Is it normal to feel like this?

z's playa · Jun 3, 2005

It sounds like you need a vacation ! And a big dose of confidence. People say you're doing a great job. Believe them and perhaps things will lighten up for you.

Or you know what? Step down and take a breather. You wouldn't be the first one who took on too much to handle. You wouldn't be quitting..just trimming off the excess so to speak. I hope you find peace.

Z

RNPATL, DNP, RN · Jun 5, 2005

I graduated from nursing school in December of 2003 and started my first RN job in Feb of 2004. In December I was made nurse manager and life hasn't been the same. I'm up most nights with a racing mind, worrying about the staff nurses, worrying about clients, what did I forget to do, what am I missing, what are the standards, etc etc. And if I do get to sleep, chances are I'll get a call or two from the nurse on duty to wake me up. I've had to let 2 nurses go in the last 2 months leaving us with 4 open positions. My migraines have come back fericiously and often, my eczema has returned after a 22 year absence. Is this what a nurse manager job is supposed to be like? Or, am I not cut out for it? Everyone keeps saying that I'm doing an awesome job, especially considering my lack of experience, my boss said "I'm going to make sure she doesn't go backwards in her career." I feel like I'm constantly "faking it" to get by, and with hardly any real nursing experience, I'm becoming "unqualified" for other job options. Advice needed! Thanks :uhoh21:

Melissa - first, allow me to congratulate you on caring about what is going on with your unit. Being a nurse manager is an awesome responsibility ... more true when the job is done correctly. However, you need to have balance in your life in order to remain in the job for any period of time. Of course, this is easier said than done.

Nurse managers are often worked beyond their ability and the job keeps taking each and everyday. I know, I have been in nursing management for many years and have recently stepped down to a more clinical role. The decision for me to step down has been very positive. However, for people that truly love the job and can influence change on a positive level for both the nurses and patients, they are a rare breed. Sounds like you are one of them.

You need to set limits through a call schedule that the other nurses share with you. In addition, you need to look at your applicant flow to replace the nurses that have left or been terminated. Sometimes this is tough when less than qualified nurses are walking in to apply. I have often kept a traveler in my back pocket in this case .... 4-6 week contracts work very well to get you over the hump until a new nurse can be hired, oriented and ready to do the job independently.

In relationship to your clinical skills .... try to schedule yourself on the floor for at least one regular shift a month .. this way you keep those skills intact and you get to use the systems to provide care first hand. This serves several purposes ... first, you get to work directly with your nurses .... second, you can assess how the flow of work goes on a particular shift .... third, it gives you an opportunity to maintain your skills. During my regular shift on the floor, I would see issues with supplies ... got to experience delays in pharmacy first hand and had to do battle with the physician that was the nurses primary "pain." Through these shifts, it gave me an appreciation for what the nurses had to endure.

A well rounded and well balanced manager makes for a strong and healthy unit. Do not let your nurses take advantage of your kindness and your availablitity. They are all professionals and should be able to lead the unit when you are not there .... if this is not the case, then make this a goal and set up programs to get your nurses to that point. I have always said that nurses want great leadership. You sound like a great leader, but you need to take precious time for yourself, life interests as well as your family. If you let the job consume you, then it will .. everytime .... trust me, I have been there, done that and probably will write a book about it.

Most of all - good luck and please revisit here often ... there are many nurse managers on this forum that can provide wonderful advice and most importantly, friendship!

melissa_rn · Jun 9, 2005

Melissa - first, allow me to congratulate you on caring about what is going on with your unit. Being a nurse manager is an awesome responsibility ... more true when the job is done correctly. However, you need to have balance in your life in order to remain in the job for any period of time. Of course, this is easier said than done.
Nurse managers are often worked beyond their ability and the job keeps taking each and everyday. I know, I have been in nursing management for many years and have recently stepped down to a more clinical role. The decision for me to step down has been very positive. However, for people that truly love the job and can influence change on a positive level for both the nurses and patients, they are a rare breed. Sounds like you are one of them.
You need to set limits through a call schedule that the other nurses share with you. In addition, you need to look at your applicant flow to replace the nurses that have left or been terminated. Sometimes this is tough when less than qualified nurses are walking in to apply. I have often kept a traveler in my back pocket in this case .... 4-6 week contracts work very well to get you over the hump until a new nurse can be hired, oriented and ready to do the job independently.
In relationship to your clinical skills .... try to schedule yourself on the floor for at least one regular shift a month .. this way you keep those skills intact and you get to use the systems to provide care first hand. This serves several purposes ... first, you get to work directly with your nurses .... second, you can assess how the flow of work goes on a particular shift .... third, it gives you an opportunity to maintain your skills. During my regular shift on the floor, I would see issues with supplies ... got to experience delays in pharmacy first hand and had to do battle with the physician that was the nurses primary "pain." Through these shifts, it gave me an appreciation for what the nurses had to endure.
A well rounded and well balanced manager makes for a strong and healthy unit. Do not let your nurses take advantage of your kindness and your availablitity. They are all professionals and should be able to lead the unit when you are not there .... if this is not the case, then make this a goal and set up programs to get your nurses to that point. I have always said that nurses want great leadership. You sound like a great leader, but you need to take precious time for yourself, life interests as well as your family. If you let the job consume you, then it will .. everytime .... trust me, I have been there, done that and probably will write a book about it.
Most of all - good luck and please revisit here often ... there are many nurse managers on this forum that can provide wonderful advice and most importantly, friendship!

Thank you for the advice, I appreciate the support I receive on this site!

FeelGDRN · Sep 12, 2005

Congratulations on your job. Its a big one no question. I started management on a skilled unit after 3 years of psych nursing. After a fiasco with an unsupportive DON, I resigned. But I learned a great deal. Firsat year nfl quarterbacks almost always have tough time. The game is faster than expected, they get hit harder. There is more pressure. They throw interceptions, fumble snaps, etc. The beginning is always rough. But.. After some time passes, the game "Slows Down". They begin to see open receivers, they feel more comfortable "in the pocket" Then their natural skills take over and alot become good quarterbacks in the league. My experience as a first time manager was absolutey stressful in the beginning. The employees would get away with what they knew they could because I was new. The families were demanding. Administration wanted better stats. The patients were sick sometimes critical. I had my share of worries, worked 11 hour days. Things did slow down. I started to see and understand what the position was about. I began to start problem solving. I turned a real corner when I typed my expectations for the staff. Accountability accross the board. They responded to clear expectations. I had each staff member sign my expectations. When they did not meet them, I pulled them in my office. Writing people up is the last management tool. I learned that too. Meeting with staff on a reg ular basis was helpful. That way no one says "I didnt know that" Seeing expectations in action is an awesome feeling and experience. You also get to see staff grow in their skills as you grow in yours. Your unit is like your child. Yall grow up together. Other things; I prayed day and night for guidance, communicate with other managers, learn to laugh and enjoy your staff, patients, and even families. A sense of humor, twisted or no is your best friend. Otherwise you will go crazy. Too late? Just kidding. It will work out how its supposed to. There will be days when you really suprise yourself. Hope that was helpful.

johnson0424 · Oct 15, 2005

i am not sure if it is normal but i feel like that too. i am a manager of a 49 bed LTC unit and it is tough and i have been in ADON, DON, NM positions and I really like the accountability sheets...that is a great idea...if you could email those to me as examples i would appreciate it greatly. because sometimes what i expect is unreasonable...email [email protected]... i am having the same problems w/ my unit i just took over on 9/15 and i feel like i am having a stroke everyday...so i am deciding right now whether or not to stick with it or step down. plus i am in FNP school too so my plate is full. good luck and remember you are only one person and delegate delegate ....

kstockdaleRN · Feb 25, 2006

Hey, I am in almost the exact same situation! I graduated in dec. 03 also, and accepted a position as assistant director of nursing on my cardiac floor 6 months ago. Has it been rocky! My first week I had to pull a nurse in the office for cussing a coworker - and I had previously been friends with her. It is hard knowing that everyone's eyes are upon you. I have to try to set a good example no matter how I am feeling or what mood I am in. I have to do the right thing, no matter how I may feel about the employee. I have to be fair. This is the hardest thing I have ever done! I face pressure from my director and complaints from the rest of the floor - I am stuck in the middle. I try to view this as a stepping stone. I am going to learn everything i can and do this job to the best of my ability until something better comes along. This keeps me going.

It seems like I get one thing fixed and 10 more things go wrong - every day. It is a thankless job. However, after 6 months - it is gratifying to hear the "I'm glad your here!" from a nurse after I have been gone for my day off. I have heard the occasional "thank god your back, it was a mess yesterday!" I take this as the ultimate compliment right now. I have often had to "fake" my way through things! I rely on the unit secretary who has 20 years of experience more than she knows! I have to "pretend" calmness all the time - I had to walk up to the CCU director and defend one of my nurses the other day, and I know my hands were shaking. But if I let an ICU nurse treat one of my nurses like crap, I stand to lose a lot more. Same situation when I stand up to a doctor - it is hard, and I worry about it at night after I go home - but I have to advocate for patients and my staff. It is the hardest, best job I have ever had. One thing I have learned - what I lack in experience, I can make up for with enthusiasm and hard work. I set the "tone" for the shift - they all follow my lead. If I stay calm in the midst of a 14-admit in 8 hours night, they can all do it too.

ythomas · Mar 24, 2006

Yes yes yes and yes. I accepted a position as a nursing unit manager for a busy intergrated obstetrical unit. We deliver between 100-130 babies per month. I had 21 years of ER experience. This unit has had 5 different managers in 10 years..... poor morale, etc. It has been 5 month now and I have psoriasis which has been gone for 14 years, neck and arm pain etc. STRESS occurs when people care I am learinging to fret over things that I have control over. We have no control over the nursing shortage it is world wide. We can make things better on our units so nurses want to stay and will recruit for you too. Keep your chin up and keep caring.

lberghood · Mar 29, 2006

Thank you all so much wonderful advice, can definitely relate. New to management myself, took job as supervisor of 180 bed acute psychiatric hospital after 17 years of bedside nursing. Learning so much and can totally relate to everything posted here. Trying to boost morale and increase accountability and communication