RN partner nurse problems

[Maremma]

I am a rehab nurse. In our facility we are suppose to have 2 nurses on my unit for both first and second shift due to the high acuity of these patients. Unfortunately more frequently I do not have a partner.

I have been on my unit several years and have have seen many partners come and go. Even with 2 on it is still extremely difficult. It seems most simply cannot handle it very long and give up and leave or transfer ect.

As anyone can imagine the longer I go without a partner the more exhausted I become. I used to be happy to hear "You have a new partner starting Monday" They will orient with you x amount of weeks first" I am to the point I now think "Oh great. Another couple of weeks of getting slaughtered every day AND having to try train someone new:("

They always wait until we are so short staffed that there is no hope of a second nurse coming to help me at least until I get the new person trained.They "try" to get me an RN for a partner. (I am an LPN) They have this delusion that RN's are going to actually STAY working the same position as us LPN's indefinitely. This alone discourages me to no end. They say RN I feel hopeless. I'm going to kill myself training this person and they are going to bail on me within 3-6 months anyway. They can go anywhere else make a lot more money for a lot less work and stress. Why WOULDN'T they bail on me?

Anyway I always give every new person 110% to try to help them learn and "carry" them until they are able to stand on their own. Even knowing what I know.

I have a new RN partner now again and I am beyond my ability to make this one work. I can work with a LOT of different personalities. I can teach a lot of different type of people too. This one though is maxing out my "training skills"! Part of what I do with new people is "shield them" from the sharks in our facility and work with them to help them blend in smoothy to work as a team on the entire unit not just my hall. Well I am almost sure this one IS a shark! Hmm.

She is systematically making one enemy after the other! Unfortunately she has the attitude that she can do no wrong. She knows everything and gets very ugly to anyone that even tries to help her or explain anything to her or explain what she did wrong and how to fix it.She attacks other people verbally. Other staff and even family members that question what she is doing or has done.

All the other staff come and tell me what she has said or done to them and tell me they are sorry but they are not going to work with her "on purpose" So pretty much don't ask them to work any days for me if I would need off. It isn't because of me they will say no, it is so they don't have to work with her. There are NO nurse's left now that will work for me if I need to trade a day or something! She has only been here a few weeks and this is where it stands already:(

I also more unfortunately have caught her lying about other nurse's to blame them when she does something wrong. Worst of all she is not a very good "floor nurse" either. She is making very serious errors in judgment and not following protocol then looking for someone else to blame when the disaster strikes that is sure to happen.

For example giving someone with a chem stick of 151 insulin at 3:30 pm when they don't get supper trays until 6-6:30 pm. IN SPITE of being directly told when the trays come, reminded that we check chem sticks and only give insulin 15 minutes before food. I even warned her WHO we do not give insulin until we make sure they will ACTUALLY eat food before giving it due to them having dementia and or behaviors.

I have a boatload of patience for new people and especially brand new nurse's out of school. I have no patience for someone that refuses to put patient safety above their arrogance and pride. She has been a nurse for many years but she was a dialysis nurse. She never worked in a fast paced environment much less the type I am in. I am overwhelmed already without my "partner" creating one disaster after the other for me to have to "clean up".

I am at my wits end how to turn this one around and get her on track. It is as if she is not able to learn from her mistakes and has no regard for who she hurts with her arrogance.

She is 60 so I have to wonder if there even is a way to get her change at this stage in her life or am I wasting my precious little energy on a lost cause?

Upper management is of the mind set "A warm body is in that slot.We are already down way to many staff and can't get them in here as it is. It has an RN attached to it making us look good on paper. Do what you as the LPN has to do to make it work" "stop trying to eat your young".

[icuRNmaggie, BSN, RN]

Wow. You have described someone that I worked with several years ago. The anger, rudeness bad judgement and totally unsafe practice were what I was witnessing on a daily basis. Finally I refused to work with her and in retrospect, I am glad that I did. She was terminated for an indisputable near miss event which she tried to blame on someone else. As it turned out, she has some form of early cognitive decline.

[Maremma]

Wow that is sad. I wonder if this lady has something like that going on. I actually feel bad for her. I can't begin to imagine what it is like to be the way she is making one enemy after the other burning one bridge after the other. She had NO idea the harm she is causing to herself by being so ugly to everyone. That may have worked for her at her old job but where I am at you need all the friends you can get. It is the only way to actually survive that environment for very long.

She was not there today but I had to spend a considerable amount of time backtracking and undoing the damage she did when she was there and I wasn't. Again causing harm to a patient with a mistake she made. Although her getting so ugly and arrogant against another nurse that tried to nicely tell her she made an error and what she did to "fix it. Sadly she did not actually "fix" the biggest problem but the attack on her from my "partner" right in front of me yesterday made me able to hone in rapidly on what happened to my patient that made her "crash and burn" at PT that day and get it corrected before it killed her.

Now I have to mull this mess over and am fully expecting to be called into the DON's office to "clarify" what I did. I will be the next one on this RN's "chopping block" if that happens I am sure. There is no way to get around this one.It is all in black and white print in the computer.

I was forced to tell her Dr what had happened and what I figured out and corrected because it did cause mayhem to this poor patient, the Physical Therapist was in a panic, I was scrambling to help this patient when they brought her back.

THIS disaster makes me REALLY hate that they have computerized everything. This could not have happened at all if we were still using paper.

I wish I COULD refuse to work with her to try to "save myself". That is not an option. They will not let me transfer off my unit. My only option is to leave the facility or hope she is just like all the rest and gives up in three to six months and just leaves....

[icuRNmaggie, BSN, RN]

The nurse is not just a problem, she is dangerous. If you have done all that you can to alert the management and the medical staff of this huge liability, and no action has been taken, then you have to remove yourself the situation. There must be other facilities in your area who would welcome your skills and abilities.

[jadelpn, LPN, EMT-B]

Each and every time the nurse in question practices dangerously, you need to report this in an incident report. It will alert risk management of some sort of issue with the practice of this nurse.

If you are getting nowhere fast, I would take it to the parent company of your facility. Usually, there's compliance and safety reporting on the parent company website.

And you could report this to the state.

However, with all that being said, tread carefully. In any number of states (and look on the BON website for your state) it is clear that in most states, one of the only specific, defining scope language is that an LPN can not clinically direct an RN. So you could get in hot water for clinically directing this RN, even if her practice is less than stellar to say the least.

And I wonder if the RN in question, due to the fact that she has exclusively been a dialysis nurse for so long, is finding the transition overwhelming, therefore is getting defensive. And banking on the fact that she could state that "the LPN showed me how to do this" which may be in direct contraindication of your scope.

Let her stew in her own juices, and clean up after herself. If she is not, and you are charge, then I would go to your nursing supervisor on call to clean up her mess.

They are putting you in a really tough spot. Going forward, I would also get some thoughts on what you are to specifically do when you feel things are unsafe. Not just some "just don't eat her" stuff...concrete.

Polish off your resume in the meanwhile.