What am I doing wrong?

[blue280]

I need some help please. I have been a RN on a med-surg floor for about 5 months and have been off orientation for about 2 months. I mainly work weekend nights with a patient load of 8-11 pts with one aide. There is usually 1 other RN who has the same workload that I do. The one aide requests that she does not take assignment with me but will constantly seek me out to tell me what is wrong with my pts. Usually its along the lines of "the pt in rm 42 needs more pain meds." Now I know I can't be everywhere at once, and I appreciate that she tells me these things, but if I don't stop what I am doing at that moment, she says I don't listen to her and cops an attitude. I've always repeated back what she has said so she knows I've heard and understand her and thank her for informing of a pts condition. but she has now accused me of not properly taking care of my pts and/or not having my priorities straight! I tried takling to her, but she walks away from me when I bring the subject up. Oddly, she has told other RN's that I answer more call lights than any of them and has beennnn very complimentary about me to the other aides. I was hoping to try to solve this problem on my own, but I overheard her asking a pt if they were in pain, and wonder out loud why "the nurse won't give you pain medicine" Obviously, I had to take this to my manager to cover my butt ( thept wasn't due for meds for another hour) I don't know how much of this is me feeling overwhelmed as a new nurse, her being a bully or maybe I have poor interpersonal skills. I feel she is trying to prove something and I really want to work this out! Any suggestions? Thanks for letting me get this off my chest! Sorry this si soo long!

[MandyInMS]

The part that caught my eye was when you said you tried to talk to her and she'd just walk away..what the heck??? Find a slower time during the shift and have a conference with her ..find a quiet room and shut the door...explain how you appreciate her advocation of pts and all that she does for them, and that you always want to know if a pt needs anything..any changes in condition, ect. Also explain that you have a large pt load and MUST prioritise (sp?) care, specifying that just because you don't just JUMP to her call doesn't mean that you aren't going to address it asap....I think a lot of times people think when you are reviewing a chart,checking meds,writing down critic info that you aren't 'doing anything'...example...family member walks by and you are sitting at the desk with a chart about to call a MD r/t problem and are rechecking all orders before the call, gathering vs,important info....what the family member SEES is " you just sitting at the desk" ....so many times at work there are misunderstandings r/t lack of knowledge and information...just explain this to the cna so she can understand...if that doesn't work..time for meeting with supervisor/DON.

Wish ya the best of luckkkkkk :)

[wishingmary]

May be this aide needs empowering (sp?). When I worked on a restorative care unit in the hospital that I work there were times a nurse would give me a nonpharmaceutical intervention like heat or cold, back rub etc. if it wasn't time yet for her pain meds. In other words, turn the tables when possible. If she truly cares for the patient, she would be thankful for the idea. Tell her to tell the patient it isn't time yet. You don't ever have to explain yourself. You are the nurse. I hope she feels your frustration toward her. Perhaps she will talk to other aides to learn better communication skills. My philosophy as an aide is to judge no one and simply pass on the message or complaint from the patient every time I heard it (with limits). Encourage questions though and look at her as a student hopefully she will learn her place. I loved nurses I could learn from but I would never question a nurse's decision at the time it was made. I might bring up something that was curious after the fact if I couldn't tell by what its' outcome was. Try to play your role that would help her find her role in communicating with you and try to keep it upbeat. That is a win win situation.

[Liddle Noodnik]

Originally posted by wishingmary

Excellent feedback, thank you!