What's WRONG with nursing management?

  1. They just DON'T get it. Sort of like talking Chinese to someone who only understands English; not communicating--not even on the same wavelength. Had a bigwig from a neighboring large hospital call the director of our nursing school, asking us in desperation if we could increase enrollment at our small community college nursing school (ADN). Of course we cannot; do not have the nursing instructors and don't have the facility to do so even IF we had the extra help. This administrator told our director that this HUGE hospital is now short XXX nurses. Well, hello, what about RETENTION???? Why are all your nurses leaving??? This particular institution is losing nurses so fast, that it is like a patient who is hemorrhaging, about to code. The administrators seem oblivious to it all. It brings to mind an old quote (don't remember the source), "There is none so blind as one who is willingly so." That about sums it up. You can tell these people what is wrong with their institution until you are blue in the face... WHY all of their nurses are leaving. They just don't hear you because you are telling them something they just DON'T WANT to hear, plain and simple. It is SO very frustrating. I am convinced that the majority of nursing administration in this hospital is STUCK in an 80's and early 90's mindset and can't adapt or accept the nursing situation as it is NOW, in the year 2002. I am further convinced that the nursing problems at this hospital won't be solved until the current "generation" of nursing managers dies off. By then, sadly, it just may be too late...
    Last edit by VickyRN on Sep 29, '02
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  2. 37 Comments

  3. by   globalRN
    yes, you are correct. Retention should be a major part of the administrative plan.....just who will be left to mentor all those new grads anyway???? They should be looking at solving the problem not throwing new grads into the lion's den.

    I think administration needs to be way more flexible....there should be permanent nights, evenings and weekends for those who want them. I think the extra pay differentials also need to be attractive++. Then nurses would have less of these unattractive shifts and maybe enjoy their lives outside of work.
  4. by   oramar
    I have been singing this song for many years. "What's wrong with nursing managment?", we should put it to music. Large and rapid turnover has been a fixture in healthcare for years. It does not work anymore but 90% of them are incapable for seeing that fact. There are signs of change and I am glad of that. However, far to many nurses continue to post here that they complained about conditions and were told that if they did not like it they should leave. Everytime I read that statement I am shocked to my toes. It proves how out of touch they are with reality. This would change very quickly if top managment made retention a priority. Right now their priority is the bottom line. All top managment would have to do is let middle mangment know it will be held accountable for rapid turnover and statements like "get lost is you don't like it" would stop getting made. Reviews of turnover should be a regular part of unit managers evaluation and if it does consistantly not look good they should be replaced. Right now the main focus is on how far a unit manager goes over budget. They mostly get in trouble for going over budget not for turnover.
  5. by   caliotter3
    I used to think it strange when I would observe mgmt people walking around in the facility right past examples of problems and do absolutely nothing. Not even notice something wrong. Or go out onto the floor and initiate or aggravate the problem themselves. Since I worked in mid-level mgmt for many years, I always found this behavior perplexing. I never would have kept my mgmt job if I acted like I didn't care what was going on around me.
  6. by   JonRN
    Nursing Management...that explains it right there. Nurses aren't trained to be managers, they are trained in nursing. I don't know what the anwer is, but the present situation is intolerable.

    Pappy
  7. by   hoolahan
    I don't know Vicky, not sure it is NURSING management you should target. I think it is more the COPORATE management who won't allow nursing management to bring in the agency staff to provide safer staffing, and who refuse to consider retention packages. I know a few nurses who left management because they really do not have any power in these issues, they are only middle management, caught between the needs of staff and the needs of coporate. Trying to get coporate to budge sometimes is like beating your head against a brick wall. Though I DO admit, I know one nurse manager who is exactly the way you describe.

    And it is just like you are speaking another language. The simply do NOT want to acknowledge there is anything wrong. This same DON at the VNA where I used to work is now also losiing nurses like a hemorhage (GREAT analogy!!) But this is a small institution.

    I think the problems began when management was taken out ofthe hands of health care professionals and put into the hands of business people who can only see dollars. Remember when docs were the Chief of the hospital? Accountatnt played a supplemental role, not they are in charge, and the true caregivers have no voice. I wonder if we ever will again?
  8. by   RNed
    I agree with most of what is said about management and the inability to accept the reality and importance of nurse retention. However, Corporate is the mountain we need to move.

    As long as we (the community and politicians) allow and encourage with tax incentives, subsidies, etc. for building additions and the newest state of art equipment, there will be minimal gains in staffing. Corporate continues to operate with the rule that "if we build it - they will come, patients and staff. " they have sold this policy and idea to the community and to the politicians with the belief - it alone improves community health care.

    WE need to terminate local, county, state and federal tax incentives to non-profits that build additions without demonstrating the ability to recruit, maintain and retain current staff for present buildings and existing services.

    They exist as non-profits soley on the idea, they re-invest in the community. That re-investment continues to be in buildings over staff because buildings continue to appreciate and add value to the power base, we call the hospital system. Our current tax laws are out dated.

    WE need to change non-profit tax laws to those that would encourage the development of staff first and buildings last.

    Has your union talked with the local mayor or state representative about supporting such tax law changes?

    Good idea or a piece of pooh ?

    Just thinking out loud !


  9. by   cactus wren
    We are having a "meeting" with the suits on Wed. about the sh***y morale in nursing...They have posted a list of questions....One is: What is a NON MONETARY way to improve morale??? HELLOOOOO !!! I for one can`t think of any. They seem to think we are nursing for enjoyment....not our paychecks. Now don`t get me wrong, I love my job, butttttt...........if I win the lottery, I`m outahere. Now if I could just remember to but a ticket
  10. by   betts
    Never give me work in the morning. Always wait until 15 minutes before the end of my shift and then bring it to me. The challenge of a deadline is refreshing.

    If it's really a "rush job," run in and interrupt me every 10 minutes to inquire how it's going. That helps.

    Always leave without telling anyone where you're going. It gives me a chance to be creative when someone asks where you are.

    If my arms are full of papers, boxes, books or supplies, don't open the door for me. I need to learn how to function as a paraplegic and opening doors is good training.

    If you give me more than one job to do, don't tell me which is the priority. Let me guess.

    Do your best to keep me late. I like the nurses station and really have nowhere to go or anything to do.

    If a job I do pleases you, keep it a secret. Leaks like that could cost me a promotion.

    If you don't like my work, tell everyone. I like my name to be popular in conversation.

    If you have special instructions for a job, don't write them down. In fact, save them until the job is almost done.

    Never introduce me to the people you're with. When you refer to them later, my shrewd deductions will identify them.

    Be nice to me only when the job I'm doing for you could really change your life.

    Tell me all your little problems. No one else has any and it's nice to know someone is less fortunate.
  11. by   FTell001
    http://www.afscme.org/una/nurse07.htm

    a gradual phase out of "the need" for many nurses?
  12. by   oramar
    you should post above article under "nurse activism and politics" forum as a topic of it's own
  13. by   bagladyrn
    I think the theory of management is that new,young(in terms of experience) nurses cost less than experienced nurses, and being new are less likely to be assertive and make waves, not knowing their rights, or feeling too intimidated to speak out.
  14. by   pebbles
    Found this quote in a book, and loved it. If anyone has any others, I'd love to hear them.

    THE BEATINGS WILL CONTINUE UNTIL MORALE IMPROVES.

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