Manager woes

[Darknights]

I work in a very remote hospital in another country. My ward caters for almost all patients who aren't surgical, from psych to CVA to detox and rehab. There are a small number of senior RN's, hospital trained who haven't done any further education since they graduated. We have a large number of LPN's and New Grads. I am one of only a couple of seniors who graduated from university with a degree. Our manager was hospital trained too, and hasn't done any further education either.

Our hospital educators are RN's with three years experience who happen to be sisters of the DON. We never see them. Part of the reason for that may be that one of them said she wanted my managers job. My manager is not a local and it is clear that admin want her out. Because of this my manager tries to keep everything on the ward and any attempts to speak to admin about issues on the ward are punished, not overtly, but enough that everyone knows who is out of favor.

We don't have inservice, don't get opportunities to do courses. Attempts to introduce best practice are undermined by the manager and the entire staff who don't want to change. I attempted to start some education by writing a publication to distribute to the staff. My manager said it was great but wouldn't distribute it.

We get lots of students who travel a long way to get the remote experience. I've had up to three students allocated to me per shift. I do my best. Unfortunately they tell my manager how much they've learnt from me. Then my manager makes a point of saying to me for a few weeks that books can't tell me everything and when others ask me for advice she tells them I am wrong. They know this is something she does and don't take any notice.

Because we have so few seniors most shifts I might be the only RN and the young nurses really struggle. I do my best to help when I can. Recently my colleagues overheard me teaching students and later asked why I don't teach them. It is because my manager seems so insecure and I really cop it from her if I say much about anything.

I have to say that overall, my manager is very good to me. My position is complicated by my having schizoaffective disorder. She has supported my time off and does try to limit the pressure on me at work, although I acknowledge she might be a cause of a lot of it. I have a reputation for being a good nurse, but that is only in comparison to others here, because I have continued to learn what I can every day. I make a point of coming home with at least one question to learn about every shift. However, I know our standard of care is poor, due to lack of knowledge and education. I know that my physical assessment skills are very poor, but you can only learn so much from books, so I yearn to find someone I can learn any of these skills from.

My having a mental illness, even if well controlled by medication, means I lack the confidence to move so I can work in a different hospital. It also means I am reluctant to say too much about how things are here. I like my colleagues. They are lovely people. Being really isolated means they are completely unaware of nursing being any different in other places. I also love our patients. They are mostly tough genuine and grateful for everything we do. They also don't know their care is substandard due to our isolation.

I try to do the best I can, but I am constantly frustrated by how things are. That becomes stressful as I feel totally powerless to influence anything. I attempt to limit this stress by telling myself that this is just how it is, and just keep quiet and do my work. But when I'm trying to effectively work with handovers lacking important information, other things being left rather than acted on, and junior nurses struggling and missing a lot....it is stressful and will be as long as I care.

[RN1980]

get out, you are on a sinking ship. i've worked in rual hospitals just as you have described. ive seen staff there tormented by issues like you have stated. because i was prn the b.s didnt affect me as much cause i could always quit. start looking for better options.

[nurse2033, MSN, RN]

It sounds like your job situation sucks. I agree with RN1980. If you might have the ability to change your work dynamic I would do it, but it sounds like an impossible task. It sounds like you want a community of professional colleagues, so look for that environment. Best of luck!