Was I justified in writing up Nursing Assistant?

DusktilDawn · Aug 23, 2005

:yeah: :yeah: :yeah:

He was out of line in using your name and lying. He could have expressed his concerns and offered to take over the showing of the patient you were with and allow you to assess the situation first.

Katillac, RN · Aug 23, 2005

Anyways.... would u guys have written him up also or should I have went abut this differently?? I talked to my boss yesterday(after she received the letter) and she said she would speak to him. I don't like to get anyone in trouble but I think someone like him needs put in their place.

Well, if your intention was to get this person to change his thinking and/or behavior, I'm not sure writing him up for this specific incident was the most effective way to go about it. He appears to have had some pretty drastic consequences in the past for inappropriate behavior and yet he hasn't changed. I doubt that your boss' "speaking to him" is going to change much. It seems as if he's pretty set in this pattern.

On the other hand, if you want him out of there, it's a good first step. Your further steps would be to document and submit every incident of insubordination. Doing that protects you as well if he does something under your supervision that could get you in trouble.

If you want to attempt to change his behavior, you could label it as unacceptable every time you saw it:

"I won't argue with you about this. As your supervisor and as a nurse, my decision stands."

"Talking to me that way was insubordinate. That is unacceptable performance."

"I need to make sure you understand our different roles. You are responsible for following my directives, not the other way around."

It would be nice if having a manager talk with a poorly performing employee was enough to fundamentally change the employee's behavior. Unfortunately (in this case), people continue to produce behavior that gets them rewards, and this guy's behavior seems to be working for him.

Good luck with this.

hhrhrn41, RN · Aug 23, 2005

Well, if your intention was to get this person to change his thinking and/or behavior, I'm not sure writing him up for this specific incident was the most effective way to go about it. He appears to have had some pretty drastic consequences in the past for inappropriate behavior and yet he hasn't changed. I doubt that your boss' "speaking to him" is going to change much. It seems as if he's pretty set in this pattern.
On the other hand, if you want him out of there, it's a good first step. Your further steps would be to document and submit every incident of insubordination. Doing that protects you as well if he does something under your supervision that could get you in trouble.
If you want to attempt to change his behavior, you could label it as unacceptable every time you saw it:
"I won't argue with you about this. As your supervisor and as a nurse, my decision stands."
"Talking to me that way was insubordinate. That is unacceptable performance."
"I need to make sure you understand our different roles. You are responsible for following my directives, not the other way around."
It would be nice if having a manager talk with a poorly performing employee was enough to fundamentally change the employee's behavior. Unfortunately (in this case), people continue to produce behavior that gets them rewards, and this guy's behavior seems to be working for him.
Good luck with this.

Kattilac,

thank you so much for the excellent advice. It seems that you have a clear picture of just what he is like. I really like your last quote about our different roles and I'm definately going to repeat it on him. Sometimes I just don't know how to get my message across to people like him. And, I think you may be right about him not changing his behavior even after my boss speaks with him b/c if getting kicked out of nrsg school and being fired didn't change his behavior, just a little reprimand from the boss won't either. I'll keep you posted. I'm on vacation for a week so I'll be anxious to find out what happened when I get back.

Theloneliest_Monk · Aug 23, 2005

Im not a nurse, but i think I would of wrote him up too. He should of asked you if you wanted him to call someone for help, instead of taking it upon his self and lying to the other person saying you told him to do it. That would piss me off.

Katillac, RN · Aug 23, 2005

Kattilac,
thank you so much for the excellent advice. It seems that you have a clear picture of just what he is like.

I'm glad you think that might work for you. You also might want to try throwing in the validation with the directives:

"You're very observant. Thank you for bringing ______________ to my attention. I'll think about it and let you know what we're going to do."

"I appreciate your input. My conclusion is ___________ , so I'll need to ask you to _________."

"You've made it clear that you think __________ . And I have decided is that the priority is ___________. "

"You may feel differently (want to try another approach, have your own idea). However, what we will be doing is __________ ."

Then when you see any sign of his coming into compliance, you say, "We work better as a team when you approach me that way," or "I know that wasn't the way you wanted to do that. I appreciate your cooperation with my decision." You are "rewarding" the behavior you want, which will make it more likely to be repeated. It sounds like he's actually trying to do the right thing. Maybe you just need to redefine for him what the right thing is.

As a nurse, I know I appreciate it when my aides notice something and tell me. But then we need to teach them to step back and let us make the decisions. And really, it's the best of both worlds for them; they don't have to take the heat for a wrong decision, but they get the positive regard when things go well!

Looking at my first post, I realize I steered away from whether or not you should have written him up. It seemed like what you were looking for was more a way to make an attitude adjustment. There's no one way to say it or do it. But I will bet if you consistently and quietly set the rules and define and "reward" the behavior you want, in a few weeks you will be wondering if this is the same guy you were working with before, and your manager will be pleased that you resolved a difficult personnel matter.

Marie_LPN, RN, LPN, RN · Aug 23, 2005

Im not a nurse, but i think I would of wrote him up too. He should of asked you if you wanted him to call someone for help, instead of taking it upon his self and lying to the other person saying you told him to do it. That would piss me off.

:yeahthat:

Cute_CNA, CNA · Aug 24, 2005

I think your action is right on. He deserves to be written up. After all, his lying is making you look bad.

If he's going to lie about something like that, what else is he going to lie about? It might come to the point where he could jeopardize your license, if he claims you told him to do something that you didn't actually tell him to do. Documentation of his actions may show a trend of his behaviors, so that in case something big happens, you can point to this as an example of his insubordination--he has a history of it.

BETSRN · Aug 24, 2005

I'm glad you think that might work for you. You also might want to try throwing in the validation with the directives:
"You're very observant. Thank you for bringing ______________ to my attention. I'll think about it and let you know what we're going to do."
"I appreciate your input. My conclusion is ___________ , so I'll need to ask you to _________."
"You've made it clear that you think __________ . And I have decided is that the priority is ___________. "
"You may feel differently (want to try another approach, have your own idea). However, what we will be doing is __________ ."
Then when you see any sign of his coming into compliance, you say, "We work better as a team when you approach me that way," or "I know that wasn't the way you wanted to do that. I appreciate your cooperation with my decision." You are "rewarding" the behavior you want, which will make it more likely to be repeated. It sounds like he's actually trying to do the right thing. Maybe you just need to redefine for him what the right thing is.
As a nurse, I know I appreciate it when my aides notice something and tell me. But then we need to teach them to step back and let us make the decisions. And really, it's the best of both worlds for them; they don't have to take the heat for a wrong decision, but they get the positive regard when things go well!
Looking at my first post, I realize I steered away from whether or not you should have written him up. It seemed like what you were looking for was more a way to make an attitude adjustment. There's no one way to say it or do it. But I will bet if you consistently and quietly set the rules and define and "reward" the behavior you want, in a few weeks you will be wondering if this is the same guy you were working with before, and your manager will be pleased that you resolved a difficult personnel matter.

This guy also obviously has a HUGE chip on his shoulder. He probably already feels bad about himself in some way and now feels very inferior. Bottom line is you probably won't change him but I like the idea of approaching him and then making sure to recognize when he DOES do things that are helpful and encourage the team approach.Can you think of (and compliment him on) the things that he does well?

BabyRN2Be · Aug 24, 2005

I think that you did the right thing. His attitude needs to change and someone else needs to be involved.

What would have been the real icing on the cake was if he called back the other nurses from their dinner just so that HE could go to dinner. Someone like what you described would possibly do something like that.

I hope this situation works itself out and this person eventually accepts his role as a help, but a subordinate.

jeepgirl, LPN, NP · Aug 24, 2005

Hello All... Hope u can help me with this as I've only had to write someone up only one other time. Worked the 3-11 shift Saturday night with 7 staff and 27 patients. It was 6:00pm and 3 nurses were off the floor at dinner. Myself and another NA were busy showering a patient who had just had a huge involuntary. So this left 2 other nurses out on the floor to answer calll bells. In the midst of showering, this NA comes into the room and states that he took it upon himself to page the other nurses back to the unit b/c it was just too crazy and then promptly left the room without giving me time to respond to him. (Since the assigned charge nurse was at dinner, I was in charge). Just a few minutes later the nurses that were paged arrived onthe unit, madder than hell of course!!! The charge nurse comes to me and asks if I was the one who told this particular NA to call them back from their dinner. I stated that no, I did no such thing. She said that this NA told her that I told him to have them paged back. At this point both of us were fuming mad:angryfire. Especially since there was only one call light ringing when they arrived back on the unit!!! Well..... I asked this NA to meet me in the report room, that we needed to chat. I confronted him and asked him why he said that I told him to call. His reply was this "well, I knew that since I'm only a NA that I wouldn't be able to have the authority to page them back, so that's why I said you told me to do it." I told him that I didn't appreciatte his lying and that he needed to speak with me first before making such phone calls. He apologized and said that "I didn't mean to implicate you." Well, both myself and the Charge nurse were so ticked off at him that we both wrote him up. This isn't the first time he's done something like this either. He thinks that he knows everything and is constantly telling the licensed staff what to do. He will argue with you and demand that you do things his way. He has no respect for anyone that is in charge.!!:angryfire He even was kicked out of nrsg school because he mouthed off one too many times to an an instructor and was fired from his last job for sleeping.
Anyways.... would u guys have written him up also or should I have went abut this differently?? I talked to my boss yesterday(after she received the letter) and she said she would speak to him. I don't like to get anyone in trouble but I think someone like him needs put in their place.

I think he was just trying to help out. 3 people gone at one time for lunch is a LOT. No wonder you were struggling. That isn't fair to the rest of the team. I think that both you and charge were on a power trip. I wish I got to go off the floor at lunch... I never, ever am able to eat uninterupted unless my patients decide to sleep during my lunch time. Must be nice... while everyone deserves a break, and my situation isn't common practice, this nurse should understand that if things are "going crazy" up on his or her floor she should expect to be called back. Get off the trip and get back to work!! :-)

Cute_CNA, CNA · Aug 24, 2005

I think he was just trying to help out. 3 people gone at one time for lunch is a LOT. No wonder you were struggling. That isn't fair to the rest of the team. I think that both you and charge were on a power trip. I wish I got to go off the floor at lunch... I never, ever am able to eat uninterupted unless my patients decide to sleep during my lunch time. Must be nice... while everyone deserves a break, and my situation isn't common practice, this nurse should understand that if things are "going crazy" up on his or her floor she should expect to be called back. Get off the trip and get back to work!! :-)

I agree that 3 people at a time should not be going to dinner. That's too many people and not enough coverage. However, I do NOT think the OP was on a power trip. This young man should not be lying and using HER authority to back his actions when it is not the case. Lying is never appropriate.