Hey, Managers! What's up with the "weeding out" of good nurses? - page 4

Recently there's been a spate of write-ups I've heard about that are basically bogus. Minor infractions that no one else would get written up over. I'm furious. On the surface, it doesn't seem to... Read More

  1. by   CseMgr1
    Quote from Angie O'Plasty, RN
    Recently there's been a spate of write-ups I've heard about that are basically bogus. Minor infractions that no one else would get written up over. I'm furious.

    On the surface, it doesn't seem to be a big deal. But anyone who's been in health care can tell you--our nursing culture teaches us that bogus write-ups are a warning to get outta Dodge; it's useless to fight; easier to just change units.

    So these nurses have all left for greener pastures.

    I have a sneaking suspicion that the nurses were targeted because they earned more than new grads. Because coincidentally, there are a few new grads on each of these units, and the basic "numbers" of the nurses has not changed. In years.

    So 'fess up, Managers, what's the deal? Is this what really is happening out there? Is your budget such that it looks better for you to keep the new grads rather than the experienced nurses? Do you use bogus writeups to "encourage" certain nurses to leave?

    Or is something else afoot here?
    More Managers are being forced to do forced ranking ("rank-and-yank"), a method which was regulary used by the now-defunct Enron Corp. in order to get rid of the 15% of the employees who scored at the bottom on periodic evaluations for whatever reasons they deemed necessary, including increasing their bottom lines. More companies are still using it today, Angie, which should help to explain all these bogus write-ups we have been hearing about. My sister was a victim of this Darwinian mentality, being shoved out the back door of the company she had given her heart and soul to, for over 19 years. She was also in her mid-50's at the time. Get my drift? Ethical or not, it's also happening in nursing too, as hospitals look to increase their bottom lines. It stinks, and all you have to do is to read the article which is contained in the following link just to get an idea of the "winner-take-all" society we now live in. Not a political commentary, but food for thought:

    http://www.inthesetimes.com/site/mai...eater_cheater/
    Last edit by CseMgr1 on Sep 3, '06
  2. by   Jolie
    Lastly, on the management issue, it seems like lately managers have been near stripped of any real authority, and the whole firing someone thing takes a darn act of congress. This is especially true if said employee really needs to be fired based on poor work performance, personality issues and such.
    I just don't think [due to legal fears I suppose] that it's that simple to fire someone these days. Then again, I could be in a weird place. This is WV and it's a whole other planet


    I have to agree with this statement, and add that front-line managers in many healthcare institutions exist for the protection of administration, not the actual running of the unit. Let me explain.

    I managed a small, specialty nursing unit in a community hospital. We typically staffed with 2 RNs per shift. Shortly after taking over responsibility for the unit, it became clear to me that the 2 RNs that were the "core" of the night shift were not performing up to par, and posed a real danger to the safety of our patients, especially if they were scheduled together. (I won't go into details, but I am not exaggerating their incompetence.) I began to investigate matters, and found their employee files to be FULL of write-ups, letters of complaint, etc. from physicians, fellow RNs, and patients. It was inconceivable to me that they were still employed! After much wrangling, I finally got HR and nursing administration to agree to a corrective plan. Both employees were to be taken off of night shift (one at a time) and go thru orientation again. They would be on probation for 6 months following their completion of re-orientation, during which time, any problems would result in their dismissal or re-assignment to another unit.

    This plan remained in action for only 2 weeks, because administration decided it was "too cumbersome" to continue. I had not had any difficulty finding pool staff to pick up the extra night shifts, and I was personally orienting them ON MY OWN TIME! I came in early and stayed late to do my management duties so that I could personally oversee their re-training. The long and short of it was that it was a wee bit too expensive for their tastes. As the nurse manager I had 24 hour accountability for events on the unit, meaning that my name would appear in any lawsuit, not the DON's. But I had no AUTHORITY to do what was necessary to facilitate the safe functioning of the unit and staff. (By removing unsafe nurses from the unit, mandating re-training, or firing.) I dont think my situation was unique. I think it is very typical for unit managers to lack the authority necessary to address staffing issues such as hiring, firing, and discipline.

    In my case, it made it impossible for me to get rid of incompetent nurses. In other settings, it may be impossible for nurse managers to protect good nurses from dismissal, if that is what administration wants to do.
  3. by   RN Randy
    Quote from mydesygn


    Oddly enough, I think it is relatively easy to fire someone (a little to easy in fact). I practice in a "at-will" state. What I have seen is good, competent nurses and nursing asst pushed out the door or fired behind staff (not patient) complaints. If the manager has done their job correctly (omitting any obvious firing offenses), the employee will (1) will have had more than ample time to improve, (2) know exactly what needs to be corrected and coached on how, (3) to some extent, they make the choice whether they will improve and stay or choose to resign. I think it is to easy to fire someone. A nursing asst was fired because "performance issues" by the manager. She had been placed on performance improvement plans. I implored her to quit because I knew that there was absolutely nothing she could do to change her situation. She was excellent with the families, had a good attitude, and always willing to help. Her only crime was that the charge nurse and her had a disagreement and since then the charge nurse made it a point of writing incident reports for every minor omission she could find. She was targeted and the manager did not have the appropiate leadership skills to understand how to stop it and refused to see the nursing asst's point of view. Every time she cried foul, she was labeled "disgruntled" or "a poor team player". What a crock!!! You should have to prove continued, serious performance issues before you can be fired. How can someone give 3 years of good service and be fired in less than 3 months after a new manager comes in.
    Agreed.. I should say that WV is also an at-will state, but unfortunately, we also have the issue of the 'good ol' boy', or 'buddy' system in the mix.
    I'm not really sure how to describe it, but it is a blend of at-will people and buddies. As you go up the ranks and across the board, you'll find a dreadful mix of the two. So it really depends on who you're talking to as to what happens later, and even when talking to an at-will supervisor, they tell you they are tied because their manager is a buddy person, and vice-versa.

    In the end, most of the time it comes down to a situation of being offered an opportunity to resign. That's for the unemployment issue, but in the moment, they pawn it off as a resume-saver.

    But again, the real issue that burns my bum is as you said: Targeted.
    Once some high-strung moron gets you in their sights, you're generally screwed unless you have a buddy in the system somewhere. Why? Because non-working managers are clueless. At least a working manager/supv. can see for themselves what's up, unless they are the problem person in question.

    I love you all when I say that most low-level managers in nursing are in their position because they wanted either more money, power, or a better schedule. Very few are there because they wanted to pursue a career in business or management. Unfortunately, too often, that makes for poor management structure.
    Equally sad is the fact that this is the way it is, and there's not much one can do about it, except band together and take the issue to higher powers. But on the other hand, that generally won't happen because no one wants to rock the boat and fear of termination runs rampant.
    Add in the butt-kissing team member [or closer relationship] that carries incident reports with them, and it's quite the sideshow if you have a good enough sense of humor to just sit back and watch it. Unfortunate, but true.

    I'm not trying to blame anyone here, or belittle anyone's job. There are plenty of good managers out there. I'm just speaking as an experienced spectator, manager and target over the years.
    If you think nurse on nurse targeting is bad, pay some attention to what those same morons do to other allied health professionals.
    As a Respiratory Therapist, I have seen it personally. I had to resign at one small facility in Williamson due to a horribly inept nursing staff. It seems I made a very innocent comment about an RN and a respiratory guy I saw out together, and unknowingly uncovered an affair that guy was having with that RN. Truly sorry and truly didn't know, as I was new there, but the RN happened to be a mid-life, bleach-blonde, thick makeup, scorned woman with a plan of revenge. Couple that with her lover in my dept and a 78yr old DON, and I was done for.
    Bear in mind that this was 12 years ago, [before WV required respiratory therapists to be licensed] and I was the only license working amongst part-time Phlebotomists and Wal-Mart employees. Only 3 people in that 18 member department took a correspondance course and passed their CRT when licensure laws were enacted. The rest went back to their 'day' jobs outside the hospital.

    Many nurses have figured out that attacking Radiology, Respiratory and other fields gives them more "power" than attacking their own, and they can really make others suffer. So be glad you're a nurse or you'd not have half a chance.
    Too many times here in the woods, I've seen the nursing dept. come down hard on those they view as *lower-class* [allied health], based on the whining of a high-strung RN. The point to that being that sadly, many times this very scratch-and-claw type is the one that weasels into the management job.

    Then again, it's also funny to watch these same knotheads scatter from their nurses station to give the almighty physician choice of seats when he comes through the door. Those that don't jump and run are marked as disrespectful by the clueless, and they huddle in a corner debating another reason to write them up. It makes one wonder who is taking care of the patients when all the RN's are busy writing each other up.
    But hey, we're a full service area, offering all kinds and all types! LOL.

    Now that I've gone waaaaay off track, I apologize and relinquish my soap-box. :-)
    rb
  4. by   pyrolady
    I know of someone who has been targeted by Directors. She is a Manager, not a floor nurse. When evil people decide to do evil things, it really doesn't matter who you are. If you are their target, you're done. They will keep after you until they run you into the ground and you leave. This usually happens when management has a "click" and no particular leader who knows what they are doing. It becomes a pack mentality. As for my friend, she will be on to bigger and better things. Why? Because she is good, and THAT is what they are afraid of.
  5. by   TazziRN
    I had worked at one facility for 6 years before I was caught diverting and went into recovery. I did everything I was supposed to do, worked hard to try and redeem myself and make amends. Every single week for the first few months I was being called into the manager's office with a union rep, having been written up for unbelieveable things: getting a normal temp on a kid at triage who was later found to be febrile (I must have lied). Getting weights in pounds instead of kilos on kids (larger kids were on the stand-up scale, which measures in pounds). Having a dish of candy behind the registration desk for me and the clerks to nibble from when it was quiet (the manager herself filched from this dish before she wrote me up). It finally stopped when I sought out an attorney and filed a suit for harassment and discrimination. Five years later I left, realizing that nothing I did would make it better. I recently found out that there are horrible rumors about how/why I left that are so outrageous that I laughed when I heard them!!
    Last edit by TazziRN on Sep 3, '06
  6. by   leslie :-D
    doesn't matter.
    if 'they' want you gone, there's no saving yourself.
    you're a goner.

    leslie
  7. by   purplemania
    I have never been asked to do such a thing with my units. However, we did some housecleaning a few years back of nurses who had been on the same unit so long they thought they owned it and all the equipment in it. They covered all sorts of bad deeds for one another and caused low morale. One by one they were eliminated on policy infractions, but not on trumped up causes. We limit our new grads to areas in need that have seasoned nurses present to support the unit. Salaries do not compare to huge insurance settlements over things that could have been avoided.
  8. by   RN Randy
    AMEN to Tazzi and earle58, as you are correct indeed.


    Quote from pyrolady
    As for my friend, she will be on to bigger and better things. Why? Because she is good, and THAT is what they are afraid of.
    ...and that is exactly the way it should be! Good ppl don't deserve to suffer with an idiot farm plowed up by lousy management.
    Ignorance is curable, stupidity isn't. So if you find yourself surrounded by stupid people; enjoy the show while you find a better job.
    rb
  9. by   mydesygn
    Quote from Jolie
    Lastly, on the management issue, it seems like lately managers have been near stripped of any real authority, and the whole firing someone thing takes a darn act of congress. This is especially true if said employee really needs to be fired based on poor work performance, personality issues and such.
    I just don't think [due to legal fears I suppose] that it's that simple to fire someone these days. Then again, I could be in a weird place. This is WV and it's a whole other planet


    I have to agree with this statement, and add that front-line managers in many healthcare institutions exist for the protection of administration, not the actual running of the unit. Let me explain.

    I managed a small, specialty nursing unit in a community hospital. We typically staffed with 2 RNs per shift. Shortly after taking over responsibility for the unit, it became clear to me that the 2 RNs that were the "core" of the night shift were not performing up to par, and posed a real danger to the safety of our patients, especially if they were scheduled together. (I won't go into details, but I am not exaggerating their incompetence.) I began to investigate matters, and found their employee files to be FULL of write-ups, letters of complaint, etc. from physicians, fellow RNs, and patients. It was inconceivable to me that they were still employed! After much wrangling, I finally got HR and nursing administration to agree to a corrective plan. Both employees were to be taken off of night shift (one at a time) and go thru orientation again. They would be on probation for 6 months following their completion of re-orientation, during which time, any problems would result in their dismissal or re-assignment to another unit.

    This plan remained in action for only 2 weeks, because administration decided it was "too cumbersome" to continue. I had not had any difficulty finding pool staff to pick up the extra night shifts, and I was personally orienting them ON MY OWN TIME! I came in early and stayed late to do my management duties so that I could personally oversee their re-training. The long and short of it was that it was a wee bit too expensive for their tastes. As the nurse manager I had 24 hour accountability for events on the unit, meaning that my name would appear in any lawsuit, not the DON's. But I had no AUTHORITY to do what was necessary to facilitate the safe functioning of the unit and staff. (By removing unsafe nurses from the unit, mandating re-training, or firing.) I dont think my situation was unique. I think it is very typical for unit managers to lack the authority necessary to address staffing issues such as hiring, firing, and discipline.

    In my case, it made it impossible for me to get rid of incompetent nurses. In other settings, it may be impossible for nurse managers to protect good nurses from dismissal, if that is what administration wants to do.

    Interesting. My question is whether their performance was ever addressed in their annual evalution or by the previous nurse manager in any sort of documented one-on-one evaluation, or performance improvement plan. I have pulled files on staff nurses that contained incident reports and complaints and yet no documentation from the prior nurse manager in the annual eval or any sort of performance improvement plan. As a matter of fact, the annual eval stated no definicies and the indiviual had good overall performance. As I see it, this is primarily a failure of management. There should be distinct, gradual, documentation of poor performance BY THE MANAGER. Otherwise, unfortunately, as the new manager, you basically start from scratch. If their performance is dangerously unsafe then you should consider reporting to the Board of Nursing, otherwise you must allow a gradual, documented performance improvement plan that clearly documents the issues and what is required to demonstrate mastery and competence. It sounds like you started that, however the effort was cut short. At least, you have begun the documentation process but you alos have to demonstrate that you have made reasonable effort to give them the information necessary to improve.
  10. by   Jolie
    Quote from mydesygn
    Interesting. My question is whether their performance was ever addressed in their annual evalution or by the previous nurse manager in any sort of documented one-on-one evaluation, or performance improvement plan. I have pulled files on staff nurses that contained incident reports and complaints and yet no documentation from the prior nurse manager in the annual eval or any sort of performance improvement plan. As a matter of fact, the annual eval stated no definicies and the indiviual had good overall performance. As I see it, this is primarily a failure of management. There should be distinct, gradual, documentation of poor performance BY THE MANAGER. Otherwise, unfortunately, as the new manager, you basically start from scratch. If their performance is dangerously unsafe then you should consider reporting to the Board of Nursing, otherwise you must allow a gradual, documented performance improvement plan that clearly documents the issues and what is required to demonstrate mastery and competence. It sounds like you started that, however the effort was cut short. At least, you have begun the documentation process but you alos have to demonstrate that you have made reasonable effort to give them the information necessary to improve.

    Yes, there was ample evidence of previous complaints being followed-up by the previous manager. She documented counseling, retraining specific to the events that had been written up, and brief periods of re-assignment to other units more suitable to these nurses' skills and knowledge base. Annual evals reflected this also, but they were meaningless, as they were not tied to employment security, raises, or any other incentive.

    Basically all was for naught, because despite their continued poor performance, administration refused to allow the former manager or me to take any effective action to require improved performance or remove them from the unit. It became a running joke that they must have either been related to our CNO, or had some really good dirt on her, because we could think of no other reason to protect them. Meanwhile, another very skilled and knowledgable nurse almost lost her job due to a single med error that she self-reported. Had she not been honest, no one would have known that the error occured. All 3 of these nurses were senior people with many years experience in various areas of the hospital, so their salaries and benefits would have been similar. I doubt that was the motivation for the differences in their treatment by administration.

    I didn't last long in that job. My letter of resignation indicated that I was unwilling to be responsible for the care delivered by anyone but myself, given administration's "blind eye" to the performance of some staff members. I stayed on for 2 more years in a staff nurse capacity. The unit manager position was filled twice during that time. When the second manager after me left, they did away with the position, combining it with another unit management job.
  11. by   UM Review RN
    Just a quick note to remind you all that this thread is about weeding out GOOD nurses, not having problems getting rid of bad ones.

    I'll reiterate briefly:

    In just the past three months, I have seen about four very good, experienced nurses written up for trivialities that most other nurses would not have been written up for.

    Three of those four are leaving.

    It's upsetting to lose people you enjoyed working with, but more upsetting to realize that these nurses have been excellent resources to new grads and less experienced nurses alike.

    Is this some kind of a trend? Why are these units not bending over backwards to keep these nurses?

    Instead, it seems as if the Unit Managers are gently showing these nurses the door.

    I don't get it. After almost 30 years in healthcare in various capacities, I've seen this phenomenon play out many many times, but I still don't get it.

    Can anyone explain why this targeting happens?
    Last edit by UM Review RN on Sep 4, '06
  12. by   Jolie
    Quote from Angie O'Plasty, RN
    Just a quick note to remind you all that this thread is about weeding out GOOD nurses, not having problems getting rid of bad ones.

    I'll reiterate briefly:

    In just the past three months, I have seen about four very good, experienced nurses written up for trivialities that most other nurses would not have been written up for.

    Three of those four are leaving.

    It's upsetting to lose people you enjoyed working with, but more upsetting to realize that these nurses have been excellent resources to new grads and less experienced nurses alike.

    Is this some kind of a trend? Why are these units not bending over backwards to keep these nurses?

    Instead, it seems as if the Unit Managers are gently showing these nurses the door.

    I don't get it. After almost 30 years in healthcare in various capacities, I've seen this phenomenon play out many many times, but I still don't get it.

    Can anyone explain why this targeting happens?
    Sorry to have gotten a little off-topic with some of my posts. But on the other hand, I don't think they were really so far off at all. In my experience, nurse managers amount to figureheads intended to protect administration. They have very little REAL authority over hiring, firing, or discipline decisions on their units, and simply enact the changes they are instructed to enact. They exist largely to do the dirty work of administration (retaining unfit nurses favored by administration, running off the excellent, but expensive experienced nurses that administration no longer wants to pay, creating evaluations that "match" administration's plans for a particular nurse, participate in force-ranking of employes as mandated by administration, etc.)

    Of course, it is terribly short-sighted of administration NOT to see the benefit of these nurses' years of experience. But administrators with vision for anything other than the short-term budget are few and far between. It's not only the higher hourly pay rates of experienced nurses that is problemmatic to administration. It is their age, meaning that they will begin to utilize health benefits at a much greater rate (if they haven't already), it's their likelihood of needing FMLA time for medical conditions, it is the increased cost of pensions and retirement should the employee hit the "magic" 20 year or 25 year mark, and it is their savvy in dealing with management/administration, such as refusing to do mandatory OT, refusing to be bullied into taking extra scheduled shifts, refusing to give up vacation plans if the unit is short staffed, etc.

    Yes, I know that young nurses get pregnant and take leave as well, but most of them are healthy, experience uncomplicated pregnancies, have little sick time built up, and need to return to work promptly, so their leaves cost the hospital very little. They are also far more vulnerable to pressure by management to do OT, take extra shifts, not complain when they are cancelled, put off their own plans when the unit is in need of staff, etc.

    So, in summary, administration WANTS young, fearful, inexperienced nurses that will do whatever they are told, and won't cost much in terms of salary and benefits. As long as they have RN after their names, they are qualified, in administration's eyes!
  13. by   nursingis4me
    Hey guys/gals,
    What's up w/ scaring off those of us who really want to be nurses? I know there's crap wherever you work (I've experienced that, but managed to come thru ok), but d***, is it really that bad? Should I be considering a career change to something other than nursing (I'm currently a m.a. who's looking to go back to school)? :uhoh21:
    Last edit by nursingis4me on Sep 4, '06

close