PCTs who just don't care....

[Kharma711]

As a new nurse I still remember what I was taught about delegation. I know new nurses are not the best delegations but I try to only delegate when there is a need. I appreciate good PCTs that don't hesitate to say sure or even yes as soon as I'm done doing xyz...

I try never to take my PCTs for granted. I have no issue with most and always try to help with total care patients. Yet at my place of employment there is this one PCT....

I literally worked myself ragged this shift. 24 bed step-down unit and only 5 nurses including the charge nurse. We all worked ourselves to death.

Yet... every time I passed the nurses station... there she was doing homework or checking email or dozing at a blank screen...

Except when I asked for something... then she would find any excuse to not have to put patient A on the bed pan or help clean up patient B. I always do everything I can to help PCTs out. If a patient asks for a bedlam while I am in the room, I get them one. I'll clean up if it spillls. I do whatever needs done that's in my power.

As short as we were, taking 5 step down... or in my case 1 borderline ICU and another transfer from ICU that should still be ICU but decided to be DNR/DNR and therefore don't qualify... plus 3 other step down patients. .. one taking go lytely at that... well it's a handful.

Our PCTs do almost zero documentation. Which doesn't help matters...

Regardless... I asked PCT to get a pt off the bed pan and meet me in another room to do a total care clean up on another patient...

Needless to say, I ended up cleaning up the patient on the bedpan and half dragging said PCT to help me with the total care... I had spent half my time to chart, doing PCT delegatable duties....

Yet it was such an inconvenience to ask any help from this person... one would think I had twiddled my thumbs and asked her to do a everything...

She even raised her voice to me in the nurses station as I got fed up and TOLD her to clean up pt #1 on go lately and meet me to clean up said total care patient....

Sorry to vent so detailed and frustrated but idk how else to get across to this person. Hoping for advice from others who have shared this situation and maybe for a bit of validation...

I had wanted to raise my voice in turn and tell her she was no "patient care" technician. She didn't even care about the patients... I imagine my family going through some of these troubles and pray they never get an uncaring PCT like this...

The kind who says "patient x always on the bedpan" or " patient Y always has the bed this wet at change of shift" even though she hasn't been changed since last shift change...

Any thoughts or advice from more seasoned nurses?? I've been licensed just under a year and work at a public teaching hospital.

[HouTx, BSN, MSN, EdD]

Since it doesn't appear that you have the authority to do a formal counseling for this person's putrid job performance... you need to escalate to your supervisor or manager. Make an appointment with him/her, armed with specific evidence (dates and times) of the instances in question. Hopefully, this will result in a formal counseling &/or initiation of progressive discipline. Yeah, the PCT will be badmouthing you to kingdom come afterward... but it sounds as though that's no loss.

Not taking action is pretty much the same thing as acceptance. The actions you have described are having a negative effect on patient care & this just shouldn't be tolerated.

[roser13, ASN, RN]

Do as above. Document, document, document. The dozing, the game playing, the sitting while no one else can. Especially since you know that she is not documenting anything work-related.

And (from personal experience) don't bend over very far to take on the PCT's duties or you will end up with them forever. Being the "nice" nurse just sets you up to be the patsy. I'm glad this one character seems to be the exception. I've worked on floors where they're all like that.

[Sunflowerinsc, ADN, RN]

I don't know if the PCT doesn't care ,but I know she/he isn't doing her job. So why is she still there? Where is the charge nurse ?

[MMC.RN]

I can understand your frustration with PCTs who don't pull their weight. I don't work in a traditional hospital setting and work in forensic psych. It's actually dangerous if the PCTs are not doing their job as I work maximum security admissions and our patients are very ill and unstable as they are often under medicated or not medicated.

For the most part our staff is great, but we have a few who don't seem to care. One that I am thinking of in particular likes to take breaks and is often never around when he is needed. He will sometimes leave the unit without telling anyone. He will pawn off his duties on others and even the other nurses will have to pick up his slack as we are often staffed at the bare minimum. One day I left over an hour late because I was picking up his slack and had to finish my charting at the end of my shift. He is Muslim and his excuse is that he needs time to pray or do religious things etc... There was one day that he went on a, "break," for 15 min and was gone for almost 30. In that time frame, our admission arrived on the unit and we had two patients fight necessitating a code for help from other units to restrain and seclude them. The code is called over the PA so everybody can hear it and he never showed up. He knew it was his own unit and that one of duties that day was to assist with any 1:1 coverage and to respond to codes. After a patient is secluded which is typically what happens after codes our protocol dictates that we have 1:1 coverage for an hour outside the door. I finally got so upset that I went to find him and when I did his excuse was that he was in the middle of prayer and that he couldn't be interrupted. This is just the tip of the iceberg in regards to what he does. I attempted to talk to him directly and handle it between us. I talked about the necessity of having staff on hand and safety. This PCT just told me I was being racist and went to the unit manager to complain about me. It was then that she got involved. People complained for months and she ignored it. Nobody especially HR wants to get involved because he always seems to scream discrimination. In this case, however, I explained the situation and she sided with me.

Now, he still tries to pull the same BS, but I told him that he has to tell me when he is going to take a break and he's followed that. I've had to be pretty strict with him and lay out guidelines and basically check in on him periodically, which isn't ideal, but it's all I can do to make sure he does his job. He doesn't take any additional breaks anymore and while he complains about me he does what he is supposed to do for the most part. Most people I can trust that they are going to do what they need to do, but I have to make sure that he is where he is supposed to be. Unfortunately maybe you need to set down rules for this PCT. I've realized that a lot of unlicensed personnel don't realize that they work under our license and that it's on us if something happens. Sometimes just telling them that will help them understand that we are not trying to be bossy or rude or arrogant, but are just trying to protect ourselves and our license. Sometimes you just have to be mean and lay down limits. It sounds like you may have to do so in your situation. You aren't going to change her or make her care, but you need to make sure she does her job.