What to do about tech refusing to get VS?

BellaC · Feb 15, 2005

I think she means certified nursing tech?? (CNT)..I took it as a aide...why can't they come up for one name already...lol...I like your parking lot idea, maybe take her down to where the lights are burned out..lol..

I worked as a critical care tech for 13 years. We did ekgs, vs, set up pressure lines for hemodynamic monitoring, assisted with line placements, helped with cont. ed., did troubleshooting for equipment, controls for monitoring equpiment, assisted with procedures, set up CVVH, did the ordering, and anything else that helped the nurses get through the day. Most importantly, we helped take care of the patients: bed pans, answer lights, etc. Sometimes people forget why they work in a hospital. That "tech" who can't be bothered with vs needs to be strapped to a bed with no care provided for a day or two and see if her attitude changes. She is driving her co-worker nuts, but she is also withholding proper care to her patient. Take her to the parking lot after you untie her. :angryfire

Riseupandnurse · Feb 18, 2005

I was an NA while I was in nursing school. It was the hardest, most unfulfilling job I ever had, and I am most appreciative of those who do it well. As an RN, however, the truth is that I am the patient's advocate. Even if the patient's MD came and ordered me to do something, I still have to exercise nursing judgment as to whether that is a correct thing. If it's not incorrect and the physician has identified it as a priority, I had better do it. But I must first judge to the best of my knowledge, according to the patient's needs alone, and I can't pass the buck on that. Neither can I refuse to do what is ordered in the interest of the patient in favor of my own agenda.

I work with some very good, capable NAs, but many of them don't understand the legalities of the situation. They think they have their job to do, I have mine, and we each decide independently what is important to get done, at what time. What is important to them on day shift is often to get the baths done and the linen changed so they don't have to face the negative judgments of their NA peers on the oncoming evening shift. They don't have the education to understand that it might be a whole lot more important to the patient's safety and health to get the postop vital signs done on time or be ambulated to prevent complications. So some of them don't actually refuse to do what I ask, they say, "When I get a chance; it will be awhile." I try to do it myself, but I almost never get a break or a meal and often stay overshift an hour or more to get caught up on the paperwork. Meanwhile they get breaks, meals, and get out on time. This isn't fair, but who cares about that? The important point is that the patient didn't get important things done for him or her, things I as a nurse realized needed to get done.

Everyone wants to feel important and to control their own work, but the truth is that the RN must adjust, with wisdom, nursing tasks to collaborative tasks with the physician, by virtue of the doctor's medical judgments, and the nurse ASSISTANTS should adjust, with wisdom, patient care to judgments of the nurse. If they don't like it, RNs can go to FNP or MD school, and NAs can become LPNs or RNs. That's America. In the meantime, understand what's really going on here, and leave your egos at the door, for the good of the patient. Please.

DutchgirlRN, ASN, RN · Feb 21, 2005

We do secret sisters at work and on Valentines we devulge who our secret sister has been all year. I had a great one this year. Always remembered every occasion and then some and very tasteful gifts. It turns out Sarah has been my secret sister all year! I gave her a big hug and said Thank You Sarah. She said you're welcome !

jessie74 · Feb 22, 2005

This is a big problem.. I f you are an union I would go to the uion a file a grivince..If not try HR..When if happens again go stright to your NM or call the superviser and sit down right then and there. If your NM said she cannot at this time tell her that you want to go over her head. You have talk to the cowork and your NM, she cannot refuse you b.c it is pt safty.also find out what your hospital policy on notifing a worker anout a problem. most of the time it is verbal, and two written warnings. ask you NM tosee the writen warnings it is you right.

Green_Dragon · Feb 24, 2005

I have a tech at work who I'll call Sarah. She is a really good tech. The problem is that she has an attitude with me. I have reported her at least twice and nothing ever gets done. It goes like this:
I always get my own admission VS, post-op, post cath, and blood VS. I very rarely ask a tech to do anything for me. They know what they are supposed to do and they do it. Yesterday I had a new patient that the physician had sent up from his office, he wasn't even allowed to stop at admitting, dx: viral meningitis. He was 80 years old and I was told that his temp was 103 and that I was to immediately start an IV, order labs, give IV Phenergan, get VS, etc, etc..... At the same time I had another admit come up from the ER. I asked Sarah to get the vital signs on the first patient while I was starting the IV. She brought the dinemapp in the room and said "since you're in here you can get them" I said no Sarah get the VS, she said " do you want me to show you how to operate the equipment, is that the problem?" and she promptly left the room. I was not only furious but embarassed in front of the patients family. I told my assistant nurse manager and she didn't say much.
This is the 3rd such similar incident with this CNT in about 3 months time. I have spoken to her directly also with no results. Any suggestions? What I'm thinking about is asking for a confrontation in the nurse managers office.
I would like to tell her that I think she does a good job but do not appreciate her reluctance to do something that I ask her to do because I only ask when it's really needed. I would like to tell her that she needs a refresher on what her job description entails. Should I mention that I am her superior, well that's not the word I want to use but you know, I'm over her, in charge......?
I want to tell her that if she wants to give the orders that she should go to school and get her nursing license. Thanks for any advice you can offer. We both work tomorrow and I'll let you know how it goes. Thanks.

Hmmm...I can see why you are upset. I had an incident happen at the hospital I work as a Charge Nurse. The nurses made complaints to me, and I addressed it with the tech. Verbal warning regarding attitude, and sent a copy to the manager. The second time, the nurses made a complaint regarding attitude and job performance, and once again I discussed with her job duties and the expectations of her, and asked if she had any questions regarding that. She stated she understood. A copy of the counseling went to the manager, along with my concerns regarding this tech. The last incident involved the nurses and two patients making a complaint regarding attitude and not performing job duties, and I confronted her once again, and spoke with my manager again. She was terminated. I understand that the tech you work with does a good job otherwise. Does she give other nurses an attitude? or is it just you? If it is just you then I would want to have a sit down with her and the manager and discuss your concerns. If it is not just you; then all the nurses should have a sit down and air any concerns either may have. My concern, which I think is very unfortunate, is that you have gone to your manager, and she/he is not supporting you and taking your viable complaints seriously. This is not about egos, this is about what is best for your patients, and the expectation that techs, nurses, and everyone else do their job respectfully to all involved. Well, that was my two cents, and it may be only worth half that, but good luck with everything truely. BTW I think it is a great idea always to start off with the positives that someone is doing first, and then going into I have noticed that.....

Green_Dragon · Feb 24, 2005

sounds like insubordination to me. probably could get her fired for it, at least if she worked at my institution.
of course, most of us don't want that. we just want our vital signs without a hassle!
please remember that the more you do it yourself and don't ask her, the easier her life is. so she continues to harrass you, knowing you won't ask her to do things if she bullies you. so you ask the cnts that are reasonable to do things for you and you don't ask her. then the cnts that you like (because they're helpful) get burned out and leave because everyone asks then to do things.
then you're stuck with you-know-who as your cnt again.
it's a vicious cycle - been there before.
remember your role as the rn is to provide strong, clear leadership of the nursing team - for the patient"s sake.
when she tries to give you a hard time, stop what you're doing and look her straight in the eye and say"let me understand what you're saying. are you refusing to get the vital signs?" if she has any sense, she'll realize where you're going - making a case for getting her fired.
if she says yes, then it's insubordination because she's refusing to take care of the patient.
if she says no, then tell her to get them and forget about it. she's not worth getting upset over.
at least she'll know you can't be messed with, and eventually she may respect you (or at least everyone else will) for standing up to her.
i know, it's not as easy as all that. it takes practice.

well spoken :yeah:

Green_Dragon · Feb 24, 2005

Is flogging still frowned upon??? I can not remember if I got that memo or not hmmm..

Ok, I could not resist hehehe :rolleyes:

alexandria1221 · Feb 25, 2005

I have a tech at work who I'll call Sarah. She is a really good tech. The problem is that she has an attitude with me. I have reported her at least twice and nothing ever gets done. It goes like this:
I always get my own admission VS, post-op, post cath, and blood VS. I very rarely ask a tech to do anything for me. They know what they are supposed to do and they do it. Yesterday I had a new patient that the physician had sent up from his office, he wasn't even allowed to stop at admitting, dx: viral meningitis. He was 80 years old and I was told that his temp was 103 and that I was to immediately start an IV, order labs, give IV Phenergan, get VS, etc, etc..... At the same time I had another admit come up from the ER. I asked Sarah to get the vital signs on the first patient while I was starting the IV. She brought the dinemapp in the room and said "since you're in here you can get them" I said no Sarah get the VS, she said " do you want me to show you how to operate the equipment, is that the problem?" and she promptly left the room. I was not only furious but embarassed in front of the patients family. I told my assistant nurse manager and she didn't say much.
This is the 3rd such similar incident with this CNT in about 3 months time. I have spoken to her directly also with no results. Any suggestions? What I'm thinking about is asking for a confrontation in the nurse managers office.
I would like to tell her that I think she does a good job but do not appreciate her reluctance to do something that I ask her to do because I only ask when it's really needed. I would like to tell her that she needs a refresher on what her job description entails. Should I mention that I am her superior, well that's not the word I want to use but you know, I'm over her, in charge......?
I want to tell her that if she wants to give the orders that she should go to school and get her nursing license. Thanks for any advice you can offer. We both work tomorrow and I'll let you know how it goes. Thanks.

Write her up!!!!! Then the parking lot idea sounded good but it needs to be off company property. Go to the street! :rotfl:

vidrine rn · Feb 28, 2005

Yes, but you see, if she does the CNA's job, then she doesn't have TIME to do her OWN....that's why they're called "Nurse Aides"....they are supposed to AID THE NURSE...not the other way around.
Yes, nurses can get VS, but it sounds like this nurse was already very busy with admissions.
What is the CNA there for, if not to do her or his job? :angryfire

i am a rn, and i have done alot of admits. at my hospital we do the initial vs on a new admit. and that is what we learned in nursing school. when the pt walks in the room, its

the first thing we do. bring the dinamap and take vs. then we do the rest of the admission. not hard at all. after, the admit is complete, if we need vs for whatever reason the nurses aides do it.

Town & Country · Mar 4, 2005

This thread was about a nurse having two admissions at once, and her need for the CNA to get VS on one of them.

There's nothing wrong or remiss in the original poster requiring that the CNA do their job.... :rolleyes:

CarVsTree · Apr 24, 2005

i thought DutchgirlRN said she was In the Room, starting an iv. my point was only that she could have put the cuff on pressed a button, start the iv, glanced at the dinamap for the signs and moved along. i am just looking at the story both ways, because i know how it feels in that specific situation.

Bet you never started an IV. I am a tech and I would not expect the nurse to get the signs on a very sick patient while she also has another ER coming. It is the tech's primary responsibility to get the signs and the RN was clearly doing other nursing duties. Start the IV press a button, watch the dynamap, blow the vein, startover. Sounds ridiculous and this tech that is making us ALL look bad needs to be fired or put in her place (same thing if you ask me, she should be fired).