New RN's delegating to Tech's/NA's

[RNSuzq1, RN]

Hi All,

Like a lot of new Nurses, delegating hasn't come easy to me. I worked as an NAII throughout nursing school and busted my rear to help the Nurses in anyway possible. I did anything they asked (as long as it was within my scope of practice). Even Nurses that were much younger than me, I respected their position of authority (they were the Nurse, I wasn't).

Most of the techs on my floor are very good at what they do, delegating usually isn't necessary - they know what is expected of them and they do it (really helpful bunch). Unfortunately, I've run into a couple who seem to have major chips on their shoulders and one of them takes the cake - she's just plain nasty. At first I had no idea who she was or if she was even an employee - everytime I saw her she was sitting down eating, on the phone, surfing the net, etc. It took me a few weeks to realize that she's a tech. on my hall and was supposed to be helping me out. She does the bare minimum, then makes herself "very scarce" the rest of the shift. I worked a few night shifts with her (she seems to love that shift - spends most of it nodding at the nurses station) - easy money I guess, get paid to sleep.

The first time I asked her to do something (change a wet bed), she gave me a disgusted look, mumbled something under her breath and suggested I do it to get the experience. OMG, I've changed so many stinky sheets, it's the last thing I need experience in. Not that it's beneath me - I still make up several a day, but I was very busy giving out meds and she was sitting on her throne eating a bag of chips.

Anyways, the few times I asked her for help after that, got rude comments, dirty looks and eventually stopped asking her - just did whatever it was myself. The problem is, I have major time-mgmt problems when she's my tech because I'm doing my job and hers. I hate confrontations and since I'm new, didn't want to ruffle any feathers. I told my Preceptor tonight that a tech was giving me a hard time - she immediately said - you mean "X", yah, don't take it personally and basically said she was useless and hated everyone. She said she even gives the Mgr. grief at times. She's even extremely unpleasant to the patients - I have no clue what she's doing working around sick people with that rotten attitude.

I don't care who she hates, what her problem is - this is an extremely busy floor and I Need Help. You know that old saying "kill them with kindness" - I tried that, I think it made her worse. I'm running myself ragged trying to do everything and not sure how long I can keep this up without blowing my top. I can't delegate tasks to "someone I can't even find"... I've heard lots of others have had issues with her - but for some reason, she still has a job, so I'm not going to the Mgr. about it. I'm at my wits end, and would appreciate any suggestions on how to get some work out of someone like this? Sorry for the length, it was a very, very long night with her and I had to blow off some steam. :angryfire

[MIA-RN1, RN]

wow---do we work together? I have one like that on my floor too. Where is surfing the internet in the description?

I have decided to become proactive. I have been asking a few of the techs (the ones who are responsible and do their jobs) what their scopes are. (do they draw blood? fingerstick bg? Ambulate for the first time OOB etc.) I am getting a good idea of waht they can and can't do.

And I have been asking them to DO THINGS. Asking by saying "would you please" instead of 'could you please". Including the tech that does not want to work. She wants to stay in the nursery all night and take care of the babies. Great. Except when I say I need vitals on four patients or a patient transported from another part of the floor, hello. Go do it. I ask nicely. The eyerolling and sighing is getting old. The other nurses all get along wonderful with her. I could too, if she would just DO HER JOB.

Tomorrow I have a meeting about the end of my orientation etc. I am bringing up our underutilized techs. And specificaly pointing her out.

I think she dislikes me becasue I already got some stuff changed that she was doing that I thought was wrong (and management obviously agreed because she is not doing them anymore). I don't know if my name ever came up or not, but truth be told, its her job to do things and I ask her to do them. Our techs are underutilized and I have decided to make my life easier and the whole thing better by delegating appropriately and nicely.

One nurse was overwhelmed tonight because she had a lot to do and needed a bg on a patient. She was saying she would have to go get the patient to the nrusery etc. I said "Why not get (the tech) to get the patient and do the blood?" She looked at me like I was nuts, and that it had never occurred to her to tell the tech to do something. Seriously.

I don't give a CRAP that she wants to stay in the nursery. That is not her job. I am nice, and I thank her, and I tell her I thik shes doing a great job.

But I am new and she is not and I think its a matter of her getting over it. And the fact that I don't bend over backwards. We will never be friends, and I don't really care. I do my job and expect no less from her.

Wow, I guess I sound b*tchy but I don't mean to and I don't act that way. I am just sick and tired of the attitude.

[RNKay31]

Wow so sad to hear that, just be patient and take everything slowly, but you are the nurse, and she should do what is expected of her, otherwise I willl take it to higher authority, all the best

[MIA-RN1, RN]

yeah I sounded pretty negative lol. Most of our techs are great but I am working on developing a way to round more on patients and include the techs. I also want to have a celebrating our techs day, to let them know that we do appreciate what they do. Kinda kill em w/ kindness. But some of them are really great and deserve to be celebrated. The others, well, they will maybe respond to positive reinforcement. I have to put it together and run it by management, but I think I can get it going.

[locolorenzo22, BSN, RN]

That's all you can do. Do what you KNOW is expected of you, delegate what she is SUPPOSED to do, and then bring it up when she decides it's not IMPORTANT enough for her to do it. Last time I checked, if she's not in the middle of a task, then you're within your rights to "suggest" she do something for you.

[RNSuzq1, RN]

Hi Cooper, I don't think you sounded negative or "b*tchy. I'm sure - like me, when you were hired, they told you they'd be "X" amount of NA's on the floor to help and you expect them to actually help.

I had my 90 day eval. yesterday, it was very good, but the subject of delegating came up. I would never have brought this up myself, but what a perfect opportunity to talk about the lack of help. The Supv. said I didn't even have to mention the name, she knew who it was and apparently has talked to this person numerous times. She said, I had done exactly what the tech. wanted me to do (quit asking for help). I was told they would once again talk to her. I'm just wondering - how many times do they talk to someone about "not working" before you're given the boot??

Interesting thing happened when I was leaving tonight. The 2 cranky techs. were coming on for the night shift - one of the Nurses told them they had to train a new Tech. The Nurse came back to where we were giving report - all upset, said the 2 Techs. outright refused to train the new person. Everyone told her to tell them to do it, if they refused again, it was insubordination and to call the Mgr. at home or one of the Clinical Admin. One Nurse told me they didn't want to train the tech - because it meant they would actually have to "Work" tonight - unbelievable.

I saw the new Tech. on my way out the door - a big tall strapping guy with muscles (we only have 1 other male tech, he's very nice, but smaller than most of the women). :wink2: They were being ridiculous - this guy was ready and willing to work and could be so much help to them with heavy patients and all those other things where muscles and strength could really come in handy. I've just never seen 2 lazier people in my life - unreal.... I'll now step down off my little soap-box... :sofahider

[MIA-RN1, RN]

thanks susan! I think that someone said something...tonight there were several of us in the nursery and a couple of the nurses were saying that it would be much harder now that tech X would not be in the nursery as much.

I haven't worked with her since but I have been quizzing other techs on their job duties. Very interesting that many have different perceptions lol.

[lauraelena]

Well, okay. Lots of good suggestions. Definately don't get into a confrontation. Saying would you instead of could you....good one. I would, after all else fails, ask that she be written up every time she is uncooperative or lazy. Can you do it? Or someone that agrees with you? I don't think she has a right to that job, especially if not performing. Still be pleasent and professional above all, but its not to be tolerated. Obviously everyone else has been manipulated by her nastiness, they just don't ask her. Thats what she wants.

Me, personally,I would ask her to do MORE than expected, maybe she'll get sick of you and leave the unit. dont be INTIMIDATED!!! Just smile while you win the battle girl.

[EmerNurse, BSN, RN]

I had one (ok more than one) tech like that in my first nursing job. I finally learned to ask on the fly, for instance: "Hi Mary, Would you please grab vitals on rooms 3 and 4 real quick, we need an updated set. Thanks", then smile, do'nt look at her and keep on going to my next task.

In 10 minutes, I'd find her and say "Mary, do you have the vitals for rooms 3 and 4? I'll chart them in the notes. Thanks" and if she said no, I'd say "Ack I really need those now, please go do them real quick and let me know what they are, THANKS!" Zip on to my next task.

The trick was to a) ask nicely and be specific in what I wanted, b) not give her time to complain or eye-roll me, and c) come back and check and ask again if they're not done yet. Now if she didn't do it when asked the second time, I'd say "Sheesh, if I was sitting on my butt reading a magazine, I could understand you being resentful of my asking, but you can very well see that I'm trying to get done x,y z, and I need your help so please go get those vital signs, oh and you better get 5's as well as 3 and 4. Thanks - just bring them to me when you're done - I may have to medicate some of them." Zip off I go again.

If it never gets done, it gets written up and documented. Never had to do that. Generally,after the 2nd request, they huff and eye-roll and go do it. Fine, I don't care if they LIKE doing it, just so they do it. After a while, they figured out that 1) I wasn't asking them to do something I wouldn't do if I had the time and 2) that it was just easier to do it the first time, than to put up with my bugging them til they do it. And every time I asked, it was with a smile and they attitude that they WOULD do it (even when I knew better).

Pain in the butt but it worked for just about all of them after a little while.

[CityKat, BSN, RN]

So then as a new nurse, when you are delegating...what happens if the tech doesn't do what you ask them to do? How would a new grad handle something like that? I HATE asking people to do things when I can't offer them something in return. I think that "celebrate tech day" is a killer idea:)

I think that should be something all places should do. It might cut down on the kind of attitude you're talking about. Maybe?

[EmerNurse, BSN, RN]

What you offer in return is that you don't abuse your techs. If you're sitting, checking your emails, don't ask the tech to do something you can do perfectly well yourself, if only you'd just get UP and move (good reason to take your legit breaks OFF the floor). (YOU meaning not you personally, but a nurse in general).

Most floors have a limited number of techs who get delegated to by several nurses. The good techs fly all day, keep up with their assigned tasks, and manage to find time to help you when you need it (along with the other nurses they're helping).

While vitals may be the tech's "job", if you see they're running like mad, and you can do it, won't hurt to do your own. Remember, every single thing in a tech job description is in yours as well.

What if they simply DO NOT do what you ask them to? Well it's YOUR job to a)make sure it was done, b) DO IT if needed for patient care, and c) report those who consistently do not do their job.

Just remember, it's possible that the tech you've asked to do vitals, has gotten sidetracked helping pick up the 89yo ORIF who just fell on the floor, or helping to clean up the new lake of stool that appeared under the c-diff bed.

Things happen. The problem techs are the ones who are sitting eating their donut while chatting with their friend from downstairs (when NOT on break). Please DO recognize the techs that truly do fly all day - when you have a reputation as a hard working nurse who isn't "above" doing basic nursing duties, your techs will go all out for you when you need them.

Yep there are lazy techs out there who need to be reported and possibly dismissed, but there are also lazy, "too good" nurses out there who treat them like crap. Team playing goes both ways.

:wink2:

[stressgal, RN]

[ I HATE asking people to do things when I can't offer them something in return. I think that "celebrate tech day" is a killer idea:)

I'm a new RN, previous tech. I have NO problem asking someone to do their job. The return for them is a paycheck, plain and simple. A super tech in our unit (ICU) was floated to a medsurg floor the other day. She was talking about how some nurses on that floor didn't assist patient's to the bsc and so on. A seasoned RN stated "You have to understand. While we can do your job, you cannot do ours. The nurses on that floor have a larger patient load and work hard just to keep up." It made the tech stop. think and at least momentarily understand. I am always sure to thank a tech who has worked hard that day, but I have worked hard too and do not expect a thanks from anyone. I've chosen my career, my place of employment and do the job I was hired to do.