why

Nurses General Nursing

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why are hospitals adding more and mor nursing managers and directoors adding more and more layers, if they just had one good manager who could do the work? and whats the need for a bed coordinator?

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

My workplace also has too many members of management walking around with no real purpose other than to micromanage.

Specializes in ACHPN.

It would be nice if they would eliminate a few of those management positons and add that back into the direct pt care budget, wouldn't it?

Specializes in Med/Surg, Ortho.

Well they have to have someone to go to all those unnecissary meetings they schedule to make themselves look busy. Heaven knows the staff, who should be there dont have the time. And heaven forbid they actually have to stay on the unit and DO some work. Havent you ever noticed those meetings are ALWAYS scheduled at the busiest time of the day?

Specializes in Nursing Professional Development.

Back in the 1980's, most hospitals did what you are suggesting -- eliminating manager positions. As middle-manager (and similar) positions were eliminated, the leadership got increasingly overworked and over-stressed. Their ability to successfully manage decreased.

Many people have FINALLY recognized that when you take away support for the leadership, the quality of leadership goes down -- and that is/was one of the major causes of the current nursing shortage.

With the health care system growing in complexity, hospitals need to invest more (not less) resources in running them. An impoverished leadership team is an ineffective leadership team.

... and unless you have experience in trying to run a unit or a hospital, you have NO IDEA how complex and how hard it is. Just as someone who has never been a staff nurse can't understand how difficult the staff nurse role is -- someone who has never tried a leadership role can't understand how difficult those roles are.

Be careful about assuming the worst about people, particularly if you have never walked in their shoes.

llg

Back in the 1980's, most hospitals did what you are suggesting -- eliminating manager positions. As middle-manager (and similar) positions were eliminated, the leadership got increasingly overworked and over-stressed. Their ability to successfully manage decreased.

Many people have FINALLY recognized that when you take away support for the leadership, the quality of leadership goes down -- and that is/was one of the major causes of the current nursing shortage.

With the health care system growing in complexity, hospitals need to invest more (not less) resources in running them. An impoverished leadership team is an ineffective leadership team.

... and unless you have experience in trying to run a unit or a hospital, you have NO IDEA how complex and how hard it is. Just as someone who has never been a staff nurse can't understand how difficult the staff nurse role is -- someone who has never tried a leadership role can't understand how difficult those roles are.

Be careful about assuming the worst about people, particularly if you have never walked in their shoes.

llg

I have walked int those shoes for many years so I do have the right to voice my opinion.

It would be nice if they would eliminate a few of those management positons and add that back into the direct pt care budget, wouldn't it?

I agree whole heartedly and if the managers in place were good at what they did then there wouldn't be a need for so many particularly on the day shift when there is only one for the entire building on the evening and night shift.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Good post llg. I didn't see where you were telling someone they didn't have the right to their opinion.

Our hospital in the mid-90s laid off a bunch of managers and directors and have slowly been adding them back over time, just not as many, as they found one person could not do the job of the three they fired. They also used to have nurse manager manage multiple floors and have since seen the err in that and have made nurse managers responsible for smaller assignments.

While I've never been in management, I've worked as a house super. I have seen the directors and managers over the years work long and hard hours, being beeped at all hours of the day and night. I don't think less of them would be effective.

In my hospital that is.

I'm not sure what you mean by a "bed coordinator".

Good post llg. I didn't see where you were telling someone they didn't have the right to their opinion.

Our hospital in the mid-90s laid off a bunch of managers and directors and have slowly been adding them back over time, just not as many, as they found one person could not do the job of the three they fired. They also used to have nurse manager manage multiple floors and have since seen the err in that and have made nurse managers responsible for smaller assignments.

While I've never been in management, I've worked as a house super. I have seen the directors and managers over the years work long and hard hours, being beeped at all hours of the day and night. I don't think less of them would be effective.

In my hospital that is.

I'm not sure what you mean by a "bed coordinator".

I dont understand why you say that you have done house supervisorn but have not worked in management. a house supervisor is a manager especeilayy if you hold the position full time. this is my point precisely house supervisors are managers and why they may not have 24 hour accountaability they are none the less managers

a manager who gets beds for patients in the ED a position created just for that that reports directly to the VP of nursing?? crazy insn't it?

Specializes in Geriatrics/Oncology/Psych/College Health.

It is important to understand that managing is a specialty just like any other area of nursing, that may be performed well or incompetently, depending on the person filling the role and the training provided. Too often I've seen managers rise to their position simply by outlasting all others. Being a good nurse doesn't automatically equal being a good boss (see: Peter Principle http://en.wikipedia.org/wiki/Peter_Principle )

Agreed with llg that the grass is greener on the other side of the fence. I've been in that grass, and there's a lot of dog doo in that other yard ;).

It is important to understand that managing is a specialty just like any other area of nursing, that may be performed well or incompetently, depending on the person filling the role and the training provided. Too often I've seen managers rise to their position simply by outlasting all others. Being a good nurse doesn't automatically equal being a good boss (see: Peter Principle http://en.wikipedia.org/wiki/Peter_Principle )

Agreed with llg that the grass is greener on the other side of the fence. I've been in that grass, and there's a lot of dog doo in that other yard ;).

i agree but don't understand why people think supervisor are not managers

Specializes in Nursing Professional Development.

House Supervisors (and bed coordinators) are performing a few specific functions that overlap with managment functions ... but don't do many of the other aspects of the management role.

In many cases, the supervisors are like "charge nurses" on a large scale. They coordinate some of the hour-by-hour events with a hospital-wide focus much like a charge nurse does for a specific unit. Just as a charge nurse is "kind of" a manager, few people would say that a charge nurse is the same thing as a head nurse. A similar comparison can be made between a house supervisor and a DON or senior-level manager.

House supervisors don't hire, fire, manage a budget, establish department goals, establish priorities, oversee supply acquisition and use, etc. -- many of the functions that distiguish management roles from any other. In most cases, house supervisors are implementing the policies, procedures, and priorities set by others -- not establishing them for themselves. They are the implementors for the higher level administrators.

On most hospital organizational charts, the house supervisors are a "staff position," not a "line" position. That says a lot.

Don't get me wrong. I have great respect for house supervisors -- and have shared an office suite with them at my current hospital. I am in a similar position organizationally -- a staff position rather than a line position -- and I know the difference between the two.

llg

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