Venting!

[raebabelvn, LVN]

My job is great. I work for a good agency, the family of my patient is fabulous and the patient is amazing! I feel extremely lucky to have been assigned to this case. I've been on it for nearly 9 months and have had few problems and the patient has only been sick once. His need for hh nursing is that he's a pediatric patient who needs round the clock care... feeding, meds, ect.

However, the other NOC nurse, who happens to be the case manager, is irritating me to the point where I'm ready to leave. She constantly overbooks herself, and will call on me last minute to "switch shifts". This literally happens at least once a week. At first, I would always answer and usually accommodate her requests because she's technically my boss. But I've started ignoring her calls and messages. So, what will she do? Wait till I'm at the patients house then call the house phone. Seems pretty unprofessional to me, but whatever. She slacks off on her nightly duties. For the first 2-3 months of my employment, I had the day nurses shocked when they came in and things were done, clean and changed. I'm positive she doesn't properly medicate the patient, and withholds anything she deems unnecessary. We have a set schedule, but if she wants one of my shifts, she'll assign herself to it without consulting me. Everything is absolutely ridiculous.

I've started applying for other positions. I hate to leave this job, because I love the patient and family, but I'm fed up with everything. I figure if I am lucky enough to get another position, I can stay on as a PRN nurse, or work a shift a week or something. This would be the perfect job if it wasn't for her.

[CFitzRN, ADN]

Have you ever voiced these issues with her? People will do whatever they want if they feel they have your permission to, and silence can equal permission to many people. You have every right to speak up and object to being jacked around with the shifts, and object to being asked at the last minute to switch things around, etc. That little boy deserves at least an attempt to work things out.

I would request a "conference" or whatever you want to call it, and sit down and address these specific issues. And if that doesn't work, go to the next level (administrator?) and tell her/him what is happening. Explain how much you love this boy and want to stay on the case, and tell her the ways this person is breaching professionalism, etc. I hope you will get support because you aren't asking too much here.

[caliotter3]

If it bothers you enough to express the desire to leave, I am surprised you haven't discussed this with the nursing supervisor yet. I have never worked for an agency where the schedule was dictated and/or changed by the nurse rather than the staffing coordinator. Do not see where this person gets the authority to go around the staffing coordinator since all schedule changes are supposed to be run through and come from the office. You need to have a serious talk with the agency about all of this. I would put it in writing so there are no questions.

[Luv2care0907]

If it bothers you enough to express the desire to leave, I am surprised you haven't discussed this with the nursing supervisor yet. I have never worked for an agency where the schedule was dictated and/or changed by the nurse rather than the staffing coordinator. Do not see where this person gets the authority to go around the staffing coordinator since all schedule changes are supposed to be run through and come from the office. You need to have a serious talk with the agency about all of this. I would put it in writing so there are no questions.

True. But let's just say for argument's sake that she has authority. You mentioned that she is the case manager. I have always found that having an impartial third party in a situation like this goes a long way to resolving things. In that conference, I would say that I don't mind flexing on occasion, but that I have needs that require me to have my schedule fixed for the most part and that I can't accommodate those things on a weekly basis and that it is causing me a great deal of stress to do so. How can we resolve this? For whatever reason, she is under the impression that this is how things work probably from past experiences whether with you or someone else or both. I wouldn't accuse her point blank of not medicating the patient, but say that you have noticed responses when caring for this baby and are concerned about the medication dosage because he is responsive to the meds when you give them or something like that. IOW, approach this from the aspect of the physical symptoms you're observing and what can we do about that? It is easy to not deal with these things and quit. Guaranteed, you are going to meet the same people with different faces the next place you go. So might as well learn now how to deal with tough situations. I know from experience that sometimes you can't. I have taken more than my share of abuse as a nurse not identically to your situation though. I need this job. So I've let a lot of things slide without doing what I'm suggesting you do. :) 9 months of employment is plenty of time to show your employers that you are worth the effort.

[raebabelvn, LVN]

With her being the case manager, and a gem in the nursing supervisors eyes, I think raising any concern regarding her would only backfire on me.

I honestly have no idea how this woman is still employed let alone adored by the agency. For about 6 months straight, every single week something was wrong with her. She hurt her leg, she hit her head, ect... And she'd call in weekly because of these things. Lately its been about once or twice a month, which is a slight improvement.

As far as the scheduling goes, I'm pretty sure she lies to the staffing coordinator. The first time it happened, he called me to ask if I could cover a shift for her (go figure), then when I asked about the change in my schedule he said "Oh, (name) said she talked to you about switching and this is what you came up with." I immediately corrected him and told him that I'd do it only because my schedule was open for it.

Tonight is my first shift on in a few nights. And I walked into a semi-disaster. She left some of the nightly cleaning undone, which doubles my load tonight. One of the meds I've suspected she hasn't been giving, I now know she doesn't. Mainly because everything is EXACTLY how I left it when I last worked. It seriously frustrates me that some nurses can become so complacent that their work ethic lacks.

I've decided that the next time she tries to pull a shift switch/change, I'm talking to her about it. See if there is another schedule we could work out on a regular basis to accommodate her schedule. I plan my weeks around my time off. I can't accommodate her requests any longer.

[caliotter3]

If you want to keep the job, it sounds as if you are aware you will have to deal with this nurse. Decide how far you will let it go or get earnest about finding another job. You can always assert yourself by telling the staffing coordinator not to change your schedule without talking to you. They are wrong to do that anyway and they know it. Tell them outright that you are telling them this because the other nurse lies about talking to you first. Still you are not going to change the agency's mind about how grand this other nurse is. When an agency bestows "fair hair" upon someone, the others on the case will suffer. That is just the way it is, like with other employers.