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.
I am so sorry you had to deal with that BS DutchgirlRN. I am a new nurse, and I had a similar problem. I work in the ER and it gets busy down there as expected. I once asked the tech if he could please go do a EKG on another nurse's pt. He said to me, "You know you guys are gonna have to start doing this kind of stuff too." I was so pisted off, although I didn't make a scene in front of everyone. I waited until he was cleaning one of the rooms, and we were alone and I asked him if he had a problem with helping out. He just said he was really busy taking pts upstairs and that he thought we should help out. I told him that the pt wasn't my pt and I was too busy with my own pts and that that nurse needed his help. I also told him that it is the ER and I understand that he is busy, however we are all busy and overworked down here. Then I said if I ask him to do something it is his job to do it. And I usually do whatever I can myself however it is his job to help the nurses out. I also told him that if I came across as rude in anyway that it was unintentional, however I do not like to be undermined and fight in front of people. So I would appreciate his compliance and to confront me if he has any problems in private. He apoligized and told me I wasn't being rude (and I knew I wasn't I mainly just said this to mend the situation and let him know I am approachable) and then told me to let him know if I needed anything else. Point blank though, this guy is so freaking lazy, he is one of those that will sit his whole shift at the computer surfing the web and kissing the docs butts. Personally I don't care that he was pist cause he had to do work, and if he is busy his conversation was just downright innappropriate. DUTCHGIRLRN, YOU GOTTA STICK UP FOR YOURSELF, CAUSE IF YOU DON'T THEN RUDE PEOPLE OUT THERE WILL TAKE ADVANTAGE OF YOU AND BULLY YOU AROUND. We as nurses are worked to death and I'm sure the CNAs/techs are too, but remember they are there to help and you should not be scared to ask for help from your fellow nurses or techs.
Some of these CNAs just want to show up to work and collect a paycheck for doing as little as they possibly can. Floor nurses should have the power to send an aide home the first time one of them refuses to do their job. If a nurse has to do her job AND the aide's job, the aide doesn't need to be there. After a few lean paychecks, either the aide would lose the attitude, or leave the job and make way for somebody new who will do the job appropriately. It's unfortunate that staffing ratios have nurses having to accept a bad CNA because "it's better than no CNA at all". That's why the ones who have attitudes get away with it.
OK,, heres a concept. Regarding the b/p and starting the IV at the same time. No there isnt any reason the Rn couldnt have gotten the b/p while the CNA got the TRP. Blood pressure cuff on patient, take the b/p, while the cuff is inflated stick the iv. Would the CNA have documented the b/p for the RN with her admittion vitals, doesnt sound like it. Simple yet because of thinking patterns between the CNA and RN it probly wasnt considered. That's ok, did the CNA go to the second patient admit and get those vitals and orientate the patient while the RN was finishing up on the first one? Probly not.
While care pattern logic is different for both practices there is a way to go around difficult feelings. But i also know if we as RN's make CNA's jobs a little easier it makes ours harder. Dont be upset with me if i ask something of you because i see you standing in the hallway chatting with another CNA or ancillary staffmember.
My philosphy when i work, and ive made this perfectly clear to everyone on my unit is if im not sitting you better not be either because ive got a list of things you CAN do. Ive tried to explain to people if management comes around and sees people sitting they are setting themselves up to be short staffed because someone will be called off. If they have time to sit there isnt enough work to go around. Not my mindset but it is managements.
I know its a bit off subject but i felt it needed to be said.
No there isnt any reason the Rn couldnt have gotten the b/p while the CNA got the TRP. Blood pressure cuff on patient, take the b/p, while the cuff is inflated stick the iv.
Yes, there is a reason. Our dinemapps are all one unit and two people cannot use it at one time besides the BP cuffs are automated and cannot be used as a tourniquet. Bottom line, she refused, she was wrong. She was written up twice for the same thing and nothing was done. If it happens again I guarantee you something will be done, by me!
It sounds like your supervisor does not know how to be an effective manager. If you have personally written this person up twice, and other people have now complained enough to finally warrant disciplinary action, why did this "sarah" still feel comfortable enough to disregard your request of her, and appear so unprofessional to the patient and his family?
Is your facility understaffed with nursing assistants? Are they afraid to let another one go? I think the only road to resolution is by the Nurse Manager getting more involved with emphasizing a team work approach on your unit. You as an RN should not bark out orders to a nursing assistant, just as the nusing assistant should not blatantly disregard your order. Mutual respect should be the rule, and it doesn't seem to be existant in this situation. That's why the Nurse Manager should be there to intervene and even FORSEE problems such as these (multiple complaints of this person should have clued her/him in).
I have never barked out an order nor shown disrespect for a co-worker. I don't see how that was ever read into this? Anyway, people I work with can get away with anything! I know the hospital has been sued twice and lost by formerly fired employees. Sarah has threatened the hospital before. I know that for a fact because I was told by my nurse manager. I think it's a **** shame.
I have read and reread some of your posts, I am picking up anger and stress from you over the situation you find yourself in dealing with this CNA. I have been exactly where you are now and I had to think and rethink my position. It may be time to look at the board for other openings at your facility. How about a change in shifts? It sounds like you have tried to do all you can do with this particular staff member and you are not getting support from the manager. Time to change tactics. I know it is lousy to have to be the one to do the changing, but if it cuts down on the stress go for it. Keep us posted on what happens.
I won't give up my position as charge nurse, and working with other nurses that I enjoy working with just because someone irritates the crap out of me. All I need to do is to tell her to her face, with a witness present in the room, what her job description is and what I expect of her. She may still continue to refuse to do things that I ask her to do, sooner or later I believe it will come back to bite her in the butt.
When I was a CNA (during nursing school), when I was asked to do something by the RN, I would not question it.
HOWEVER.......as a CNA I also know when I am being "abused" by my RN....
1. The RN comes OUT of a patient's room as I am walking in, and she asks me to empty the urinal/take out the patient's food tray. GIVE ME A BREAK!!!!!!!!!!
2. The RN asks me to take the vitals when she is giving blood to a patient. OK so I have 6+ patients to bathe, do I/O's, take vitals on etc and YOU want me to stand in the room and take vitals q15min x 1 hour?!?! I can understand you wanting me to take the pre-transfusion vitals and maybe the post, but come on......
Only a couple of reasons why I decided to go into ICU (where its my patient that I have total care of...no CNA to do my vitals!)
In this particular situation, I think the CNA was out of line for acting so unprofessional in front of the patient and family. If she had issues w/the RN "bossing her around" she should have talked to the RN afterward about it.
In this particular situation, I think the CNA was out of line for acting so unprofessional in front of the patient and family. If she had issues w/the RN "bossing her around" she should have talked to the RN afterward about it.
Exactly my point, because I never ask the CNT's to do anything for me, never. It was just in these 2 recent situations where I really needed her to help. I have seen RN's/LPN's walk out of a patient room to hunt down a CNT to go empty a BSC or put another blanket on a patient or something so simple that she could have done herself rather than take time to hunt down the CNT. :angryfire I think that's total disregard for her co-worker, her patient, and shows herself as being either too lazy or too good to do minial tasks or both. I would say that nurse has RN-itis.
humiliated
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I am so sorry you had to deal with that BS DutchgirlRN. I am a new nurse, and I had a similar problem. I work in the ER and it gets busy down there as expected. I once asked the tech if he could please go do a EKG on another nurse's pt. He said to me, "You know you guys are gonna have to start doing this kind of stuff too." I was so pisted off, although I didn't make a scene in front of everyone. I waited until he was cleaning one of the rooms, and we were alone and I asked him if he had a problem with helping out. He just said he was really busy taking pts upstairs and that he thought we should help out. I told him that the pt wasn't my pt and I was too busy with my own pts and that that nurse needed his help. I also told him that it is the ER and I understand that he is busy, however we are all busy and overworked down here. Then I said if I ask him to do something it is his job to do it. And I usually do whatever I can myself however it is his job to help the nurses out. I also told him that if I came across as rude in anyway that it was unintentional, however I do not like to be undermined and fight in front of people. So I would appreciate his compliance and to confront me if he has any problems in private. He apoligized and told me I wasn't being rude (and I knew I wasn't I mainly just said this to mend the situation and let him know I am approachable) and then told me to let him know if I needed anything else. Point blank though, this guy is so freaking lazy, he is one of those that will sit his whole shift at the computer surfing the web and kissing the docs butts. Personally I don't care that he was pist cause he had to do work, and if he is busy his conversation was just downright innappropriate. DUTCHGIRLRN, YOU GOTTA STICK UP FOR YOURSELF, CAUSE IF YOU DON'T THEN RUDE PEOPLE OUT THERE WILL TAKE ADVANTAGE OF YOU AND BULLY YOU AROUND. We as nurses are worked to death and I'm sure the CNAs/techs are too, but remember they are there to help and you should not be scared to ask for help from your fellow nurses or techs.