Managing difficult nurse managers

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    I am so frustrated with my staff. I have 12 direct reports and my direct reports have about 80 nurses. I just started this job in April and no ones performance evaluations have been completed since 2009. Hard to complain when my boss is my predecessor, he did not do anything. I was monitoring my direct reports, time & attendance to determine if nurse managers are being consistent with coaching. Well come to find out one nurse had major attendance issues. 75% of the time was late absent or leaving early. No one has held her accountable. So I tell my direct report she needs to deal with her. (Write up), she ask for my help and I consult legal & HR. since there was no prior documentation, legal advised a formal verbal warning & initation of performance plan. Everything went smooth, the nurses has no doubt of her expectations. Here where it gets interesting, the same nurse came to me to file an administrative complaint against her supervisor. My direct report send a text message to a non manager nurse stating that I went easy on her direct report with her attendance issue because the nurse "hit my soft spot" saying her children had been sick. Funny thing is the text message went to her direct report the one that she was talking about versus the nurse that it was intended for. Now we have a huge mess.
    1. Confidentiality violation
    2. Innappropriate manager relationship
    3. Talking crap about me when I was the one who brought this to her attention
    I am very frustrated at this point & disappointed in my nurse. Any feedback would be great.
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  3. 8 Comments so far...

  4. 0
    It sounds like you have a lot of catching up to do to correct past omissions and behaviors!
    When I came on board at my job, my position had been vacant 6 months, and the interim already had her own full time duties with her own department.

    Are you meeting with your directs regularly, both individually and as a group? And with your group of 80?
    I feel it's really important off to be highly visible from day one, and to set your expectations for performance and behaviors.

    Your subordinate was inappropriate by bringing up this issue with someone outside the leadership group, and we all need to really be careful about what we text, or email, because it never goes away & we have no control over where it goes after that. I'd suggest meeting with her, and then dropping a note in her file documenting the conversation. I'd also consider having your 12 meet together once a month, without you, to discuss issues they may be having. The meeting would be led by each one on a rotating basis, who would prepare the agenda, and then create the minutes.

    In terms of time and attendance, I'd suggest addressing the staff, presenting the HR policy, and tell them that going forward the policy will be enforced. Consider an amnesty, start at zero, or only go back to June 1st or whatever. Prepare a list of past callins for the worst offenders, and meet very briefly with each of them, give them a heads up & tell them they need to clean it up going forward. If attendance hasn't been an issue for months, maybe years, then a culture of lax attendance may have developed.

    I know how challenging it must be right now, and it probably seems like you have 50 things that need to be done "now." Just tell yourself that you won't get everything done today...or this week...or month. Your staff will usually do what they need to do, but you need to set the expectations. It took me about 6 months to feel things were starting to fall into place. Hang in there.
  5. 0
    MrChichagoRN,
    Thanks so much for your feedback. Do you believe that a breach in confidentiality only deserved a "note" in her file? i was pursuing something more serious. Breach of confidently is considered a serious offense in our policy, which requires a "level". I have conducted meetings will all my direct reports upon my initial arrival which were 1:1. With my nurse managers I have weekly meeting with them to develop a rapport. Two of my nurses managers a new to there position however they have been with the company for 5+ years. I have also statred in the month of May documenting the nurses that have attendance issues, eventualky i expect my nurse managers to do this. Went i took the position i knew it would be a challange, I am staying prayed up and asking God for guidance. I think that your suggestion is great with regards to presenting the HR policy. I do have 50+ things to do plus other deartment complaints. I came into the facility on the "delinquent list"

    Again thanks and I really feel better.
  6. 0
    Every facility has its own customs & nuances regarding how issues are handled. I try to handle issues in a manner consistent with the place I'm at, so I'm still asking HR or my manager how things are handled there. If your HR says a level, then definitely do the level. Sometimes once you deal with the first, the others fall into place

    Good luck
  7. 0
    Hi! I am new to this and as not sure how to send you a message @ Tasha_RN_BSN.......I read one of your comments on someone else's post, she was having trouble finding a job as an LVN with stipulations, your comment read that you knew of places in SA that hire with STIPS, I am in the same situation, and am having trouble finding a job....I live in the SA area and would be very grateful if you could give me names of facilities that hire with STIPS, I was working at a place in NB but had to resign due to surgery, I am now able to return back to work but she is fully staffed, I am currently on food stamps and my family and friends are helping me with all my living expenses , I feel this is a travesty because I am a licensed nurse and should be able to provide for myself and my children.....your help would be gratefully appreciated. Thank you
  8. 0
    These two are considered 2nd chance employers.

    Health Care
    Wellcare
    (210) 454-5913

    Girling Home Health Care
    5282 Medical Drive
    San Antonio, TX 78229-4849
    (210) 616-0212
  9. 2
    I also walked into a mess. My predecessor was a dictatorial type of leader whose primary method of communication was to yell at people. She knew the only "correct" way to do everything, and she imposed her own will on people rather than involving them in developing solutions. The first three weeks I was on the job nobody came into my office, because they were used to only bad things happening in there. I set the tone early, telling the staff that if there was going to be any drama it would be of their own making, because it wasn't going to come from my office. My department had also been at war with pretty much every other department in the facility, because my predecessor approached other department heads the same way she did her own staff: We have a problem, and here is how you are going to fix it. She tried to force her own solution on them rather than with mutual respect and cooperation. I had to spend considerable time building relationships with other department heads, and assuring them that if we have problems of mutual interest, we will arrive at a solution that we both can live with.

    Like you, I had staff with attendance and punctuality problems. Some had previously been dealt with severely, while others were pretty much allowed to do as they pleased. It took a while (and several letters of instruction) for people to get the idea that (a) I am paying attention to what they are and are not doing, and (b) everyone is going to get fair and equal treatment.

    When you walk into a situation that has been poorly managed, it takes time, effort and a lot of frustration along the way to get it under control. However, if you are firm, fair and consistent you will be respected, and your staff will appreciate the change in atmosphere. Managers who are lax on things like evaluations usually don't pay attention to other, more important issues either. You can bet that your staff has recognized this, and many of them have probably developed the same lax attitudes toward what they are doing. Fixing this won't happen quickly, but it will happen. Just stick to the path you set.

    While it is therapeutic to spell out everything you are dealing with in a forum like this amongst your peers, you will drive yourself nuts if you take a "whole picture" view of things as you proceed to create some semblance of order. Prioritize what you want to do. First and foremost, you need people on duty and properly doing their jobs to accomplish anything, so address the personnel issues first, particularly attendance issues and any performance problems. Once those are relatively stable, you can begin to look at any procedural changes you want to make. Once you start those, change one thing at a time and allow people time to adjust. People don't deal well with a lot of major changes made all at once. They need time to adapt to the new way of doing things. Engage your staff as you develop better ways of doing things. They will appreciate having input into changes in their tasks, and the buy-in is always better when solutions are mutually developed rather than imposed (not that there aren't occasions when you have to do this, too). Give them credit for their knowledge and skills. Soliciting their ideas and implementing the good ones is a good way to acknowledge their skills and expertise. Openly recognize those who make significant contributions.

    Perhaps most importantly, leave your problems at the door when you go home. There aren't any problems that require your 24/7 attention, so give yourself time to unwind and not think about work.

    Now past the six year mark in this job, things run pretty much smoothly, the problems I do have are usually relatively insignificant, and when we have an acute staffing issue people are generally willing to develop solutions on their own and present them to me for approval. I have no problem finding volunteers. We have peace with the other departments. Employees realize that they will be treated with respect, but also that there are set expectations.

    The tone is set at the top. Good luck, Keep us posted on how things are progressing.
    Last edit by Orca on Aug 14, '13
    flowerpower and romantic like this.
  10. 0
    Loved your message for being very constructive and, most importantly, very positive. If I could give you more "Like," you would receive plenty of them .
  11. 0
    Thank you.
    Last edit by romantic on Aug 21, '13 : Reason: add


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