conflicting personalities with Nurse Manager?

LakeEmerald · Oct 19, 2013

So, is she saying that your work is fine but because you are quiet she doesn't know if you fit in? As a manager she should know that the first six months as a new nurse you are focusing on working/learning and not "opening up" to coworkers. Who cares if you are "opening up" as long as you are doing a good job? Since when did bonding with "the family" become a basis for judging job performance? I did not read that you were fighting/causing problems with your coworkers.

So, you have 3 days to open up to people? How will this be judged? This stinks royally.

The criticism she is throwing at you, examine yourself, if there are changes that can be made, make them. Strive to improve and become above reproach. Document your tasks so no one can say you aren't doing your job. You can't let a stupid thng like having 3 days to bond with coworkers become more important than being a good nurse. This just seems cruel. If she has time to come to you with dumb thing after dumb thing, she's got too much time on her hands. If you are doing a good job then surely she has more important things to do!

I wish I could tell you what to do to fix this. Take an honest look at yourself and correct what you can. Acknowledge if mistakes were made and state what you'll do differently next time. Then do good nursing and stand firm. Let the proof of your responsible actions be your defense.

jadelpn, LPN, EMT-B · Oct 19, 2013

The pp is absolutely correct.

This situation stinks, and "bonding" with co-workers as a point to keep your job is a little off to say the least. And this is NOT your family, they are your co-workers. Who you would support and help and have the backs of for 8 or 12 hours a day.

Unfortunetely, sometimes there's a whole different reason for coming up with these vauge, weird "reasons" to set someone up to fail. And sometimes it is within a probation period.

**canoehead, BSN, RN** · Oct 19, 2013

Is your preceptor telling you things are fine, but bringing concerns to your manager? Have a frank talk with her about what your manager said, and ask if she shares those concerns. Tell her that the manager is thinking about letting you go. She may need to go in and correct something that was misunderstood, and everything will be fine.

If you do get let go, take comfort in the fact that the manager made it a crappy job. You would have been constantly looking over your shoulder. That's a shame, because it's great when you find a group of coworkers that are supportive.

lil0401 · Oct 19, 2013

Thanks for your guys' responses! I am about 6 months into my job now and I was not let go after that time period she gave me as everyone could see that I do open up in time I am just quiet at first and terrified about doing my job right. IT was just weird because my preceptors told me they were the same way when they started, quiet and concerned about making a mistake all the time because they were brand new. My focus was always on my patients. I have gotten to know all the staff now And LOVE all of them. Now that whole thing is over though I feel like my manager has found new after new "situation" for me to get in trouble for that don't even make sense and I'm getting to the point where I don't know what to do anymore.

A couple weeks ago I had a patient who was getting a lot of pain medication at once, a pca, percocet, and roxicodone all could be given at the same time and was super demanding about getting it the second he could. He was in a lot of pain and very opiod tolerant and then 15mg oxycodone on top of his morphine pca wasn't even touching his pain. I had called his team twice to try to change his medications and they never did while I was on shift. nbd... couple days go by and the head attending was back assessing the patient and they had increased his pca and oral pain med dose at this time. RNs allegedly were given all the oral pain meds together and one RN that day told the doctor, infront of the patient, that she didn't feel comfortable doing this all at one time like other RNS did. The doctor freaked out, bc it was infront of the patient and that is his licencse at stake, said he didn't understand why we wouldn't use our nursing judgment and spread those out, ( I guess the patient seemed confused at this time but not at the time I had him) and went to our manager and yelled, called that nurse a b****, and threatened to take his pts off the floor. I was working that day and my NM goes back in the charting which she barely knows how to use anyway and finds my name and calls me in. She says I was the first to do it and then people started doing it after me ( like thats my fault ) I explain my side that i tried to get it changed, he was alert and oriented, I followed orders, and I never gave when he was confused. She says she understands but makes me write an email to the doctor explaining my side. ( doesn't sound like she understand to me). So I do and a lot of the nurses on the floor new about this and they all supported me and told me to stand up for myself I didnt do anything wrong. One of the team leads went back and looked at charting realized I was not the first or second to do this and their were 5 of us total so for her to just randomly choose me and make me write this email was wrong. She went and talked to our NM about it who then changed her story and was like Oh I totally understand now I will talk to her about it ( which she never admitted that she knew I wasn't the first one and these 4 others had at least 5 years more nursing experience than me, I have barely 6 months, or mentioned to me that the doctor sent an emailing apologizing for freaking out the next day, the team lead told me that ). The only other thing she said was she understood where I was coming from at that time.

Then I had a patient that I couldn't stand that I was going out of my way to do things the way she wanted and she was complaining about her night shift nurse and pharmacy all day to me and I was just trying to make her happy. Then at night she complained about me and how I didn't wear gloves and gown everytime i was in her room. She is a CF patient who we get all the time and we always wear gowns and gloves when we go in there but if I just walked in real quick to ask a question and not touch anything sometimes I didn't and there are SO many people who don't wear them. So she lied about that, then said I ran over all her Iv tubing ( not true and I switched out the tubing she thought I ran over) but made the night nurse switch all of it. Also told the night nurse I left the clips unsterile when I took them out of her IV and some people put sterile caps on them. The reason I do that is because I switch out the cap every time I hang something new I think that is more sterile then placing some cap that doesn't even fit properly. She, of course, disagrees and says she has never seen that before which 80% of our floor does that. She complains to the CF coordinator who then complains to our manager. I talk to our manager about it and she asks if I want to switch and I said I really don't care i talked to her about it we are doing fine now and she was like well I am going to go talk to her and see if she wants to switch. my thoughts were why?? our NM does not usually handle that type of stuff our TLs are excellent and can handle that or our ANM. We don't usually just ask people if we want to switch we do if they say they want a new new. I feel like by our NM going in there and offering to switch nurses she is taking her side and saying what I am doing is wrong. It makes the patient have the upper hand and makes her feel like yea my nurse was doing something wrong

Later on our NM sent out an email saying it is policy for us to wear gown and gloves ANYTIME we go into a CF patient's room. I talked to my coworkers and they said they have gone in their millions of times just to ask a question or drop something off real quick without gowning up, so once again I get called out for something everyone does.

I understand that my NM has to make her feel comfortable and listen to her concerns, but she could still stand up for me and not straight out offer a new nurse, tell her I was following policy and not doing anything wrong but if she still wants a new nurse we can get her one, which I know is not what she said.

I don't know what to do anymore.

lil0401 · Oct 19, 2013

I just got bored reading that last response So I'm sure not many others are going to want to either haha. Basically I have a NM that treats me differently and I know it sounds crazy but she truly takes any little opportunity to bring me down and I have been nothing but respectful to her and done everything she asked of me. I am to the point where I don't know what to do anymore, she ruins my week everytime sometime something happens because I take this job very seriously and want to do a good job. I just don't feel supported by her at all and she controls my job so I feel absolutely terrified all the time.

jadelpn, LPN, EMT-B · Oct 19, 2013

If there's employee relations as part of your parent company, have a conversation with them. Site specific examples, not any subjective "I don't think she likes me" stuff, but specifics on why you were spoken to, singled out, etc. If you are a union hospital, go to a union rep with this. Just a FYI thing, but in any event, someone else needs to know this is happening.

Be careful and through in your documentation. If you need order clarification for meds, get it before you give it.

Sorry this is happening to you. Be really, really mindful and careful.

lil0401 · Oct 19, 2013

I did get order clarifications for those drugs I gave together, they said to give everything I could to bring down the pain in giving those medications. This of course was the resident, not the attending who got talked to who would have never cared had if he had never been called out. He had no idea what the orders were. i agree that the nurse should have never said something in front of the patient and the Dr. Should have never reacted that way and said those words, I am just not sure how out of everyone I am the one who was lectured and had to send an email to him?

Thank you so much for your responses, I appreciate them greatly!

jadelpn, LPN, EMT-B · Oct 20, 2013

Look at it this way for just a minute. Food for thought only. You ARE doing the right thing. Getting clarifications, that sort of thing. Look at it from the NM's view for a moment. Although her presentation is not ideal, perhaps the bottom line of this is that she is not calling you out, rather, reviewing all of this as you are new, and she wants to make sure you are doing things how she would like them done on the unit. Or to just point out that what you are doing is correct, just a review of the situation. That perhaps you were not the first nurse who gave the meds together, but why it was questioned (and you questioned it, which was correct) for your future reference.

Many times a unit will hire a new grad and create a nurse that they want for their unit. Because you have a sense that the NM "doesn't like you" which, by the way, doesn't even matter as you are wanting to be respected for your practice, not liked for your person (if that makes sense), you may be a little more mindful of being "spoken to".

But it is OK, this is what happens when one starts out as a nurse. No need to get defensive (and I KNOW it is hard not to be) as if the NM didn't want you on her unit, chances are you would have been let go before your probation was up. This is a time of learning and growing as a nurse. This did not lead into any sort of disciplinary action, therefore, I am sure that the NM just "enjoys" putting in her 2 cents about how you should be practicing. Mold you into her vision, if you will.

Next time you are "spoken to" if there is a next time, I would really listen to what she has to say. Then be ready with a "thank you so much for your direction. I noticed that something was wrong with the medication order, and called to clarify, then reported off to nurse xyz as she would more than likely have to take the clarification order." AND the MOST important aspect of this conversation "how would you have me do this differently? I want my nursing practice to reflect the standards of this unit".

Yes, it is frustrating. Yes, it can come off that you are being scolded. However, CONGRATULATIONS! You, lil401, are the new managerial project!! There must be some sort of managerial kudo's for creating the "perfect" nurse. And I would bet my bottom dollar that the manager has never been, or hasn't been in a long time, at the bedside......

monkeybug · Oct 22, 2013

I've been in a situation with a NM who absolutely didn't like me, and who did go out of her way to treat me differently. I was not the only nurse in that position on the unit, either. At first, I tried to figure out what she wanted and tried to change my ways. That did me no good, none at all. Finally, I couldn't take it anymore, and decided that I was going to fight her in a way that she couldn't fault me. When I would get called in to the office, I utilized my flattest affect and flattest tone. I would listen to her complaint "The patient said that it took you two tries to get their IV, that you let their vein roll." I would explain what I did, and then I would ask how to fix it. "Could you please tell me how to keep the patient's vein from rolling? I am always interested in learning." Of course, there is no answer for this. I've not been defensive, I've not gotten angry or disrespectful, but I'm not begging and cowering either. If I felt that I'd been picked on a bit too much for the week, I would calmly tell her that I felt the I was in a hostile work environment, and ask if we needed to go to HR for further discussions. "Hostile work environment" would evoke a deer-in-the-headlights look and I'd get a few days peace. If she told me that the doctors were unhappy with me, I'd ask for the names of the doctors, and I'd go discuss it with them. The next time it was brought up, I'd tell her that Dr. X and I had talked, and I felt like we were on the same page. Same thing for coworkers. (99% of the other staff and 99% of the OBs on our unit despised her as much or more than I did). The one time she really threatened my job, the time she actually came out and said, "You might lose your job over this" I told her that we needed a meeting ASAP with her, me, our nursing director, and my legal counsel. When I mentioned lawyer, her complaint just blew away in the breeze. She even told me that I was being silly, that my job was safe. I asked her to repeat that a couple of times, and said again that if there was a question over that issue, let's settle it this week, just give me the day and time so my lawyer could fit it in their schedule.

The torture went on for several years. Now, I have a job elsewhere, a dream job. And the evil, demonic, no-good, inept, incompetent NM? She was asked to resign, effective immediately, a couple of months ago. She's now a staff nurse at our sister hospital. Karma can be quite a wondrous thing, and it's particularly satisfying to get to witness it in action.