I have worked at SNF as a manager for about six months. When I started I was told by my DON about the roles of he nurses on my unit. I have a "head nurse" who is an LPN and acts as a charge nurse, and two LPNs to work the floor for meds and treatments. The head nurse used to be the unit manager before the facility decided they needed RNs in that role (some years ago) and there hasn't been stable leadership on my unit since.
Most recently, while I was out sick, my ADON had a staff meeting with all my CNAs and my nurses to discuss lack-luster performance and care. (Why she didn't wait Until I came back to address the issues myself, I don't know, and that is a whole other issue) I do hold regular meetings and make my expectations known to the staff. When my ADON asked my head nurse what she had been doing to stay on top of care issues and the work of the CNAs, she said that "my manager (me) doesn't give me permission to discipline CNAs".
I heard this from the ADON upon my return. I was furious. I have been forthright with my head nurse about her leadership role on the unit and her accountability for CNA performance. I cannot patrol the floors and go to care plan meetings and complete my work as well. I have told her that I expect her to correct staff behavior and I will back her decisions. I have been trying to give her authority and autonomy from day one.
I feel that she is letting the unit fall to pieces and hoping I take the fall for it. She has stated several times that she "doesn't work for RNs, she works for the facility" and she openly disrespects me in front of the rest of the team. (Said "whatever" to me when I made a suggestion she disagreed with, speaks rudely, and gave me a nickname) I am beginning to feel paranoid and stripped of my confidence. To make matters worse, she is engaged to the ADONs cousin and soaks up at least two to three days of OT every week. I am salaried, which is part of my job. The extra hours make her unbelievably cranky and possessive of the floor- because she never leaves.
The DON told me that the last manager was demoted after the head nurse was in her office non-stop with complaints about her skills. Another RN at the facility told me that if it came down to me or the head nurse, I'd be out of a job. I'm thinking of heading for the hills before that happens, but I don't feel I should be the one to leave!!
Productivity is up, my census is full, we had a ZERO deficiency survey on my unit. I'm doing a good job. I think that makes my nurse feel threatened and now she is trying to throw me under any bus that will come along. Am I over reacting? How do I survive with an unprofessional, demoralizing, manipulative "first mate"? We are supposed to be a team.