Completed first week as new NM, could use a little help

[MomRN0913]

I completed my first week as a new nurse manager in a LTACH facility. I came right from the bedside. I am not filling an old position, but I am starting a new one. The hospital is still building, so policies and procedures are changing all the time. I faced some challenges. I thought they were going to ease me in, but not so much....

I am taking over alot of the responsibilities the VP of nursing services had. She is the one I have been following. I thought the first week would be me getting to know the staff, how things are run, so on and so forth. They threw me in head first! Nicely though, with support, but woah. They sent me all of the PI stuff and are handing it over to me. They are guiding me. I am responsible already for compling that data in the nursing aspect. They do chart review weekly, I am to now take that data, tally it up, address it with the CEO... keep track of the deficiecies and have the staff take care of them. I have been in a meeting 4 times a day, position control (we are expanding and need to hire 36 new RN's by March?????!!! with expereicence, not new grads) I was informed on my second day I needed to be there on Fridays at 6am to do vent weaning rounds and then start conducting interviews at 3pm on a friday? Hello? All this in my first week. Plus more. They wanted me to start discipling staff I never even met.... how seriously are they going to take me if they never met me? My second day they had me taking care of all complaing patients. Which I did. Which I am very good at, it's my strong point.

There is a charge nurse who is very on top of things every shift. They are very good. One never bothered me at all. On my 3rd day, that one met me and was like "oooohhhh, nurse manager" And started telling me the things she should be taking care of and passing me them off to me. Otherwise they are very knowledgable and excellent charge nurses.

I have conducted 8 interviews in my first week. This friday I was there 12 hours, 6am-6p, because I was pulled into a meeting every 10 min, had vent weaning rounds, then we had about 5 admissions at once, and I wasn't going to bail, I helped. I had 7 interviews too.

I understand that even though my hours are 830-5, it isn't always going to be that way. And it sure as hell wasn't. I left later everyday. especially friday.

There are alot of things that need to be changed, but I am not going ot go into that slowly. The staffing is an issue. They do the schedules 2 weeks at a time, and almost all the emplyees have 1 or 2 other jobs. Theya re getting whatever they want. The staffing coordinator handles it. Next week there are 2 days where we have 2 nurses and we should have 5 on per shift. I believe you cannot issue a schedule without everyday being filled. In my facility, the schedule was arranged so that every day was adequately staffed. Some of your days need to get bounced around to meet staffing requirements.

Also, they want it so that that you can't take more than 2 weeks vacation at once. Well, majoirity of the staff live here in America alone and get ot see their families once a year in the Phillipenes. They can't only go for 2 weeks with cost and travel. i am am scared if we adhere to that, we will lose alot fo god workers.

These are only my issues. On the good side, they are excellent nurses, good personalities and work together as a team. They all respect eachother for the most part, which is good.

I am sorry this is so long, but i need some feedback. Does this sound like everything that should take place in a the first week as a nurse manager who has never been one before? It's alot at once and quite honestly stressing me out a little bit. The management team is great, they are just anxious I guess to get alot of what they have been doing off their backs. ANy feedback would be appreciated:)

[MomRN0913]

Oh, and my boss, VP of nursing services was telling me about the cultural issues, the CEO (who is black) was feeling that she was hiring only phillipinos (there are a great deal there, but most are nurses..) she actually told me she was happy I was white american. it makes me wonder how my employees feel about that? I hope they hired me because they are confident in my abilities, not because I am white! Funny, most places with their affirmative action deals try to go diverse and not hire so many whites, but it is different in nursing. i have always beent he minority in my nursing career. But I also don;t look at color or nationality, but I am blind to it. Good workers are good workers, that's it.

[Kyasi]

I don't know that I have any advice for you but can say I've been there and done that and it did get better. My situation was different in that I replaced a very unpopular Nursing Supervisor of a Home Health Agency that I already worked for. I was offered the position before she was hired and turned it down. After 6 months of working for her, I was offered it again, they fired her, and I replaced her. I was thrown in head first and don't ever want to relive the first 2 months. I had lots of support from my direct boss and the office nurse case managers but I had no idea what a real mess the previous supervisor had left things. So I was interviewing, hiring, firing, disciplining, and had a State audit shortly after I started. I lost about 17 lbs, was working tons of overtime, and couldn't sleep for all the stress. Eventually, as the staffing situation stabilized and I became more confident and knowledgeable in my new role, things got much better. It took about 6 months before I lost the feeling that I was hanging onto a life preserver and just keeping my nose above water. I've been in the position for 2 yrs now and rarely work overtime. The stress level, on a scale of 1-10 went from about a 12 to 3.

So all this to say, if you have good support from your boss, which it seems you do, and if you can hang in there, it will get better. You mentioned your strong points and sound confident in your abilities... this makes for a solid foundation. If you are determined, know that you can do the job, and are willing to hang in there until you get the needed staff, it will get better. You will need someone to vent your frustrations to but make sure it isn't your coworkers. Best of luck to you.

Kyasi

[MomRN0913]

Thanks for the reaasurance. I have been texted and called all weekend. And only have a week under my belt. Today the medical director (whom I know well from my other hospital) actually texted me! We had a staffing issue and something about a woman bleeding from her foley, a blown uretha or something. he was complaining about the staffing, the charge nurse called me, the staffing coordinator called me, as did my boss.

I'm OK with it, but I have one issue. I am a single mother. I have my daughter every other weekend, and every weeknight except 1. I have to get her before her preschool closes and on my weekend with her, there is no going into work. I have no family to help. Her father does his time, but otherwise, I'm alone.

I can be a manager and a mother, but if they are expecting me to run out of the house all the time when I am home, it's not doable.

This si really stressing me out.

[Kyasi]

It sounds like you are expected to be on call 24/7. With a job like this you need time to de-stress and also to just be a mom and have 'me' time. You need to clarify what is expected of you when you are not at work. Nobody can handle getting calls like that all the time. Are you being paid to be on call or is this just expected?? Yikes! It sounds like you need to get some clarification from your boss about this. I know I couldn't handle calls like this all the time.

Kyasi