And while we're at it-things you'd LOVE to ask/tell management and get away with

[HelenofOz]

cos they really get me going!

Why is it that when the nursing staff ask for new equipment it is refused, but if we get the doctors to ask for it we get it. I HATE having to play that game, it's so unprofessional. If we need it, we need it, regardless of who asks for it.

Why do you cave in to the doctors, why not back up your unit managers some times when they tell the doc 'no, you can't do that' (not necessarily so bluntly). You're just rewarding bad behaviour, and it'll just get worse.

Don't think I can be bought off with a burnt sausage at a staff BBQ after I've been racing round like a mad thing because you think we're overstaffed. (see below)

Do not walk through PACU in our quiet time, please come through half an hour later -and help- when we are packed and most of the pts need one on one care, and we've had to stop theatres bringing out pts for the third or fourth time that day

And, no, I will not have any respect for you when you've been here for 4 years and you still don't know who I am as you present me with a long service award-it's not that big a hospital, make an effort!

[CathRN]

While working as a staff nurse on a very busy neuro floor, I was quite blunt with our nurse manager when she was complaining during a manadatory staff meeting that our press gainey (gag!) scores were too low. I told her that on holidays, weekends, etc, that the floor runs much better when there isn't manglement around. And since that is a fact, why don't they cut out so many office positions and put more people on the floor so that maybe the blasted press gainey scores would improve.

I got into so much trouble for that, but it felt so good to say it.

[Moogie]

Please respect your staff. We are adults, not children, and deserve to be treated as competent individuals who are carrying out very important functions in your facility. We do not need you or your designate to baby sit us during our shift. Although yes, some might need some guidance and motivation to get the job done, please expect the best out of us rather than the worst. If you consistently label certain staff members as "lazy" or "slow", they will surely live up (or down) to your low expectations of them.

Don't talk about us behind our backs to your peers or our co-workers. And please don't lecture us about gossiping about co-workers when you in fact do it yourself. Don't spend half a staff meeting talking trash about a co-worker who is not at that meeting and then smirk and say, "Oh, I shouldn't be saying this." You are a role model for the entire staff. Moreover, when you gossip about us and we find out---surprise---we might be more likely to gossip about you. A vicious cycle indeed.

Don't tell us that you welcome staff input into how to make our institution or floor better and then turn around and do whatever you want anyway. Respect each person's opinion and listen---really listen to his/her suggestions. Don't tell us to think outside the box and then slap us down when we do so---simply because you have the power and we don't. Sometimes a new person---someone from outside the system---might see something that isn't apparent to the seasoned staff. Please listen to that person and don't dismiss his/her input as the blathering of a newbie who knows nothing. BTW, just because you're management doesn't mean you can't learn from all of your staff members. Listen to the RNs who are more experienced than you, who have different experiences or more education. Don't be threatened by their competence. Similarly, don't dismiss the insights of LPNs, CNAs or PCTs simply because you're an RN and they're not. In some clinical settings, particularly LTC, the LPNs, CNAs and tech are your backbone and provide the most direct care to your patients/residents/clients. Listen to them!

If you have a concern about me or my work, please bring it to my attention ASAP. Please don't spread gossip or talk behind my back. I am here to provide the best nursing care I possibly can but if the care I am providing is mediocre or needs improvement, I want to hear it directly from you, not from the gossip mill. Please don't tell me, several weeks after the fact, that I did something wrong or failed to follow policy in some way. If I make a mistake, please tell me right away so I can correct that mistake and learn from my error. Don't wait until my annual evaluation or until it's serious enough that you feel I need to be "written up". Tell me right away and in a respectful manner that upholds my dignity.

Please do not constantly hold the threat of suspension or termination over everyone's head. Management by intimidation is never appropriate and it's merely an excuse for poor managerial skills. There are some staff members who are so intimidated over the fear of getting disciplined or fired that their ability to work is inhibited. Some get so frightened they just stop thinking and are drones instead of nurses. You are an authority figure and wield much more power than your staff. Please use that power wisely and judiciously.

Please don't yell. Yelling is ineffective and creates a hostile work environment. It dehumanizes both of us. Speak to me in a calm, clear voice if I have done something wrong. Verbal abuse is never appropriate in any situation. And if you're a screamer, if you have a volatile temper that can't be controlled on the job, if can't stop yelling at your staff, please get some help for anger management and stress reduction. Figure out what's going on in your life to make you so angry. If there are non-work issues that you're bringing with you to the job, take action---do what's necessary for you to deal with your stress so you don't take your problems out on your staff. If your life is falling apart, maybe you need a hiatus from your job so you can deal with your problems more effectively.

Please give me adequate, consistent guidelines that are appropriate for my position and job description, especially when I am new and asking for such guidelines. Do not tell me I was hired to do "A" and then get upset when I haven't done "B, C and D". You didn't tell me that "B, C and D" were part of my job description. Then again, you did not give me a job description to begin with and then you denied me access to the policy and procedure manuals for weeks because the administrator had them. Moreover, please make sure that the chain of command is clear and consistent. Do I take orders from the NM/DON or from his/her assistant? What if those orders are contradictory? If I'm supposed to under the direct supervision of more than one person, please make sure everyone is on the same page. I can't do my job if one person tells me to do this and the other supervisor tells me to do the exact opposite.

And last, please give your staff feedback, both positive and negative. Try to catch us doing a good job instead of always looking for our mistakes. It doesn't take much effort to tell someone he/she is doing well. It's demeaning and frustrating to always be told what you're doing wrong and never, ever hear what you're doing right. If you never see your night shift staff, come in a little early one morning to touch base with them. Stay a little later in the evening to see how things go for your PM people. If you appreciate your people, let them know. And if you don't appreciate them, figure out why.

There truly are some excellent nurse managers in many settings who treat their staffs with respect. Unfortunately, I haven't run across many of them as of late. Thanks for posting this thread. Sorry this is so long; the subject touched a nerve. I hope I haven't offended anyone but good gracious, I needed to vent!

[Ruby Vee, BSN]

"if you think it's such a good idea to give the patient's daughter 10 mg. of im valium because her screeching and carrying on after the patient's demise is annoying the physician, you do it. i'm not going to do it." (oh wait -- i did say that. when the patient's daughter respiratory arrested right outside the patient's room following the im valium my manager gave, she changed her mind about what a good idea it was.)

"i really don't care that you slept with my husband years ago before i met him and presumably before you met and married your own husband. i wish you would stop introducing yourself to patients as his "old girlfriend," and adding "and this is his wife."

"i would take care of all five of these patients if i could, but this is an icu. wishing they were floor care doesn't make them floor care and wishing i was three nurses doesn't make me triplets."

"no, i do not have time to talk to the joint commission right now. see that "48" up there on the monitor? that's his systolic blood pressure, not his pa pressure. if you really want me to come talk to the joint commission, please get someone in here to take care of my patient first."

"i understand that you're really drunk, but i have no desire to hear the intimate details of your affair with one of your employees or the divorce it caused." (that was my husband's boss, at his christmas party.)

"no, ma'm. i did not tell a patient to "just (bad word meaning feces that rhymes with "it") on your bed and someone will clean it up." as you well know, patients do not always remember things accurately, and this particular patient has a long history of lying to management to try to get staff into trouble when they don't do what he demands. what i did say was that he couldn't get up and walk to the bathroom with that balloon pump in his femoral artery, and that i would get him a bedpan."

"i know he's your husband's partner, but when dr. jones comes out of a patient room followed by a very angry male nurse and the first words out of his mouth are "no matter what he says, i didn't hit him," and the male nurse has a bloody nose and a developing black eye, i'm somewhat suspicious that dr. jones did hit him. especially when the nurse says dr. jones hit him. yes, i know dr. jones has already been to anger management classes. i suspect he didn't learn anything."

"i promise, the very next time the assistant manager changes my schedule after i've left for vacation and puts me on one day in the middle of my time off, i will somehow magically know this and teleport back to work for that one day."

[Cindy-san]

"Take your Pressy-Gainey nonsense and your Magnet drama and shove them up your donut hole!"

[Moogie]

"i really don't care that you slept with my husband years ago before i met him and presumably before you met and married your own husband. i wish you would stop introducing yourself to patients as his "old girlfriend," and adding "and this is his wife."

"i would take care of all five of these patients if i could, but this is an icu. wishing they were floor care doesn't make them floor care and wishing i was three nurses doesn't make me triplets."

"no, ma'm. i did not tell a patient to "just (bad word meaning feces that rhymes with "it") on your bed and someone will clean it up." as you well know, patients do not always remember things accurately, and this particular patient has a long history of lying to management to try to get staff into trouble when they don't do what he demands. what i did say was that he couldn't get up and walk to the bathroom with that balloon pump in his femoral artery, and that i would get him a bedpan."

i've had similar experiences. when a patient/resident/client has a known history of, ahem, stretching the truth, i do not understand why management listens to him/her before going ballistic on the nurse.

[mama_d, BSN, RN]

Less is more with interior design, NOT with staffing. With staffing, less is less. Period.

Please, please, please, give me the benefit of the doubt once a year. Because that's how often patients complain about me. It's a pretty good track record, how about "wow, only one patient complaint this year, good job!" instead of almost loosing my raise over it? Nevermind the fact that the three complaints you have on my record from the last five years were all complete psycho nutjobs that the nursing supervisor couldn't even handle, and I was in the right every time. Oh, and the next time you tell me that I need to "watch my nonverbals", you might want to do it without that smirk on your face.

Why is it that, when I find grevious errors and bring them to your attention, I get in trouble? Aren't we supposed to be focusing on patient safety here? This is a health care facilty, right?

No, night shift cannot do all of the work. My techs work damned hard, and trying to get them to add baths to their patient load is ridiculous. How about you address why day shift refuses to do them, when they have one more tech and two more nurses for the same number of patients? My techs already do all of the a.m. lab draws and all of the EKGs, and the nurses are stretched too thin to assist with bathing in general. Yes, I give someone a bath about once a week, but that's to help out and be nice, not set a precedent.

How many freaking write ups does one nurse have to get before they're canned? Seriously. I know I've written up this incompetent fool who found her nursing license in a cereal box at least six times in the last year, and I know for a fact that between the other nurses and charge nurses on the floor, she's got about twenty other write ups. She's going to kill someone, and that's not being overdramatic. And when the time comes, I hope they sue your butt too for keeping her on.

Press-Gainey is a poor reflection of the care we give, we consistently get rated at four or five, it's the darned ED scores of one or two that are dragging us down. I have no control over what happens to them in the ED, why don't you go down there and talk to them about it? And, BTW, you might want to talk to whoever the idiot is that decided to expand the ED without getting us more licensed beds. Twice the ED space is nice, but that means twice the pool of patients waiting for those imaginary beds that....drumroll please....WE DON'T HAVE.

Having medical nurses work on the tele floors is a nightmare. You cannot expect that two tele trained nurses can "take care of" watching all the patients on the floor. There's a reason why the more medical nurses we have on the floor, the more rapid response and codes we're calling. Nothing against the medical nurses, but they don't have the training that we are REQUIRED to have to work tele...it would be like putting me in the ICU with a vent patient. You're so into evidence based practice, check out the stats. You can't put nurses who don't even know what a troponin is on the heart floor and expect it all to be hunky dory. Oh, wait, you can...and you do...but from those of us on the floor, it ain't working.

[HelenofOz]

Don't suppose any management types are reading this and getting some insight?

NO, of course not-the bad ones know they're great managers and don't need any help!!!:icon_roll

Funny how it doesn't matter what country we're in we all have the same issues, and most of them boil down to respect.

The good managers are out there, and we love 'em-the DON who answered call bells-tottering down the hall in her stilettos, urinal in hand. She knew your name the day after you started working there, she knew the patients by name, and they loved her for it, she ate her lunch in the staff dining room, at the same table as everyone else, and thus was approachable even to the shyest. I know there's more to management than just that, but she certainly made it easy to work there, and she got more from her staff as a result.

[regularRN]

How about... just because it's the weekend, why do you think it isn't as busy as weekdays? And why do you think it's acceptable to schedule fewer staff - one CNA for 15 pts.? Maybe because you never work weekends...

[nursechris1]

"You are wrong, It is not my job to appease the physicians. How about this, I will call the Joint Commission, and see what they say when I tell them nobody in administration will deal with this physician's disruptive behavior."

[Pepper The Cat, BSN, RN]

Please don't come through the unit and announce that you are "going off site for the next 2 hours to have lunch" when the floor staff haven't even had a break yet.

Don't walk through the unit at 14:00 on a Friday, saying "have a good weekend" when you know that we are still down a nurse on both day shifts, leaving us with 4 nurses for 28 pts.

Tell these pita families to either comply with the rules/care plan or take their family member home.

Stick to the rules. Don't suddenly decide that the rules don't apply for this family because they "know" the CEO.

I don't care if this family is friends with the CEO. I am not going to short change the care of my other pts so that this one can have some "extra TLC". If you think they need "extra TLC" YOU do it.

And for God's sake - get over your dislike of confrontation and confront the night shift about the increasing sloopy/poor nsg care they are providing. Before some dies please.

[abbaking]

please don't come through the unit and announce that you are "going off site for the next 2 hours to have lunch" when the floor staff haven't even had a break yet.

Don't walk through the unit at 14:00 on a friday, saying "have a good weekend" when you know that we are still down a nurse on both day shifts, leaving us with 4 nurses for 28 pts.

Tell these pita families to either comply with the rules/care plan or take their family member home.

Stick to the rules. Don't suddenly decide that the rules don't apply for this family because they "know" the ceo.

I don't care if this family is friends with the ceo. I am not going to short change the care of my other pts so that this one can have some "extra tlc". If you think they need "extra tlc" you do it.

And for god's sake - get over your dislike of confrontation and confront the night shift about the increasing sloopy/poor nsg care they are providing. Before some dies please.

night shift works hard!!!!

[abbaking]

"No, I won't be a slave and robot - I will work the best I can with my resources. I will not go room to room asking patients if they have had a rewarding experience while passing out Sleepy Time Herbal tea.

"If you have a problems with me Missy LOSE THAT TONE - You may be older than me but I have more brains in my little finger than you have in your whole body"

"For pete's sake GET US NEW EQUIPMENT - This is not a third world county using 1985 BP machines"

"Repect is a 2 way street"

"When I am talking - you are listening and if you interrupt me It won't be nice"

"Oh really, I am nasty and rude to my co-workers = Thats the pot calling the kettle black"