What to say?

[ABQLNDRN]

Hi everyone--I need your advice. I have to confront a notoriously lazy tech about what she did wrong the last time I worked with her and what I expect of her in the future and need to streamline what I am going to say.

This tech has been written up before by one of our nurse educators. The reason she's still working in the Newborn Nursery (NBN) is a mystery to me. I was charge in the NBN a couple of days ago. Here's a list of the things she did that were a problem for me:

• Took a 40-minute breakfast break (should've been 15 mins.)
  
• Took a 40-minute lunch break (should've been 30 mins.)
  
• Asked me for an afternoon break
  
• Got mad and virtually slowed down to a near halt because she couldn't get that last break (a pt.'s acuity went up & there was work to do)
  
• Was devising and discussing a pt's plan of care with the attending MD behind my back (I walked in on the conversation). The pt. was apneic and I was not going to let the pt. go out to breastfeed until I could see that the pt. could sat well on room air. She wanted to take the pt. to the mother. (Practicing nursing without a license?)
  
• Did not do a routine blood test that must be done in a timely manner. I'd asked her twice to do it. I went to give report at shift change and realized that she hadn't done the blood test and there was only 12 minutes to get the test done. I had to find someone to do it because I had to give report to the NBN night shift charge RN.
  
• She left without asking if there was anything else to be done (which would've included the above-mentioned blood test). One has to check out with the charge RN before leaving.
  
• She left an infant warmer unit TRASHED for two hours. It didn't get cleaned until the night shift came in. (I didn't have time to do it; it was her responsibility. I was taking care of patients.)
  
• She TOLD me to do one of our daily chores because "all the other nurses have been doing it, and frankly, the nurse SHOULD do it." If I ahdn't already been doing it in the interest of the fact that we were running out of time, I'd have told her to do it. I just told her that I was already in the process of doing it.

This tech has been working on the unit for 8 years. I think she does what she does because she doesn't want to work for her paycheck. She pushes to see how much she can get away with. I have only been a nurse for a year, but I will be darned if I am going to allow her to do this to me. I am going to state my expectations to her and let her know that if she does not meet them, she will be written up. I know writing people up "makes waves," etc. , but her behavior is affecting staff morale and more importantly, patient care.

Any advice is appreciated in how I should go about dealing with this.

[TexasPediRN]

I think that you need to write her up as well as have a talk with the NM about her.

I think you need to tell her that you expect her to perform her job and to not leave things undone. That you all need to work as a team and the unit cannot function properly unless everyone pulls their weight, which includes cleaning, doing the tests, and not taking longer than approved breaks. I would also inform her that discussing the pts POC with the MD is out of her scope of practice and it could cause her to loose her job.

I also think that next time you work with her, you should set those expectations at the beginning of the shift. If you ask her to clean the infant warmer and she is sitting there, ask again, and remind her that it is her responsibility. If she does not do it after that, I'd verbally repremand her and write her up, and let her know shes getting written up.

I have no tolerance for people who dont do their jobs. We are all there to work as a team to make a unit function properly, and that is not a viable option unless everyone does their job.

I wish you the best of luck, its a sticky situation. But honestly, write her up. If you dont, the next person may not either and you'll still be working there with her not doing her job.

-Meghan

[TazziRN, RN]

I think you should talk with her in the NM's presence. With a third person there, and one in a position of authority, she can't snide her way out of it. Write down (as you did above) the things you saw and let her give her side. (In the NM's presence, remember!) Then tell her what your expectations are. Ask your NM ahead of time to let you do the talking, that you just need a third person present. Good luck.

[loricatus]

A checkoff sheet outlining duties and expectations may help. This way she has her job duties in writing and must come to the charge nurse to verify (co-sign) each timed checkoff, including giving report at the end of her shift. If she were to refuse this, have her document that also. Anything in writing supplies tangible proof on performance/nonperformance and provides you an objective way to initiate disciplinary action. If she, perhaps, tried to claim that she was being singled out/discriminated against, you could implement this checkoff sheet across the board to eliminate that possibility. Those that do their jobs well would welcome a way to prove it!

Also, include scheduled break time in that sheet, with signatures required before leaving and when returning. Spaces for comments could be used to document deviances and other issues you mentioned (including positive comments to those who do their job well).

[patchy]

I am hoping to get into the program in 2008 so I am not a nurse yet, but this topic is still very interesting to me. It helps to know what to expect, and how to handle possible future situations I will face myself.

[gina gina]

yes tell her to take her lazy a-- home.

[ABQLNDRN]

yes tell her to take her lazy a-- home.

Oh yeah, I want to...SOOOOO badly.

[TazziRN, RN]

Actually, that might be a good thing......if you have the authority to do so. Why should she get paid for not working?

[crissrn27, RN]

I find that techs (and nurses) like this are just in the way, tell her to go home if she doesn't want to do her job. I would print out the same list you have here and take it to the NM, tell NM you want to be there when these issues are addressed, also. That way, you can make sure all of this is out in the open and the NM doesn't just brush it off.

[ABQLNDRN]

Actually, that might be a good thing......if you have the authority to do so. Why should she get paid for not working?

I don't think that I have that authority; I only float as charge in the NBN. But if I do, she's got some short days coming.

[TazziRN, RN]

Check into that. Even as the float charge, if you are in charge of the shift then you might have that option. If you don't, the house supe does. Call the supe when the CNA doesn't do something and you have said something without resolution at the moment, and ask the supe to send the CNA home.

[walk6miles]

First of all, how LUCKY you are to have a tech at all! I've worked busy, busy transplant/open heart surgery units and never had a tech at all.

I think (my opinion) you need a meeting with the "powers that be" and the tech to sort out your expectations and her realizations.

I was also very impressed that you were able to come up with such a long list of the tech's "faults"... must have taken a lot of time.