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ProfRN4, MSN 15,720 Views

Joined Apr 5, '03. ProfRN4 is a Staff Educator. She has '22' year(s) of experience and specializes in 'Pediatrics'. Posts: 2,281 (22% Liked) Likes: 1,382

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  • Feb 13

    I am so over joyed by all of the positive responses I have received. I am now reading them as I am riding back to the metroplex. I was not expecting this level of support; I honestly feel refreshed! I am also taking the not so positive comments into consideration... as many of them are also valuable.

    Many of you have offered great suggestions. I am doing many of them now, and will try the new ones!

    Wow, thank you everyone! I will keep you udated as time goes by.

    To answer a burning question: Yes, I was a nurse before being the manager. I was PRN, a staff nurse, a clinical supervisor, and then manager. All within that same unit. It's been an exciting journey!

  • Feb 12

    It is refreshing to read this, as you care and want to try. I just want to tell you, that in and of itself, is absolutely awesome!

  • Feb 12

    Quote from I.Am.A.Nurse.
    Do you know what it's like to not have anyone like you? To know that everyone hates you? That's my life as a nurse manager. They now see me as the enemy. I have to deny vacations, write people up, give not so good performance evaluations, tell people how to do their job better, short the unit. They think I am sitting in my office everyday doing nothing when I am drowning in work. Blah!!!! I spend almost all my time in meetings. Sometimes I literally have 30 minutes outside of meetings. So then I work at home or on my days off. When I am in my office, sometimes I close my door. I literally cannot get a thing done when my door is open because people always come in to talk. I cannot send people away because I don't want to unapproachable.

    What they don't know is how hard I fight for them. They forget about all the new equipment I fight for. They forget all about the changes I have made so they have it easier. I talk about these in our staff meetings but very few people come. I send out weekly emails but people don't read them.

    I was so happy to take this job. It has proved to be the hardest job ever. I have senior leaders handing never ending tasks down to me and staff level employees complaining so much. It's exhausting. Was I like that as a staff nurse?

    Balancing the schedule for 70 people is nuts. No one gets 100% of what they want. That makes people very angry but someone has to work!

    People complain and gossip but refuse to get involved. They won't come to staff meetings, they won't join committees, they won't offer solutions.

    I love my job and I love the team. However; it is so exhausting. I am on call 24-7. People tend to forget that too. I respond to calls and messages all day long.

    I just want people to meet me in the middle.

    I try to get to know the staff members, send thank notes monthly, ask people what they think.

    I can't seem to get ahead. I think a big part of the problem is that I came from this unit. People wonder why I got the job. I'm sure some people even hate it. No matter how hard I try, I can't get them to understand that I work for them. I want them to grow and succeed. I want us to be a great unit that everyone wants to work on.

    Any tips??? Any advice???
    You're not the enemy -- you're the one protecting your staff from frivolous edicts from on high, from abusive patients and family members, from ill-conceived policies that will negatively impact their paychecks, their schedules or their working day. Staff nurses don't know what you do because they don't see you doing it. But they do know when you have their backs.

    The best managers I've ever had (and I've had some good and some bad) realize that despite Press-Ganey, you cannot please everyone. There are some folks that just cannot be pleased, no matter what. Make sure your staff sees you standing up for them to those folks that just cannot be pleased. Trying to please THEM is wasted effort -- standing up for your staff is an investment in your staff. Your staff ought to be able to count on you to run interference with ranting and raving medical staff as well. Your staff may not always be in the right, but they need to know you'll keep an open mind until you've investigated the complaint, that you won't automatically take the side of the physician or upper management or the visitor who claims to be best buds with the CEO.

    Start scheduling the staff meetings into their schedules. If they don't show up, it's an occurrence unless they've cleared it with you in advance for solid reasons such as they'll be on a previously scheduled vacation, they're taking final exams at that moment or they're scheduled for surgery. Make committees a prestigious thing. I was in my first year of nursing when my head nurse asked me to represent our unit at Nursing Grand Rounds . . . I was so flattered! I was primed to volunteer for committees after that.

    My current manager ascended through the ranks, and there was some pushback at first from the nurses who were more senior to her when she got the job. Most of them have moved on now, the newbies never knew her before she was a manager and those of us in between have grown to respect the way she stands up for us. Hopefully you'll be as respected as she is!

  • Feb 12

    Quote from AliNajaCat
    Wonderful. When I was a clin spec and classed as middle management, I wore street clothes and a well-fitting lab coat with my scissors, clamp, steth, and suchlike in the pockets. They got pretty regular use, but I still put on scrubs and worked a shift in the ICU about once a month to keep my hand in. Once somebody said to me, "Oh, Ali, you look like a nurse today," and fortunately I had the presence of mind to say, with a smile, "I look like a nurse every day."

    On a related note, in my present role I get asked when the last time was I worked as a nurse. Same answer. "I'm working a a nurse today, counselor." Opportunities for education are boundless.
    I've run into that a lot. I even wrote a paper about it for grad school. For some nurses, if you are not doing the same job they are doing .... then they don't consider you to be working. We can't allow that. We have to speak up for ourselves and teach them that we also have legitimate jobs.

    It's sort of a "reverse NETY."

  • Feb 12

    There is a saying, if you don't like the way things run, get into a position to make a change. Sick and tired of people complaining that wont give feedback to the NM and wont give suggestions. Not all NM are great, but the ones I had have tried. The upper management is the problem. Not lower management like NMs and ANMS.


    People need to join committees, in services, practice, etc.

    My current floor is new and people sit there and complain but do not offer solutions. They are complaining that they are short. Nurse Manager is offering double time for people to come in and the nurses are still attacking her saying she isn't doing anything.

    You have 2 sides wailing on you and its hard to make people happy. I tip my hat to you

  • Feb 11

    Staff nurses will never fully understand the Manager Role unless they have been managers in the past. That's just a fact of life -- and is true of just about any position that is not the staff nurse role they know. Being happy in any role that is not the traditional staff nurse usually involves having to come to terms with the fact that many nurses will misunderstand your role and think you don't "really work for a living as a nurse like they do" because you are not doing the same job as they do. So, accept that and move on.

    However, you can do some things to foster their support of you even though they never fully understand your job.

    1. Let them see your work. Tell them what you are doing on a regular basis so that they can see you being their advocate. Instead of saying that you are doing paperwork, say that you are "preparing a report to try to get XYZ improved for them." Instead of saying you are doing the payroll, say that you are making sure their work hours are correct so that they can be correctly and on time this pay period. etc.

    2. Don't ever let them say something like, "Oh, I see you working today" when you help them on the unit clinically -- which implies that you are NOT working when you are doing office stuff. Respond with something like, "Oh I work every day -- I just don't do the same job tasks that you do." Of course, say things like that with a smile.

    3. Give them updates on your work and progress with projects that are meaningful to them. I have been in mostly educational positions -- but I have had some jobs that were a combination of education and management at the unit level. I found that posting a monthly report of my activities (written in politically wise ways, of course) was very helpful. When people knew what I was working on and how it could help them ... they were much more supportive.

    4. I am also a big fan of being as honest as possible. Sometimes, you have to say something like ...."Listen, I have my doubts about the value of this change, too. But we need to give it an honest try. We'll collect data and if it doesn't work, then we'll have the evidence we need to change it to something that will work better." Or ... "Listen, I know this isn't the most convenient thing for us to do ... but it will really help our colleagues in the XYZ department. Let's given it a try to help them and maybe we can figure out a way to make it work for us by adjusting it a bit. But we won't be in a position to help either XYZ or us until we start giving it a try."

    Those are just a few thoughts off the top of my head.

  • Feb 11

    Do you know what it's like to not have anyone like you? To know that everyone hates you? That's my life as a nurse manager. They now see me as the enemy. I have to deny vacations, write people up, give not so good performance evaluations, tell people how to do their job better, short the unit. They think I am sitting in my office everyday doing nothing when I am drowning in work. Blah!!!! I spend almost all my time in meetings. Sometimes I literally have 30 minutes outside of meetings. So then I work at home or on my days off. When I am in my office, sometimes I close my door. I literally cannot get a thing done when my door is open because people always come in to talk. I cannot send people away because I don't want to unapproachable.

    What they don't know is how hard I fight for them. They forget about all the new equipment I fight for. They forget all about the changes I have made so they have it easier. I talk about these in our staff meetings but very few people come. I send out weekly emails but people don't read them.

    I was so happy to take this job. It has proved to be the hardest job ever. I have senior leaders handing never ending tasks down to me and staff level employees complaining so much. It's exhausting. Was I like that as a staff nurse?

    Balancing the schedule for 70 people is nuts. No one gets 100% of what they want. That makes people very angry but someone has to work!

    People complain and gossip but refuse to get involved. They won't come to staff meetings, they won't join committees, they won't offer solutions.

    I love my job and I love the team. However; it is so exhausting. I am on call 24-7. People tend to forget that too. I respond to calls and messages all day long.

    I just want people to meet me in the middle.

    I try to get to know the staff members, send thank notes monthly, ask people what they think.

    I can't seem to get ahead. I think a big part of the problem is that I came from this unit. People wonder why I got the job. I'm sure some people even hate it. No matter how hard I try, I can't get them to understand that I work for them. I want them to grow and succeed. I want us to be a great unit that everyone wants to work on.

    Any tips??? Any advice???

  • Jan 19

    Ooh ooh ooh...settle in. I hope to be brief but that is unlikely.

    When I was in nursing school, I had the vaguest of ideas that I would be working with adults, maybe in a CCU or med-surg or something like that. I didn't mind working with adults. I was fine with it. I also enjoyed the teaching aspect and geriatrics was nice -- old people like me for some reason. Whatevs, not too exciting, not really clear on what my future would really hold. I knew that I would never work with peds. Never! Hah! Me with kids and babies and, ugh, teenagers?!?!?! NEVER!

    Lol.

    And then I had my first day in my peds clinical and I had hemonc patients (which I was totally freaked out by because cancer was something I had 0% experience with) and IT WAS AWESOME and I knew exactly what I wanted to do. I still did health coaching with adults and that annoyed me to no end. Imagine: patients we try to keep from going to the ED who are homies with everyone in the ED and like going and waiting for 8-9 hours in the ED for dumb stuff that the primary medical doctor could easily deal with but can't because the patients don't trust their PMDs. Adults. So much disappointment.

    Anyway, my first job is in a top hospital for pediatric hemonc. I couldn't be more thrilled. I actually am sad because I had to call of work today because I am quite sick and can't really mask it as well as I wish I could. I love my hospital. I love my patient population. I love my patient's families. I am in the best possible place to do this type of work. However, there are some drawbacks that make me look back to the adult world. I drive very far (80 miles one way in terrible traffic) to work. People think I'm nuts but I'm not moving closer in the near future. I worked on the unit I am employed as an RN as a nursing assistant about a year prior. This summer had quite a terrible string of deaths -- nothing really unexpected, most brain tumor-related (not coincidentally, brain tumors overtook leukemia this year as the top cause of cancer-related deaths in pediatric oncology). I was already emotionally wrecked going into my new position as an RN (textbook case of moral distress over here). I always say that, when I'm tired of working with a broken heart, I will seek work elsewhere.

    Now, I am getting platinum class training at a world class hospital. I look forward to, maybe, one day, a long time from now, bringing my expertise and training to a hospital closer to where I live. Where I live, kids in the hemonc population are terribly underserved and burdened to travel to better treatment. Maybe I can help make that less awful one day.

    Then again, maybe I'll go to hemonc for adults. Or, ICU.

    There are a lot of times where I think, "If this was the same situation with an adult, I would be out." But, I don't hate adult nursing. It's not something that I count out completely. I seek versatility in my experience. Many of the nurses I work with work per diem at the hospital a block away with an adult population.

    The long and short of my story is that, ultimately, I cherish versatility (because I hope to teach at my nursing school one day and they always need someone for something) and being well-rounded as a nurse. I will never say no to adults. Pediatrics, unfortunately, is kind of a money pit where medicine is concerned. I have been told that a peds unit in a hospital is meant only to increase community access but ultimately runs at a loss for the hospital (because kids don't have jobs and don't have awesome insurance like middle aged adults). The hospital I work at is only peds and we run on donations and grants and are lucky to be based where celebrities love us and love to give gobs of money to us. However, we are still a money pit. So, finding work in peds is not easy and it's better to maintain versatility and be able to work with the wealthier, ever-growing adult population.

    So, I guess all I can say is, no, you aren't alone. If you want to work with adults, you can. If you want to also work with peds. You can. I may one day switch to a per diem position at the hospital I'm at and work full time with adults. It depends on where the currents of life take me.

    Good luck!

  • Jan 19

    It is sometimes hard to turn off the "I am a nurse and I want to fix everything I see/hear/encounter". As in those threads "you know you're a nurse when..." and people post all the crazy stuff we do outside of work (like fixing the slings of total strangers in Walmart).

    It took a while, but when I'm off the clock, my nursing is OFF DUTY. Except for emergencies. Or slings in Walmart . My facebook people are not my patients. My facebook people are not my patients. My facebook friends are not my patients. ad infinitum!

  • Jan 15

    You answer your question in the first line of your post: "I know it's not my job to police my friends and family...."

  • Jan 15

    Quote from Emergent
    I've had to unfollow a lot of people who mainly post about how much they hate Hillary or Donald. I get sick of that tiring subject.

    I generally find Facebook posts of people's meals ridiculously boring. I prefer pet videos, family photos, and interesting discussions. (Sadly, the latter is rare on Facebook).
    I unfollowed a lot of people during the election . . . and while I check in on them periodically to see if it's "safe" to re-engage, the most vociferous among them are still ranting. I've also unfollowed a few cousins and one friend who obsessively post pictures of every meal they are about to eat, every craft project they finish and more than one picture per day of their "awesome baby." (That includes the two-legged AND four-legged variety.) Generally, if you're posting multiple times a day, most of it is not interesting.

  • Jan 15

    Quote from ClaraRedheart
    I know it's NOT my job to police my friends and family... However,
    My aunt just posted a photo of heavily carb-laden Chinese food plates that she (diabetic) and her husband (also diabetic) are about to enjoy. She does this all the time. I have told her this is dangerous and she needs to be careful, but now I'm just biting my tongue and hoping she doesn't get a nasty ulcer.

    Also have a friend with a morbidly obese 5yo child that she buys 2 adult sized meals for (have witnessed this when I was in town to visit family... , I wondered what was causing it until I saw it first hand) . It's hard not to cringe when seeing photos, knowing how the parents feed him. Said friend does crossfit and eats healthily herself, but why stuff the child like that? Her other child is obese too. Have not said anything to this one.

    Of course, there are the hoards of anti-vax friends... I just bite my tongue and move along.

    Just curious what the rest of you encounter on facebook or even on a daily basis. Do you feel compelled to "educate", or are you like me and keep your mouth shut and wish you'd have said something?
    I'm sure your friend with diabetes knows by now that her lifestyle choices are not good. She is an adult. Let her deal with the consequences.

    The five year old child who is morbidly obese and being fed two adult sized meals bugs me. But we also don't know the full story. Hopefully, something can be done for this child because that is just sad. Children need our guidance and he is not old enough to decide for himself.

  • Jan 15

    Quote from Farawyn
    MMMMMMmmmmmmmmmmm, carb laden Chinese food!

    NOMB

    I do, however, open my mouth, loudly and often on the anti vaxxers.
    If they don't like it, they can unfriend me. Meh.
    I'm with you on the anti-vaxxers. But I usually just link articles, share other FB pro-vaccine pages, or put up memes on my on FB page and don't respond to family or friends personally.

    I am friends with one young woman who went to school with my kids and I worked with her mom. She has a troubled family history that I won't go into here but suffice it to say that I keep her as a "friend" in hopes that she will at least see the scientific research regarding vaccines. She's pretty rabidly anti-vax though and won't get her 3 kids their shots. (I've noticed people from all over the world will say "jabs" or "needles").

    The political stuff got kind of heated during the election. My FB friends run the gamut of the political spectrum which kinda drives my own husband crazy. I didn't post political stuff though . . . and I'm not outing myself by saying who I ended up voting for in this election.

    Speaking of diabetics, I gave up a long time ago trying to do any teaching to someone who is diabetic and still makes choices that are not healthy.

    As to kids who are obese, I was a school nurse for 5 years and this is a big problem. Actually, it is a big problem for Americans. Just look around you when you are out at a public event. Most people are overweight.

    One thing that really does frost my cookies is when someone posts about a medical issue or about someone dying BEFORE asking the family if it is ok or even true.

    Last week we had a family member call us to ask if another family member had died - "It was on FB". Well, no . . . the family member was alive and well. I told that family member to kick the person in the tush and tell them to never post things like that unless you check to make sure it is true AND have permission from the family.

  • Jan 15

    These days it's safer to just not have a public opinion about anything...

  • Jan 13

    The aunt and uncle: My grandmother was diagnosed with diabetes at around 65. Everyone told her to eat healthy, etc. She ate how she wanted, lived it up, and died at the ripe old age of 90. Until about the last year, she had a very good quality of life. Instead of giving her crap about what she ate, I talked to her about her past, life lessons, etc. Did both me and her a lot of good, I think.

    The friend + child: Well, if you must say something, I would write her privately and express your concern in a way that shows you respect her and her mothering, and the child seems so happy and well-adjusted, but did his doctor say anything cuz you're concerned. This would have to be done very carefully and craftily, or you will lose a friend and no one will benefit.

    As for CPS, IMO that's nuts. I have seen them rip families apart for a LOT less than overfeeding a child (which may even be happening because the child has a goofy metabolism, some condition, or God knows what else). To me, that's just a sad commentary on the state of our often hysterical society, and definitely not the route to go. But I could be wrong, of course.


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