Nurse Coordinator Roles and management by physicians

[HRHNurse Carol]

In the emergency dept. where I work we are going under a huge restructoring. We now report to a divisional nurse who reports to the medical director of the dept. We no longer are under the hospital nursing administration. I am trying hard to be optimistic about it, but failing. I was wondering if any one has any reports on similar experiances and what the outcome was. Also, what do most people see the nurse coordinator role as?? I received a new job description yesterday and as of today I am really a glorified charge nurse. I don't mind doing more clinical. I am a good clinical nurse. We had a staffing clerk, really a consultant, start working and I am more than willing to let the staffing stuff go and be out on the floor more. Funny thing is, the nurses who were charge nurses (actually our titles don't change) are now supposed to be doing educational stuff. Isn't that backwards? My role 4 days a week is as the flow(charge) nurse. That means helping the 300 plus people who register to be seen each day get to the back when theres a spot open. Pushing carts, wheelchairs, through double doors, etc., we have a number of areas and lots of doors to push through. We are the size of a football field. It is a brutal job, one I never ever assigned a nurse to 2 days in a row if I could help it. It isn't just physically hard, it is mentally hard also, we might have 12 extremely urgent pts to get in and only 2 beds open in an hour, with maybe 70 other pts waiting to get in. It is the armpit job of the ER. Very stressful. While I could physically do my job in my former nurse coordinator role, I am uncertain if I can in the current nurse coordinator role. Also, it is so busy I no longer have time for my staff. I can't really help them a whole lot any more. Every time I try to state how I feel to the nurse who is my boss I get met with being told that decisions are being made in the patients best interests. I really don't feel welcome in my dept. anymore. The staff have been reassured, all us coordinators get from the boss is a cold dead look and the words that we have decisions to make and no one can help us with it. I feel like my heart is breaking. I have been with this dept. for 11 yrs. I have been a nurse coordinator for 3. I have every certification for ER ya can get, and very good evaluations. Up until now I have not had a problem with bosses not reconizing my work. We have 200 plus staff and I have the 3-11 shift. That is the busiest shift although 11-7 "cleans up" if they can. I know the docs can't stand that we did so much paperwork, but dang it we were working!! If you can take it away from us, bless you, but why the anger that we were doing our jobs when we did have it to do?? By the way, only staffing and some of the other stuff was taken away. We are still responsible for the things we have always been responsible for. Flow is so very very consuming though. I would rather take a pt. assignment and maybe get to do some real nursing work. But I feel like I am being pushed out. Not just me, all of us coordinators. I'm not being singled out. I know the docs used to act like I should publicaly reprimand nurses that they were mad at and I know a few times I responded sarcastically that oh well, we will just have to take them out and shoot em when they have been ranting and raving about a nurses relatively minor difference with a doc. Ok, lets say I am a bad coordinator (I don't think I am) - I still was a good staff nurse. But the underlying hostility says that I wouldn't even be welcome to go back to staff nurse. Not that I would do that on my own power. I went into management because I wanted to do management. But the docs liked me when I was on staff- has that all been erased?? Has the past 11 years just been a waste of my time? Am I wrong to be feeling the way I am?? Is it just my ego? So what do coordinators out there do?? By the way- fortunately, my staff has been very supportive of me, and almost protective of me. I don't feel uncomfortable, as far as embarrassment, in my new role, and I know that the staff will be there for me if I need help. The only change with my staff has been that today they stopped being enthusiastic about the changes. But that could be me. Up until today I was trying to be a cheerleader. After all, benefit of the doubt. But I tell ya, it is nervewracking not to be under nursing anymore. We only have the one nurse over us to explain why we do things the way we do and she's not listening to us, she's listening to the doctors. She's been with us a little over a year and has always had her mind made up, no disussion. OK, I know that I need to leave. I really need some help in dealing with this though and would appreciate any support, suggestions, etc.

[sjoe]

"We now report to a divisional nurse who reports to the medical director of the dept. We no longer are under the hospital nursing administration."

This is a POLITICAL move on the part of your facility. As in most politics, if you don't fight hard (by striking, lawsuits, formal complaints to regulatory agencies and relevant politicians, etc.) any power you have will be taken away by others. It's the nature of the beast.

Now is a good time to learn how to play the game. Otherwise you have three choices: 1) suck it up, 2) get pushed out (or choose to leave, which amounts to the same thing), or 3) kick butt.

You're right, they don't care if you leave and would like to push out anyone and everyone who won't "get with the program." Power and control is their goal, not healthcare. Smell the coffee instead of trying to find some reason why this is your fault. That misses the point completely and keeps you in helplessness mode.

IMHO.

[mattsmom81]

Boy, after reading your post now I acutely remember why I hated mid level nursing management....all the feelings came rushing back

We go in with the best of intentions and run into brick walls, politics, etc.

I don't have any specific advice other than look out for yourself and don't be consumed by the 'beast' (s).

My heart goes out to you...take care of yourself...make good decisions for YOU. Personally I have learned to RUN not walk out of anywhere my manager is not openly supportive of me ....

Best wishes and (((HUGS))) coming your way.