so occasionally when our regular assistant managers are off or vacation, the manager from our holding unit (basically a med-surg unit) will stand in. Her background is in ICU and probably med-surg. Now you would think that having a background in critical care would enable her to work as charge in the ED right?
Well no-one likes when she's on because not only does she lack the sense of urgency and quick thinking that it takes to work in the ER let alone an incredibly large and busy one but she also lacks the skills.
If it is very busy (which is pretty much always) our regular assistant NM's will jump on at triage or in the resus bay and help out. But she cannot and never does.
When triage is slamming she will pull a nurse from an area (make us, who are already overwhelmed take that RN's patients, so that nurse can go help triage while she just walks around doing nothing but answering her phone and overseeing and this makes us even more overwhelmed and confusion. Not to mention the patients are wondering why they keep switching nurses. And how aggravating is it to have one assignment for the first 5 hours of your shift only to be told to drop it for a new one????
One time I had to cover an entire side with a vent down the hall.
She admitted that she cannot place IV's all that well
The only thing she can do and may help you with is doing some SBAR forms so you're patient can go up to their room. And this is only when it is obviously busy and she can't help you in any other way.
If the floors are stalling and not taking patients she will tell us to hold our patients and give the floors some time. Like really do you see the waiting room??? and we each have like 8 patients???
It's almost as if she's scared to do any hands on bedside care for fear of making mistakes.
I remember one horrible night in the resus bay and you could see that she was visibly flustered, not even knowing where to start. After about 30 minutes she ripped off her white lab coat and was like ''OK I will handle this patient'' Like really? You should've done that an hour ago!
Me thinks this will become a problem down the line.
Aug 27, '12
Thanks Edmia, and thanks llg!
Honestly speaking as a staff nurse I feel way too intimidated to speak out against the manager in this particular situation. The rapport between management and staff isn't all that great in my department to begin with. This manager is personable and nice but like you said Edmia, her lack of skills are straining us and most staff (from the aides on up to the MD's) just roll their eyes (so to speak) when she is filling in as manager, because we know it's going to be one of those shifts where we're going to suffer on our own and have to rectify our own issues as the shift rolls along.
Our ED can be very intimidating, so on a bad day w/up to 150 total patients at any given time/400+ patients seen in 24 hours, non stop traumas, strokes, notifications, with a waiting room bursting at the seams and a line of ambulances. Large, continous volume of patients, mid to high level acuity. Even our regular managers get flustered and overwhelmed, so I can imagine for her it's too much, so much that she either ignores certain issues (like finding ways to decompress the ED, move staff around, and making sure the nurses all get relieved for break) or she just cannot (or will not) roll up her sleeves when we're drowning (particularly in the resus bay and ambulance triage areas)
Most of the senior ED RN's hate being charge, so unless they force them to rotate the charge, that's out of the question :-(
Last edit by All4NursingRN on Aug 27, '12