management nursing

  1. Hi guys, I have been a registered nurse for 5 years now, usually CCU but alwats with PT or PRN jobs in SNFs, recently i took a job in management in a SNF, as ADON. At first i loved this position, i was getting perks of being management, while also having power to actually change things and help. As time goes on though, I believe I am beginning to hate this place, not necessarily the building but the other menegement team. The 2 unit managers are jokes (and by the way coonsidered even with me, so I cannot reprimand), the one has been a nurse for 100 years and literally believes the best way to help our floor nurses and aides grow is to make them feel as stupid and useless as possible. Its seriously to the poit that every time i have a hiring session, i have to beg at least 2 new employees not to leave on thier first day because how horrible she is to them. and yes i have spoken to my DON about this, her answer is staff doesnt like her because she olds them accountable. The other manager is so flippin lazy that as long as she doesnt have to do anyting she doesnt care, to the point of assigning aides on her unit with 6 showers a shift and assignments of say 13 just so she doesnt have to redo assignments. I know thats possible but this building has awesome staffing so very unnecessary. We start the day every morning with
    AM meetings with is really just a ***** fest about the staff, leaving me just ugh. So i am hoping i can get some feedback on how to deal with these types of nurses and please tell me it gets better at the top. I just cant help thinking gosh it was so much more enjoyable to be playing with a chest tube and not hearing constant complaining and negativity!!!
  2. Visit katieRNlove profile page

    About katieRNlove

    Joined: Dec '02; Posts: 40; Likes: 2
    Staff education coordinator
    Specialty: 4 year(s) of experience in LTACH, CCU, ICU, M/S, ECF


  3. by   patwil73
    This is a very difficult situation to get into as I expect they have more seniority in the building than you do. My only advice is to document specifically what happens - what does the mean manager say to the staff; which staff members have you had to beg to stay on after their first day and what exactly was their excuse for leaving. Print out the assigments the other manager made and point out the discrepencies.

    None of this might help if your boss thinks it would be tougher to replace than to correct so be prepared for no change. Then you have to decide if you are willing to stay or not. Management experience can transfer over to other facilities and now you know somethings to check out before taking the job.

    Hope this helps,

  4. by   CINDY SUNG
    Dear Sir or Madam:
    We're writing from Taipei Veterans General Hospital Nursing department of Pediatric in Taiwan.
    Recently, we are going to move on a study about nurse-patient ratio. So we really appreciate that your consult.

    We're would like to know about how many Nurses (RN) take care for patients during the day shift and middle shift, night shift? Is there having LPN for assist? Especially we are curious about nurse -patient ratio in Pediatric of Hematology. Like 1(RN): 6(P'T) or 1(RN):8(P'T)?
    Also we're wanted to know the same ratio for the Oncology (Adult).

    Thank you for your sharing hope can hear from you soon.

    [FONT=Times New Roman]Sincerely,

    Jan Wu,

    HN of Ward A093
  5. by   RN1989
    No, it is not better at the top. When you are management, you are responsible for EVERYTHING. It is a battle of wills daily. You must juggle doing what is right by the patients and staff with keeping the bduget in line, being politically correct so as not to offend other, and make compromises where there should not be any compromise. You sound like you went into management for the same reason I did - to make a difference on a larger scale. Unfortunately, you just end up getting beaten down without making that big difference that you had hoped for.

    You have no authority at this job and neither does the DON. Those 2 crummy nurses are running the show and the DON/ADON titles are just that - titles. They mean nothing and the chances of you doing what you set out to do is slim. Managers rarely stay in their positions long these days, unless they are the crappy managers that I wouldn't want work for/with. I wish you luck in your endeavor but you are already seeing firsthand the appetizers of what is to come when you are the manager. It all rolls downhill and you will get the crap but rarely any of the good stuff.
  6. by   Dierdre
    Welcome to the wonderful world of LTC 'management'.

    Dang, it seems like even after eight months out of the job I keep finding ways to get angry at the place I was working before, and seeing your plight really torques me off to the maximum. I'm mad at them again, and they had nothing to do with the situation. (sorry, that was completely off-topic.)

    Most likely, the above poster is correct, those two nurses have been at the nursing home for a long time and are running the show. Most likely, the administration thinks that they are angels of mercy, and hasn't seen the ugly/lazy/cruel side of them. Also, they most likely have the corporate staff buffaloed as well, I'd be horribly surprised if they didn't.

    Unfortunately, this is a reality of the system in LTC. Management and the Corporate Office see the patients as cash, and the floor staff see the patients as people. The unfortunate thing is that you will never really be able to convince (upper) management (in your case) that those patients are not cash cows. If you systematically work through your staff and question them you will also most likely find that they are assigned too many patients to be safe, that they are most likely angry and frustrated with their jobs, and that they feel trapped because they don't know what job they can go to because of the family life that restricts them into that role (babysitting and things of this nature.)

    Unfortunately for you, if you go too far into trying to fix the problem, the most likely thing that will happen is that you will get fired. Of course, by this time you will have a large bruise on your forehead from beating it against the brick wall of LTC as well, which your insurance won't cover because it happened at work. The problem with LTC is that the system is broken. It is so deeply malfunctional that one person cannot change it, and that if any one person tries they will eventually lose their job because of the pressure that they put on the established system.

    The only way that things are going to change in LTC is legislatively, and it's going to take intense lobbying by the nursing community to get anything changed because the owner PACs are so strong. From the ads you see by lawyers on tv, you've gotta know that things are broken, but repairing them is beyond one person's ability to do.

    Best of luck to you! Sorry I'm so pessimistic on this subject, but I spent six combined years working in LTC and this is how I see the situation.