Young Nurse-New Care Coordinator

[Rebel_Kitty]

Hello members,

Im a new care coordinator for a long term care facility, I handle four units; 90 beds. I'm a fairly new RN only been practicing for 1.5 years. On my first week there, I had to do job observation wherein I shadowed the careaides and I noticed so many wrong things that they were doing for example; leaving soiled diapers on the floor and side tables, using sit to stand lift with only one out of two buckles secured, using paper towels and not toilet paper when wiping after bm, pushing wandering residents roughly down onto lounge chairs for them to 'sit' (we are a no restraint facility), mouthcare inconsistent (not done for all residents), not repositioning enough even though it says on the careplan to reposition q2 hours, pad checks not done enough and etc.

What do you think is the best way to handle this and make sure staff knows what they are supposed to do. I started by talking to the careaide one by one and discussing their poor practices and letting the nurse in on the discussion (as the nurse is the shift supervisor and would be with them more than I would). I also said I will be documenting our discussion and will get them to sign it once I have it typed up, for it to go on their record. Am I being too strict? Should I have given them a verbal warning first? We are a non union facility btw..The CEO btw is a very passionate lady and wants to be the BEST care facility in the world.

Thanks

[KateRN1]

You might start with assessing the situation and making sure that the aides have the time and supplies to do their jobs properly. Many years ago, I was a nurses aide in a nursing home and I can tell you that it is no easy job. First make sure that they do indeed know how to do things properly. Then make sure that they have the tools they need and the time to accomplish it all. You might be surprised if you actually had to do that job yourself, rather than follow around and make note of all the things people did wrong. Did you see them do anything right? Did you praise anyone for the good care that they did give? Did you pass out any kudos along with your write-ups? My mother used to say, and it's still true today, that you catch more flies with honey than you do with vinegar.

[classicdame, MSN, EdD]

be sure to ask the aides why they believe these things are happening. Ask with the attitude of "I need your help in getting this resolved". You could learn a lot.

[jlcole45]

Education, counseling for non compliance and then if necessary fire them. Period.

If you set up high standards then they will either meet them or leave (quit or be fired).

Make sure their evaluations are tied to the expectations you set up and be CONSISTENT.

That is the key - consistency.

[Orca, ADN, ASN, RN]

You might start with assessing the situation and making sure that the aides have the time and supplies to do their jobs properly.

Some bad habits are adaptations to not having the proper equipment and supplies.

You might be surprised if you actually had to do that job yourself, rather than follow around and make note of all the things people did wrong. Did you see them do anything right? Did you praise anyone for the good care that they did give? Did you pass out any kudos along with your write-ups? My mother used to say, and it's still true today, that you catch more flies with honey than you do with vinegar.

If the change is to be lasting, it is important to get staff buy-in on the changes you plan to make. Explain your observations in a non-judgmental way, and explain why the changes are beneficial to your patients. Kate made an excellent point about praising staff for the things they do well. If everything they hear from you is criticism or about things they are doing wrong and need to change, all you will get from them is looks of dread when you come anywhere near them.

When I go into a new environment the first thing I do is observe. I go in without any pre-conceived notions of what I am going to find or what needs to be changed. Those things will become apparent soon enough. You have already taken the first step. It is also important not to throw too much change at your staff at once. This can be very anxiety-inducing for some employees. Commend them for something they have corrected and say, "Let's build on that. Now let's do (whatever)." It also helps to solicit staff ideas. Ask for their input on how to correct a problem you have observed, and implement their suggestions if they are good. This goes along with the concept of buy-in. If they see that their opinions are valued and can result in change, you will soon have a plethora of ideas and you won't have to come up with as many yourself. Some of the best things I've put in have been staff suggestions.