Monday, May 26, 2014

Tips for New Nurses: Effective delegation starts with understanding this

new nurse, graduate nurse, student nurse, nursing assistants

One of the biggest struggles new nurses face is learning how to effectively delegate to nursing assistants. Let’s say you’re 23 years old and get your first job on a busy cardiac unit. You quickly learn that the most of the nursing assistants are much, much older and have been there for centuries! When you meet them, they give you a look – a look that says, “We’ve been here for 30 years and we’re not about to let a young whippersnapper like you tell US what to do!” Seriously, I spend most of my time helping individual nurses and organizations eliminate nurse-to-nurse bullying but sometimes it’s not the nurses – it’s the nursing assistants!!! Many nursing assistants try to intimidate the new nurses on purpose so that they will be less likely to delegate to them.
However, the only way you can successfully provide high quality, safe and effective patient care is to learn how to work WITH nursing assistants (and others) and delegate.

The good news is that just like inserting an IV, delegation is a skill that can be learned!! The first step to effectively delegate to even the crustiest of nursing assistants is to truly understand WHY they behave that way.
Understand the reason for their behavior
Several years ago I was speaking to a group of graduating nurses and asked them what they were most looking forward to as new nurses. One graduate, who had been working as a nursing assistant, said, “Now that I’m going to be a nurse, I’ll never have to wipe butt again!”  Really??? I’ve been a nurse for more than 23 years and let me tell you, although not my favorite job to do, I can “wipe butt” better than anyone I know!!! Taking care of patient’s hygiene needs is just part of the job.
I’ve seen nurses walk out of a patient’s room and spend 10 minutes trying to find the nursing assistant to put her patient on the bedpan. Really? In the time it took that nurse to find the nursing assistant, she could have already taken care of it.
Trust me…nursing assistants KNOW this and then develop a distrust for nurses. This delegation dance has existed for decades and hence why many nursing assistants take on a defensive approach when they meet new nurses. They think you’re going to be “just like the rest of them.”
Keep in mind that understanding doesn’t justify their behaviors but it helps you to start paving the path to building respectful relationships with all members of the healthcare team. After all, it takes all of us to care for patients!!
Action Steps:
·      When talking about patients, use words such as “we” and “our”
·      Include nursing assistants in report
·      Ask them about their workload for the shift
·      Pitch in and help them when you have time even if you’re not assigned to that patient
·      Show your gratitude any time you can
These are just a few simple ways you can start gaining trust with the humans who play a significant role in YOUR ability to care for patients. Remember, we are all humans first and then we each have a functional role that needs to be respected and valued!
Thanks so much for reading and for choosing to be a nurse. I’m cheering for your success!
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  1. You have an interesting blog. thanks for sharing, I enjoyed reading your posts.

  2. Thanks for the comment! This is my second blog. My first one ( has been around longer but I wanted to do something to support students and new nurses. Glad you enjoy.


  3. You hit it on the head with this article and I must say we see this a lot. Bullying in the nursing field and nurse assistants trying to intimidate new nurses so they are not told what to do. This article really gives us the inside view of what goes on in these nurse facilities. Please see as we are going to be adding nursing blogs there

  4. I am a new nurse and I do not understand this behavior. We all had to come to being a nurse the same way, nursing school.

  5. I don't understand it either Sunflower!!! That's why I'm spending my time doing something to stop it!! Nurses should be kind to each other - not cruel!!!