Managers can I change your opinion of them?

I read threads about managers and how ineffective they are I would like to see if I can change readers minds about how their manager is performing and what barriers there may be. Nurses Announcements Archive Article

It is a very lonely world out there for managers. I became a manager of a dialysis facility in august 2010.

I was promoted from within, not the best way to start out in your new role! why-because everybody has certain expectations of you which you cannot live up to. You start out with the best possible rationale which quickly turns into realization that in the big bad world of management that 'behind the scenes' is not as it seems when trying to look in.

Everything and I mean everything works very slowly, to get even the simplest task takes for ever to implement. To get a huge project under way takes forever and ever amen

An example of this is when you know an employee is not performing at their job description you cannot just fire them! (this is not what i want to do just for the record this is just an example-and not a very good one!)

No matter what we read on here 'normally' and if you work for a company who is actually cares about their employees there are huge hoops to jump through to fire somebody.

In my company you have to have a paper trail it starts with

  • a first negative anecdotal
  • a second negative anecdotal
  • a step one corrective action
  • a step two corrective action
  • a step three corrective action
  • suspension pending investigation
  • termination

If you don't have all your ducks in a row then you cannot ... I repeat, cannot fire/discipline an employee.

You can however depending on the severity of the issue progress the employee through the steps faster and if a danger to a pt then jump to suspension pending investigation.

This whole process can take 6 months which is a long time when there are severe concerns about an employee. Everything has to go through human resources and approved once you get into the step actions. HR will advise how to proceed and will consult with lawyers.

Why you ask-this is to protect the company from litigation and also as I learned recently help to reduce the unemployment payouts!

Meanwhile the bad behavior continues and the other staff think that an unproductive, mean, non-compliant work colleague is getting away with behaving badly or has poor performance! they think if he/she can do it then so can I.

They start to lose faith in you as a manager because 'there is no point in going to see her she does nothing'. When in reality you are working your butt off to try and improve bad situations.

It takes 100's of hours sometimes to get one piece of work completed because of the red tape and the hoops.

You cannot tell the rest of the staff what you are doing as this would not be fair, so you have to smile and hope they will one day have the results needed.

When I first became a manager I would stress every night that i had not completed my work. s an RN I hardly ever left work for somebody to complete I went home in the evening satisfied I had done what was expected! now I left piles of work half completed and something to look forward to when i got back in the next day. Now 8 months on I no longer have nightmares about uncompleted work, it is all part of the job description.

My day is never boring and never predictable, I do however miss the patients because I really never have any time to work on the floor I know my skills are going rusty I know I could not perform as a nurse in the same level I did before because I am now a paper pusher, a therapist, a sounding board, I am a boss, but am bossed from a higher level, a financial expert, a scheduler, a kindergarten teacher, a referee, a swing door, a borrower, a lender, a sponge, an executioner and a friend when somebody needs a shoulder.

I read threads on managers and I have to ask am I like that? do i do that? And what is the bigger picture?

It is such a huge topic and I would like to deal with each role individually.

Nothing and I mean nothing is as you see it! A poor performance which has a impact on a team may not be just that the staff member is trying to be troublesome or nasty or not able to complete a task!

We all have the problem that we tell an 'ugly story" about somebody else to justify why they are behaving in such a way, and we already have that story in our heads, if we just asked or discussed we may find out the true picture and it will probably be different that what we had told ourselves.

Many times I have staff telling me a story about another staff member sometimes I just listen and other times I ask the other person to come see me in the 'dungeon'-because if you pop in my office, it is ok but if I ask you to come into the office and see me, then I become the executioner immediately!

When you ask what is going on and if everything is ok, then a quite different story emerges.

A huge lesson I learned early on as a manager was to hear all sides of the story and not act before you have considered both! another huge lesson I have learned is, if an employee is having an issue with another employee I ask questions like, "What do you think the solution is?"

I am encouraging the staff to come to me with solutions not just problems. After all, nobody woke up and made me god! I don't know everything and I don't have all the answers I am just a person like you!


Added 4/14/2011

I would like to add when starting this blog article I was trying to reassure people that you cannot just get fired in good companies-but it does look like I am trigger happy when I re-read! So I apologise that was not my intention.

However, I did need to correct some very bad behaviour which needed immediate action very soon into my job and that how I know how hard it is to make sure things are dealt with fairly and correctly.

Specializes in ICU, PACU, OR.

Managers have a lot to learn. Most take leadership classes and have the knowledge. The problem is in the implementation. Managing employees is a real experiment. Sometimes things you learn work others don't. What you learn over time is that employees don't necessarily want you to solve their problems, they just want a safe place to vent. Most people if LISTENED to and not dismissed, are able to solve their own issues. Unfortunately it is sometimes easier to dictate for the sake of time. When staff nurses are promoted to management, and from within the same environment, its a real challenge. It's US against THEM mentality, and employees watch for the new manager to turn to the elite mentality. Employees respect a manager that knows all aspects of the work environment, knows that they have the skills to work side by side with co-workers when needed. They don't mind someone who is "Tough-But Fair" Believe me word gets around if there is favoritism. You have to cut social ties with folks you used to "Hang" with. And you have to keep confidences to a fault. Employees look to the manager to defend them, to assist them with problem solving, and love managers that aren't afraid to take a survey, give the result (good and bad) and follow up on decisions and ask the employees how things are going and what they can do to make things better. Ironically managers are usually controllers and they are afraid of giving up that control. Wow, what a shame. If you delegate things appropriately you won't be frazzled, tired and frustrated. You also will build morale and let your employees work more efficiently in an environment that is their daily grind. Hard to know what's going on if your always meeting. Sometimes you have to limit the amount of meetings you are required to attend. If you select wisely, you will be able to feel the pulse of your department and intervene quickly before the situation sours. Peer to peer relations between middle managers is crucial to solving many of the miss-perceptions that lead to disputes interdepartmentally. I know this is so because I experimented with this and it worked so well, everyone liked everyone. Hard to believe? No it worked and our processed were worked out without the "upper management" having to intervene. Food for thought. Management is not easy, you do not get rewarded for a job well done. You have to be satisfied that you did the best you could and leave at work. Nothing good happens over night. You must like politics, you must be willing to be vulnerable, and you must be willing to make safe and high quality patient care the priority for everyone no matter what the job is. When you take a management role, envision what you want your department to look like, what you want your staff to be known for, how you would like staff to handle their differences. If you envision it then find a way to articulate it. Remember the saying "Good communication is not what is said, is what is NOT said" Have your sensors out to test the air.

Specializes in RN, BSN, CHDN.

Thank you all so much for all the information and insite you are already providing for me. In try really hard to bring stuff to the staff to dicuss/debate and make them part of the decison making and planning.

The changes we have all had to undergo the last few months are horrendous, some of them have been because of the changing round of staff, some have been because of new legistation from the government which has been felt by the whole of the renal system in this country and some because attitudes and behaviors have had to change.

If anybody got into management to fire people they would be on my list of unfriendlies too!

Specializes in RN, BSN, CHDN.

I would like to add when starting this blog article I was trying to reassured people that you cannot just get fired in good companies-but it does look like I am trigger happy when I re read! So I apologise that was not my intention.

However I did need to correct some very bad behaviour which needed immediate action very soon into my job, and that how I know how hard it is to make sure things are dealt with fairly and correctly.

Specializes in ICU, PACU, OR.

To Madwife 2002: It's not easy to involve staff. The mindset of you as a manager is to know that much work must be done up front to make the road easier down the line. But you have the power to do it if you choose to. The problem is overcoming all the negatives that have led to the mindset that you have read here on this blog. Employees are cynical and suspicious of all managers. They're an easy target because managers on top of the pecking order. That's just part of the job, being the scape-goat for all the uncomfortable change that is inevitable. You, though, are in the position to assist in the transitions. No one will know all the thought and energy that goes into your job. It's impossible to let employees know everything that you know, nor should they. What they need to know are these things: 1) Expectations of their performance 2) Consistent and fair counselling 3) Involvement in decisions that directly impact practice and efficiency that is dictated from sources higher than you and 4) Proper and thorough education to explain processes, new practice guidelines/products and the rationale behind changes in those processes/products etc. If you can filter items in 3 buckets Must do/urgent, Can wait/not urgent, and My wish list then things will process pretty readily. It takes time and when all the pressure is on to make fast change it makes things more clouded. You will do fine, I feel your heart is really in the right place. Even little things make a difference-the trick is being consistent and being seen by the staff in challenging moments and letting the staff get the word out that you are fair and have high expectations. "What you permit you promote"-so remember that quote.

I used to complain about my manager until I became one!! No one understands the phrase "an exercise in futility" until they have had to be in a managers position. You have to justify EVERYTHING you want to purchase. (and "because screaming ortho Dr. wants it" is NOT a justification). You have to deal with people who don't really want to work but you don't have any hard justification for termination. You deal with inexperienced nurses thinking they know all and fight you every step of the way when you try to implement changes. You are accused of having favorites-yes I do-they are the one's that work and do very little complaining!! No one realizes that we don't control raises or pay increases but they expect us to pull out a miracle and get them more money. It has surely brought out a new appreciation for my old manager!! I put in twice the hours I used to and my pay only went up $1.25 and hour. We are expected to have everything perfect during surveys-ignorance is no excuse-and submit everything in on time-payroll, capital budget, evals. etc....If I ever leave this job I will NEVER get back into management again!!

cdsga, I like what you have to say, except nurse managers are not the top of the pecking order, very much in the lower middle in most institutions with several layers over them. And I for one don't want a manager to "get in the trenches" with me I want my manager doing her (or his) job, which they are all paid for a job with FULL TIME duties too. Sure it's nice for managers to spend alot of time "in the trenches", but is anyone helping your manager with their duties? I have worked with managers who are still at work after day shift has gone home. I don't think their directors pick up some of their chores. .. we are all nurses; I know my manager hasn't forgot "what it's like out there" just because she doesn't have a patient assignment. I'd rather have my patients and a committed manager with high standards and expectations who does their job and runs our unit smoothly so I can do my job. .. which can't be done if they are out there helping "in the trenches" every time it gets busy. Every one has a job to do, and in our hospital, I think we have good , hard-working managers who support the staff (the ones who deserve support),and put in long hours, are on call 24/7, hold staff accountable for their performance and quality, arrange education classes and inservices, counsel staff and patients, round on patients, investigate and report findings on incident reports, answer to administration for staff's non-compliance, negotiate and communicate nursing and patient concerns with other departments and services, appease and explain incidents to doctors and convince them they can trust our nursing staff when mistakes happen (our docs have anxiety about their patient's safety and care when things go wrong), serve on hospital wide committees to develop guidelines, develop action plans for administration when outcomes are not at acceptable levels and that's just the stuff that I know about that my manager does. ANd chase down the lazy staff who don't want to get BLS and PPD done on time! No thank you! sounds like alot of you either work with crappy managers or don't have a clue about what yours really do. I don't like everything that happens where I work but I respect my manager who works just as hard, if not harder, than the rest of us and it seems pretty thankless to me.

Jean67, thank you for what you do. We need good nurse managers just like we need good nurses. Oh, enough with us vs. them mentality. I think most managers (at least the good ones) sometimes derserve a medal for dealing with inexperienced staff who think they know best, who fight changes. Yet another reason why we as nurses are not taken seriously as professionals, many nurses fight against and tear down their manager and those around them instead of trying to work together to meet goals because we all come to work to take care of patients! ANd give good care! Not to spend 20 minutes ******** about assignments, 20 mintues ******** about doctors, etc. I have heard rumors that some hospitals are employing business managers to run units! I can guarantee you that no business manager would ever put up with the crap many of my nurse managers have to put up with from staff who think they know it all, or know better than the manager. I know i have good ideas to contribute and I am a really good nurse, but I do not have the experience, education, or the skill of dealing with people that my manager has. Thank God someone has those skills and I am really glad I can go home at end of my shift and relax!

Madwife 2002, good luck to you! you sound like your heart is in the right place. Do what you know is right and know that when you do the right thing, it is not always the popular thing. Don't waste time trying to win over the negative Nancy's, they sap everyone's energy and enthusiasm. Some nurses will never be happy, just have high expectations and hold everyone to them equally and maybe the miserable ones will do everyone a favor and leave

Specializes in critical care.
I have recently been hired as a personal care home administrator. I have been on the job for 4 months. I am very frustrated and annoyed. My co-administrator is not training me properly. I have asked to be trained, asked many questions etc. Still only given bits and pieces of information. When I make a decision about the staff or the care of the residents she changes it.

Please take heart! I am in the same boat! Sort of anyway. Inpatient critical care new management. My manager too. Ask for expectations/training told read job description, thanks helpful. Then find out what I thought was us talking, was actually taking taking notes for file? Really? Good to know..... Remember what NOT to do. Surprised to find honesty on Gallup goals hmmmmm....

I recently received my evaluation and it was poor. I was told that I did not abide by the budget. Hello, I never ordered anything(she did). I was told that I do not watch the staffing budget. That I am to cover vacant shifts. Which I have, however, we are so short staffed that I would be there 24/7. She is the one that did the scheduling. I was told that when I complete work I am to do it with her. She has redone any paper work that I have done. Any work I do is a waste of time. I was very insulted, I have been a nurse for many years and always got praise and awards for my documentation. Especially care plans.

And she changes my support plans. If anyone has done DPW support plans they are very simple to do. It never fails to amaze me

how evil people in health care can be. I was basically thrown under the bus to save her ASS.

So, I will go into work do what I have to do. Have them pay for my administration course, get more experience and go else where. Do I feel guilty to use them. No. Did she feel guilty when she blamed me for her mistakes. No. Very sad place healthcare is in.

Feel like I am being ran over a bit as well. Never had a work related issue in my life, feel like a nervous wreck walking on eggshells. No problem asking me for help/ opinion about things needed however quick to take credit for any results/work completed. Never dealt with this type of this behavior, it is overwhelming and draining. Her whole thing is "accountability and fairness for everyone" but then when I try to apply the expectations she MADE, she makes exceptions. Oh and of course, the rules dont apply to her. Sorry, along with the new role goes the ability to vent to anyone at work. Thanks

Let me get this right, you were a nurse and now in management and the worst experience you had is a firing? Ever been in a bad code? People die in bad codes, in bad firings people just yell and holler.

The thing is, any manager who is worth anything understands that he/she could be destroying someone's life by firing them. In a code the person is already dead. You are trying to save them. As nurses that is what we do- save, not destroy. Firing someone can lead to depression, suicide, murder, PTSD, bankruptcy, etc. It is not something to be taken lightly. I think the firing is the worse experience. I would rather deal with an awful code.

Specializes in Med./Surg., Diabetes, Med. ICU, home hea.

I've done "management" in a previous career, but in 25 years of nursing... NEVER! By the time my feet were wet enough in nursing to be able to pay attention to what nurse managers were doing, I KNEW I would NEVER do that. With all the divergent personalities in nursing, the personality disorders, the varying commitment levels, the variety of reasons for choosing nursing, I knew that for me, it would be a fools decision to even consider it.

The way I see it, a "floor" or "unit" nurse manager, a manager of a home health agency branch, an clinic nurse manager, has all the responsibility, very little authority to initiate or make real change. Sure, you can begin the sometimes tedious process of documentation aiming towards termination, sometimes you get to sit on a panel when hiring, but in my experience, that's about it.

I've seen, basically, three types of nurses who have gone into "managemnt." 1. The lazy nurse who wants to go to meetings and "delegate" tasks. These people either learn the subtle cut-throat politics of administration or are eventually "found out" and given the option to quit before termination. 2. The altruistic nurse that wants to make the "system" better, who is determined never to be like those who have soured their previous experiences. These are quickly disenchanted when they find they will never, ever, have the opportunity or the authority to do so and usually quit. 3. The rarest of the bunch. They are true leaders but have the patience of Job. They learn the "politics" of administration, don't make waves, but do what little they can for those working under them... even if its just listening. They mediate the personality conflicts and the unit moves on. Eventually, they find a more rewarding position and move on, sad that they couldn't do more for their clients and employees.

Now, for solutions to working for the 1st type of manager. Put in your time, keep you head low, help those you can and avoid politics and cliques. No matter how much you like the work, move on when you can. If anyone in HR wants to do an "exit interview," be polite, but honest about the manager knowing that in doing so, you've likely burned your bridges behind you. Aministration likely knows of these weasels and will do anything unless it costs them money or there is liability. Such is the BUSINESS of health care.

Specializes in ICU, PACU, OR.

Middle managers don't get credit for what they do. Staff perceive all people in management positions as top of the order compared to them. They look to managers for support and discipline and really want them to be consistent. I'm sure there are favorite employees-the ones that work hard but remember some managers always turn to the fave and they get dumped on because they get the job done well without complaining. So you have to balance so you don't burn out your best. I do want a manager that can get in the trenches when needed. I don't want them there all the time, but when there is a critical need, sure I want them there to support supervise, observe etc. I want them to go to meetings, budget, counsel all the things that are needed. All I am saying is staff respects a manager that knows they have their back at the bedside and can help when needed. That goes a long way in building respect and rapport with your staff. Because you help them, they will help you too.

I am finding that we are hiring more business managers for departmental positions, and the jury is still out on that. Big problem they don't know much about the clinical business. Some have gained knowledge, but it's not the same. Maybe that's the problem is the change. I do know they can't help in a crisis other than answer the phone or report events days later after the crisis is over. This is really apparent in specialty areas like the OR where folks have to know electrical equipment, implant issues-product failures, sterilization parameters etc., not enough staff when multiple emergencies arise. Its difficult to say the least. I agree with the 3 types of managers aileen stated. those successful and by that I mean stay in mgmt for a while, learn to play the game, lower expectations and keep the right people happy most of the time. Don't play Don Quixote-it will drive you insane and you will have nothing to show for it.