RN Graduate Establishes Dominance

[nicmdavi]

Hello fellow Nurses!

I am in need of some advice and alternate opinions. I am experiencing difficulty making a decision on what to do. The situation is as follows:

I am an LPN working for a General Surgeon and Nurse Practitioner. I am the only clinical employee in the office; so, needless to say, the work load is WAY too much. They recently hired a medical assistant for me to help. I was so excited to have a partner/coworker; and, even more excited to have a Graduate Nurse from an RN associates program. She graduated six years ago; however, she is not licensed. She failed the NCLEX five times and decided she was done trying. This was the reason she gave in the interview for not becoming licensed, "Family is more important to me and I didn't want to work RN hours." At first, I was perplexed but thought that maybe life handed her some higher priorities. Now I know she lied about it. I wouldn't have thought any different of her had she told me the truth. I guess I am rambling so I will get straight to the point. She has made multiple comments to me, the providers and the my other coworkers about her superiority compared to my LPN status. She has tried to tell me how to do my job ( mind you it is only her second week working ). She will cut me off mid-sentence when trying to teach her how to do something in order to let me know she is already aware of how to do it; however, she does it incorrectly. There are so many other things this person has done that disappoint me greatly. I would never ever disrespect a fellow RN or LPN and I have never been treated as a lesser equal by those RN's I have worked for. It is quite the contrary: They have asked me for help/advice in areas I was more knowledgeable in and vice-versa. Friends are telling me I need to assert my authority right away but I am a very passive person. Plus, I really wanted my assistant and I to have a great working relationship. Like police partners...sharing the load and having each others backs. I guess I am hesitant to assert my authority because I do respect her for graduating from RN school (even though she is not an RN, Not even a certified medical assistant) I know it is drilled into LPN's during school to always report to their RN;so, maybe that is why I am lacking in putting my foot down. Maybe in my mind she has some authority over me??? I am a bit surprised in the lack of her basic nursing knowledge for a graduate nurse, for example: not knowing what warfarin was, or knowing that Mycin antibiotics are not Penicillins. ( Maybe those are just some things she forgot right? I mean....I don't remember everything ) I feel so indecisive and confused. I guess what I really want to know is this:

Would I be in the wrong for treating her like a medical assistant and not a graduate nurse?

I gave her my trust and the privileges of a graduate nurse but now I am thinking the better of it. She doesn't respect me at all and has made that quite clear. I am so bummed out. Any suggestions, reassurance, advice or opinions would be MUCH APPRECIATED!

-Nic

[AutumnApple]

But this is work... Peoples lives are in this persons hand...... It's not therapy. Do your job, or leave.

All the more reason to keep your own professionalism intact. The office is already lacking in it due to the problematic employee.

You do realize don't you, that: 1. The OP is in charge of the problematic employee but is not the boss. She is not the one who fires people. Going to someone and saying "Do it or leave" isn't an option for her. 2. "Do your job, or leave" never works even if you have the authority to go there. It sounds great in a rant on a nursing forum, not so effective real life.

End result of that approach is, you get just the opposite. They dig in their heels. The behavior escalates AND they aren't going anywhere until it's on their terms.

As you said, "This is work". It's not a hair pulling fight in the playground at high school. Dropping your own professionalism on the floor with "Do it or else" comments won't help. As a professional, I'd want this girl to either change, or be rid of her as fast as possible. You're not going to get there if the powers that be, the ones who can get rid of her, think you escalated the problem.

[neenrn]

All the more reason to keep your own professionalism intact. The office is already lacking in it due to the problematic employee.

You do realize don't you, that: 1. The OP is in charge of the problematic employee but is not the boss. She is not the one who fires people. Going to someone and saying "Do it or leave" isn't an option for her. 2. "Do your job, or leave" never works even if you have the authority to go there. It sounds great in a rant on a nursing forum, not so effective real life.

End result of that approach is, you get just the opposite. They dig in their heels. The behavior escalates AND they aren't going anywhere until it's on their terms.

As you said, "This is work". It's not a hair pulling fight in the playground at high school. Dropping your own professionalism on the floor with "Do it or else" comments won't help. As a professional, I'd want this girl to either change, or be rid of her as fast as possible. You're not going to get there if the powers that be, the ones who can get rid of her, think you escalated the problem.

The problem I had to deal with when I took over as the charge RN in a fly in rural clinic.... MA- gave a steroid injection the NP was supposed to give in a shoulder joint into a deltoid, gave sets of Vaccination shots to the sibling of the infant who was actually there for the injections, small gage IVs being used to re-hydrate adult clients, IV tubing dragging on the floor, client wondering why the fluid wasn't going in.... Her chair leg was on the tubing.... Oh yes then there was the child who developed cellulitis from and antibiotic injection.... I asked the MA how she'd drawn up the med.... She very carefully with unwashed heads opened the bottle of im Abx after she mixed it with a for irrigation only saline......took the syringe apart and poured it into the syringe tube plugging the hole at the bottom with her dirty finger..... She said she was too busy to try and use a needle to draw the thick fluid up..... She felt she was correct in how she was doing things and that nurses just make a big beal out of nothing.....I took over this mess.... I could not believe the clinic was being run like this. I guess the nurse before me just let this crap go. Nothing was ever written up about the errors......After many educational sessions, staff meeting and individual counselling ( like 6 months of it) I finally had to say my way or the highway. I would not allow one more 'never' event to occur again. The attitude of management was " this is XYZ town we don't get excited about this stuff".... I asked them if the people of this community deserved a lower standard of care because they weren't in the lower 48..... They just looked at me. And yes we are talking about an isolated native community with management and staff being mostly white! When I finally left the clinic, it was running incredibly smoothly and we had next to none of these crazy, insane things happening. Infection rates declined, patient satisfaction scores went up..... I prefer to work in a collegial environment where we all work as equals, but in this case it was out of control. And no I don't apologize for blowing a gasket.

[NuGuyNurse2b]

^ Bingo. that coyote analogy, while good on paper, is just like most nursing literature that assumes a perfect environment and things get done. It's just too idealistic. the offending party simply needs to leave if she won't change. lives are at stake here, and unfortunately it seems management condones the behavior. but that doesn't mean some idealistic positive reinforcement is going to make a change - it won't. people who are miserable will continue being miserable because that brings them joy in an otherwise miserable life experience.

[AutumnApple]

The problem I had to deal with when I took over as the charge RN in a fly in rural clinic.... MA- gave a steroid injection the NP was supposed to give in a shoulder joint into a deltoid, gave sets of Vaccination shots to the sibling of the infant who was actually there for the injections, small gage IVs being used to re-hydrate adult clients, IV tubing dragging on the floor, client wondering why the fluid wasn't going in.... Her chair leg was on the tubing.... Oh yes then there was the child who developed cellulitis from and antibiotic injection.... I asked the MA how she'd drawn up the med.... She very carefully with unwashed heads opened the bottle of im Abx after she mixed it with a for irrigation only saline......took the syringe apart and poured it into the syringe tube plugging the hole at the bottom with her dirty finger..... She said she was too busy to try and use a needle to draw the thick fluid up..... She felt she was correct in how she was doing things and that nurses just make a big beal out of nothing.....I took over this mess.... I could not believe the clinic was being run like this. I guess the nurse before me just let this crap go. Nothing was ever written up about the errors......After many educational sessions, staff meeting and individual counselling ( like 6 months of it) I finally had to say my way or the highway. I would not allow one more 'never' event to occur again. The attitude of management was " this is XYZ town we don't get excited about this stuff".... I asked them if the people of this community deserved a lower standard of care because they weren't in the lower 48..... They just looked at me. And yes we are talking about an isolated native community with management and staff being mostly white! When I finally left the clinic, it was running incredibly smoothly and we had next to none of these crazy, insane things happening. Infection rates declined, patient satisfaction scores went up..... I prefer to work in a collegial environment where we all work as equals, but in this case it was out of control. And no I don't apologize for blowing a gasket.

You agree with me more than you think.

You didn't come out with "My way or the highway" until you had performed 6 months worth of educational sessions, staff meetings and even individual counsoling. That was the part I am talking about, the part where you put them in a position to succeed.

And after having done that you then were in a position to bring out the chopping block. After all that work, it would have been hard for anyone above you to claim you didn't practice leadership and create an environment that encouraged better performance.

In the absence of that six months of leadership, I have my doubts that you could have brought out the chopping block. Instead of the higher ups supporting your "My way or the highway" statement, my guess is: You would have been the one getting corrected.

[Shellaaay10x]

OP's post reported an unlicensed person, not following her direction. Whereas, you may have had a different experience in the office, it is comparing apples to oranges. As you don't want nurses to feel they are "better" , define better. The supervisory ROLE includes responsibility for the actions of unlicensed personnel... such as CNA's, MA's .

I just meant that everyone should be treated equally. Just like the OP stated "I was never treated as a lesser equal" compared to the RNs she has worked for. I was just stating my personal previous experience as a uap which unfortunately there were some nurses that acted superior to us while there were others that treated us kindly and with respect. Like I said, she is in the supervisory role and since she is licensed she has taken over some responsibility- esp over somebody else that is unlicensed. So it's a shame that their working relationship together is not so ideal. Everyone should work as a TEAM.