New psych RN: Advocating for antisocials? Or being manipulated?

[justpoorfect]

Just a couple of months in my new position, I am in a quandry! As a new grad, I am dropped in the middle of ward drama, and dealing with hostility (both open and in grievances that I have not seen) from my aides due to their perception that I am "not backing them up" in enforcing the rules re: a.m. coffee time. Previous staff allowed bending the rule for some time until 1 or more patients began complaining that "so-and-so got more coffee than me!" The solution then became all pts that wake up in time for coffee get an equal amount and that any remaining coffee at the end of a 15 minute interval would be dumped out, not distributed to anyone. Sounds okay so far, right? Except when the moon is full and a manic wakes up 2 to 3 minutes too late to get coffee! At that time it is open season on staff, and all sins of such staff are shouted out for all to hear (I know they catalog staff shortcomings for use as ammunition) while staff point to a schedule and say "There is the rule. You must live by the rules outside the hospital, too...etc." Security is called and is brought into the mix (their sins are enumerated as well), while I am trying to de-escalate the situation impassively (my words are repeated by various individuals to my super as non-supportive), and I say I will look into the "rule" vs the "schedule" before I take a stand.

My dilemma is now that I don't believe I can support the strict enforcement of the "rule". I have the most up-to-date copy of the ward's publicized Rules and Guidelines that are given to patients on admission, which states, "Wake up time is 6:00 a.m." and "Unless you are restricted from caffeine and fluids, you will be allowed 2 small cups of coffee in the morning and early afternoon..." This is different from the posted schedule, which says coffee break is at 5:30 a.m. until 5:45 a.m..

I have been told that the different time schedule was due to the patients voting to have coffee before their 15 minute smoke break. (Except that the facility has now gone non-smoking.) I received a non-answer to the query of whether another vote may be taken, to return to the original rule or to re-write the wake-up time to 5:30.

Every time I open my mouth to say anything, I am ever-so-gently reminded that these are manipulators, who if given an inch will take a mile and push every limit. However, my gut tells me not to ignore every complaint just because they are "mental" with "antisocial" personalities. (Much as I am hoping supers won't dismiss my "new grad" inquiries as ridiculous.)

BTW, I have NOT given this info to the patients to use against the treatment team, so I hope you won't accuse me of being taken in with staff-splitting. I am determined to hang in there and prove to my aides how much I value them and their work, without letting them go on a rampaging power trip, wherein rehabilitation is now just incarceration and punishment. (I get to hear "Someone should order seclusion for that one!" though I don't see it as justified for ranting - no danger, just distasteful.)

I will value all your thoughtful replies, as I realize I have much to learn.

[inthesky]

my unit had a 'coffee controversy' =P People like coffee first thing in the morning; it is comforting. Some staff made a pot (first come first serve) and others refused. There really needs to be consistency or it gets messy "oh but so and so made coffee" and people get agitated. My personal opinion is that wanting morning coffee isnt unreasonable, but unit consistency is crucial.

[justpoorfect]

Thanks for the reply inthesky. Last night the super said the tx team did listen and decided that coffee would be available from 5:30 - 6:00, THEN be dumped. She told the staff herself, and they didn't all quit, so that's a good thing too. Looks like maybe they have decided to give me a chance to work with them instead of against them!

Now we'll just have to see if the patients decide if this was the victory they wanted! (Stay tuned for the next soap opera episode??!! :typing:bugeyes: )

[medsurgrnco, BSN, RN]

Wow, your unit sounds very restrictive! Good to hear you advocating for your patients.

[aloevera]

our coffee is open to the pts. and staff from wake-up time until we close the door for first group (9:00 am).....it is rather weak, but they are happy with being able to get it....your unit does seem rather strict regarding this...

[winterbot428]

Go with your gut...you sound very reasonable.

[wonderbee, BSN, RN]

As a newbie you have a fresh perspective with no preconceived notions. You haven't been dragged down yet with a thousand and one regulations. Your eyes see what they see, period. This is not a bad thing. Your unit would do well to respectfully incline themselves to your observations while you experience first hand the various problems. There is a middle ground.