Caregiver - Nurse Relationship

Teamwork is the key!  Chances are, everyone at your workplace would agree that client care improves when nurses and caregivers work together as a team.  Unfortunately, it can be a challenge!

WHAT CAN THE NURSE DELEGATE TO YOU?

Delegation is when a nurse entrusts the performance of a selected nursing
task to someone who is qualified, competent and able to perform that task.

Every state’s Board of Nursing has regulations about which tasks may be delegated by nurses to both certified and non-medical caregivers.  In most cases, nurses follow a five step delegation process.  In this process, the nurse: 

1. Assesses each client thoroughly before delegating any tasks to you.
2. Plans how the task should be performed, based on the client’s individual needs.
3. Trusts you with the task, but because you are working under the nurse’s license, the nurse remains responsible for the task.
4. Gives you clear instructions and adequate supervision.
5. Follows up to see how you performed the task and how the client responded.

As a caregiver, when you have tasks delegated to you, you have the right to expect that:

• The task assigned to you is one for which you have been trained and is an approved task in your state and at your workplace.
• The client’s health will not be jeopardized by what you have been asked to do.
• In the past, your performance of this same task has met the standards of your workplace.
• You have been given all the details you need to perform the task safely—and you understand what is expected of you.
• The nurse will be available (either in person or by phone) should you have questions about any aspect of the task.

COMMUNICATION IS A PRIORITY

Remember: no matter how well you perform technical skills—like taking vital signs—you will never be completely successful without good communication skills.  A key skill that improves communication is assertiveness. 

When assertive people communicate, they try to balance the power between themselves and the people around them.  They give as much as they get.  

Assertive people express what they need clearly—without any hidden messages—and without trying to control anyone else. 

HOW CAN YOU create a “friction-free” team of nurses and caregivers?

• Avoid the “grapevine.”  Unfortunately, it seems that when humans get together in groups, gossiping and talking behind other people’s backs is common.  This is very destructive behavior!  Try to keep your personal feelings about co-workers to yourself, and refuse to listen to gossip.  You’ll have a happier workplace!
• Say thank you.   If you wish that the nurses would express their gratitude to you more often, try sending some appreciation their way.  For example try saying to a nurse, “Thanks for helping me finish up with Mr. Jones.  You really saved my morning!”  Chances are, your kindness will come back to you!
• Praise yourself, too!  At the end of each work day, tell yourself a few things that you did really well that day, such as, “I finished all my client care on time today.” or “I really feel good about how I handled that disagreement with Susan.” or “Mrs. Smith and I had such a good conversation during her bath today.”  Remember that being professional means that you admit both your mistakes and your achievements.
• Be willing to listen.  People who choose to work in nursing tend to be sensitive to the needs of others.  They are expected to be warm and caring people.  Yet at the same time, they are expected never to make a mistake and to work as tirelessly as machines.  It’s a lot to ask of people—to be kind and sensitive and still get all the work done quickly!  But, this is the goal for everyone in the nursing field.  Help your nursing team by encouraging them to talk to you when they are stressed and by being willing to share your feelings with them.  No one knows better what the stresses of your job are than the other nurses and caregivers!
• Stick to the rules.  Don’t ever perform a task that you know is beyond your training—no matter who asks you to do it!  For example, let’s say your supervisor is a registered nurse and she asks you to change the sterile dressing on Mr. Tucker’s chest wound—just this once.  You know it’s against regulations but you want to make your supervisor happy.  Don’t do it!  You could lose your job, as well as your ability to work as a caregvier.
• Be a problem solver!  When talking with your nursing team, offer solutions not just problems.  Your team will benefit from your creative ideas and your ability to solve problems.  Don’t be shy about offering your opinion about how to make things better for your co-workers and your clients.
• Keep it to yourself.  Never say anything negative about another team member—especially to a client.  For example, during her bath, Mrs. Miller says to her caregiver, Roberta, “Oh, that nurse, Sylvia...she’s mean.  She’s always telling me what to do.”  If Roberta says, “You’re right, Mrs. Miller.  Sylvia can really be a witch!” what do you think that will do to Mrs. Miller’s relationship with her nurse?  Even if Roberta dislikes Sylvia, she should support her work with the client and say something like, “Mrs. Miller, you must get tired of all of us coming to see you.  But, we all want to help you get better.”
• Remember your clients.  Most people get into nursing because they want to help others.  But sometimes, this fact gets lost if nurses and caregivers aren’t getting along.  In the end, sharing information about clients is the most important communication for your nursing team.  Whether you communicate in writing, with an oral report, during a meeting or one-on-one, it’s all about working together for the best interests of the client.  Don’t let anything get in the way of that.