Staff Boundaries?

[hollyberry678]

Hi, I am a relatively new grad working on an intense floor, some critical patients. I transitioned to this role from working at the desk and as an aide.

Yesterday I had 3 pts: one who needed aalot of work, many issues, iv's lab replacements, NPO starting on TPN, ect who was constantly stooling (liquid) was total assist with reddened skin (turn freq, ect), another was a terminal dx who was d/c-ing to hospice and very teary, and another on a hepain gtt who maybe was to d/c.

The aide I was assigned to I have never liked. She is in the float pool and seems to my standards is rough with patients (when turning ect), she has been there a long time though. In the past she has made snide comments to me when I got my new role, and has tried to tell me what to do with patients while in the room (hope you know what I mean).

She was in the 'heavy' pt's room when I went in to do assessment. I think she figures to do a quick washcloth-down and call it a day on him. She was there when the DR came in and was somewhat interuptive to the DR who was talking to the pt.

Later, I was trying to do a d/c on the hospice pt, and got a page this pt had stooled again. As I was paging the aide another aide said she could help. I said great, I will have "Dora" meet you there. I was trying to get the hospice pt ready to go.

I went to the supply room to get a bag, and saw "Dora", I said 'did you get my page? she walked away from me, muttering under her breath, and then turned and hsouted something like "i'm doing something, cant you see?" or something like that, but it was really disrespectful. I was like 'whatever'.. and turned to go back to my pt's room.

she followed me into the room and began yelling at me in front of this pt. I told her like 5 times that it wasn't appropriate for her to come into this pt's room to discuss this. the pt was shocked and when she left kept telling me how distressing that was and that she felt sorry for me, ect. I could also hear this aide loudly talking at the desk, "that Sarah!!, ect" the pt later told me that her son who was at the desk heard her out there.

I went to the charge nurse, and told her she needed to talk to "dora". she said something like, Whats that going to do? but I will page her.

Then I saw the two of them hugging.

Then "dora", as I am again walking with a chart in hand and paperwork I copied down the hall, pulls me by my arm, trying to get me into an empty room, I said excuse me, i am busy, and she continues to pull my arm, I said that like 3 times, and she cont to pull my arm. In order to avoid a scene, I went in and she is saying, 'we need to talk, ect ect. and at one point said "I know you are having a hard time in your new job" I said, no (?)I said I am busy, I will have the charge nurse and your supvr talk to you, I have to go.

I went to talk to the charge who said Dora went to MY mgr. I went to my mgr who said dora and I need to work it out outside of work... I was so tired (12 and no break at all yet) and didnt know what to make of this... I said what would you have done? ect

I went to Doras mgr who said that was innappropriate and that she would talk to her.

I feel so non-supported by my own floor...And I feel this aide is resentful of me in my new role, and that she used her being 'loud' to intimidate me.

Can anyone help/give insight on this? I am ready to look for a new job over this!! I can't work and concentrate on pt care issues when I have to deal with this, with no safety net..

Dora later came to me at the end of the shift and said "Well, we didnt get along, but I have to say i enjoyed working wiith you' (*******)

[Tweety, BSN, RN]

There's a good book that might help you called "Crucial Confrontations" that might help you.

You need to try to directly handle this situation first because it's not going to go away and telling management isn't going to help.

[TazziRN, RN]

I hate it when managers say "You need to work it out." Sometimes it just ain't possible. At those times the manager needs to sit in as a mediator.

One drastic thing you can do is go to HR and ask them to mediate. Tell them there is an employee you have been unable to work out problems with and that you feel a mediator would be good. This would show that you are willing to work on the problem, and it would also prevent her from being able to justify her actions/attitude.

[nurseby07]

I had similiar issues when I started, the cna (who had just gotten into nursing school) liked to order me around in the pt's room. This is something she is known for doing with the new grads. The managment and experienced nurses love her however, so I decided to step away from the situation. The first thing I had to do was get some time under my belt to gain confidence and working with her was not worth the stress so I just didn't use her help at all. I too worked on a heavy floor, had the same patients you described, but with clean ups and turns I just asked my buddy and made sure I was available for anyone else who needed a turn. After a few months I grew into my role as the nurse and was able to accept her as the cna and not accept her attitude.

That part about the CN hugging her really gets me, however.

This cna had take home nursing tests (and finals) and she would bring them to work, give them to the charge nurse who would take them home and DO THEM FOR HER. One of the nurses went to managment about it and they said "Talk to the cna, not me" so she did.

Don't let this episode define your job, especially since she is a float!

[oneLoneNurse]

Have you passed probation yet? If you haven't I think you need to eat this. Management will probably see it all as your fault since you are the newbie. Maybe start looking for at least a casual position somewhere else so you have that to fall back on.

Once you pass probation and get reasonable evaluations you can probably weather complaining about this tech. But for now be very :crying2:careful.

[Rhone]

I can understand your frustration and your point of view that (assuming I'm understanding you're POV correctly) "Dora" behaved in a way that was rude and unprofessional, and her superiors should address it with her to correct the problem with no involvement from you beyond reporting the incident. I can empathize with your position.

However, I would strongly suggest looking at this situation from a different perspective. First, a few points:

• A big pet peeve for managers/supervisors (especially the good ones) is staff who complain about other staff but aren't willing to be a part of resolving the conflict.
  
• You apparently don't know the content of the discussions Dora had with the charge nurse and your manager, but based on your post there are two things I would be willing to bet on:
  • Dora feels stressed out and overwhelmed by her workload
    
  • Dora feels that you have wronged her in some way--now, I'm sure you haven't done anything negative to her intentionally, but I know all too well from personal experience that, especially in stressful work environments, many people are inclined to make very negative interpretations of completely benign statements and to feel disrespected and put down when there was no disrespect intended.

  [*]Something I'm less certain of, but that also strikes me as a strong possibility, is that Dora may be aware that she overreacted and might actually feel bad for it and want to talk to you to make up for it.

  [*]What she said at the end of the shift sounds like it could have been passive aggressive, but it also sounds like it could have been a serious attempt to try patching things up.

  [*]If she is trying to talk to you to resolve the conflict (whether sincerely or not) and you brush her off, then you risk making yourself look bad (as per my first point) even though she was the one who did the yelling.

Now, with that said, my recommendation to you is that you try to find an appropriate opportunity to talk to her. Swallow your pride and approach it with some humility--start out apologizing for not talking to her before, and ask her for her perspective on things. Try to hear her out and show her some empathy first before you try to clear up any misunderstandings, and then give her your own perspective on things as nicely and respectfully as you can. Don't make the conversation about who's right and who's wrong, or who did what wrong, but rather make it about "what can we do to make this work?".

I know this might sound ridiculous, especially if you're angry at her, but from what I've seen most people have fairly good intentions and want to have good working relationships with their coworkers even if their behavior suggests the opposite. This kind of conversation often goes a long way to building positive working relationships. And if it doesn't, and she continues to be rude and unprofessional, then you are in a good position to go to a manager and say "I've done this and this to try to resolve the problem but she's still doing blah blah," which looks much better for you than "She did blah blah, you deal with her."

[Tweety, BSN, RN]

I hate it when managers say "You need to work it out." Sometimes it just ain't possible. At those times the manager needs to sit in as a mediator.

One drastic thing you can do is go to HR and ask them to mediate. Tell them there is an employee you have been unable to work out problems with and that you feel a mediator would be good. This would show that you are willing to work on the problem, and it would also prevent her from being able to justify her actions/attitude.

Too often employees run to the manager before they even tried to work it out properly. Like kids in a playground nurses tattle on each other rather than have a face to face confrontation. It's amazing that when you actually confront the person in private with a "you're coming across to me as you don't like me, you don't like working with me, the patients feel you're rough, and I feel the patients are suffering, do you really mean to have the patient care compromised because we can't get along?", what kind of results you will get. Sometimes just merely the act of getting in their face shuts them up and shapes them up.

Often though we don't approach it properly. We get in their face with the wrong attitude "how dare you act like such a *****, and I'm not putting up with your crap anymore...." and it get's nowhere. There's a fine art that we should learn in how to deal constructively with these kinds of people.

Also note that studies show that manager tend to ignore these types of problems 85% of the time.

However, I 100% agree that when people can't work it out, after giving it an honest try, then it's time to use the chain of command.

[Dolce, RN]

Then "dora", as I am again walking with a chart in hand and paperwork I copied down the hall, pulls me by my arm, trying to get me into an empty room, I said excuse me, i am busy, and she continues to pull my arm, I said that like 3 times, and she cont to pull my arm. In order to avoid a scene, I went in and she is saying, 'we need to talk, ect ect. and at one point said "I know you are having a hard time in your new job" I said, no (?)I said I am busy, I will have the charge nurse and your supvr talk to you, I have to go.

If it were me I would advise Dora not to place her hands on me (which you tried to do three times). I would then have notified my charge nurse and manager about the physical aspect of Dora's behavior. It is not appropriate for her to physically pull you into a room. I know it might sound petty, but it wouldn't have been a bad idea to fill out an incident report about that very issue. You cannot have staff forcing you into private rooms to "hash it out."