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!
Ooooohhh, this totally resonates with me. I got it, too. Self-reflection is key and yes, tone does make a difference. As mentioned above, asking if they have time, would they mind doing this..., thank you, please, etc...It is understood it's their job, but no one likes to be talked down to. You might not think you need to change your behavior, but the reality is that you do if you want to be 'liked.' It is simply the POLITICS of the job and happens everywhere.
Trust me, there are others out there just like you! My manager had a similar conversation with me when I was about two months into my new job. I was also told there was more than one complaint, and no, not one single person addressed it with me directly. It was just this vague "others." Part of me wanted to say screw 'em, but the reality is that the work atmosphere improved tremendously by making adjustments...also probably because I got used to the system and work, so my stress levels came down. Oh, I also started working out before work, which felt terrible at first, but then I wasn't so on edge during the shift!! I also look angry at the world when I'm stressed out and realize I probably looked right down furious! In fact, on busy days, I still do. My projection can be abrasive and curt, so when I catch myself, I will actually go out of my way to address it/apologize to the other person. It's not a perfect system, but my way to soften the impact and has helped to ease the tension when working. It may seem unnecessary to have taken these steps, but they have helped the social day-to-day environment.
I'm so sorry OP, you have a perfectly logical position but it won't fly. You gotta play the game.
I was in a similar position, in my manager's office, and after the little "play nice" session, the union rep with me said, "I understand where you are coming from. You're from the Midwest like me where we say things more to the point. Out here on the West Coast they're all passive aggressive and don't take straight talk very well."
You're new and not going to be writing the rules. Apparently the superficial sweetness and light is part of that culture and you are expected to play. So you can choose to fight an uphill battle and watch your back or treat everybody like spoiled little kids and get along. After awhile, if you survive, they will get to know you better and understand that it's just your way and be more forgiving. Sometimes you can tease out a little more cooperation with humor and food. Bring some cookies (chocolate in various forms is also a plus).
I am a med/surg nurse and a contingent psych nurse and I don't like a lot of psych nurses. They are hard and assume that every patient is "attention seeking" or "med seeking". I love working with the patients, though. I will say that as a new med surg nurse I have earned the respect of my NAs and NTs because of how I treat my PATIENTS. I've had one of the older ones stop and talk to me. My compliment is that she thinks I really DO care about the patient and it shows. The CNAs (or whatever they are at your facility) spend quantity time with the patients...they talk about their children, their lives, and their families as they wipe their butts, walk them, shower them, and bring them ice packs. They often look at the longer stay patients almost as an extension of their families and they get to be "old" CNAs simply because they love what they do for their patients because it is backbreaking work. Start to treat each patient as if he/she is your precious family member and not an illness. And then start to recognize that you couldn't do your job without the CNA. Legally, that poopie brief and patient's shower is YOUR responsibility and what the aid does is under YOUR LICENSE. You can't delegate that away. Treat them like they matter so they want to take care of you too. Honestly, how hard is it to pass meds? It just takes time and a little bit of thought. Now go change grannies c.diff brief while she assaults you because of dementia. And do it with a smile on your face while reassuring her "that it is okay, honey...we are just making sure you are nice and clean and this will be over in a few minutes."
They need to toughen up and grow some thick skin. I'm a CNA and some nurses may seem rude but it's not like they mean to and even if they are I don't take it personally.
CNA's are vital to the treatment team and if you want them to have your back you need to play ball. Their salary isn't coming out of your check, so you have no right to speak to them in a demeaning tone. It's really not that hard to be nice and it doesn't take anymore time out of your day either.
This post comes across mean, and belittling to CNA's, PCT's or "Aides". It is likely that you come across that way because you are that way. You seem to be priding yourself on doing nursing tasks that are "below" you.... but that is your job. The "aide" is there to help you perform your job optimally. Like another user said.... I think you have some major reflecting to do.
Specializes in Post Acute, Home, Inpatient, Hospice/Pall Care.
Honestly, how hard is it to pass meds? It just takes time and a little bit of thought. Now go change grannies c.diff brief while she assaults you because of dementia. And do it with a smile on your face while reassuring her "that it is okay, honey...we are just making sure you are nice and clean and this will be over in a few minutes."
First lets address meds-how hard is it? Depends on the med and the way they are administered. IV's take time, CAD take time, if you don't use a scanner there are extra checks to be complete, is that medication compatible with the fluids running? How many PRN's are you giving? Medication errors are one of the largest nursing hazards in the field and I don't care if you have been a nurse for a day, a year or 50 years I would expect you take your time on those meds and the patients getting them-are their vitals stable, is their pressure high enough? Etc. etc.
Second it is considered demeaning to talk down to patients by calling them "honey" "sweet" "sugar" etc. dementia or no. It is Mr. So and So Mrs. So and So Ms So and So etc. Unless otherwise asked by the patient to call them something else I use their formal name, especially with elderly patients as they can take offense at the familiarity with someone they don't know.
I think the OP needs to take a look at how she is coming off, but didn't get the feel that she is delegating anything inappropriate.
I am on a med surg floor as well and I am lucky if I have ONE aide on my floor. We as nurses do most of the self care, toileting, changing briefs, changing linens etc. if we do happen to have an aide then we are doing it together and saying please and thank you each time. Just my 2 cents
Ugh. Recently had an aide tell my manager she thinks I "HATE her" ... because I delegated something, found out she didn't do it, and asked her why that was. Maybe she was nervous for her job? I have no idea, but my manager didn't back me up one bit. Take the advice you are getting--- just find a way to smooth over the relationship at least a little so that the tech will have a higher chance of taking direction from you.
obrn2
16 Posts
Ooooohhh, this totally resonates with me. I got it, too. Self-reflection is key and yes, tone does make a difference. As mentioned above, asking if they have time, would they mind doing this..., thank you, please, etc...It is understood it's their job, but no one likes to be talked down to. You might not think you need to change your behavior, but the reality is that you do if you want to be 'liked.' It is simply the POLITICS of the job and happens everywhere.
Trust me, there are others out there just like you! My manager had a similar conversation with me when I was about two months into my new job. I was also told there was more than one complaint, and no, not one single person addressed it with me directly. It was just this vague "others." Part of me wanted to say screw 'em, but the reality is that the work atmosphere improved tremendously by making adjustments...also probably because I got used to the system and work, so my stress levels came down. Oh, I also started working out before work, which felt terrible at first, but then I wasn't so on edge during the shift!! I also look angry at the world when I'm stressed out and realize I probably looked right down furious! In fact, on busy days, I still do. My projection can be abrasive and curt, so when I catch myself, I will actually go out of my way to address it/apologize to the other person. It's not a perfect system, but my way to soften the impact and has helped to ease the tension when working. It may seem unnecessary to have taken these steps, but they have helped the social day-to-day environment.
Stay strong, you will survive this!