaps that is something that you could ask for to remedy this problem going forward. Then you could change out the needle for injection. That could certainly solve that issue.
Is it just you and her, or are there other nurses? I know everyone's patient load can be overwhelming at times, but if you make it a point to help each other out when you can. And try to chart as you go. Very frustrating for sure.
But until you have the backing of the powers that be who are in a position to do something about it, DOCUMENT and CYA. "Charge nurse made aware, 1800 hours" or something of that nature. Because the only way this may (may) change is when all heck breaks loose and you document "sought assistance of charge nurse at 1800 hours" and charge nurse says she was doing crosswords at the nurses station, I would think there would be no choice at that point.
Thank you for the work you do in a difficult specialty. Best wishes and let us know how it goes.

Thank you for the advice! Nope, we don't have 18 gauges on our unit, however I asked for them on a recent supply order. However, we don't have needles that you can change for injections, what you draw it up in is what you give it with.

Usually it would be just myself and her along with 4-5 techs. She micromanages them as well, however as she is not as familiar with their job, which she really should be she's not as bad. Our unit manager and other clinical staff are there intermittently throughout the shift. Everyone sees it, at least I would hope, although no one does anything about it.

Over the last week or so I have documented EVERYTHING, as have all of our other nurses. We are sick of covering for her. I most definitely am, especially after last week. She called administration one morning to let them know I wasn't on the unit in the nursing station at 0700. I was in the building, there was an admission coming in and all of the gates were closed so I had to make a detour which took an extra 10 minutes. Yes, I admit I was running a little later than usual, but had I not hit that unexpected snag I would've been more than on time. However, due to this I walked on the unit at 0701 (I checked my phone) and now that, "late," arrival is on my record. I was not the only one, "late," that day half of our unit was delayed. I called and explained the situation to admin and they told me we should prepare for that possibility which means getting to work almost 25-30 min early instead of just 15-20 before my scheduled shift now to get through security and plan for any unforeseen events! It just irks me that she can, "take a break," for an hour or more and do nothing most of the day and she won't allow a little leeway for something like that. I never call admin unless it's been 10 min or more. Sometimes there are security things or admissions coming that cause delays throughout the building. We don't get paid extra to come in 30 min early so if you're a few min late because of that so be it. Sorry, rant over!

chacha82, ADN, BSN · Apr 24, 2016

I am in a a comparable situation, although the person doing the micromanaging is a cna, not charge...right. I agree with Been there, killing her with kindness is passive aggressive. Admin does nothing. If you like other parts of the job, I would just say "ok, thank you." I have found the grass is not always greener. Or if it is preventing you from doing safe patient care, put together an exit strategy.

Anna Flaxis, BSN, RN · Apr 24, 2016

I'm going to preface my comments with the disclaimer that you may not like what I have to say-but I'm going to be candid and share my impression of what I see here.

For example, I was preparing an IM injection of Haldol Dec, which is very thick and syrup-like and she told me that I was using the wrong gauge needle. I was using a 20 gauge and she told me I needed to use a 25 gauge. I would be there for days drawing it up if I used a 25 gauge. She also told me that I could give 2.5 ml in the deltoid per patient request and that she does it all the time. I refused....

There are no absolute contraindications to injecting 2.5mL in the deltoid. It is best practice? Maybe not, but is it flat out wrong? No. As far as needle size, while it's true that more viscous medications take longer to draw up in a smaller needle, the injection will be more painful with the larger needle. Unless there was a compelling reason to draw up this medication rapidly, other than for your own convenience, your charge nurse is right that the smaller needle is appropriate. In the absence of contraindications, honoring the patient's request and injecting into the deltoid and using the smallest gauge needle possible for patient comfort is more patient centered care, and I think your charge nurse is correct here.

she told me I needed to brush up on my nursing skills and told me that I was, "being stupid and insubordinate."

While I don't advocate this response and I think it was inappropriate and unprofessional, what I am seeing is that she was very frustrated by your refusal to receive her input.

As a Charge Nurse, she has the authority to supervise you and give you feedback on your practice. That is part of her job. The line between "micromanaging" and "managing" can be a fine one, and it's easy, when given feedback about improving your performance, to feel defensive and to view that feedback as micromanaging, especially when the supervisor is not skilled in giving constructive feedback. But, this doesn't make her wrong, and it doesn't erase the fact that she has the authority to give you this feedback.

From what I can gather from your post, she appears to have an 'Authoritarian" or autocratic leadership style. This is the "do as I say, not as I do" type, who will sit in front of a desk and bark out orders. There is a time and a place for this style of leadership, but in the day to day running of the unit, most people will chafe against it, particularly when the autocratic leader is not very skilled at communication.

Does anyone have any tips in dealing with this?

Short of finding a new job (not because that would let her "win", but because you will have to work with all kids of different people for your entire career, and leaving a workplace because of interpersonal difficulties is not a pattern that I see as particularly healthy), my suggestion would be that when she gives you feedback, try to rise above the manner in which she is delivering it that makes you feel so defensive, and ask yourself if maybe she has a point? Give her the benefit of the doubt that maybe she knows something. Treat these interactions like a conversation in which you might learn something.

In the end, she is the Charge Nurse, and management is aware of her behaviors, and if you love your job as much as you do, you have got to figure out how to make this work. If you just can't, then I think looking for work elsewhere is probably your best option, although as I stated above, it would be a last resort. You're going to work with difficult people everywhere you go.

Good luck! :-)

Lucy1798, BSN, RN · Apr 24, 2016

Interesting perspective. :)