Need help helping an unconfident nurse

[Aeterna, BSN, RN]

(Reposting this since I think it got lost during the revamp. I can't find it anywhere but if it's still around, mods can feel free to merge or delete the threads!)

I don't consider myself a particularly experienced or knowledgeable nurse. I mean, I know enough to do my job and get through most days without asking others for help (so many things can be looked up on my own), but if I don't know something and can't find the answer, yes, I'll ask for help until I feel confident enough to do it on my own.

I have a colleague, however, who can't really seem to stop asking for help for simple things. She's been working for about the same amount of time as me (roughly 1.5 years) yet she still asks for help on things like simple dressings, PCAs, or PICCs (all of which are common on our floor). I've helped her numerous times and each time, it's like she feels content to allow me to show her what to do. I say, no, you have to do it yourself and I'll watch and help if you get stuck. I show her, get her to demonstrate skills back to me, etc., but I feel like a week or two later, she's asking me about the same things! I'll tell her, "You can do it yourself. I've seen you do it" and she answers "If I make a mistake, it's my license" or "Every time I do it, bad things happen."

When she first came, she asked another nurse to watch her give Lactulose. It took her months before she would even touch a PICC. She once didn't want to flush an IV because "the family is there and it makes [her] nervous." She's gotten better but she still fusses about the simplest things.

For example, one day, I had some extra time and asked her if she needed any help. She said she had two packing dressings to do on one patient (one on each foot) and she was freaking out about it. I told her we could tag-team it - I'd do one dressing while she did the other. We went into the room. We took off the old dressings and there wasn't even anything to pack - both wounds were small, relatively shallow craters. I did the one wound (only took a couple of minutes), looked up, and saw my colleague hadn't done the other. She then asked me to do the other wound, too! I told her, no, she could do the wound on her side. I can't remember what she said but she kept insisting and pushing the dressing supplies to me. I felt very awkward arguing in front of the patient so I just did it myself since it would only take an extra couple of minutes.

Just recently, she kept fussing that she had three wound dressings to do in a day. It was hard to feel sympathy because I knew a "big wound dressing" for her could be nothing to anyone else; and, if I offered my help, I'd probably end up having to do the dressings myself.

It's just very frustrating. I've heard other nurses tell me similar stories (though, maybe less kindly than I'd like). When she asks for help so much, it adds to everyone else's work. As I've said, I've tried encouraging, teaching, and having her do things herself, but progress is slow. And if you deny her help or tell her she can do it herself, she goes off and complains about how "no one helps around here"!

[Pepper The Cat, BSN, RN]

Sounds frustrating! She really needs to get over this.

Can you refer her to your Education person? Maybe they can preceptor her a bit more?

People like this scare me because one day something will happen that requires a quick response and they won't be able to provide it.

[leslie :-D]

i agree with pepper the cat...about consulting with an ed person, or finding another resource for her.

this goes beyond you or other nurses now.

she now needs input from a higher-up.

go to the cn, um, nm...whoever is next in line.

but warn her first.

share your concerns, that she has been there 1.5 yrs and remains too dependent on others...

and that it's now out of your hands.

it's her choice how she chooses to proceed.

scary.

leslie

[nurseprnRN, BSN, RN]

what i posted before may be worth repeating: you are good to want to help her and we all share new info and support with our colleagues, but you are enabling her behavior and reinforcing her learned helplessness by doing all this.

you are not there to provide her with an extended (very extended) preceptorship. that's staff development's job. refer her to them, and tell her you have told them to expect her call.

your part from here is behavior modification. next time she asks you, smile, and say firmly, "no, i think you can do this without me." if she goes to others, you can share this technique with them, too. next week, say no twice; the week afterwards, if she stlll hasn't gotten the message, three times. i wouldn't worry about her complaining that "nobody helps around here" because it's clear that everyone knows her pattern. i suppose an extreme measure would be to have your manager stage an intervention at a staff meeting, but although this would get it out in the open and remove her deniability, this might be going a bit overboard.

again, you are good to care about her, but this is not your problem unless you continue to let her make it so. time to bow out, gracefully.

[Ruby Vee, BSN]

this gal needs more help than you, as a peer, can give her. if you truly want to help her, you might sit down with her and ask her why she thinks she needs so much help . . . because if she doesn't get with the program soon, i can forsee a "fired for no reason" complaint in her future. she just isn't doing her job.

[LynnLRN]

WOW! I'm surprised after a year and a half that nobody has had her sit down with the manager yet. The stuff you mentioned is basic nursing care, if she can't do that independently after a year and a half she should find a different job.

My worry would be what happens when people do not have time to do their job and her job, do her patients receive the care they need? Does she just not do it if nobody is present? It would be worth asking the following shift what the condition of her patients are in.

I think she needs to quit being babied. If you are going to help her, I would say I am going in to shadow you and offer advice if needed, do not hand the supplies to me or I will walk out of the room. Then after you have seen it once, the next time she asks I would send her in independently, that's the only way she will ever become comfortable and gain confidence is to do it herself. This of course would have to be how all nurses on the unit respond to her.

However, really after a year and a half maybe she just isn't cut out for this. I really think the manager needs to step in if its as bad as you say it is, I just worry about patient safety.

[dishes, BSN, RN]

I have worked with nurses who had similar behavour to what you describe, it turned out they had anxiety disorder. I found being supportive and letting them know I understood their level of anxiety was making it difficult for them to do their job, helped to build trust and I was able to encourgae them to seek help for anxiety through their health care provider. It's a hard topic to discuss with a colleague but if you keep in mind how you would want to be treated if you were struggling with anxiety, you will be able to do it.

[GHGoonette, BSN, RN]

It's possible she's suffering from an anxiety disorder, as the above post suggests, but she bears a remarkable similarity to someone I encountered outside the field of nursing. She was not in any way mentally/psychologically incapable, she was just too lazy to do the work herself.

She'd flummox the next person to "take over" what she was busy with, then either stand back and ooh and aah about how well her victim was doing it, how much better than she herself, or she'd have "something urgent that needed to be taken care of", and you'd usually see her half an hour or so later on the other side of the room in earnest conversation with someone else.

Either you and your colleagues need to put your collective foot down and refuse to empower her inadequacy/terminal inertia, or you need to take it up with your immediate superior.

[Rayisa]

Sounds like you all are "enablers". She's getting paid for you helpers doing her job. Did she really graduate from nursing school? She's protecting her license, while you're putting yours in Jeopardy. If she suffers from anxiety disorder, she needs to get help. If nursing is not for her, she needs to change profession. Period. End of story.

[Wishinonastar, BSN]

I don't think it sounds like laziness, I do agree that she is very insecure. It is scary having to take responsibility but how did she get through nursing school? I see trouble ahead. Just as you would with a patient you have to push her to do on her own. New skills are one thing, but things that she sees every day? No, it is time to cut the cord. Tell her that you don't have any more experience then her and it is time for her to be independent. This is kind of disturbing actually. She sounds way too insecure at this point.

I had a coworker like this, she went into psych and did very well. Hands on skills scared her, but she was good with the softer stuff and had a lot of tolerance for psych patients. Maybe because of her own anxiety.

[Rayisa]

Actually, I'm starting to think this is a joke, really. :) Are you kidding? Why doesn't the nurse manager know about her? or does she? and why has nothing been done to get her retrained, helped(anxiety) or point blank get rid of her? this has to be a joke. Patients' lives are at stake. Possibility for lawsuits. really? A year and a half??? Laughable!

[gypsyd8]

She sounds like a lazy person who is getting you to do her work for her. It sounds like you are a caring decent person who finds it difficult to say "no" but this is really what you both need. Inform her that you will not do her work for her anymore and if the behavior continues you will have to speak to the nurse educator (or manager, if you do not have an educator).