Surviving a passive aggressive co-worker?

[TheOracle]

Just scanning through the forums I can see that all of us have at one time or another had to deal with a difficult personality at work. I wanted to put my situation out there and see if I could get some feedback on how I'm currently managing a situation that is really starting to put me at the end of my rope.

I am the only male working in a clinic/urgent care; I am studying to be a FNP and am the only RN (aside from NPs) in a clinic with LPNs and medical assistants. I work in a managerial capacity ensuring that patient care is delivered effectively and safely in a streamlined manner in addition to occasional odds and ends in actual practice. I started as a medical assistant at this clinic while in nursing school and worked my way up to where I am today and am continuing to work towards becoming a provider.

I'm noticing a split with the girls at work - one half is very open and willing to work with me to build our success and the other half wants to bicker and complain and fight me on policies that are set outside of my control. One of the girls in particular is giving me the most grief right now and she frequently stirs the others up.

She's roughly the same age as me (mid-late 20s) and says she started working as a medical assistant when she was around 16, eventually going no further in education than becoming a certified medical assistant. She moved from another state where she had more liberties (such as administering medications) and a more hands-on role in lab work. In our state medical assistants can't administer injections and that's just the way it is. For the most part, her job falls into reception type duties and phlebotomy.

She initially expressed dissatisfaction with this, so I took measures to involve her more in the lab as well as clarifying that she could draw up meds provided there was documentation she had been trained to do so, it was not a controlled substance, and that another nurse checked behind her. After that she still persisted in complaining about how she was not challenged in her job and how stupid it was that she couldn't do what she knew she could do; further she complained the LPNs were keeping her out of the loop on doing lab type stuff. I had a talk with my LPNs to reiterate that if they needed a hand to let the medical assistant know.

I was only half surprised to find that they tried to involve her, but she always made them feel like they were imposing on her and that she would make a fuss about how she couldn't leave reception and that it was on them if she got in trouble. So they just stopped going to her. As I looked further into it some of the others were lodging complaints that this girl had confronted them on numerous occasions accusing them of talking about her because they were either ending conversations when she walked past or were attempting to keep from grand standing with patient details that didn't directly concern her.

This girl comes in to work and is distantly cordial and she is sharp at what she can do lab wise, but there's something missing in her attitude. Ask her to help with something, she sighs heavily, will roll her eyes (and think I can't see her out of the corner of my eye) and just gives off the overall energy of a bad apple.

She complains about everything. This past week I listened to her complain about having to work the day before and the day after Thanksgiving and when I offered to see if someone would switch with her she refused and continued to complain. She complained to me, her other co-workers and one of the providers about how sorry it is that our boss insists on being up, but isn't working herself. She complains because her pay is low and that if the boss didn't go buy a new dress or eat out maybe the pay would be better. etc etc etc

She complains that no one helps her, but she never indicates she requires assistance. I finally had her convinced if she was unhappy with how her professional life was going she would have to do something to change it and so she enrolled in college (part time) again with the hope of becoming a RN because as she said "if they let you in, they would be crazy to not take me." Now she complains about how hard it is to work and go to school and it's stupid that she has to do it because she knows what she's doing, etc. etc. Never mind that I did her job while going to school full time and am still going to school full time as well as working full time.

What started out as passive aggressive behavior and backhanded compliments when dealing with me is now progressing to more and more hostile behavior and speech. She ignores me if I ask her something or she'll just turn around and walk off if I'm in the middle of talking to her. She goes around me completely on tasks and problems that I specifically handle in the clinic, so I'm always out of the loop.

I've tried focusing on her positives and made it a priority to catch her doing things right and letting her know what a good job she's doing and she smarts back about how I'm just trying to brown nose. So I can't win with this girl and it's about to make me physically ill.

The rock and the hard place I'm stuck between is that the boss likes her and thinks she's smart and sharp; from a professional clinical stand point I agree that she has valuable skills, but I'm worried that her personality is gonna be a problem not just for me, but the patients as well. She wants to be taking vital signs and brief HPIs and I'm not okay with that because she's too abrasive and non-therapeutic in the dealings she already has with our patients.

With this girl on the clock, our no shows are at an all time low because she gets in there and gets the patients in by calling and following up with appointments.

If the decision were completely in my hands, I'd have fired her weeks ago. But at this point my hands are tied and I have to find a way to manage the situation better - any advice? I'm south of fed up with walking on egg shells around her by a few thousand miles.

[Double-Helix, BSN, RN]

You sound like a really good manager!

Some people just want to complain and will always find something to complain about, not matter what the situation. I think it might help to sit down with this person and say something like, "You know, you're a really great worker. When you're here all your work gets done and you make sure out patients make it in for their appointments. You're really an asset to this facility. However I've noticed that you seem to be discouraged a lot lately. I hear you complain quite frequently and witnessed some disrespectful behavior toward your co-workers. I'm concerned that this attitude is damaging the office morale. I wanted to dicuss this with you because it seems to be getting out of hand and I don't want to have to let you go. What do you think we can do to improve this situation?"

As you talk with her, make it clear that there is no place for her bad attitude at work if she wants to keep her job.

Also, you need to stop walking on egg shells. Treat her as you would any other employee. Don't do anything different for her because when she sees that she can get you to work for her (ie, offering to find someone to switch her shift when she is capable of finding someone on her own) it's just enabling her bahavior.

Good luck with this!!

[DixieRedHead, ASN, RN]

The above is fine, but given that you boss likes her it might not work. If you want to get rid of her, here is how.

When there is an issue with a patient, document, document, document.

The practice might put up with a lot of issues with the staff but if it comes down to patients that's another story. Also get a small calendar. Put a star on the days she works, and write the number of no shows on that calendar. Let it speak for it's self. Hitting the practice in the wallet will do the trick.

[Guest717236]

The rock and the hard place I'm stuck between is that the boss likes her and thinks she's smart and sharp; from a professional clinical stand point I agree that she has valuable skills, but I'm worried that her personality is gonna be a problem not just for me, but the patients as well. She wants to be taking vital signs and brief HPIs and I'm not okay with that because she's too abrasive and non-therapeutic in the dealings she already has with our patients.

With this girl on the clock, our no shows are at an all time low because she gets in there and gets the patients in by calling and following up with appointments.

If the decision were completely in my hands, I'd have fired her weeks ago. But at this point my hands are tied and I have to find a way to manage the situation better - any advice? I'm south of fed up with walking on egg shells around her by a few thousand miles.

This is the point where I get confused, you have done everything you can in an impossible situation.The confusing part is your managers attitude.

The employee may be smart and sharp per your manager,

yet she is not a team player, walks away from you etc.

Would it be better in this economy to find a smart and sharp individual who works well with staff and patients and helps create an environment focused on caring for patients and not staff ego.

It appears she is splitting, she knows she has the manager on her side, and that is why she can dance with attitude, because she knows there is no consequence.

I work in a managerial capacity ensuring that patient care is delivered effectively and safely in a streamlined manner in addition to occasional odds and ends in actual practice.

In your statement above, seems you need to pin down the scope of your managerial capacity.

In my opinion, if the ensuring that patient care is delivered effectively and safely in a streamlined manner is your role, you should have the power to select who is on the team, and replace this employee who is so out of line.

She is disrupting the team environment, and I am sure that has an effect

on other team members, let alone patient care.

I saw this issue in a office practice years ago.Very overwhelming, impossible MA with big attitude.I was the RN, and the office manager would do nothing.

The individual was a constant source of conflict, and patients would complain to me about her clinical(not front desk) presentation. I was baffled, until

I discovered why they kept her......................The office manager (MDs wife) did not want to confront patients about their balance owed on the bill.

Not so with the MA, she confronted, embarrassed,harassed patients , and these patients were good people with small balances. She was really aggressive with the others...and that is why they kept her.

So, look for a hidden reason, what is their real advantage to keeping her?

It also sounds like she is very jealous of you, so enjoys making your life a misery.

[Been there,done that, ASN, RN]

I can't get past your referring to them as the "girls".

Also, unless you laying in a bed, being tended to.. they are not "your LPN 's".

This lack of professionalism may have something to do with her attitude.

[SuperStarRN]

I can't get past your referring to them as the "girls".

Also, unless you laying in a bed, being tended to.. they are not "your LPN 's".

This lack of professionalism may have something to do with her attitude.

It never amazes me on this site how there is always one person who can't see the bigger picture of what the OP is saying and would rather just pick apart the way he phrases things sentence by sentence. He's a boy so they are "girls". He's an RN and they are "LPNs". He is not discussing this with patients in the office he is talking to his peers. His post does not reflect a lack of professionalism. Get a hobby.

[hiddencatRN, BSN, RN]

It never amazes me on this site how there is always one person who can't see the bigger picture of what the OP is saying and would rather just pick apart the way he phrases things sentence by sentence. He's a boy so they are "girls". He's an RN and they are "LPNs". He is not discussing this with patients in the office he is talking to his peers. His post does not reflect a lack of professionalism. Get a hobby.

No, as a manager he should make a point not to refer to the adults he works with as "girls". That's not a little nitpicky thing, that's basic respect in a professional environment. I'm not convinced it's the root of the problem with the MA, but I cringed every time he wrote it.

[noahsmama]

I can't get past your referring to them as the "girls".

Also, unless you laying in a bed, being tended to.. they are not "your LPN 's".

This lack of professionalism may have something to do with her attitude.

Amen to that!

[Double-Helix, BSN, RN]

The above is fine, but given that you boss likes her it might not work. If you want to get rid of her, here is how.

When there is an issue with a patient, document, document, document.

The practice might put up with a lot of issues with the staff but if it comes down to patients that's another story. Also get a small calendar. Put a star on the days she works, and write the number of no shows on that calendar. Let it speak for it's self. Hitting the practice in the wallet will do the trick.

I believe the OP was saying that this MA is HELPING the practice by calling patients and getting the to come for their appointments. Note the phrase: "With this girl on the clock, our no shows are at an all time low because she gets in there and gets the patients in by calling and following up with appointments." So bringing this to the attention of the boss would actually benefit the MA.

[Altra, BSN, RN]

No, as a manager he should make a point not to refer to the adults he works with as "girls". That's not a little nitpicky thing, that's basic respect in a professional environment. I'm not convinced it's the root of the problem with the MA, but I cringed every time he wrote it.

Agree. However, in the OPs defense, in some predominantly female workplaces, "the girls" set themselves apart in that manner. Obviously I can't know if that is the case in this situation as I'm not there.

[TheCommuter, BSN, RN]

After that she still persisted in complaining about how she was not challenged in her job and how stupid it was that she couldn't do what she knew she could do; further she complained the LPNs were keeping her out of the loop on doing lab type stuff.

Perhaps she should attain more education and attend nursing school if she wants a challenge and the legal ability to perform more skills. She should stop complaining and do something proactive about her situation.

Ask her to help with something, she sighs heavily, will roll her eyes (and think I can't see her out of the corner of my eye) and just gives off the overall energy of a bad apple.

Confront her on her bad behavior. "Did you just roll your eyes?" "Do you not want to work today?" "Do you have a problem you'd like to discuss?"

She complains because her pay is low and that if the boss didn't go buy a new dress or eat out maybe the pay would be better.

I'll reiterate that perhaps she should attain more education and become a nurse if she wants to earn more money. In this society, people must pay to play. She ought to stop complaining and make a change in her situation.

. . .she enrolled in college (part time) again with the hope of becoming a RN because as she said "if they let you in, they would be crazy to not take me." Now she complains about how hard it is to work and go to school and it's stupid that she has to do it because she knows what she's doing, etc. etc. Never mind that I did her job while going to school full time and am still going to school full time as well as working full time.

People do not know what they do not know.

She ignores me if I ask her something or she'll just turn around and walk off if I'm in the middle of talking to her. She goes around me completely on tasks and problems that I specifically handle in the clinic, so I'm always out of the loop.

Again, confront the behavior. "Please tell me the reason why you are walking away from me." "Is there a reason for not making me aware of the task/problem that occurred earlier today?"

I've tried focusing on her positives and made it a priority to catch her doing things right and letting her know what a good job she's doing and she smarts back about how I'm just trying to brown nose. So I can't win with this girl and it's about to make me physically ill.

It might be time to focus on her negative attributes and write her up for everything that she does wrong. Write her up every time she fails to follow a policy or procedure.

If the decision were completely in my hands, I'd have fired her weeks ago. But at this point my hands are tied and I have to find a way to manage the situation better - any advice? I'm south of fed up with walking on egg shells around her by a few thousand miles.

I'd get the paper trail started with written verbal warnings and write-ups. Medical assisting is a saturated career pathway, and there's absolutely a glut of unemployed MAs who would love to have her job and would fulfill the duties without complaining. In addition, she needs to realize that she would have nothing to do without the paying patients.

[Altra, BSN, RN]

OP, I find the MA's behavior you describe as being disruptive and unprofessional. But if you have objectively discussed this with your boss and gotten rebuffed, then I'm not sure what else you can do. Take your cue from her and be "distantly cordial", and try to carry on with the business at hand. I would, however, keep a very close eye on potential conflicts between your workplace and her other educational commitments -- if she is allowed to bend attendance policies, for example, this will greatly increase the tension among staff.