Supervising a coworker with the same amount of experience

[luckynurse_1234]

I recently became a charge nurse on my shift. Two of my coworkers started at the same time I did. One of them is also a charge nurse and when he is charge, I always defer to him and do anything he asks because, well, he is in charge. Regardless of his qualifications, he deserves respect and we are supposed to defer to the charge nurse.

The problem is my other coworker doesn't understand this. This individual is barely competent with his patients even though they have over a year of experience. We recently went from a 1:4 ratio to a 1:6 and they can't even handle three stable, moderately difficult patients. I have had to "rescue" this person's patients several times when they appeared to be declining because this indivdual invariably states "I'm too busy to deal with it right now." The last time we worked together I was the charge nurse and one of said individual's patients appeared to have had a cardiac event. I got the vitals as the first person on the scene to make sure the patient was ok then informed this individual of what was going on. This person literally stated "I am too busy to deal with that right now." I couldn't find an aide and all my other nurses were busy with their own patients, so I ended up having to do all the running around to make sure the patient was ok myself (I didn't want to wait if the person was having a heart attack and/or insufficient perfusion).

The patient ended up being fine, but I feel like the nurse doesn't respect me because we started at the same time and we are friends outside of work. I was told by my supervisor that when I am in charge I should assert myself i.e. "you will go do this now!" I feel I shouldn't have to, and it's hard because this person is basically a nice person but still incompetent. Any suggestions?

[caliotter3]

Have another talk with your supervisor. Since you are new to all of this, it is ok to ask for advice on how to handle it. But to be quite frank about it, your coworker should have been written up for the situation you described. However it seems you are not the permanent charge nurse. That complicates matters. That is one big reason the supervisor should get involved.

[sofla98]

Having had almost 15 years experience, I've worn many different hats being a nurse. Being in charge literally means, being in charge. If the nurse was swamped (I know I would be w/six patients ) then it is the CHARGE NURSES'S responsibility to step in by either tending to the nurses other patients while they handled the emergency, or responding to the emergency. Of ALL the places I have worked, when there was an emergency, code, etc. the charge nurse always responded. They stayed with the patient and the nurse until the patient was stabilized or transferred, etc.

I don't see this person being disrespectful to you because you are "in charge". I see a nurse that probably has a real crapper of an assignment and is completely overwhelmed. Nurses, no matter how competent or good they are, can only physically and mentally deal with so much at one time. Having the same amount of experience, you don't really have a right to question their competency, either. In fact, I am sure that if this nurse was incompetent, the management would have addressed it.

I know that if I were in that situation and a newer grad was in charge, I'd be really assertive and tell YOU what YOU could do for me. That is one (of many) responsibilities of being in charge. Delegating a nurse AIDE to take vitals on a patient who is possibly having a cardiac event is a BIG no-no. Having been in charge many many many many times, I know that I have found it boring and usually end up helping the staff with anything they may need help with. Passing meds, giving a bath, taking report, admitting a patient, I've done it all and took care of the staffing, complaints, etc.

You have a lot more free time when you are in charge. How you use that time is up to you. But, I know the best charge nurses use their time to help out their co-workers in anyway they can, especially during emergent situations.

[LiberatedRN]

I agree with sofl98, you probably need to be a little more assertive as a charge nurse. I became charge after only being a nurse for 1 year and it can be a scary thing. But now, 13 years later (and after having supervisor experience), I look back knowing that I should've been a little more assertive but didn't know how to.

After you start to be in charge, you start to notice things about your fellow co-workers that you didn't realize just working on the floor with them. You start to understand their weaknesses, their strengths, and realize who's doing their work & vice versa. Maybe your experiences with this person has given you insight on what kind of nurse this person is. The next time you have an emergency, just TAKE CHARGE, tell him what you want him to do....make sure it is in front of other people. If he talks to you crazy or challenges you, others are around to be witnesses that you gave him orders and he didn't follow them. It'll be a long time coming, but you'll learn tricks of the nursing trade. It's just sad we have to be that way to some co-workers, but this is a dog-eat-dog world! Other professions have to deal with the same type of issues.