The shine is wearing off

[JenniferSews]

Holy cow, this is long and probably boring!

I have been an employed nurse since 3/10. My first job was at a sub acute rehab facility and while it was incredibly stressful to have so many patients, it was very rewarding. But it was so overwhelming when the position for unit manager came open I applied for it. A big part of my reasoning was that we needed some sort of assistance. It could get so overwhelming with orders to be taken off, docs to follow up with, labs needing tracking, and 10,000 other things I ended up working 10 hours at least most days. So I applied with the encouragement of all my coworkers who vowed to support me, as well as my mentor. I got the job. Then in a weird twist I was moved to another unit as unit manager instead.

Now I have the title of unit manager, but my duties are undefined. I have a superior with a different job title but the same duties as unit manager. The end result is I am now her assistant. Overall, I wouldn't have minded. But it's been 6 weeks now and I'm feeling very unhappy. I can't put my finger on what exactly is wrong, because when I started I LOVED the job.

I think part of the problem is that I have less to do, but everyone has expectations of me that are often outside of my new "job." I am told by upper management that I am not the ward clerk and am not to take off orders. The nurses were very upset at first that they could no longer delegate to me. I spend a lot of time instead making sure that labs, etc are completed as ordered, physicians notified, new orders obtained and then written correctly on the MAR. Basically following up to be sure everyone else did what they signed off and said they already did. It's lifeless at best as a job.

While I do have some authority, I also have a lot more responsibility. When we get a ton of admissions, I can't leave until I am sure the team is okay. So orders are handwritten (often by me) then called to the doc and verified. Then the consents are signed and the skin assessments are done. Last week I had to race to pick up my kids (ages 6, 4 and 2) by 6pm, then I got McDonalds and brought them back to work with me to finish. On top of that I am on call. I apparently have the worst luck while on call and have already worked 2 night shifts in the 7 days of call I've had. I spent a TON of time on the phone begging people to work so I wouldn't have to go in for other shifts.

All this comes down to no pay raise for another 6 weeks. Then when I DO get a pay raise I'll still be salary, so the extra hours and the on call and the phone calls and the night shifts are FREE labor. I expect the pay raise will be what it would normally be for a nurse with 1 yr experience. Right now I am at 8 months experience and I'm wondering why I ever thought this was a good idea. Some of the new grads hired after me make significantly more than me and don't have the same issues.

Surely management has some perks I'm not aware of yet? Is there some piece I'm missing so far that I haven't grasped? Overall I loved the challenge of the goals I set for myself of building a cohesive team, improving patient satisfaction, etc. By all accounts we are on the way to those goals and making great strides. But the reality is I won't/can't reach those goals within the constraints of this position. On top of it all I lost my mentor and it was so nice to have someone to go to! So what is the point anyway? Should I request to go back to the floor after just 6 weeks? Should I stick it out and hope it gets better? I'm lost in a way I never expected at my age, help!

[HouTx, BSN, MSN, EdD]

Sounds like you are actually doing very well for such a new grad - but I am sorry that your first taste of 'mgt' is not what you expected.

Normally, when nurses move up into mgt positions, there is a phase of 'grieving' over the loss of all the positive strokes that are involved in patient care. Let's face it, making people feel better does great things for our egos. However - as you move away from the bedside those opportunities become scarce, and mgt 'stuff' just doesn't provide the same level of emotional support. However, in your case, I don't think you were in a clinical position long enough for this to be the primary cause of your malaise.

There are basically three different types of 'things' you have to do as a manager. You still have tasks to do - these are pretty clearly defined; e.g., ordering supplies, filling out payroll & schedules, replacing call-ins, addressing performance issues, etc. These are pretty self-explanatory. Then, you will head up 'projects' - things you want to do that take a long time such as implementing self-scheduling, developing a new way to document patient teaching, etc. And finally, there are the 'initiatives' to support organizational goals - these usually involve other depts and you probably won't be leading them. Manager job satisfaction usually comes from project management - achieving goals that are important to you.

Your boss should actually have worked with you to make sure that you understand what is expected from you in all three areas. You can't effectively prioritize & manage your time without this information. Ask for clarification - exactly what does 'success' look like??? What resources are available?? Keep track of your time so you know where it is going. Regulate your time so you aren't putting in too many hours. Increased flexibility of hours is one of basic perks of management. If you have to come in, take a day off to compensate. If this is not allowed, I would seek work elsewhere.

[baldee]

Leaders don't need stinkin' titles or authority. Use compassionate people power and you will prosper. No one is going to give you the world without verification first. You are in a fast-track position and the opportunity of a lifetime: what you have worked so hard for to date. Smell the coffee, smile, and do the best you can (and send me $3500 for career consultation - ha ha)!