Late to Work

Question: One of our RNs is habitually late by 5 to 10 minutes at the beginning of every work day. The senior physician has spoken to her about this at every performance review for the past three years. When confronted she explains she just can't be on time. This nurse is great with patients, gets along well with the staff, is flexible, thorough, and professional in every other area, which is why we have only threatened to fire her but never have. We can't seem to make her understand that running in the back door breathless while our first patient of the day waits to be called in and the physician's schedule starts late is not acceptable. Any suggestions on how to get through to her - short of firing her?

Answer: You need to have another heart-to-heart talk with her.

I'd make these suggestions:

Point out that though this has gone on for years, no one in the practice is willing to take it lightly anymore and you really expect a response from this meeting.

Be clear about why it matters. This isn't about living a breezy lifestyle or her personality. Tardiness impacts patients and everyone she works with. Forcing patients and physicians to wait, and staff to spend the rest of the morning scurrying is just plain impolite and can have negative consequences for patient care.

Work cooperatively to find a solution. Ask why she is late. Does she have to drop kids off at daycare/school? (Believe me, this can nearly always take longer than expected.) Is she up late at night working a second job or on a hobby, making it hard for her to wake up on time? Would it help if someone on staff gave her a wake-up call until she had a new habit established? Maybe she'd prefer to go half-time and only work noon to five, leaving you free to find someone else to cover the morning. Can someone else be trained to room the first patient of the day so that the rest of you don't have to wait for her to arrive? Maybe the first patient doesn't get scheduled until 15 minutes after the hour and the nurse and physicians can all start later and work later.

Be serious about working with her to find the best solution - whether it's about her getting there on time or about you finding some work around if it's apparent that she can't change. This is not a conversation about "do it, or else." It's about practical solutions that everyone can agree on. Respect goes a long way to making people change. They feel like they need to live up to an arrangement they have agreed to.