Micro-Management=Poor Morale and feelings of negativity

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    The bottom line in health care these days is $$$$$$$$$ upper management staff are hired to weed out and improve that bottom line, by any means necessary! They are not interested in 'moral' they are only interested in pleasing the board of directors.

    Recently it has come to my attention that I am being micro-managed, so what does Micro-Management mean to the everyday worker?
    I can tell you that I don't enjoy being micro-managed and it feels very negative and nowadays negativity is a bad word which should not be uttered!

    Merriam-Webster's Online Dictionary defines[3] micromanagement as "manage[ment] especially with excessive control or attention on details".

    So how do I know I am being micromanaged? I have a new regional director who is new to our company, as a manager of a health care facility I am already competent in managing my unit, although we are short of staff and we are having problems recruiting appropriate staff.

    My new manager in new to managing managers, so while she is supposed to be very good at managing a unit, she has zero experience of managing managers!

    Managing Managers is a complete different concept than managing floor staff because 'normally' managers are already experts in their specialty, they have further education, they should be current in policy and procedures, have some knowledge of employment law, they are motivated and they should be excellent resources.

    As a regional director her responsibility is support of her managers not trying to micro manage staff who already have too many bosses as it is. If a unit is running well, knows the p&p and their only gripe is 'we are always working short' it does not help if an RD comes in and starts criticizing the floor staff before they have actually taken the time to get to know the staff.

    The bottom line in health care these days is $$$$$$$$$ upper management staff are hired to weed out and improve that bottom line, by any means necessary! They are not interested in 'moral' they are only interested in pleasing the board of directors.

    Quality of care has to be maintained at a high level, but upper management do not believe that 'low morale' should have an impact on the Quality of Care.

    BOD believe that cut the RN's, LPN's, and the aids-give the RN more accountability and more patients, save money and increase the level of Quality of Care. They do not see it is unobtainable because if any of them or their families end up in the hospital they get top notch care, because the powers that be make sure they need for nothing.

    I am sure every RN has at some time looked after a 'VIP' and I know special arrangements have been made for these people who fall under the category of a "VIP'!

    Another phrase which should not be uttered is 'low morale' this has become a swear word in the health care management community.

    Did you know that low morale due to cut backs, staff shortages and general feeling of discontent because staff are working short, is now the responsibility of the manager and charge nurses to improve-it doesn't matter that they have NO control over cut backs, staff shortages and general feeling of discontent!

    So I hear a deep inhalation of breath, you are thinking that yes the managers do control the cut backs and staff shortages.

    Well they don't managers of health care workers manage the staff within the budget which is allocated to them. If you are fully staffed and things are going really well, what happens is the budget is cut and the thumb screws are put on!

    If you are within budget then you must be able to tighten things up, so lets cut the budget and the manager has to manage because that is their job.

    If you are over budget well you are not doing well, you have tighten things up and staff must go!

    So is the manager in control of the morale of the unit-Yes they are. I cannot count the amount of times I have encouraged the morale of the staff to be high!

    Months and months of keeping them updated, sharing plans of recruitment, little gifts, pizza days, the list is endless of how I support my staff.

    Yet I cannot solve the staffing problem, they always have to work short, we recruit but they dont make it for one reason or another.

    Recently it has been so bad I have worked as a tech, as a nurse, as a cleaner-anything to support the staff and the patients. But I cannot sort out the staffing issues no matter how hard I try.

    When low morale is caused by staff shortages it is extremely difficult to keep morale high because the only thing that will increase the morale is having/adding more staff!

    The solution appears simple but actually it is very difficult!

    Overwork, in and of itself, is seldom the cause of low morale. Exhaustion, yes. Low morale? No. However, when people are working very hard over and extended period of time and feel no hope for reward or a break, then morale suffers
    Turning Around Low Morale
    by A. J. Schuler, Psy. D.

    Employee Morale
    and the Healthcare Industry

    Low employee morale has increased in the healthcare industries. Studies have found that 1 /5 of healthcare employees were reporting low morale. 40% of healthcare workers claim that they lack motivation. And studies have also found that nearly 25% did not feel any loyalty towards their employer.




    Last edit by Joe V on Oct 23, '11
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  3. by   oramar
    Thank you so much for publishing this informative article. It really gets it's teeth into some of the problems that don't get talked about much.
  4. by   Rodoon
    All good points. Low morale is hard to boost when its due to short staffing. It worsens if time off is denied due to short staffing. I feel for you because I've been there and done that. If staff don't get that down time when they've requested off per policy that's when everything goes out of whack. I wish I had more suggestions to offer but this has been going on for years and years. Sadly, it's not new.
  5. by   NurseShelly
    Thanks so much for sharing this article. I'm tempted to print it out and share it with my coworkers as we are currently suffering from low morale. This low morale has caused a palpable tension between the various disciplines, and many of us dread going into work. I think this article might actually help. I know it sounds like "misery loves company" but it's really easy to forget that many nurses/ nursing staff everywhere are going through the same thing, and I think it's really important for us nurses to keep in mind that its not just our unit/ facility. So, the next time we get that patient from another hospital, or that transfer from another unit, or send that patient to the ED, let's remember that the nurses we're dealing with are also understaffed, overworked, and underpaid.
  6. by   VivaLasViejas
    Boy, do I hear you on this issue!! We've had such a tough time covering staffing gaps lately that the morale of my subordinate managers is almost as bad as that of the staff. Of course, that could be because they're working double shifts on the floor, which means they're not doing their jobs, which means I get to do their jobs in addition to my job, and since my boss is catching crap from his bosses he's delegated some of his work to me as well. There is just too much top-heaviness in healthcare organizations these days---too many chiefs and not enough Indians, as they used to say before the PC police took over---and the employees on the bottom get squashed by multiple layers of bureaucracy. So do the middle managers, for that matter........and then everyone wonders why we burn out.
  7. by   kelll
    i understand this all too well. I am a charge nurse who is soon to change direction. When management is not around to answer questions, or not visably present to support the floor staff I am the next in line to help or listen. I am not able to do my job because of staffing issues, mostly understaffing and low morale...and now major burnout on the unit. I just feel helpless anymore.
  8. by   tralalaRN
    Most excellent article. I too, have been in a dept with very low morale, short-staffing (I know, big yawn, heard it all before). .but the hospital I worked at was also a "magnet hospital". .and I really came to believe that it meant nothing. Nurses were just expected to do yet MORE work, sitting on committees (unpaid of course), using their precious personal time to serve the magnet status of the hospital. I've never been in a situation where there were so many nurses who were being treated for chronic migraines. It had to be stress. I jumped ship, so glad I did.
  9. by   joyouter
    Thanks for this. Micro management has been and continues to be the reason for demoralization, devaluation and frustration within all professions. The nursing profession, a labour intensive work with high levels of physical and psychological challenges is especially vulnerable. Nurses working under these conditions, thus become more vulnerable with escalating feelings of hopelessness and burn out.
    Micro management can be a symptom of fear of not knowing what to do, initial distrust of self ( the manager) uncertainty and the probability, that the micro manager is being observed by the more ( senior management) person or persons, who want to see how the new manager will behave. Will coaption, coercion and collusion form part of his/her power dynamic? After all, that manager has the power over the team, even if the end result is destructive and counter productive, especially if there is outright bullying and personnel, fearing repercussions, remain silent.
    Hiring policies differ in every organization, but I do believe that political elements influences hiring management choices today. Ironically, hiring new managers without competence and previous experience, also reinforces the level above, ie. the new manager will be fired first, despite poor policy while the intimidation will continue. . A smart manager recognizes the strengths of their staff, is aware of their achievements under difficult times and through offering support and demonstrating respect of their difficulties, shows a level of EQ. EQ ( emotional intelligence) The simple steps can deflect negativity and boost morale and hey, it costs nothing. EQ has never been more necessary than right now. Unless the focus shifts to an honest awareness, the bottom line will simply reflect the deficits accrued. due to rotten management, blind, incompetence and unrealistic expectations. Hang in there and just do your job and set an example.
  10. by   MomRN0913
    That is exactly what happened at my last job. As a manager of an LTACH, I was micromanaged by the CEO who had ZERO clinical education or skills. he was a business man. Yet when staffing was an issue and he asked about it. I told him it was unsafe and this is how many nurses we need with the patient population and the level of care they required. He basically laughed at me and had a vendetta against me ever since then when he disagreed and I supported my reasoning with clincal data.

    Then he started secretly checking up on me, wanting to see the schedules, the census, everything himself, instead of my direct manager. He still wouldn't allow me the staffing I needed. We ended up having really sick patients, they were dying..... and it was my fault somehow.

    He came to our interdisciplinary rounds and started asking questions that didn't make sense about clinical things.... to challenge my reasoning about why a patient was sent out..... he just didn't get it. Crap, he called a hyperbaric chamber a "hyperbariatric chamber"

    I eventually was discharged from this position for not signing a non-compete agreement.

    I am glad, even though I am out of work, I can breathe again. Being a manager being micromanaged by someone who only knows $$$$$$ just doesn't work in nursing.
  11. by   joyouter
    Thanks for sharing. What you have described sounds not only like micro management and incompetence ( from fear of being promoted well above his functioning level) but in all honesty, direct intimidation and bullying. He suceeded in removing his perceived enemy (you) because you were too close for comfort, addressed the gaps in his knowledge by reinforcing your position with data, which he could not argue against. I really hope you see Legal Aid and find a recourse to this abuse and bullying, before there is an epidemic in your former workplace due to his criminal mismanagement and ignorance. Most of all, it will give you a feeling of defending yourself and what you believe in.
    We all need nurse managers like you, so God speed, luck and strength to you.
  12. by   PPAA
    I feel as though each year managers expect more and more from us per hour.
  13. by   codeblue22
    If only the managers could understand the recipe to a critique sandwich... Praise, followed by target issue with suggestion on ways to improve, followed by more praise. (Poor morale and negativity would no longer be a problem.)
    Instead, they just constantly point out mistakes rather than shifting focus on anything you're doing well.
  14. by   madwife2002
    They say that sandwiching criticism is not recommended, yet as a manager I feel it is important to point out positive as well as negative-I want staff to improve not fail