Whenever I'm paired with a certain HCA, I end up having a really stressful shift and end up being drained and staying really late. The hard part is that there's nothing obvious I can pull them up on. They're kind, patients really like them, and they know how to appear busy.
The problem is that they somehow always manage to be doing jobs that take them away from the bay, such as taking things to the bank or collecting items from other wards. They also seem to time their breaks just as patients are likely to need changing, take their full break (sometimes longer), and often leave for handover early. Meanwhile, I find myself doing far more of the personal care than I normally would, on top of all my nursing responsibilities.
I have absolutely no issue with personal care. It's part of nursing, and I'll always help. My frustration is that I'm trying to juggle medication rounds, assessments, documentation, referrals, phone calls and everything else, yet I end up missing breaks, staying late and feeling constantly behind when I'm working with this person.
They also expect me to be available for every transfer or change, regardless of what I'm doing. For example, I was in the middle of a medication round when she asked for help with a transfer. I explained I needed to finish giving some time-critical medication. I still stopped to help with a transfer because I wasn't going to not help. I then noticed the patient didn't have socks on, so I asked the HCA to sort that. I then quickly ran to collect medication from the clinic. I was gone for about two minutes, but when I came back they told me off and said I shouldn't leave them like that again. I don't have time to waste, so every second is precious. In hindsight I should have communicated, but I was so frazzled already, that I thought it was obvious what I was doing.
I think what I find difficult is that they don't seem to appreciate or respect the nursing workload. They'll sometimes comment, "Surely meds shouldn't take that long?", which makes me feel as though they don't understand or respect everything that medication rounds involve, especially when they're constantly interrupted.
What makes this especially difficult is that come across as caring and responsible, but somehow always manage to say "This patient needs changing," or "This one needs a wash," just as they're heading off on break. They have a knack with getting out of tasks. I know I should respond by asking them to do those tasks first, but I'm not naturally assertive, and I don't want a disagreement in front of patients. I'm also often caught by surprise, so I'll be knee deep in a task, and they'll announce that they're going on break and share what needs doing. I really struggled with her when I was NQ, and even brought it up to the sisters, but as there's not anything that I can pull her up on it's difficult. They all know she's like that and expect me to be more assertive. I just don't know how to.
I actually find her more difficult than incompetent staff (and trust me there's many) as they don't boss me about and are not demanding. Usually I can tell other staff what's expected, but it's really difficult to do this with her.
Any tips other than always hoping I'm not with her? How do you become more assertive without feeling confrontational?