Too good for poo

[Nursesmurf14]

So, I am looking for some advice on how to deal with a new employee. I am a charge nurse on nights. My unit has gone through many changes and now we have a new manager.

Anyway, we have a new nurse. She is not even off orientation yet and I am receiving complaints. She works on dayshift so I personally have not had any problems with her. Multiple day staff members have come to me saying that she basically refuses to clean patients, will leave the patient in sitting in stool until the tech can get there, won't answer call light. Basically, a very large ego and not a team player. I told the day nurses that had these complaints that they should talk with her. They reportedly have but nothing has changed. So, I guess that I should take this issue to our new manager. Any suggestions how to handle this?

[caliotter3]

care to explain, WHY?

I do not know why, she did not consult me before she fired him. I avoided her like the plague, though, lest something similar happen to me.

[heron, ASN, RN]

Before any write-ups occur or any HR is involved, have you checked with her first? Also, "very big ego and not a team player" What does that exactly mean? Trust me that can mean a lot of different things to many different people.

Whenever you have to confront any employee, you need the facts. When I am assessing new nurses, I provide them with only the facts so there is no drama and or defensiveness.

Call lights

"Excuse me nurse X, today you had 3 patients who pressed their call light and you did not respond within the designated amount of time. This goes against our floor policy and we need to answer call lights as soon as possible. Our patient's safety is at risk if we do not respond in a timely manner. Can you tell me why this is happening?"

Poop

"Nurse x, I have been told that 2 times last week, you left soiled patients in their own feces, waiting for a nursing assistant to help them instead of cleaning them yourself. It is very important that you respond to your patient's needs right away. It is also important that we work as a team and it is everyone's responsibility on this floor to make patients comfortable as soon as possible. Is there a reason you have been having the nursing assistants to take care of these patients instead?"

In my opinion, you have to confront the situation with facts and then with the expected behavior/outcome. Telling someone that they are not a team player or have a big ego will only make them defensive. Also, it is very important to document all of the interactions as HR will have nothing to go on except your word against theirs. As a former manager, there was nothing worse than having to "discipline" someone who had never been talked to and who had no documentation surrounding the situation. It only leaves the new nurse resentful and mistrusting of her fellow nurses. Hope that helps.

The problem is, the OP is not the poo-averse nurse's supervisor. She has no business disciplining someone that doesn't even work with her. Especially when the only evidence she can present is gossip.

The dayshift folks are being pretty inappropriate taking their concerns to her rather than the problem nurse's direct supervisor. They are manipulating her to do their work for them. Or setting her up. Or setting up the dayshift charge ... or the new manager.

I think the OP needs to have a come-to-Jesus with the dayshift charge(s) or the manager to let them know that this is going on, then mind her own business and her own shift.

If the poo-queen ever works the OP's shift when OP is in charge, then the advice given here sounds pretty spot on.

There's something about the politics here that puts the hairs up on the back of my neck. Sounds like a real nasty place to work.

[imintrouble, BSN, RN]

Just as a matter of interest, one of my DON's fired an RN one time because​ he cleaned a resident instead of calling for a CNA.

I've never had my job threatened by cleaning incontinent patients.

However, I've had my supervisory ability questioned when I didn't delegate those jobs.

Just an explanation of why someone might get in trouble for doing the "CNA job".

[Asystole RN]

care to explain, WHY?

Although exact details will not be forthcoming it is not hard to imagine the circumstances around the termination.

#1) The cause of the termination is third party hearsay and could very well be a liberal retelling of the story to sensationalize the event for internet forum consumption or a imaginative story by the terminated to make his antagonist appear unreasonable and thus his termination unjustified. #2) The details are more mundane and reasonable such as the nurse ignored a significant clinical event in another patient to attend the bathroom needs of his favored patient etc.

Who knows.

[caliotter3]

Although exact details will not be forthcoming it is not hard to imagine the circumstances around the termination.

#1) The cause of the termination is third party hearsay and could very well be a liberal retelling of the story to sensationalize the event for internet forum consumption or a imaginative story by the terminated to make his antagonist appear unreasonable and thus his termination unjustified. #2) The details are more mundane and reasonable such as the nurse ignored a significant clinical event in another patient to attend the bathroom needs of his favored patient etc.

Who knows.

Wrong on all counts. The original post was written the way the poster intended. No further explanation is necessary.

[psu_213, BSN, RN]

I'm curious as to where this RN's preceptor is in this entire situation? As others have said, as night shift charge, the OP really has no horse in this race. The very most the OP can do is tell the NM "I've had a lot of our nurses complain to me about Nurse X's work ethic." Even that is probably more than the OP should do with this.

[Asystole RN]

I am a charge nurse on nights.

She works on dayshift so I personally have not had any problems with her.

Basically, a very large ego and not a team player.

Those statements seem to conflict and make me believe that the working environment at your facility is unhealthy and potentially hostile.

I am not sure why (actually I do know why) as a leader you would entertain gossip from the dayshift nurses let alone take it to heart without having any first hand knowledge nor speaking with the subject of their ridicule.

Do these nurses not have their own leadership structure in which they can address their concerns? Chain of command? Perhaps to someone with firsthand knowledge of the situation?

Is it remotely possible that this new hire is unaware of the expectations or possible she is reverting to a behavioral pattern as a defensive matter?

I have seen many times where the new employee is hazed by giving them heavier loads, throwing them unrealistic or unfair expectations, or simply people have sensationalized the events that have occurred.

I would tread very lightly and not get involved in events that are literally gossip to you and have no real bearing upon your current role.

A leader cannot lead if you allow yourself to be poisoned with gossip.

[jadelpn, LPN, EMT-B]

I would advise the complainers to take their concerns to the correct person--the charge nurse on days. If the complaining continues, I would further direct them to bring it to the correct chain of command.

One universal complaint is that "nurses are too good to clean a patient". With the sheer number of patient loads, "being too good" for anything is a non-issue. That meds are given on time, that patients are assessed and yes, even catered to is the focus.

Most nursing programs speak to delegating. And how important that function is. And it is not inappropriate to ask a CNA to give incontinence care to a patient.

And yes, nurses are thrown under a bus when they are late doing what can only be done by a nurse (ie: meds) because the patient down the hall needs to be given incontinence care and the CNA's are candy crushing on social media on their phones, no where to be found, etc.

It should be noted that most CNA's are worth their weight in gold. To direct CNA's to turn and reposition every 2 hours and know that is being done is a good thing. Nurses are taught that they are to delegate. And that it is an important function to do so.

Bottom line, if you have a leadership meeting, you could state that you have received complaints that would best be served on dayshift, regarding a day shift nurse. Keep unemotional, and direct "I am not sure the process on days, so I have directed the complaints to go directly to day charge."

If your fear is that this nurse is going to be coming to nights, then you can see for yourself what is going on, and respond accordingy with a timelined, goal specific improvement plan if one is warranted.

[applewhitern, BSN, RN]

I agree that sometimes new nurses are "hazed" and thrown under the bus. I have worked in environments where the RN did not need to spend time cleaning patients; the philosophy was "if you are doing THEIR job, who is doing YOURS?" That said, I have also worked in places where everybody pitched in and cleaned patients. Maybe she simply does not realize the expectations at your facility. You said she is still on orientation. Did she come from a facility that had someone, like a unit clerk, who answered call lights? Did she come from a facility that had plenty of nursing assistants that did the non-licensed duties? Shouldn't the person orienting her take care of this?

[Red Kryptonite]

And it is not inappropriate to ask a CNA to give incontinence care to a patient.

Of course it's not, and my nurses do this regularly if they discover someone needs cleaned up while in the middle of their med pass. But what happens when the CNA has already had to interrupt her Q4 vitals run for a blowout cdiff brief and isn't going to be available for a while?

*this comment inspired by real life events

[sofla98]

Lol, this seems to be an epidemic...ESPECIALLY with new grads/new nurses. The younger ones seem to be worse about it than the older new grads, maybe bc most of them have kids...idk.

I've also noticed that when we have students to our unit the students don't even want to change diapers, etc. They will actually try and delegate it to the PCA's on the unit! I think schools have gotten so carried away with how to delegate they're forgetting how to teach basic patient care.

Everyone is responsible and leaving a patient in a diaper full of stool is a disgrace. I would go to your new manager and inform her of the multiple complaints you've gotten about her...Forget about talking to her directly because that obviously isn't going to make a bit of difference.

For the life of me, I do NOT understand what some of these people think nursing is all about!!

[LadyFree28, BSN, LPN, RN]

Of course it's not, and my nurses do this regularly if they discover someone needs cleaned up while in the middle of their med pass. But what happens when the CNA has already had to interrupt her Q4 vitals run for a blowout cdiff brief and isn't going to be available for a while?

*this comment inspired by real life events

They will have to wait...

A nurse can't stop in the middle of a med pass to change; they can't, especially if they discover a skin tear, a pt is symptomatic of a CVA and needs to be sent out, and the incident report needs to filled out along with statements from the CNAs, along with a change in condition needs to be completed and a transfer form and information attached to it, along with calling the ambulance.

I can do a CNA job all day long (BTDT), but CNAs CANT do MY job.