Please help me! Serious issues with my unit!

[nursemelyn]

I really, really, really need some advice guys. I'm very, very frustrated with the people I work with. The actual patient load is great, and I love this kind of nursing. But the people...ugh. Let me tell you. The unit manager (UM) is supposed to be in charge, and the unit coordinator (UC) does the schedule and other stuff that I don't know about. The UC was hired a couple years ago, and has basically taken over the UM's job. The UM constantly defers to the UC's ideas. That's the first problem. The UM doesn't do her job.

The UC has some major, deep-set issues. She seems like she has a chip on her shoulder. She is friends or family with about 6 or 7 of the staff, and constantly gives them preferential treatment over everyone else. She lets them work whenever the heck they want, lets them come into work or leave work whenever the heck they want, lies to administration to cover for them (this has been witnessed by several employees), and is a brat to everyone that she's not friends with. She has a major chip on her shoulder about her position and her dominance over the UM. Almost all the staff members have made complaints about this woman and her behavior to the UM, but obviously since the UM does whatever the UC wants, the complaints go nowhere. They have also complained to the Chief Nursing Officer (CNO), and there have been some investigations, but this woman and the UM have been given chance after chance to shape up and no real action has been taken.

The UC is supposed to make out the unit schedule, and as truly horrifying as it sounds, the schedule is only ever made out a week in advance. And even then, there are holes in the schedule so that some of the units don't even have enough coverage. The UC has been offered help with this aspect of her job. One RN even made out the schedule for this week and had all holes filled, and the UC went back and changed it, making tons of empty spaces. She doesn't utilize her part-time staff to help fill in the holes, and lets her best friends work whenever they want, so there are obvious issues there. She doesn't allow people who aren't part of the clique to work any overtime, but lets her friends work 56 hours a week. Not only is this not fair to staff members, but it's unsafe for patient care as well. If the unit is not appropriately staffed, and there are multiple psychotic patients, one of the patients or staff members could get hurt, leading to multiple legal issues against the nurses and the hospital. For example: Every other week I work on the unit with only 8 beds. The other nurse who usually works with me is the UC's sister, so she comes in almost every day TWO hours late!!! This makes the nurse from the previous shift have to stay so that the unit is staffed appropriately. But, if the nurse decides to leave (not right) then it's just me waiting two hours. If a patient decided to freak out and kill or seriously injure me, no help would be available for two hours. This is SERIOUS. We're dealing with people's lives!

There are a couple things I could do.

1. Quit, find another job.

2. Don't say anything, wait for it to get better.

3. Voice my concerns with the CNO and maybe even the CEO to get some action, and consequently get in trouble with the UM and UC.

4. Find another job part-time and stay here full-time. Transition to full time at the other job if this one doesn't improve.

I really don't know what to do. Please, please help me.

[brandy1017, ASN, RN]

Don't know what to tell you? Sounds a lot like where I work. If your a pet you get the vacations, holidays and days off you want. If not good luck! You know it when she's mad at you if you get put on alot of Fridays in a row!

[Crux1024]

Specifically referring to the last situation, how are you being left alone with all the patients? Stop taking report and thereby making your assignment heavy and unsafe until things can possibly be sorted out. The nurse leaving you with the patients is abandoning them. If you care for your license and livelihood, youll stop accepting report.

There has to be someone else who can do something. If you want to stay there you will have to make moves. It will not get better otherwise. Who is above the CNO? Who owns the place? Is there a human resources? Are the lot of you (the unfavored misfits..lol ) willing to get together and set things right?

[nursemelyn]

Specifically referring to the last situation, how are you being left alone with all the patients? Stop taking report and thereby making your assignment heavy and unsafe until things can possibly be sorted out. The nurse leaving you with the patients is abandoning them. If you care for your license and livelihood, youll stop accepting report.

There has to be someone else who can do something. If you want to stay there you will have to make moves. It will not get better otherwise. Who is above the CNO? Who owns the place? Is there a human resources? Are the lot of you (the unfavored misfits..lol ) willing to get together and set things right?

We do taped report and the nurses leave while we're listening, so I don't know they've left until I come out of the room with the recorder. I've spoken with almost all of my coworkers, and they all agree that something needs to be done, but they don't want to do much for fear of getting in trouble. The CEO is above the CNO. There is a HR, but I'm getting advice before I take any action. Thanks for your opinion! :redbeathe

[Davey Do]

Whenever a situation affects the quality of care a Patient receives or affects me directly, I document the situation objectively. If I believe my Supervisor or the Director needs to know about the situation, I'll generate a letter.

This method has served me well. An objective documentation and reporting is not a malicious move. Objective documentation merely states facts that cannot be disputed. Once I report a situation, I have to let it go. I've done my duty. Then, the responsibility for rectifying the situation belongs to someone else.

Now, this method is not a quick fix solution by any means. However, objective documentation keeps a running report. It is also a fail-safe device should any occurence you've been involved in comes back to haunt you. You've got documentation to support your actions.

Please allow me to cite an example which you may be able to relate to, nursemelyn: A Co-Worker was a drinking buddy of a particular Supervisor. One night, I instructed this Co-Worker to perform a task. They refused. I said, "You know, this type of behavior could be interpretted as insubordination." The Co-Worker replied, "I don't care." I then said, "I'll have to report this behavior to my Superiors." The Co-Worker said, "I don't care."

So, I performed the task and later generated a letter objectively describing the occurence and sent it to the Supervisor of the Unit. The Supervisor telephoned me during my daytime sleeping hours and left a message on my machine requesting a discussion of the occurence. I sent another letter to the Supervisor requesting that this work matter be discussed during my scheduled working hours. The Supervisor again left a message on my answering machine that we would talk at such and such a time. It never happened. I believe it was due to the Supervisor's feelings toward their friend. So, I let it go.

Months later, this same Co-Worker was terminated due to inappropriate behavior with a Patient during a crisis. The crisis situation was videoed by a monitor. The Patient complained about the Co-Worker's behavior, the recording was reviewed by those higher up than the Supervisor, and the Co-Worker was terminated.

I believe, that had the Supervisor addressed the insubordination issue, the Co-Worker would have had boundaries established and would not have allowed themself unbridaled behavior. In a sense, the Co-worker was given enough rope to hang themself.

Now, my objective documentation may have done nothing to assist in this Person's Professional demise. However, my documentation has repeatedly been a portends for future dismissals. And I always have my backside covered, just in case.

Besides, I truly believe in something Edgar Caycee said: "You can't get any one into any more trouble than they can get themselves into."

I hope you can take something from my wordy comment, nursemelyn. The very best to you.

Dave

[kakamegamama]

OP--definitely document. It doesn't sound that the UC or NM will do anything about the situations, so you do need objective, factual information. Documentation will do that. Then, decide what's best for the patients and yourself (sounds like your fellow staff members are working out of fear, and fear sometimes prevent righting of wrongs, sadly). So, you may just have to take a stance alone. Hang in there & best to you.

[traumaRUs, MSN, APRN]

Moved to Colleague/Pt Relations forum.

[nursemelyn]

Thanks for your advice. I just got this job a couple months ago and really don't want to go through the whole job search again. Hopefully it will get better!

[IdrilRN, BSN, RN]

Don't go into report until the staffing situation is sorted out. Most places won't let you work at a place if a family memeber is your direct supervisor/subordinate, but if I worked for my sister and or friends I think I would do a good job. And your situation stinks.

[xtxrn, ASN, RN]

Don't start report until there is a full staff to hear it. If they squawk, ask for (or do it yourself) the nursing supervisor to be called. If there aren't enough nurses to take report, don't hear it alone. You CAN refuse an unsafe assignment BEFORE hearing report... when it's over, they're yours.

If it gets to be a total stalemate, cut your losses and get out of there.

Geez... nursing has become more of a nightmare because of nurses- not the patients- IMHO

There are better places out there....