An Open Letter to (Micro)Managers

**VivaLasViejas**, ASN, RN

Yeah, I'm talking about YOU. The unit manager who never met a rule she didn't like, makes new ones daily, and rarely, if ever, comes out of the office to see how they affect the folks doing the actual work. The DNS who lays everything on the charge nurse that the CNAs are either too busy, or too lazy, to get to during the course of a shift, including cleaning duties.....as if s/he doesn't already have enough to do. The social services director who encourages residents' families to help develop care plans, which almost always wind up so detailed that we have seventy-five residents who think they alone have the right to monopolize "the help". The audit nurse who issues write-ups to every employee who, in the process of passing meds and doing treatments for 45 residents, forgets to initial so much as a single space on the MARs/TARs.

You know, I was a manager myself in a former life, and while I may not have been the corporate ideal of a great boss---I wasn't tough enough---I treated my staff like adults. Even the eighteen-year-olds fresh out of high school. I hired them to do adult work, for adult wages, and I expected them to make work their first priority when they were on the clock. And now, as a lowly charge nurse, I still do.....which could be why most of my CNAs consistently outperform those working on other floors and other shifts.

But none of that really matters. No, you're the Big Kahuna, so you get to dictate every last detail of how I, a fiftysomething grandmother, am to spend MY workday. It's not that you can't teach an old dog new tricks; I've never made a secret of the fact that I don't know everything, and I'm always willing to listen. But do you honestly believe I raised four teenagers to have learned NOTHING about handling weird situations and unhappy people? And do you think I'm such an idiot that I need a paint-by-numbers task schedule and a kick in the pants to jump-start me?

Seriously, I wonder about that sometimes, especially when you leave your nasty-grams at the nurses' station where everyone from the janitor to the med aide can see what an individual did "wrong" and gossip about it. I know we're all subject to the same humiliation, but again,you're dealing with a grownup here.......someone who takes a great deal of pride in doing a good job. When I fall short in some way (or violate one of your gazillion rules), I'd much prefer to be taken to task in private.

Look, as I said before, I've walked a mile or two in your stilettos, and I know you don't really hold interdisciplinary meetings for the purpose of dreaming up new torments for the staff. I understand that when basic care doesn't get done, or a resident falls and fractures his skull because his aide stepped out for five minutes instead of answering his call light, you have to tighten up. Heck, I once fired an entire weekend evening crew because all four aides were outside on the patio smoking, instead of in the dining room like they should have been during dinner. Their stupidity nearly cost a resident her life when she choked on a piece of steak; fortunately for all concerned, the cook came out and performed a Heimlich to save her, then called me at home. I came in, assessed the resident, sent her to the ER as a precaution, and then wrote out termination notices. Yep, I know management isn't as easy as it looks from where I sit now.....and that's one of the reasons why I went back to the cheap seats.

But since I also know you're wondering why staff morale is in the toilet these days, I'll tell you that it wouldn't be if you gave us credit for having some brains, instead of micromanaging us.........and if you'd stop allowing certain 'favorite' employees to get away with poor performance. I can't count the number of times I've written up the same four or five CNAs for not giving showers and leaving residents marinating in their own waste for hours on end. I can't tell you how many times I've walked onto the unit and smacked right into a wall of ammonia, or found residents who have clearly been in bed all day, still clad in the gowns my staff put on them last night, with tell-tale brown rings on the drawsheet. Nor can I count the number of times I've tried to explain to residents AND staff why these bad apples are still employed here, mainly because I don't know either.

Which brings me to this: how, in the name of all that is reasonable, do you expect to recruit and retain good staff members if you're unwilling to acknowledge them as such, or offer incentives for excellence? Instead, you give the laziest and the worst-tempered aides the choice positions, you're 'too busy' for performance reviews even when they're due and deserved, and you STILL haven't done anything about the LPN who's alienated CNAs, residents, and families alike with her rude manner and sharp tongue. (In case you've forgotten, this is the same nurse who has committed several extremely serious judgment errors that landed one resident in the hospital and caused the families of two others to move them to other facilities; she has also failed on numerous other occasions even to assess residents whose aides reported new skin issues or other significant changes. I know this because her aides are forever asking ME to check out their concerns.)

Don't get me wrong; for the most part I enjoy working here, I love my residents, and have no desire to change jobs anytime soon. You get to be my age, and work isn't so much about the money or the prestige any more---all I really want is to do what I went to nursing school for: namely, take care of people. And I know I can do a great job.......if you'll just back off and trust me to DO it!!

Thank you.

Signed,

Your Employee

An Open Letter to (Micro)Managers

About VivaLasViejas, ASN, RN

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