charge nurse and nurse manager

[vedm]

what do you think about charge nurses or nurse managers, that never work the floor anymore? do they think they are above and beyond their call to duty? do they think they don't need to do the "hard work" anymore? Even, if people call in sick and they let their staff work short because they have "other things to do?" please, your opionion matters.

a nurse is a nurse in my opinion. I know our managers are busy, but if you were a manager, would you let your staff work short, rather than picking up the slack? This is a big issue with me

[RNPATL, DNP, RN]

VEDM - I have to reply to this thread. I was a manager of a busy med-surg unit for more than 2 years. I was totally conflicted in my role and finally made a decision to leave and return to the floor. Here is why:

Most of the time, the nurse manager has so much work that has to get done that the nurses do not even realize. Nurse managers are the middle guys between senior management and the nurses. They are squeezed and often pulled upon by both levels. Senior management wants the nurse manager to run the unit to the letter of the budget. The nurses want to have the unit run with a lower nurse to patient ratio. There is no easy compromise.

In addition, the nurse manager has to complete certain tasks that have deadlines. If these tasks are not complete, the unit suffers for it. These tasks include: getting the schedule out, even if the unit self-schedules, the manager has to make sure it balances and there are sufficient numbers to meet the unit census. Chart and patient care audits, complaint resolutions, committee work, and regulatory compliance. He or she has to complete payroll and edit payroll for those staff members that forget to punch in. Hiring, disciplinary action terminations, and a lot of HR functions as well as paperwork ..... I often found myself asking if it would ever end. 10-12 hour days, almost every day were not uncommon for me in this role.

My success as a manager, which ultimately was my failure was that I spent little time doing the paperwork and more time working on the floor with the nurses. I could not let my nurses work short staffed. I was always on the unit, helping and working if they needed me. I would come in all hours of the day and night. Being a single parent, this was very hard on me. Even though my nurses knew I cared about them and worked hard for them, there were still nurses that were critical of me and told other nurses that I did not do enough to support the unit.

After a little over 2 years of this, I finally made a decision to leave the position. I actually moved out of the area, which made the decision a little easier. Today I am working as a staff nurse. I have a renewed feeling of respect for my manager because I know the trials she goes through just to be effective and get the job done. However, there is never an excuse for the nurse manager to not be available to her/his nurses. The managers role is that of advocate for the nurses and for the success of the unit. Up until the day I left, I fought for my unit.

Perhaps this does not answer your original question, but maybe it gives a little more insight into what a nurse manager actually does all day long.

[vedm]

believe me, I truly can see your point and I do understand that nurse managers are busy with other things. But I have to say this and I don't mean to offend. First of all, I am very proud of you for helping out your unit the way you did and I can see that maybe you did this to a point that you could not do your job. But I also have to say this. SHAME, SHAME, SHAME on a manager that is ABSOLUTELY NOT WILLING TO FILL IN OR HELP OUT. My nurse manager has an ASSOC. degree just like me. she now feels that her ------ doesn't stink. she comes to work most days dressed in professional clothes and not scrubs. (easy not to have to work the floor dressed like the ordinary person huh?) she goes to meetings that really don't matter like magnet status. please, lets get real, if you are going to obtain magnet status, your staff needs to be full, and you don't have problems like this. i am really proud of you for what you did. i wish i had worked for you.

[RNPATL, DNP, RN]

It sounds like you have a tough situation there. A manager that does not have the pulse of her unit will simply not be successful. I agree that magnet status does not take priority over the units operation and the needs of the nurses. It might be good for you to discuss with her how you feel about the complexity of the patients you are caring for and the need to review the staffing ratios. If she is out of touch with the unit, she might not know that you all are struggling. Just a suggestion.

[vedm]

oh, she knows, this has been brought to her on numerous occasions and she responds to her nurses by saying

"well, .......... has been with us for so long, and she is set in her ways and we can't change her. so we just need to adapt to her."

I say No. she needs to get a grip of the unit. she is the manager.

[RNPATL, DNP, RN]

Now that is a different issue. The workload should be divided evenly and every nurse on the unit should pull his or her far share. Just because a nurse has been on the unit for a bazillion years, does not give her permission to have a lighter workload than everyone else. Besides, it has the potential of compromising patient care and that is unacceptable to me.

Talk to her supervisor and let her know what is going on. There has to be some recourse for you at this hospital!

[Alnamvet]

Clinical Director, Manager, Nurse Educator, Clinical Nurse Specialist, Secretary to the "Management " team, payroll/time keeper person, "Team Leaders" (3 of them)...our ED is so top heavy, that most of us have no clue as to who really is in charge. What we do know is that when the caca hits the fan, they all stand, look serious, point fingers, and never so much as lift a finger, except to "point" in the direction where help is needed. One thing is for certain...they all take their one hour lunch breaks on time, every time, and do so together, as a "team". What a monumental waste of resources!

[Tweety, BSN, RN]

As a charge nurse I very very frequently am taking an assignment and helping on the floor, with toileting and "dirty" work.

If we asked our manager to take patients and help on the floor everytime we were short, she wouldn't have time to do her job. I'm not sure what all a manager does so I can't judge why she has to choose to stay in her office while the unit is busy. She has on several occasions taken the role of charge nurse and sent the charge nurse to the floor to take patients.

I try not to be too harsh on the manager because I don't know what she does. And I know it's a job that I couldn't do, and would never want to do.

Good luck with your situation. There are some horrible managers and charge nurses out there. As I've said on another thread, I'm becoming more and more disillusioned with the management team at the insitituation that I work in.

[nursemaa]

Thank you RNPATL! I don't have much to add to what you said. All I can add is this: We all have different job descriptions, and expectations for what we are supposed to do. Mine, as a manger, is different from the staff nurse. Desn't mean I think I'm better, just that my job is different. The amount of time required to meet the expectations of my job is enormous. Just because it is not done at the bedside doesn't mean that it can be left undone. For example: I have had days where I have spent hours in medical records, reviewing charts to try and decipher what happened so that I can respond to the numerous incident reports that cross my desk. Then I have to try and track down the nurses involved to get feedback from them about the situation. Sometimes I also have to contact other departments to further investigate the problem. These things can't really be done right in the middle of the unit, but I am required to do it. Someone has to. I also interview, do performance improvement activities (not optional, has to be done), attend meetings so there is nursing representation for decision-making in the organization, scheduling, calling for more staff to cover the numerous call-offs that occur, write up attendance and other counselings and give them, spend lots of time defending my staff to pharmacy, administration, physicians, etc., visit patients who have complaints to try and work it out, check and order new equipment so nurses have what they need to do their job, order repairs and follow up to see that it's done,....the list goes on and on. If you feel that your manager should be taking an assignment, who do you feel is the person to do these other things? Don't assume that just because someone is not doing what you're doing, they're not really working.

Having said that, I do let my staff know that if they are sinking they should page me and I'll come help. But it seems that no matter how much I help, some still feel that since I'm not taking a patient assignment, I'm not working hard enough. Very frustrating......

[ADNRN]

Nurse managers shouldn't be on the floor filling in for nurses who call off. If they have time to do that, then the unit probably needs to be combined with another unit.

Managers are managers. I totally respect what they do. I never, repeat never, want to be a manager. If I want extra money, I'll work extra shifts. But I sure am glad that some people do want to be managers, becuase I need them in order to do my job.

[Tweety, BSN, RN]

Originally posted by nursemaa

Thank you RNPATL! I don't have much to add to what you said. All I can add is this: We all have different job descriptions, and expectations for what we are supposed to do. Mine, as a manger, is different from the staff nurse. Desn't mean I think I'm better, just that my job is different. The amount of time required to meet the expectations of my job is enormous. Just because it is not done at the bedside doesn't mean that it can be left undone. For example: I have had days where I have spent hours in medical records, reviewing charts to try and decipher what happened so that I can respond to the numerous incident reports that cross my desk. Then I have to try and track down the nurses involved to get feedback from them about the situation. Sometimes I also have to contact other departments to further investigate the problem. These things can't really be done right in the middle of the unit, but I am required to do it. Someone has to. I also interview, do performance improvement activities (not optional, has to be done), attend meetings so there is nursing representation for decision-making in the organization, scheduling, calling for more staff to cover the numerous call-offs that occur, write up attendance and other counselings and give them, spend lots of time defending my staff to pharmacy, administration, physicians, etc., visit patients who have complaints to try and work it out, check and order new equipment so nurses have what they need to do their job, order repairs and follow up to see that it's done,....the list goes on and on. If you feel that your manager should be taking an assignment, who do you feel is the person to do these other things? Don't assume that just because someone is not doing what you're doing, they're not really working.

Having said that, I do let my staff know that if they are sinking they should page me and I'll come help. But it seems that no matter how much I help, some still feel that since I'm not taking a patient assignment, I'm not working hard enough. Very frustrating......

Excellent post! Thanks.

[NicuGal, MSN, RN]

There are some managers in our hospital that will come in and help out, esp if staffing is critical. On the other hand, our manager says tough and she is the one that LEFT during the big blackout, during an internal disaster and then called in the next day. She called to see how things were going (no AC, about a million degrees, no food, no water, a few very sick kids--including one on nitric) and she was like, oh, so it isn't too bad! The L/D manager had to keep coming over to make sure all was well.

Our charge person is on the floor and frequently we will have a full assignment, which stinks when you have a large unit like ours and an extra pair of hands is always welcomed!