What do I do with a nasty nurse?

[DixieRedHead, ASN, RN]

I am at my wits end. I am ADON/ House Supervisor in LTC facility. We have several new grads hired to work PRN. We do give them lots of orientation. They orient on all shifts due to their PRN status.

One nurse on second shift consistently is nasty to her orientees. They have to orient with her because of the need to fill that track if needed.

Anyway, we have talked with her and counseled her, verbally. Then this last week she has a new nurse with her in tears. Now the new nurse has lots of issues. She's scared to death and has very little confidence. But people are different, and some require more feedback than others. I just want this seasoned nurse to provide POSITIVE feed back. I have done all that I know to do, short of writing her up. (I really don't like to do that unless it's a care issue or absenteeism).

Any feedback would be appreciated.

[TopazLover, BSN, RN]

I am having difficulty wrapping my head around why she should be allowed to have poor performance in an area of her work without a write up. If orienting new staff is part of her job it is just as critical, and perhaps more so, as using sterile technique to insert a foley, or do trach care appropriately. If you allow this poor performance to go on without increasing disciplinary action you are condoning it.

Identify what the problem really is. Does she really hate to orient? Is she tired of a parade of new grads that don't stay? Does she lack people skills to interact properly?

Allowing this behavior to continue means the people she orients will not be fully prepared. They will have learned how to avoid her, how to ignore nasty comments, and how to read want ads for other employment.

She probably is very good at what she does in other areas. Talk honestly to her. If no headway can be made verbally you need to put it in writing.

[CapeCodMermaid, RN]

aknottedyarn hit the nail on the head. If orienting new nurses is part of her job and she isn't doing it satisfactorily, she should be written up. Maybe she is the one with little confidence and is overwhelmed by having to teach a new grad. Whatever the problem is, you have to make it clear that she isn't allowed to treat any co worker badly.

[caliotter3]

You have to keep in mind that this person's behavior could be a major contributor to new employees making the decision to leave at some point. Deal with her or accept the consequences of her poor performance.

[4_Sq]

This doesn't sound to far from "bullying" to me, and if I were manager here, I would not allow this nurse to keep behaving this way, she will indeed distance other staff.

Nursing is busy enough without the other garbage!

[Nurse SMS, MSN, RN]

I cannot fathom why this would not be considered a performance issue on the part of the nurse in question??

[WorriedAbout2Morrow]

Since you've already given her a verbal warning, follow up with a written one. There's no reason for her be acting in such a manner. We all experience personal things that threaten to affect us, but hopefully we draw the line and leave those problems at home. In no way should this nurse be able to carry on like this. With that being said, I would definitely write her up. If that doesn't work, fire her!!!!! There are lots of nurses who are equally qualified and probably be glad to replace her.

[EMT-newbie]

A note from my side of the universe in software: it is far more productive for a software team to fire a member who is disruptive no matter how brilliant or productive they are, allowing "that guy" to stay poisons the workplace and undermines your authority.

The hardest part of being a manager, as told to me by various managers of mine over the years, is disciplining or firing someone and yet it must be done. Having clear guidelines from HR helps keep the process professional, as I learned from my ex who was in Hospital HR for years.

Nurses eating their young is not "culture," it's just wrong. Who knows, with a formal paper trail your recalcitrant nurse may turn it around and teach instead of threaten.

[caroladybelle, BSN, RN]

Why has this nasty nurse with this rep been allowed to continue?

[realnursealso/LPN, LPN]

Plain and simple, the offending nurse should be written up and told if this continues she will be fired. Why would you let this continue? I worked with a nasty nurse when I moved south after my divorce. She actually pointed her finger at me and said, "You're a blank yankee and I hate everyone from NY." The other nurses told me, it's just how she is. If that happened where I am from, (I only stayed 6 months, went back home, culture shock), you would be fired. Nothing was done to her for treating me in that manner. That was almost 10 years ago now, I can still hear her saying that to me. Don't let this nurse give your facility a bad wrap, get rid of the mean queen. People don't forget how they are treated and nurses talk.

[JBudd, MSN]

If she is nasty to new grads where you can see her, how on earth do you think she is treating even more vulnerable patients where no one can see her. Nasty people don't tend to just be nasty in one area of their lives.

Get tough.

[netglow, ASN, RN]

Yup, write her up and let her know that she has no time left to think about her attitude towards these new nurses. She's got one foot out the door already.

In this economy, or in any economy, there is no need to keep a poor excuse of an employee like that. No need at all.

If that doesn't sway ya, just count how many new nurses you have and multiply that by what is it now, $30,000 to orient each one? Well, that nurse then, is destroying company property, and needs to be fired for it.