Calling All Managers (Who Were Once Abused Nurses)

[VivaLasViejas, ASN, RN]

Sorry about the unwieldy title, but Angie O'Plasty's thread on the all-too-common practice of 'weeding out' staff nurses has gotten me to wondering: How many of you have gone into management yourselves after leaving a staff-nursing position in which you were unfairly targeted or abused by an unscrupulous boss? And how has that experience affected the way you manage your own staff?

For those who are unfamiliar with it, the short version of my story is this: From March 2003 until December of last year, I worked as a float nurse on a unit where one of the two assistant department managers decided she was going to make life miserable for a few of us older, and perhaps slower, staff nurses. To this day I don't know why, because I was reliable, flexible, good with patients, technically competent, and easy to get along with, but she did, and for a year-and-a-half I was given some of the worst assignments, criticized for every single minor mistake or omission, told that my co-workers saw me as "unmotivated", driven hard, and generally made to feel I couldn't do anything right. Finally, after a year of stress-related illness and hospitalizations, I realized that nothing I did was ever going to be enough even if I killed myself doing it, and I left that job nine days before Christmas.

Fast-forward to the present time: I am now the director of health services for a 42-bed assisted living community, a position which is roughly the equivalent of a DON/DNS in a nursing home. I'm no stranger to supervision and management, having been a care manager and assistant DON in two different LTCs; but in this job I've been given a huge amount of leeway to use my creativity and independent judgment to make the position conform to my wishes and needs, as well as to oversee nursing services the way I see fit.

Now, nine months later, I've had mostly great results with my staff, most of whom are unlicensed caregivers with specialized training in medications and nursing skills. Being a relatively patient person, for the most part, I'm pretty laid-back when it comes to managing people (although I'm finding that this backfires now and again) and I like to facilitate their learning and growth, rather than micromanaging them the way I've had done to me. I don't call employees on every little mistake; I make a point to always look for the GOOD things they do and praise them. Even when I have to discipline someone, I try to do it in such a manner that it's a learning experience rather than a punitive one. In return, I expect workers to behave as responsible adults (if you're hung over out of your gourd, too bad---you STILL have to come to work in the morning) and to treat the residents as they would their own parents or grandparents, because if this is just a way to earn beer money, they need to go flip burgers or something!

This approach doesn't always work, of course (in fact, I've got a couple of disciplinary issues to deal with tomorrow morning:madface: ) but I'd rather put up with a little immaturity from otherwise good workers than grind them down and make them feel the way I did when I worked under that one assistant manager.

So now I'm curious about other nurses who have made the leap from being a staff nurse with little say and even less control over their working lives, to supervisory or executive roles with their own challenges, headaches, adversities, and successes. I'm still a little dizzy over the enormous changes that have taken place; I literally went from a frightened little mouse with a sharp-clawed, mean-tempered, and very hungry cat watching my every move, to a (relatively) self-confident authority figure in less than a year. Yet I know I'm not the only nurse who's been through something like it and learned to thrive, and I'd like to hear others' perspectives........not only from a manager's point of view, but from that cold, dark place we have come from as the targets of cruel, insensitive, power-hungry, inept, or just plain uncaring supervisors.

[SmilingBluEyes]

Oh Marla.....glad you learned from your experiences. My manager leaves a whole lot to be desired. But then again, she has not been a floor nurse since who-knows-when and seems to almost have contempt for us who are...esp night shifters. She is utterly clueless as to our issues or even what we do on a given shift....and can't be bothered when we try to tell her.

She has actually held her hand up and told us to "deal with it" when we try to bring up serious issues that need her attention as a manager...

and communication?

good luck.....

I realize management is a HARD job...and I appreciate that so much....but dangit a LITTLE effort or appreciation would sure go a long way for me. Oh well, guess it's too much to ask...and she is too stressed out.

I wish I worked for someone more like you.........sighhhhhhhhhhhhhhhhhh......I wish more were like you.

[VivaLasViejas, ASN, RN]

Oh Marla.....glad you learned from your experiences. My manager leaves a whole lot to be desired. But then again, she has not been a floor nurse since who-knows-when and seems to almost have contempt for us who are...esp night shifters. She is utterly clueless as to our issues or even what we do on a given shift....and can't be bothered when we try to tell her.

She has actually held her hand up and told us to "deal with it" when we try to bring up serious issues that need her attention as a manager...

and communication?

good luck.....

I realize management is a HARD job...and I appreciate that so much....but dangit a LITTLE effort or appreciation would sure go a long way for me. Oh well, guess it's too much to ask...and she is too stressed out.

I wish I worked for someone more like you.........sighhhhhhhhhhhhhhhhhh......I wish more were like you.

Thank you, Deb.

I remember once about a year ago, during a horrendous shift in which my patient turnover was 100%---five discharges and five admissions---I had one patient go bad. Hematemesis that had somehow gone unnoticed for several shifts, BP dropping like a rock, pt. had been A&O and now obtunded. I also had a fresh post-op plus two new pts. I'd picked up at 3 PM because I "only had two patients". I couldn't get anyone else to help because they were all drowning too, and I was going completely crazy trying to deal with all of it plus all the paperwork from the 11-3 leg of my shift, so I asked one of the 'brass' for some help.

She looked me straight in the eye and said "Sorry, you're just going to have to suck it up---now get back out there and be a professional".:angryfire :angryfire :angryfire

If that was meant to be a 'pep talk', it didn't work. All it did was prove to me beyond the shadow of a doubt that it didn't matter to TPTB how bad things were---for us OR our patients!---as long as they could keep to "the matrix"---X number of nurses for X number of patients, regardless of how sick those patients were, how much care they required, or how many of them came and went during the course of a shift.

I vowed then that if I were ever in a position of responsibility, I would NEVER tell someone to "suck it up" and just deal with an impossible situation. I've come close to it---I'm sorry, but if it's 11 PM and I'm in bed with a milligram of Ativan on board, I'm not going to risk getting in my car and driving 12 miles to the facility to replace someone who didn't bother to let me know she was feeling ill until an hour into her shift. (That's actually happened only once.) But I will call around until I do find someone to cover for the sick staff member, and I will make sure to cover her next few shifts until she's healthy enough to come back to work. And yes, I've been known to come in and serve lunch, bus tables, wash dishes, answer lights, whatever it takes to help 'em get through crunch times. I remember all too well what it's like to be left to twist in the wind; I don't understand why good old-fashioned TEAMWORK only applies to the "worker bees" in so many facilities, and not to the management.

[CseMgr1, ASN, RN]

She looked me straight in the eye and said "Sorry, you're just going to have to suck it up---now get back out there and be a professional".:angryfire :angryfire :angryfire

Didn't she have that BACKWARDS??

[SmilingBluEyes]

Oh yea I have heard that one before...in some variation. "Deal with it....." or "I just can't handle that now".....or a huge sigh when she knows a "problem" is knocking on the door.....

The special effect being the hand up in the air, to wave us off, love that!

.....while you go home at night at 4:30 to 5:00 and never to be seen again til 8 or so....

forget the night shift. Don't even try to bring up OUR issues there....does not want to hear from us at all.

Management is HARD no doubt. I respect the position and the difficulties that go with it. I know for sure I won't be one.....(a manager). I hope you can keep up on the path you are pursuing, Marla. I hope they don't beat ya down....

Ok enough from me. I am not a manager and this was not my thread.....Simply...

Sign me:

Nurse who knows better....and is better FOR IT.

[mydesygn]

Funny, that sounds a bit like my story. I was a pedi nurse for over 15 years, the first 9 years on the same floor. I was fortunate in that I worked with a really good group of nurses, we really did work as a team in the fullest sense. After 9 years, I felt I needed to grow and wanted to advance in my career so I choose another position which also was among a good group who worked well as a team and I had a really great manager. I guess having had a positive experience with my first two jobs, I had the same expectations when I decided to return to floor nursing. Wow, was I in for a susprise. Within the first month, I had a nurse report me to the manager (and I kid you not) for being 20 minutes late to give her report. This is after I had said I would be a few minutes late because I needed to hang an antibiotic and after I had spent the day discharging 4 of my 5 patients and admitted 4 new patients. I was called into the new interim managers office and handed a "write-up" to sign about timely report. It was all I could do not to just walk out when I was faced with this nonsense. Having been a manager previously in a non-clinical position, I calmy wrote "my side" and signed it with the addendum that "I did not agree however I had received ...". Well, that was just the start and 6 mos later I left, after realizing that I was in a no-win situation. No matter what I said or did, it just led to my being labeled "disgruntled". All of my previous years of good service were ignored, I had been recognized only 5 years earlier at this institution for clincal excellence. Initially, I was naive, believing that it would resolve with time or that I could stick it out. I was ready to leave within the first month ( I had never felt like that about any job before) but I did not listen to my gut and wasted 6 mos. I discovered what the staff meant about the "pettiness, the politics, the cliqueishness, poor management" I experienced it first hand. Quite honestly, my positive impression of nursing was shattered. All I could think of was to find a way out of bedside nursing. I questioned my competence and my confidence. Eventually, I took a clinical manager position and I can say the previous experience certainly influenced how I managed. I would always request the "other" side before I formed an opinion, I was very open about who and what complaints were made, I made sure that no one was called in to the office just to be "surprised" by a list of complaints, I went out of my way to guarantee that no nurse was "targeted".

I have since left that position (not because of the staff but mainly to work more normal hours) and have taken an administrative position. In retrospect, the experience left me a much better and empathetic nurse and now I am doing work that I absolutuely love. Without that horrible experience, I would have wasted god knows how much time in that place.

I miss taking care of patients but I don't miss the unit and I don't miss the politics. I once read a nurse say that "I love my work but I hate my job". I now understand what she meant.

[VivaLasViejas, ASN, RN]

I was the one who wrote that.

It's the truth, I DID love my work at the hospital........but the job stank on ice. I work longer hours now and I don't make anywhere near as much money, but the peace of mind and the enjoyment of what I do are well worth the financial sacrifice. Besides, the way I figure it, the hospital and doctor bills I'm no longer running up as the result of unremitting stress and physical exhaustion pretty much even things out.

I'm not even kidding: between February of last year and January of this year, I amassed over $60,000 in hospital charges alone. We won't even talk about the costs not covered by insurance, such as co-pays and prescriptions.........I think we paid over $10,000 out-of-pocket for medical expenses last year. This year, it's been approximately $1,000........and I didn't even have health insurance for six months. What a difference a job change can make!!

[pyrolady]

I had frozen shoulder as the Administrator of a SNF for four months. Three weeks after I stepped down it released. Became a Manager of a Stroke/Telemetry/Med-Surg unit for 18 months but dealing with HCA and the three witches in the ivory tower soon got me returning to LTC, this time as a DON. What a difference !!! Now I can actually implement change and people listen when I say something. No more 12 committees to study the problem if you need to have bed alarms - just order 'em and they show up the next few days for use. Yup, I definately have a challenged staff, but I am sure with a little teamwork, weeding out the bad apples, and plenty of TLC we will have a sweet facility when we're done. People are already noticing changes and it's only been a short while (six weeks) - I look forward to work and the day flys. Only problem is that I could stay until 9 pm every night and keep right on working but my hubby wouldn't be too happy with me :) There are manager's who care out there....

[mydesygn]

It's funny how we are always taught early how emotional and mental stress can lead to physical illness. I had lived with the stress for so long that it was not until I left that job (and my clinical management job) that I realized the extent of the effect. Within 2 weeks, I began falling asleep as soon as my head hit the pillow and also sleeping a full 7-8 hours witout waking. I also noticed how much more energy I had as well. I was never hospitalized but I have to wonder what the toll of years would have brought (I began having gall bladder issues soon after I started and not had another one since I left). I admire nurses who are willing to sacrifice so much for the sake of their staff and for their dedication to bedside care. I recognize that I am no longer willing to do that, one bad unit and one bad manager has changed my outlook on hospital nursing. I doubt if I will ever return to bedside care but I will always support those who remain.

[tkhayman]

Thank you everyone who replied to this thread. In response to pyrolady i too am having frozen shoulder problems and have already given my notice. I was at a permanent position as charge nurse with no dept manager, but a constant change of manager trying to micromanage a dept they had no clue as to day to day activities. It is in constant chaos and is so frustrating with no one listening to my input. Just imagine a non nurse telling me an RN how to do my job. I was at the point that i was questioning my own skills as a nurse.

On the other hand i may or may not be getting a new position that would put me in a management position. The feeling i have gotten from this thread that all who were treated badly have actually turned things around for the postive and better. It is a good thing to learn from my own mistakes and i will certainly take that with me no matter where i am hired next.

[Miss Ludie]

I also have seen how becoming a manager changes a person. The nurse I recall was fairly good, nothing remarkable who left the floor for a QA job. I assume it was stress and burnout but I wasn't told directly by her this was the case.

Fast forward 5 years when the NM was to be replaced, this same nurse applied and got the job. Well to hear her talk when she was this, and when she was that when she was a floor nurse.

The ones of us who remembered her from before were totally amazed at her memory of events.

She worked straight 9-5 M-F and never came in to cover etc. although she would put in for Call-pay .

I left and went to a different unit as assistant manager. It's only then that you hear the other side of the story. The managers' take on what happened is that there was a lawsuit that was dismissed right before she was rehired.

I left and took another staff job for a different facility. Politics. I'd rather not.

[UM Review RN, ASN, RN]

I don't know the answer to that Marla, but I sure do wish you were my supervisor, and I must say that I hope your staff knows what a jewel they have in you! :flowersfo