[pamperednurse]

I am a nurse manager for a 18 acute rehab unit. We have a program director and a nursing director. Each one of them reports to a different vice-president. I am in the middle as the unit nurse manager, having to report to both. Hard to support one and not the other. Any one else ever heard of this mix, and what is your management structure?

[wendilynn]

I am the Clinical Manager (same thing as Nurse Manager) for 28 acute rehab beds. I have a Director over me and then the VP is over her. I just have to report to her. The only downside thing is that she is not a nurse. I also have to be charge nurse and educator. The director does not use charge nurses.

[wendilynn]

sorry...duplicate.

[takenbyjoy]

I'm Case Manager for 25 bed acute rehab center. We are part of "University" system, big teaching hospital, even though we are not in the main hospital. I report to the Program Director (she's an OT, but good with nurses). She reports to an Assistant Administrator (with NO rehab background). Our nurse manager (no rehab background) should report to the Program Director, but somehow reports directly to the Assistant Administrator. We are constantly fighting with the Administrator about rehab issues.......esp. staffing. She's been in the system sooooo long that she can't see that what works in the acute hospital setting is not necessarily gonna work in rehab. Our medical director goes to bat for us, but it is a long up-hill battle. Pampered Nurse, I've never heard of your set-up before......but I do know what it's like to be responsible to more than one boss. That is VERY difficult. I would hope you have a good job description.

[MNlpn]

Talk about top heavy with management....we have the Rehab system director, the Medical Director,then the Program Director, then a DON, then the nurse manager! Too many cooks in the kitchen

[Louiemae]

Hi PamperedNurse,
I am a nurse manager for a 20 bed acute rehab unit and report to an AVP for nursing. I also have a peer relationship with the program director. I once worked in an acute hospital as the nurse manager of a rehab unit and reported to a nursing director and had an indirect reporting relationship with the VP of Rehab. It was termed a Matrix Organization. It was tricky at times to manage the politics, but I knew which person I ultimately reported to (the DON) and always made sure that what I was doing was in line with her direction. There were times, however, that I used my relationship with the VP to get things done (since she had more clout in the organization). My question for you is who does your performance appraisal? I have learned through a long nursing career to never ruin the relationship with the person who does your performance appraisal. That person is the one who would have my ultimate allegiance when I had to choose. Of course, I try to always work well with the others too. The politics in rehab are trying at times. Hope this helps some.