The Enemy... The Nurse Manager

[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???

[TheCommuter, BSN, RN]

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.

You are describing the crab mentality, a.k.a. the 'crabs in the barrel' phenomenon. It is a potent metaphor for the human response to self-improvement in others.

In response to some type of self-betterment (e.g., promotion, weight loss, career change, educational advancement), the people around us can be unsupportive.

It is similar to crabs left in an open barrel: one striving crab tries to climb up and out of the barrel toward freedom, but the other crabs nonsensically do everything possible to pull it back to the bottom so they all suffer the same bleak fate.

[luvsltcrn]

OP I could not agree with your post more!! Middle management is the most difficult position I have ever had. You hear complaints from administration/CEO and also from floor staff. Impossible to make everyone happy and nobody understands what you actually do!!!

all of your free time is consumed by your job because you are always on call. Sleep in never uninterrupted because there is always something happening that requires your attention. It totally consumes your life and very few people appreciate anything you do.

Good Luck to you!! Unfortunately I have no advice and it has been a difficult week so I can't even seem to pull off being a little positive.

[guest52816]

That is too bad.

I know I have used employee suggestions to make changes.

In industry we call it the VOC or Voice of Customer and it is considered the most important data one can find and one of the most difficult to obtain.

Do you abstain from voting in elections as well?

Sorry, but I agree with Sour Lemon.

I started in my position in mid-October. Since that time, I have attended every monthly unit staff meeting. However, it was clear to me by meeting number three, that input from nurses was only valued if it aligned with the CNO's sentiments.

When I brought up a situation in which I felt conditions on the unit were unsafe for my fellow nurses on the next shift, and the patient, I was given an excuse of why it would have been too difficult to call in additional staff to remedy the problem.

The problems I brought up, were always thrown back at me, the nurse.

So now, I dutifully attend the meetings, keep my eyes and head down and my mouth shut. Nothing will change, until management WANTS it to.

And yes, I vote in elections.

[Ruby Vee, BSN]

Night nurses might need to get home to get their kids off to school. Or their spouses need the car to get to work and the Night nurse is going to do child care all day while needing to sleep. Just sayin'.

If the meeting were scheduled well in advance and was mandatory, you can work something else for child car, transportation or whatever.

[knurse10]

I'll start by saying that the nurse manager role is most likely one of the more difficult jobs in the nursing profession. I do not wish this career on my worst enemy. That being said...

There are certain things that nurse managers do that can be quite inexcusable. The main one that comes to mind is cutting corners when it comes to patient safety. To me, this means staffing issues which lead to unsafe situations. When the nurse manager doesn't have our back on this issue, my floor is at a lower morale.

So take this lower morale and then demand mandatory education, meetings, mandatory extra shifts, and volunteer projects. Believe it or not, some people want to come in and work their required hours and then go home to be with their families.

I think the model of having one nurse manager is not sufficient to meet the needs when you are pulled in so many directions. The ideal team would be a nurse manager and an associate nurse manager who can share the burden. Unfortunately that is not the reality we live in. Best of luck to you, op.

[foggnm]

I definitely think it is true that nurses can target management for their discontent. However, 'good' managers might be criticized by gossiping nurses, but they aren't usually seen as the enemy if they are reasonable and fair. If you are being reasonable, fair, and following policy then don't worry about what people think. If you develop your professional confidence to do the right thing, rather than trying to please people, you'll become a better leader. That being said, if you're constantly doing things that upset your employees (like denying leave time for a wedding), you're not going to win anyone's heart.

[guest358111]

Nurse management is such a tough job. I have always thought that the management alone is hard, but then to have to do scheduling and coverage on top of that? Crazy.

Thanks for such a forthright and accurate post. I'm sorry you feel like you are the enemy-you're not.

I'm really enjoying reading everyone's posts-a lot of great perspectives.

A few tips from a stint that I had in the management world:

1. Develop alligator skin.

2. You can't change personalities-but you can limit the time they spend behind your door. There will always be a select few people that always have a problem with EVERYTHING and will have to tell you about it every single day/week. I'm not saying their concerns aren't valid...but usually you have to listen to them respectfully for a bit and then figure out how to end it so you can get on your way and your day and make them happy and not get yourself get sucked into the quicksand...

3. Maybe this is naive of me, but don't waste time worrying about gossip on the unit etc. in other words unless something is said right to your face, don't deal with it or waste the energy.

4. And if possible, always granting PTO (as much as possible, you are right about no-one gets 100% of what they want )that might help set a culture where everyone realizes that they all have to help build the sandcastle...

Really, at the end of the day though, developing alligator skin was what worked/works best for me. Haters gonna hate and all that. I can't let snarky personalities impact mine or I'd drown in the negativity. Just because you posted this obviously means to me that you are a caring person who wants to do a good job. So don't let it bring you down!!

[Here.I.Stand, BSN, RN]

OP I'm one of those that rarely comes to staff meetings; I would have to make a trip downtown and pay for parking on my day off, and they're usually scheduled in the time frame when I am dropping off or picking kids up from school. They are open enrolled in another district, so no school buses or neighbors to carpool with. Back when I worked overnight, no way in hades was I going to wake up in the middle of my "night" to go to a meeting.

What my manager sometimes does for the important stuff is leave the meeting minutes in a binder in the break room, and if we didn't go to the meeting we have to read and sign. That way everyone was accountable for the information at the same time not putting undue stress on people.

[marcellahays1]

Thank you for your forum discussion post. I am so sorry that you are going through this. I work in the memory care unit at an assisted living facility. There is a nurse manager there who is managing everyone on the floor everyday and night. She has a lot to do like you mentioned in your forum posting. I am sometimes scared when she gets angry with me sometimes, but I know that it is for my own good. Thank you for all that you do for your staff and I know that it is a hard job.

[NuGuyNurse2b]

As a staff nurse and prior experience in a managerial role (not as a nurse) I can sympathize with the feeling of being trapped in the middle when you are a manager. But as others have pointed out, staff meetings are pretty pointless because the frustrations and suggestions brought forth by the staff are ignored. Case in point - attrition. We actually had a meeting because our NM wanted to know why so many of the new hires, whether straight out of school or experienced, were leaving the floor. We all know why people don't stay - the pay isn't competitive with other hospitals in the area, and we are constantly short staffed. That's the proverbial elephant in the room that neither the NM wants to honestly address nor the staff intrepid enough to bring it up. And if the NM isn't willing to bring forth an honest and open dialogue, the staff certainly won't.

[GaleSRN, BSN, RN]

I, too, am a nurse manager. It is one of the most difficult jobs in nursing. I love it. There are pluses and there are the horrors.

First off, staff meetings are mandatory. I bring food. There has to be a good reason for a "no show".

The most important thing I do is taking care of my staff. When I have a difficult situation to deal with, such as a budget issue, I go to my staff. If I am having a staffing issue, I take it to the people most affected by it and ask for solutions.

I turn PTO requests over to them to work out. I let them know that I can only let one person off at a time. They decide who is going to be off when.

In other words, if they make the decision, then they own it. That is key.

[Nur7138]

The nurse manager I have is amazing. She is a floor nurse and always works around our schedules. There around 10 full time then part time and float pool. You have to give your nurses their days off they ask, they have a life you need to stand up to upper management and tell them. Nurses have options and respect their lives as well. You get paid the big bucks to be a manager.