Bad Supervisor

[Sochi]

I work in the med/surg unit at a rural hospital. We recently had a mandatory staff meeting and it was another 1.5hr talk about how we suck at our jobs and need to do better. No positive notes or mention of accomplishments just a barrage of why we should be grateful to work at our facility and how bad we are at our jobs. One of the area we as nurses were told to address was for a pediatrician who has his own IV basket at the nurses station. This is a physician who has a reputation for throwing charts and yelling at nurses. We were told and this is a direct quote from the meeting notes that we all have to sign:

*The next time Dr. X(omitted) comes in and finds his basket not stocked, I'm going to let him throw things at each of you. His basket was empty and did not even have a 2x2 in it. Restocking and cleaning is EVERYONE'S responsibility and is not being done.

The above was not said with any humor but was her threat to us. The physicians basket is often pilfered by lab techs when they come on the floor but that doesn't matter to her. She is also adding a cleaning and stocking schedule for staff during downtime that includes cleaning the break room refrigerator and going room to room to clean and pick up what maintenance may have missed. Cleaning bedside commodes ect are on the list.

Our downtime is few and far between with a pt load of up to 12 pts per RN, 1 LPN and 1CNA for each 18 pts. We also don't have a pediatric or post surgery unit so our little med/surg gets it all. It's not unusual to have a mix of pediatric, post surgery, chest pain, elderly mental status change with neuro checks as part of your 10-12 pt group. And now they want to put my name on a list to clean the break room refrigerator! Am I overreacting or is this ridiculous?

[macawake, MSN]

One of the area we as nurses were told to address was for a pediatrician who has his own IV basket at the nurses station. This is a physician who has a reputation for throwing charts and yelling at nurses. We were told and this is a direct quote from the meeting notes that we all have to sign:

*The next time Dr. X(omitted) comes in and finds his basket not stocked, I'm going to let him throw things at each of you. His basket was empty and did not even have a 2x2 in it. Restocking and cleaning is EVERYONE'S responsibility and is not being done.

Are you seriously saying that your supervisor is stupid enough to put this part in writing?

I'm not in the US and I don't know which the appropriate party is to whom you can file a complaint regarding your supervisor. Personally, I'd ask for a copy of the meeting notes and include it in said complaint. I don't know how your situation is, so I can't really offer you any advice but if it were me, I'd resign from this job.

Am I overreacting or is this ridiculous?

A physician yelling at nurses and throwing things? Of course it's ridiculous. As well as unacceptable.

[OrganizedChaos, LVN]

Uh I'd find another job. That's ridiculous. Can you go up the chain of command & show that to HER boss? I mean, that's messed up.

[Sochi]

She seriously has that quote as part of the department meeting minutes. It was no joke when she made the statement either. I'm looking for another job because even though I don't interact with her very often it is always a negative experience. She simply looks down on us and is to good to acknowledge our presence when we arrive at the unit to work. Just looks right thru you without saying a word. I'm constantly telling the new hires to not take it personally - she hates all of us!

[OrganizedChaos, LVN]

Well I agree with the PP. I would get a copy of the letter from the meeting & write up a complaint. I hope you find another job. No one deserves to be treated like that.

[jadelpn, LPN, EMT-B]

Your parent company has a website, on which is a reporting feature for reporting unethical behavior. By the fact that this supervisor proclaimed that she was going to "let" anyone "throw things at you" is absolutely out of line. I would report it, immediately. I would also report it to your DON. And your parent company who has an employee relations department.

And while you are at it, I am oh so curious as to what your state licensing or joint commission would say about IV "baskets" being left out at the nurse's station, unsecured, as well as 2x2's and the like that is a huge infection control issue, that then is carried room to room as needed. That is a huge amount of hogwash.

Do you have a union? If you do, go to your delegates. If you don't then now is perhaps the time. And each time that a nurse has 12 patients, I would put in an occurrence report for unsafe staffing.

Make sure you all have malpractice insurance. Make sure that everyone also makes a report to the parent company website each time this MD comes around and throws charts at people. And your risk management team would be appalled, I would think. Especially when this MD hits someone with a chart, and they are sued for assault, and have a workman's comp claim on their hands.

This is one hot mess. I would start putting out some resumes.

[Here.I.Stand, BSN, RN]

I hope you didn't sign it!

I'm sure HR would be interested that a staff member is inciting violence (willing to "let" an overgrown toddler throw things in his temper tantrums.) Show them a copy of this "contract." The hospital's risk management dept, and OSHA, should hear about this also.

This toddler should also be reported to the police every time he throws something at someone. His behaviors are called "Battery," and battery is a crime.

[Mavrick, BSN, RN]

Am I overreacting or is this ridiculous?

I vote ridiculous.

Take her ridiculous note and send it up the chain of command. She's writing her own termination letter.

[GuEsT78]

I know how you feel. I endured close over a year of increasing tension for the nurses at a big city teaching hospital, although the problem had little or nothing to do with our physicians. With the exception of a few immature residents, they displayed maturity and decency. That's perhaps one difference between physicians who do well in their profession and those who don't. The latter can end up with a chip on their shoulder.

In fact, in one case two residents started an IV on a child and then left their mess behind, with one of them commenting as he walked away that cleaning up was "nurse work." According to the account I was told, within an hour that incident had made its way up the nursing chain of command, leapt across to those managing the residents, and those two residents came back to the nurse involved and apologized. That's training them right.

That's clearly not what is happening here. A physician is being allow to throw a toddler-like temper tantrum and the nurses are expected to go along—something that must astonish the hospital's patients. Keep in mind that in this case the hospital has a lot of leverage. Being rural, this hospital is likely to be the only or one of only a few hospitals in the area where he could practice. He's not a high-powered specialist at a major hospital who can threaten to take a million dollars worth of patient care elsewhere.

My first suggestion? Smartphones with that can record events are common now. The next time this physician throws a fit, discretely record it. Then file a complaint without mentioning that recording. If he claims events were other than what happened, offer that recording as evidence. Then it's no longer a 'he says, she says' dispute. Just keep in mind that recording can have privacy gotchas. If a sound recording is enough to damn him, just make a sound recording.

In my case, it was the nursing administration that was harsh and demanding, so much so that the complaints I put in my resignation letter were the only formal complaint from the nursing staff that I heard about during that terrible, draining ordeal. A few weeks after I left to go back to school, nurses began to quit en masse. Within about three months, some 20% of the nursing staff had left and hiring replacements became very difficult.

You summed up precisely what triggered that mass exodus when you wrote: "No positive notes or mention of accomplishments just a barrage of why we should be grateful to work at our facility and how bad we are at our jobs."

To this day, I remain proud of the fact that, despite my head nurse pressuring me to come up with dirt on the nurses I was working with, I flat out refused. During those last few months, I promised myself that not one word of criticism would come from my lips. Despite being terribly overloaded, they were doing good work. They did not deserve the barrage of criticism they were getting.

A second suggestion. Acting as a group carries far more weight than a nurse here and there filing a complaint. If all or most of the nurses on your unit file a complaint against the pandering to this ill-tempered physician, the hospital will have to take it seriously. Just be sure to offer a positive alternative. In my complaint, I pointed out that, while day shift was dreadfully overworked, evening shift wasn't, and suggested that what didn't have to be done on day shift be moved to evenings. It made no sense, I said, to expect day shift to handle baths and showers. As soon as a patient was sent to one, a physician or med tech was likely to show up needing to see them.

One final suggestion. Let that refrigerator cleaning list issue fall by the wayside. Mixing the serious with the petty will only weaken the impact of the serious. Get what matters most changed and many of the smaller issues will correct themselves or at least seem less important. Having staff clean the break room refrigerator is common on jobs and probably won't seem that big a deal if these major issues get addressed.

-----

Now for a little background. Problems like these come up all the time in highly structured work environments, so much so that in the 1990s, the U.S. military expanded the role of the senior non-commissioned officer in a unit to add a position with names such as Command Master Chief. Their responsibilities include listening to complains from those in the ranks and taking them up with their commanding officer. Woe be it to the commanding officer if he doesn't listen to his Master Chief.

I'm now wrapping up a book that'll suggest the obvious—that nursing needs someone in a similar role, a role I call that Senior Nurse Mentor. Like a Command Master Chief, she'd be completely outside the nursing administration, reporting only to the hospital's CEO. Like a Command Master Chief, nurses could talk to her in complete confidence that there'd be no retribution for what they say. She'd be a very experienced nurse and at the center of her job would be maintaining nursing morale.

She'd save a hospital more than her salary both by reducing turnover and preventing nursing mistakes. You didn't mention it, but during my experience I saw all too well that nurses under highly critical pressure make far more mistakes. Bad morale is bad for everyone, nurses, patients and the hospital.

[dudette10, MSN, RN]

I would send the meeting notes to HR, the C-suite, the BON, and see what they have to say about it. Her negative behavior is escalating because no one does anything about it. She needs to go. Yesterday.

[thecool1Nscrubs2no]

Advice and please act on it.

1. Make 6 copies of that memo

2. Keep one for yourself

3. Forward one to HR and CEO/CNO (let them know you want a response to this if not address locally you will be contacting HQ and the BON) Place a time frame on the response..... for example I would like a response in 30days that will have a course of action and implementation related to language utilized within the work setting.

4. Also give one to the MD that was mentioned in the letter

Threats are not to be taken lightly in any type of work setting. If they try it once they will do it again. Stand up for yourself don't be bullied. It sounds like the supervisor is abusing their role to produce a hostile work environment. The approach used by the supervisor will not work all that does is create division in a team and lowers morale.

Please keep us posted.

[BrandonLPN, LPN]

I'd be more upset by the basket-throwing doctor than by the idiot nurse manager. If a doctor ever threw an empty supply basket at me, it would be the last thing he ever throws.

The fact that filling Dr God's goodie baskets is "everyone's" responsibility in the first place says a lot about the culture of this hospital. I wonder if the difficulty of attracting MDs to rural hospitals is playing a role in letting him get away with being ridiculous.