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Discussion

Does your administration support you?

I am the 3-11 coordinator on a very busy telemetry unit. We have been getting a lot of really inappropriate admissions because there are no beds available anywhere else in the hospital. The other day we had a new VP Shunt on our unit. The order read, Vancomycin 500mg q12hours IV x1. I called the neurosurgeon to find out if he just wanted that 12 hours after the end of the surgery or what, it didn't make sense to me. The med-dent bureau called back a few minutes later and said, he isn't on call, Dr. S is on tonight, you can page him on his pager. Ummm, ok, no problem. So I called Dr. S and made the horrible mistake of mentioning that I called the bureau and he went OFF. "This is insane. You have an on-call list on your unit, I know you do. Look for it right now. I want to know what it says. Who is on call, why would you call the bureau. This went on for about 3 minutes, finally I said, LISTEN, Just answer the question, how many doses of vanc is this guy suppose to get? The next day I get a call at home, he went to the VICE PRES of Nursing to complain that I called the bureau instead of his beeper. COME ON! We have about 500 doctors in our institution. I am suppose to know which ones want called through the bureau, which ones want called on their pagers, which ones want called at home, which ones will only take calls through the service. Do you think this woman could have maybe said, You know doctor, I will inform the staff of your wishes, however please understand this is a unit that doesn't normally deal with you and take that into consideration? Nooooooo, she had to call my manager to "investigate this issue." It is no bloody wonder so many people leave nursing. Like I don't have enough REAL stress on my job, I have to put up with the doctor's temper tantrums. The thing is, it isn't the doctors who are regulars on my unit that give me problems, it is the ones like this who come around every now and then. These hospital administrators that bow down to these people make me sick as well, I mean, the doctors provide the patients but if nurses weren't there to take care of them what would they do?

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i've found that a nursing administrator who supports her staff is a rare thing indeed. :o in fact, a nursing administrator who has any idea of what her staff actually does is not all that common.

I'm sorry that happened. I've found the same thing administration tends to be least supporting of those of us taking care of the patients, and this includes respiratory and PT.

What a jerk!! Why couldn't he be appreciative and focus on the fact that you called to clarify a poorly written order so that you didn't harm his patient! Uugghh!! His behavior towards you was abusive. Can you imagine what would have happened if you talked this way to him?? And shame on your VP of nursing for not backing you up based on the situation you were dealing with that day.

Slightly off topic, but this reminds me of the time I was working in the hospital, and the same doctor would throw insults and degrade the nurse he was making rounds with each day. We couldn't stand him, and we had no support from our nurse manager to help deal with this guy. So I got really, really fed up one day as he was calling me an idiot and asking if I was even qualified to be a nurse, and I said to him, "Every time I make rounds with you, you give me grief. You make me nervous every time I see you." He responded, "Well at least I'm consistent." After that he was a peach to me when he saw me. Go figure. Jerk.

Our nursing administrators come out to the units about once/year to visit the staff and see how things are. They high tail it out of there the first time someone dares to ask a difficult question or tell an unhappy tale.

You can't lead from your desk with email and memos. You actually have to remember where you came from in order to do a good job. But once they put on that suit, they forget they were ever nurses.

I've seen very neglectful nurse managers And very good nurse managers in my days. When you finally get a good one, treat him/her like gold. Truly a priceless thing. I think much has to do with the general admin philosophy of management from the very top, trickling downward. It effects the entire milieu. You are very correct. Leadership and respect of leadership is often something "earned" in the process by being highly visible, very approachable, and leading by example. Ineffective leaders are quite often the very opposite. Invisible paper/memo pushers does not a leader make.

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