new grad struggling with unit politics and poor performance

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I've been working as a new grad on a nursing unit for the past few months and things have been going pretty smoothly for the most part. Over the past few weeks to month, I've been experiencing some side effects from a medication that I'm on including the following: excessive sleepiness and poor concentration. During my first few months, I received nothing but positive feedback from both my nurse manager and my co-workers. As a result of the excessive sleepiness, I've had a few tardies (as a result of over-sleeping) and it was brought to my attention that it had gotten back to my nurse manager. I was recently confronted by a co-worker last night about how apparently a few of my night shift co-workers were going to bring to attention the following behaviors that they have deemed unacceptable: apparently I gave a shoddy report one day, I've been "slacking" on doing my work (which I deny. I would say I was a bit of an over-achiever when I first started and have noticed a decrease in the quality of the work that I've been doing and will acknowledge that it needs to be addressed) and that I'm not pulling my weight as I should be. Aside from the one comment where I've been slacking, I think the other complaints sound vague and while they may be true, I wish that this had been addressed when these behaviors first cropped up. On top of this drama, I've been having real trouble sleeping lately and would consider asking my nurse manager to switch me to day shift, but I don't want to rock the boat anymore than I already have.

How do I approach my nurse manager about my accountability for these behaviors? I realize that it's become a problem and I'd like to work on a solution, but I feel like part of it is not my fault and I'm really trying to improve my behaviors, but when I'm on a med that makes me excessively sleepy, it's hard to get everything done to the best of my ability. I have been battling with bi-polar disorder and have been having a particularly tough time with my symptoms lately. I work on an inpatient psychiatry unit and sometimes I wonder if I'm crazy enough to necessitate becoming a patient myself. I feel like I'm providing good care to my patients and I'm making every effort to separate my work life and my personal life, but it's been really difficult lately. How do I bring this up to my nurse manager without making her think that I'm incapable of performing my job? I'd like to improve my behavior and make it up to my co-workers that I feel I've let down, but it's frustrating that this was all mostly hear say and things said behind my back. I feel like my co-workers don't like the fact that I was hired as a new grad and can't help but think that I've fallen into becoming a victim of unit politics. I'm not saying that I shouldn't be held accountable for my own actions, but I would like support and advice on working out a plan to solve this problem.

I've contemplated taking a leave of absence until my medications get sorted out or going inpatient and just getting things sorted out on a STAT basis because this is really affecting me and my peers negatively, but I'm not sure if that's the best idea. I can't afford to make any mistakes and I want to improve my behavior. I should add that I have the next couple of days off from work and I was thinking about scheduling a meeting with my NM on Monday, before I make the decision whether to go in or think about a leave.

Specializes in General adult inpatient psychiatry.
I agree with Virgo and would tread lightly especially as a new grad/new hire because they may or may not be willing to work with you. FWIW I'd be hesitant to disclose to my NM or anyone on my team. Putting personal stuff out there always seems to result in a bite in the butt sooner or later. :( If you decide to discuss your performance with your NM I'd be very humble and not make excuses. Perhaps just saying that you are on a new medication and it has affecting your sleep but you have come up with a plan to fix it would be sufficient? Wishing you all the best. You know I'm a fan. ;)

Jules, thanks for your response. I am indeed trying to figure out how to tread lightly because I don't want to put myself out there even more if I'm already being targeted or noticed. I think leaving out the details about my disorder is imperative at this time, although I will check with HR/EAP to see what my options might be.

If you are taking meds for a psychological/emotional problem, notify your superiors in writing. The ADA will protect you from being fired.

Secondly, take a long hard look at your situation. Are your problems are putting pt's at risk? That is your #1 concern - not keeping your job. If your pt's are being put at risk, you need to leave that job and concentrate on your own problems. You can't help someone else unless you help yourself first.

I wish you the best. Many people go through these sorts of problems and it isn't the end of the world. :loveya:

Specializes in Rodeo Nursing (Neuro).

I think discussing your situation with your NM is a good idea. There may be a stigma attached to a Dx of mental illness, but the path you are on now will lead to termination, or worse. Prescribed or recreational, the meds you are taking may be rendering you unfit for duty. Not your fault, but as another poster observed, the safety of your patients is a crucial issue. Getting in touch with EAP sounds like a real good idea, and invoking ADA probably wouldn't be a bad one, either. You might consider engaging an attorney for that part--it's a bite, but not always as expensive as you might imagine. $50-100 might get a letter that would be just what you need, and some will do an initial consultation for free or a nominal fee.

I would not recommend bringing up politics with your manager. It's okay to vent about it, here, but it will sound like trying to divert blame to your manager. You need to send a clear message that you're ready to own this as your problem. I commend you for doing so with us. It greatly improves your chances of finding a solution.

How much of this you want to share with your co-workers is up to you. I believe you said you work on a psych unit. You'd think if anyone would understand...but I probably wouldn't bet on it. Generally, the less you share of your personal life, the less people have to gossip about.

Finally, I agree with the statement that your own health is a top priority. I hope it doesn't come to that, but if you have to choose between your own well-being and your job, you can get another job, and they can get another nurse.

Good luck.

Specializes in Cardiac Telemetry, ED.
Jules, thanks for your response. I am indeed trying to figure out how to tread lightly because I don't want to put myself out there even more if I'm already being targeted or noticed. I think leaving out the details about my disorder is imperative at this time, although I will check with HR/EAP to see what my options might be.

I think this is the best plan at this point. Good luck! We're rooting for you!

Specializes in General adult inpatient psychiatry.
I think discussing your situation with your NM is a good idea. There may be a stigma attached to a Dx of mental illness, but the path you are on now will lead to termination, or worse. Prescribed or recreational, the meds you are taking may be rendering you unfit for duty. Not your fault, but as another poster observed, the safety of your patients is a crucial issue. Getting in touch with EAP sounds like a real good idea, and invoking ADA probably wouldn't be a bad one, either. You might consider engaging an attorney for that part--it's a bite, but not always as expensive as you might imagine. $50-100 might get a letter that would be just what you need, and some will do an initial consultation for free or a nominal fee.

I would not recommend bringing up politics with your manager. It's okay to vent about it, here, but it will sound like trying to divert blame to your manager. You need to send a clear message that you're ready to own this as your problem. I commend you for doing so with us. It greatly improves your chances of finding a solution.

How much of this you want to share with your co-workers is up to you. I believe you said you work on a psych unit. You'd think if anyone would understand...but I probably wouldn't bet on it. Generally, the less you share of your personal life, the less people have to gossip about.

Finally, I agree with the statement that your own health is a top priority. I hope it doesn't come to that, but if you have to choose between your own well-being and your job, you can get another job, and they can get another nurse.

Good luck.

Thanks; I'm going to do some research on the ADA act this weekend so I can be prepared to talk about it before I talk with my NM on Monday (hopefully). I will not bring up the politics, but is it appropriate that I bring up what that I've heard negative talk about me and want to confirm the reality of the situation with her?

Thanks to everyone for their support in my issues.

Specializes in Rodeo Nursing (Neuro).

I don't suppose it would be wrong to acknowledge that you've had inklings that some co-workers may have misgivings about you. In any case, before forming any too-negative opinions of them, please consider how things might look from their point of view. To someone who didn't know your situation, the behavior you described could look like a problem with illicit drugs, in which case your coworkers biggest sin would be not acting more directly. The ethical thing to do would be to report your behavior to management, but the reality is that people find it hard to "rat-out" a colleague, so problems tend to get whispered around until management finally hears. But it is possible your manager might have ideas to help you regain your co-workers' confidence, although that's likely to be an uphill battle. Your best hope is probably to get your meds and condition under control, then just figure on having to work hard to earn people's respect. Ultimately, at least some may come to respect you more for having overcome this.

Specializes in General adult inpatient psychiatry.
I don't suppose it would be wrong to acknowledge that you've had inklings that some co-workers may have misgivings about you. In any case, before forming any too-negative opinions of them, please consider how things might look from their point of view. To someone who didn't know your situation, the behavior you described could look like a problem with illicit drugs, in which case your coworkers biggest sin would be not acting more directly. The ethical thing to do would be to report your behavior to management, but the reality is that people find it hard to "rat-out" a colleague, so problems tend to get whispered around until management finally hears. But it is possible your manager might have ideas to help you regain your co-workers' confidence, although that's likely to be an uphill battle. Your best hope is probably to get your meds and condition under control, then just figure on having to work hard to earn people's respect. Ultimately, at least some may come to respect you more for having overcome this.

This is a great idea. I really wanted to hear advice like this. I can see where my behavior could be mis-perceived very easily by co-workers and draw concerns about my behavior. Thanks for your POV.

Specializes in General adult inpatient psychiatry.

This is what I've written as what I'm planning to say to my NM. Does this sound appropriate?

It has recently come to my attention that my performance at work during my

assigned shift has been lacking in quality and that I haven't been performing as

a team player. I am appalled at my own behavior and would like to accept full

responsibility for my actions and would like to work on formulating a

performance improvement plan in order to facilitate my improvement and

prevent further escalation of my behavior and problems associated with my

behavior.

I would like to offer an explanation and seek support for the problems in my life

that have been leading to my decrease in performance on the job. I am on

medication for a non-contagious chronic medical condition and have recently

been going through some changes in my medication that have given me side

effects, including decreased concentration and increased sleepiness. By working

night shift, my medication admistration schedule is thrown off kilter, as my

medication is supposed to be taken at HS and it has been difficult to adjust my

sleeping and medication schedule. I have been trying my best to monitor my

behavior, and I would appreciate that any further concerns be brought to my

attention before things get any worse.

I feel it would be both in my interest and in the interest of patients and my co-

workers that I would make a shift from night shift to day shift, in the interest of

maintaining a more regular schedule. I am currently looking into behaviors to

facilitate my waking up for work on time and staying busy at work in an effort to

stave off my sleepiness and increase my concentration for the time being but am

interested in changing my work environment as I feel the combination of my

behavioral problems and medical issues are not conducive to working odd hours.

I apologize for not having acknowledged this earlier, but this is a recently

diagnosed condition for me and I am working on getting the right balance of

medications to manage my symptoms.

Specializes in Rodeo Nursing (Neuro).

If you took this to my manager, I think she might get sexually aroused. Well, perhaps I exaggerate. But I'm sure she would be impressed.

"Behaviours", "..before things get any worse...", "...manage my symptoms...", "..problems in my life..".

Hmm, maybe it's just me. But do you have to write her?Couldn't you possibly request audience with her and have a conversation.Plus that way, you can also watch her body language.Just a suggestion:)

Specializes in Rodeo Nursing (Neuro).
"Behaviours", "..before things get any worse...", "...manage my symptoms...", "..problems in my life..".

Hmm, maybe it's just me. But do you have to write her?Couldn't you possibly request audience with her and have a conversation.Plus that way, you can also watch her body language.Just a suggestion:)

It's just you. The poster specified it was a written rehearsal of what she plans to say. Which isn't a bad idea.

I agree, being able to assess body language face-to-face could help. But it wouldn't be wrong to deliver it in writing, if a person couldn't handle it face-to-face. And the poster has apparently chosen to be a bit vague, as opposed to full disclosure. I think either approach is valid, since there are pros and cons to each.

Specializes in General adult inpatient psychiatry.
"Behaviours", "..before things get any worse...", "...manage my symptoms...", "..problems in my life..".

Hmm, maybe it's just me. But do you have to write her?Couldn't you possibly request audience with her and have a conversation.Plus that way, you can also watch her body language.Just a suggestion:)

I wrote things out to manage my thoughts appropriately. I ended up just winging a conversation with her but we got things out in the open and it's much more comfortable to go to work now knowing that my manager supports me.

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