New hire RN accused of being "mean."

[NS885RN]

Looking for some advice here...

I'm still considered a new nurse (had my RN for a little over 1 year) and I just recently started my second job as an RN on a busy med-surg floor. Prior to this job I worked in an acute care locked psychiatric unit; routinely dealing with addiction, drug/alcohol withdrawal, and physically aggressive behaviors in mentally ill and suicidal patients. I left that job because that was not what I wanted for my nursing career, and I landed exactly the type of job I was looking for. I've been working on this med-surg floor on my own about 2 months now, and I've recently been called to the manager's office to discuss how my demeanor is making the aides on the floor uncomfortable. Apparently an aide was so upset by how I treated her that she was in tears. I had no idea she was even upset! A specific day was named, and right away I knew who the aide was, I guessed and mgmt reluctantly said "yes, she was the one in tears." This aide is new also, an older woman trying a second career. She is in a constant state of panic, never able to get her job done and freaks out in front of patients. So I begin to defend myself stating that she can be a little over sensitive at times, and I have personally witnessed her panicked numerous times when she is working with other nurses. The response I received was that "if she were the only one, we wouldn't be having this conversation."

I was shocked. I try every day to make sure I communicate with the aide in the morning, I tell them who needs blood sugar checks, what I specifically need help from them on (e.g. we need to make sure patient X gets up and walks today) I never walk away from a patient who needs toileted, needs their Foley emptied, wants a juice from the refrigerator, can't work the remote to their TV, etc. even though I have between 5 and 6 patients to see, assess, pass meds to, etc. I left a very high stress environment when I left the psych position, and in that environment you must be direct and to the point, which is why I think I got the job. This new job is still stressful, but in different ways. Until I get a real sense of the flow for the unit, I have to keep focused and make sure that I stay on top of my patient care, because one mistake can put me under. I don't feel like I've ever been rude, I have a direct personality and when I'm busy, focused, and working I will tell the aide what I need help with in no uncertain terms. I delegate appropriate things, if I need to pass meds and a different patient needs up to toilet, yes I'm going to tell the aide to help patient in room X get to the toilet because the aide can't pass meds. I do everything I can to help my aides, when I have a patient that I need to check for pressure ulcers, or change a dressing, I call the aide and say I'll be in there to do this at x time, if you come and help me hold we can get the bath done together and it makes it easier for both of us to work together. At this point I have no idea which aides I've upset by being "mean" because, of course, none of them have come to talk to me personally. If I have a problem or concern, I go to the person directly. I've honestly been unable to identify what I could be doing differently to improve the situation. I don't delegate anything to the aide that's not in their job description, and there have been plenty of times I've toileted a patient while the aide sits in the hallway on the computer looking at email, but I'm the kind of nurse if I answer the call light I do the task. The only thing I've come up with is maybe my tone of voice is putting them off. I don't feel I should alter my behavior because people don't like the way I sound. I think it's ridiculous, and I think the aides complaining need to get over it and do their job. I asked my manager for feedback and possible suggestions and he had nothing, saying he's asked my charge nurses and they say I'm not rude, they say I work hard, but I don't sugar coat anything....And that's a problem? I'm just really confused about how this landed me in the manager's office, he said it was just to make me aware and let me know that he's been on my end of this conversation back when he was a floor nurse. But that just made me question even more why we were even having this conversation.

Anyone have any issues like this? Is this a problem, should I care that a couple aides are unable to take direction from someone with a direct personality? I don't want a hostile work environment, but I also don't want to be so concerned with befriending the aides that things don't get done. Please help!

[AlwaysLearning247, BSN]

I know you probably don't mean it but maybe the aides are feeling like you "talk down" to them. I have definitely experienced that as a CNA. Honestly just treat them with respect and be understanding if they're feeling overwhelmed. Sometimes nurses overlook CNA work and think that it's easy, it is not easy to say the least. Just remember to say please and thank you (if you don't already) and try to talk in a demeanor that doesn't sound like they work for you. Remember they work alongside you and are your coworkers. You have the same boss, you are not their boss. We wouldn't be able to do our jobs without their help and they deserve respect. After reading I think it could just be the tone, maybe try to delegate in a nicer tone. Don't be the nurse that just walks by an aide and say "go toilet room 217," say "room 217 needs to use the bathroom and would like your help, thank you." It's all about the tone that can make someone feel worthless, remember that. I've had nurses delegate tasks to me with an awful tone as a CNA and I hated working with those particular nurses. Good luck!

[Rose_Queen, BSN, MSN, RN]

I think some self reflection is in order. You were in an environment where you most likely spoke one way, and it's not the best way to speak where you are now. To you, it's normal. To others, it comes off another way. I had the same issue when I first started- how my entire family speaks normally came across as abrasive to some of the staff.

[FlufferNutter, ASN, RN]

Just curious if you've ever worked as a CNA? It is a thankless job that is instrumental to us nurses to get our jobs done properly. If I hadn't worked as an aide prior to becoming an RN, I would not recognize that it takes enormous amounts of compassion and selflessness to do that job, and they get ridiculously underpaid. I also work on a psych unit, so I understand the need to be decisive and brusque sometimes.

[catebsn25]

Do you ever converse with the CNA's about anything other than when you are delegating tasks? Try getting to know them on a more personal level... Another suggestion that could be helpful in improving your rapport with your coworkers is to be sure to express gratitude and appreciation when you see them working hard and doing a good job with a patient of yours... A thank you and kind word really goes a long way.

[llg, PhD, RN]

The only thing I've come up with is maybe my tone of voice is putting them off. I don't feel I should alter my behavior because people don't like the way I sound. I think it's ridiculous, and I think the aides complaining need to get over it and do their job.

Well there's your problem right there. You don't care if you hurt people's feelings and that lack of caring is coming across in your tone and choice of words.

Most people want to feel accepted and respected by their co-workers. One important way we show acceptance and respect is in how we talk to people. Apparently, you need to improve your communication skills so that your way of talking better demonstrates acceptance and respect.

Manners, politeness, courtesy, friendliness ... etc. ... These are not empty or insignificant words. They are the foundation of social connectedness and mutual support. Words like "please," "thank-you," "How is your day going?" "How was your weekend?" etc. should be a regular part of your communication with your co-workers. They help build a cohesive team and positive work environment in which everyone feels comfortable, accepted, and respected as people.

[ScrappytheCoco]

When I delegate a task, I always use phrases like "do you have time, would you mind, would you please..." etc...and because of that when I do have an emergency and say I need help NOW they know it's legit and not a juice box or something dumb. Treat the techs like equals and don't delegate unless you have to. Maybe you didn't mean to hurt anyone's feelings but that doesn't invalidate them. Try a little kindness...it really does go a long way.

[greenerpastures]

Honestly, you may just have "one of those faces/voices." I have one too. Most people tell me, "I thought you were a witch when I first met you, but you are actually really nice." It's partially because my lips naturally turn down, which makes it look like I'm frowning when I'm thinking, but it's also because I tend to have a lower voice which means I have to speak up to talk to people. People see it as "aggressive" at times when it's actually just my voice/face. I actually had a joke name tag at a place that I work that said "I'm not mad or angry, it's just my face." Take it with a grain of salt, try to be aware of people who might be more sensitive. I go by the philosophy of this is my job, not my life, I'm not here to be your friend, WE'RE here to care for people in crisis TOGETHER.

[BonnieSc]

Echoing a poster above, I've gotten appreciation from aides and nurses because I ask them to do things instead of telling them. It always surprises me because I'm not aware that that's my habit, and I'm surprised it means so much to them. I think many nurses assume that aides understand that their statements are requests without it being expressly put that way, and it comes off as an order.

But when I was a new nurse I also got a couple of comments about being mean. I was busy and stressed and didn't have as much time, or room in my brain, to put things nicely. Once a patient misunderstood a comment I made (a poorly thought out explanation of why I couldn't lift her alone), she told a CNA, that one told another, next thing you know I'm "mean to patients". It took me awhile to come back from that one.

You've gotten great advice here but keep in mind, it really has to be genuine or they will see through you. I know some nurses who "don't sugarcoat" but because they show in other ways that they are genuinely good people, they are loved and respected by the staff.

[morte, LPN, LVN]

because the manager said she wasn't the only one, doesn't make it so.

[BuckyBadgerRN, ASN, RN]

Weeeelllll, don't get mad, but I saw a LOT of "I's" and "I'ms" in your post. If you speak like that in real life, I can see where they could be thinking what they seem to be. Try substituting "we" in place of "I" and see what happens.

[kidzcare]

Treat the techs like equals and don't delegate unless you have to.

:goodpost:

Treat them as equal because they ARE EQUALS.

I get consistently positive comments from my CNAs, they tell me they are always happy to find out they are working with me. I always make a point to not delegate every task, as well. Refilling a water takes a minute and I can usually spare that. Helping a CNA boost a pt or help change a brief/bedding so they don't have to go in search of or wait for another CNA to help them speak volumes as to how much you respect them. Once my CNAs see that I'm willing to do what I can to help them, they are always more willing to go the extra mile for me.