Getting staff to "own" the unit

1Tulip · Jan 16, 2006

My apologies to Turk. I painted with a very broad brush and it was a picture that certainly did not apply.

I am not in management for very obvious reasons.

If I am being paid, I feel it's a part of my job (that is job) to be there. I do things outside of work for my professional development. But, if the management thought the matter important enough to pay... I'm there. Hell, if there was something they wanted me to think about or research outside of work, on my time... it would probably overlap with my professional development... I would like as not volunteer to do it.

But, look at what you said:

Never before did any of these staff members receive gifts or lunches during nurse/cna week, until I arrived. I went to all the physicians and asked for money, donated myself and made these weeks a big deal for them.

You are demonstrating how much YOU care about the staff. The doctors are, as well (or at least they can be prevailed upon to care.) But isn't someone missing in action here?

You've shown the staff nurses that they as individuals, and as a team, are important to you. But that's not enough.

I've admitted I'm not in administration or management. But, I wonder (in fact I believe) that these sorts of problems start at the top. And by putting the squeeze on middle management, they're making it your fault. And that's what institutions do.

We have a hospital here that had horrible/awful/terrible relationship with their nurses. Ended up voting in the union. People were sacked. Rolling walk-outs, informational picketing...It was a mess. If you walked in that hospital today, you'd think the nurses there are the stars of the show. They're used in all the posters for promotion, and on the web page and so on. Nurses are the public face of this hospital. And, guess what... on most units, the nurses are quite engaged.

I don't know. Just something to think about. I know you're putting your heart and soul into this, but cast a gimlet eye above you in the chain of command. Burden yourself with the things about which you are responsible.

Turk182 · Jan 16, 2006

Thank You Tulip, I appreciate the response. For all of us managers out there, your frustration is a good reminder of what we need to remember and try to accomplish.

mydesygn · Jan 16, 2006

In terms of meetings, I am a manager and admire how much you have done to try to accomdate everyone in regards to meeting attendance. I think all the positive approaches also need to be countered with accountability.

(1) Staff meetings should have a set time (i.e. first Thurs of every month at 1700) Set the date and time and do not change.

(2) Take role and include attendance as part of your job requirements. When evaluation comes, you acknowledge that that person attended only 20 percent of staff meetings and there merit raise was decreased by 1 percent because of poor attendance. It only needs to happen to one person before the word gets out.

(3) Look for your stars. Some staff want to come in, do their job and go home. Let them. But single out the indiviuals who show initiative. These are probably the few people attending staff meeting. Meet with them one on one, get their feedback and assign them tasks based on that but hold them accountable to completing them and thank them for their involvement.

UM Review RN, ASN, RN · Jan 16, 2006

In terms of meetings, I am a manager and admire how much you have done to try to accomdate everyone in regards to meeting attendance. I think all the positive approaches also need to be countered with accountability.
(1) Staff meetings should have a set time (i.e. first Thurs of every month at 1700) Set the date and time and do not change.
(2) Take role and include attendance as part of your job requirements. When evaluation comes, you acknowledge that that person attended only 20 percent of staff meetings and there merit raise was decreased by 1 percent because of poor attendance. It only needs to happen to one person before the word gets out.
(3) Look for your stars. Some staff want to come in, do their job and go home. Let them. But single out the indiviuals who show initiative. These are probably the few people attending staff meeting. Meet with them one on one, get their feedback and assign them tasks based on that but hold them accountable to completing them and thank them for their involvement.

Just a suggestion: Hold the staff meetings immediately after each shift. Voluntary Quality Improvement committees would meet after that. By the way, all those meetings need not be face-to-face; in a small committee, there are ways to get work done and results in without having to travel.

We have a Book for those who've missed the staff meetings, which contain all the relevant information that was given in the meeting. We are responsible for that information, and we sign off when we read it.That way, we don't have to come to work just for a short meeting and we can rest on our day off. Or we don't have to break up our sleeptime to drive to work, go home, and then show up for our shift all bleary-eyed and resentful.

Using those ideas, we do get 100% compliance and everyone gets the information.

Here's another:

Keep a record of suggestions that are made and by whom, and if they are implemented, give credit. For instance, I made a suggestion that would help keep our patients' Fall Risk lower and it was used. I got a nice thank-you card. Since it wasn't an original idea, I didn't expect even that, but it was still very nice to have.

At this point, your best tactic is to use word-of-mouth. The point is that your staff is saying some things that are valid and want to see you pick up the ball and run with it before they commit themselves to anything.

They quite rightly don't want to be labelled troublemakers for pushing an agenda that might be seen as only their own. They feel that they have to work in less-than-optimal conditions already, and they're dealing with it, but they would rather not get their hopes up for change and be disappointed. But implementing suggestions obtained by word-of-mouth will encourage the staff to keep suggesting, rather than making the staff feel they're being targeted.

Surely you can understand that.

JKDON · Jan 18, 2006

Sometimes ownership comes with the comfort level in taking risks. Are the staff allowed to take risks, improve things without permission? Who makes the decisions for the team? It helps if you have a natural leader in the team and ask them for advice, build a rapport with that person and let them lead the group with your gentle guidance. Let them see their ideas at work and praise them for their own success. But also allow them to take ownership of the failures to and learn from them to make things better. I'm afraid that sometimes we work with people who do just come in, clock in and do their thing and leave. One day when I've had it with the stress of my job, I will probably look forward to a job where I can do that for awhile. Turn it on at the timeclock, and turn it off when I leave. I think some people need that space too. For a period of time...

nursemaa · Jan 18, 2006

I've tried to start committees to address and make change to complaints that we can actually do something about-- nobody wants to do it. But everybody wants to complain about the things that a manager cannot just fix, overnight, if at all. I finally got to a point where I realized that I cared about the unit and the perception of the unit so very much more than they did, and that's okay if it has to be. I just don't allow them to complain and moan about how the "hospital doesn't care", and remind them that if they don't want to help be part of the solution, then they have no right to complain. One of my favorite sayings is " if you are not part of the solution, then you are part of the problem." Another favorite is from a John Cougar Mellancamp song ".... if you are not part of the future, then get out of the way." I have no tolerance for people who gripe and complain, but won't do what they personally can to make something more positive.

Amen!! For the record, I always pay people who come in on their own time for meetings, but that doesn't seem to help either. I post minutes in a notebook for them to read...some do, some don't.

tammki5g · Jan 26, 2006

I post the meeting notes also. I attach it to a sign in sheet with everyone's names on it and everyone has to read then sign. I do this for any other notes or notices in between staff meetings.

I also do my staff meetings on all three shifts. its not easy but since I used to be a night shift nurse I know how important it is to meet face to face with all the nurses. I will usually run the day shift meeting sometime during the shift during a lul in the action. I stay and do evening shift at the start of their shift and then I come in at 5 am and talk with nights.

I also try and make a point of coming on the unit every morning around 6:30 to talk to the nurses on nights and make sure all is going well for them. I don't know if it is working I am still very new in this position and I hope that if I continue to show up and be there they will learn to trust me.

NOFAIN · Mar 9, 2006

You Are Definitely Not Alone I To Am Struggling With Staff Ownership And I Am A New Nurse Manager At The Same Time. There Have Been Some Interest, But Its Usually The Same Staff Members That Are Already More Aggressive Or Taht Already Work As Teams!?!

ZASHAGALKA, RN · Mar 9, 2006

I have no tolerance for people who gripe and complain, but won't do what they personally can to make something more positive.

What a poor management style.

Part of being a manager is to be a go-between between upper management and staff. And that makes part of your job to listen to the gripes and complaints.

If you have staff that isn't as interested in the management/administrative side of making things better as you are, well maybe that's because THAT'S YOUR JOB, as a manager. You sought out that job because that stuff appeals to you.

Punishing your staff because it doesn't appeal to them is not only bad management, it's totally unrealistic.

Some of us are so tired after being short staffed (again) on our 2nd overtime shift for the week - making sure that YOU don't have to come in to fill in the blanks, that we have no more motivation for anything work related, ESPECIALLY administrative (crap) stuff.

I am on a committee that I believe is important.

But I know full well how that committee thing works, too. You get out on a committee and the result is to take it off the manager's plate. Instead of being a venue of change, now, it's just one less thing for the manager to deal with . . .

Unless I take tons of initiative.

And I don't get paid any extra for working the administrative side. It's just like you managers coming in to work a shift. You don't get paid more to do it, and it takes time from your personal life.

So before YOU gripe and complain anymore that staff members don't take the initiative and do YOUR job, you sit back and think about how much you like coming in and doing THEIR job without more pay. The level of the sound of the scratch on the chalkboard is roughly equivalent.

~faith,

Timothy.

**canoehead, BSN, RN** · Mar 9, 2006

In a recent experiment on our unit the manager gave a group a problem to solve, which they did, except one person wouldn't go along with the group. The manager pronounced the experiment a "disaster" and redid the entire thing herself- coming out with a solution that no one liked.

Next month she asked for volunteers for another project, with a less than enthusiastic response, and she wonders why no one will volunteer.

nursemaa · Mar 10, 2006

So before YOU gripe and complain anymore that staff members don't take the initiative and do YOUR job, you sit back and think about how much you like coming in and doing THEIR job without more pay. The level of the sound of the scratch on the chalkboard is roughly equivalent.
~faith,
Timothy.

I can't speak for any others, but for me it's not a matter of asking them to do my job. It's simply that I really do believe that when the team works together on a project or problem, the outcome is usually better than if one person (me) decides everything. Staff complain when they don't have a say in decision-making, but then don't want to be part of it. So they send conflicting messages to management.

You seem to be really angry about management in general- please believe that we aren't all slackers, or uncaring, or whatever it is that you think. Some of us (many that I know of) really care about our units and what happens with our staff. I feel bad that your experiences have made you feel this way.

ZASHAGALKA, RN · Mar 10, 2006

I can't speak for any others, but for me it's not a matter of asking them to do my job. It's simply that I really do believe that when the team works together on a project or problem, the outcome is usually better than if one person (me) decides everything. Staff complain when they don't have a say in decision-making, but then don't want to be part of it. So they send conflicting messages to management.
You seem to be really angry about management in general- please believe that we aren't all slackers, or uncaring, or whatever it is that you think. Some of us (many that I know of) really care about our units and what happens with our staff. I feel bad that your experiences have made you feel this way.

I'm not angry about management in general - I'm generally supportive of management. See below in quotes for an example on how I normally post about management.

But see, this is the thing. People do things for different reasons. And all you managers out there: you have to love, like, or at least tolerate the paper pushing way to creep things along - in order to do your jobs.

The paper pushing way of doing things might be YOUR perspective, but that does not mean it is EVERYBODY'S perspective, particularly the, in many cases, well-seasoned people under your command that CHOSE not to go into management.

Why do you think that is so?

Just because I don't want to go to your committee doesn't mean that I don't want my voice heard. And it doesn't mean I want you to make unilateral decisions without my input. If you listen, somewhere in those infamous 'gripes and complaints' is the seeds of how to respond to your staff.

I said it was poor management to tell your staff that, unless they are committed to the paperwork game just as much as you are, they have no right to input to you. I mean that.

Not coming to meetings/being on committees only means your nurses aren't 'owning' their unit if that is YOUR definition of 'owning'. But, if you reach out to those same nurses, not on YOUR playing field, but on THEIRS, you might find much more 'ownership' than you expected to find.

Ownership in things like not abusing sick leave and working extra shifts so my co-workers aren't short staffed (or so YOU don't have to come in on the night shift and work). Ownership like being a resource person for more junior staff. Ownership like taking pride in my work and trying to convey that to pts and family.

"Ownership" is a subjective measurement. I took umbrage before, not because I dislike management, but because of the attitude that 'ownership' is only defined by how well your nurses play the administrative game.

And most nurses working the bedside after 10 or more years - those nurses made, at some point, a conscious decision to invest their ownership AWAY from administration, or they would have been vying for YOUR jobs. You can't disrespect them for that.

And you can't hold that against them, or if you do, you do so at your own peril. Because there is probably a direct relationship between how much you feel your nurses aren't there for you and how much they feel you aren't there for them.

~faith,

Timothy.

From the thread: What nursing Managers fail to see:
Most managers are indeed, deeply involved with management and all the meetings and paperwork that involves.
And those managers are normally involved in many a public relations battle: representing their staff to upper management, their staff to patients and complaints, and their statf to each other and countless intrastaff bickerings and squabbles.
And some of their great victories often go unnoticed because they involve compromise and sometimes staff only see what they have to give up, and not the whole picture of what was 'got' for them in return.
And being squeezed between upper mangement and staff is a very stressful job, not unlike the stress of the managing of mulitiple, complexed, and prioritized bedside situations.
And yes, sometimes managers forget the first maxim of management: praise often in public, criticize in private. Or sometimes, just like you, they are so busy prioritizing other things they forget this important thing too, because, while it is VITAL longterm, it can be lost day to day.
But.
But.
But.
The premise of your post is invalid. I seriously DOUBT that many managers forget, lose touch with, or don't understand the value of your input. But just as you complain that managers don't recognize YOUR value, you make the same error that you accuse in relation to your understanding of THEIR value.
Without my manager, I would be completely, instead of relatively, at the mercy of the bean counters. . . And if you don't think that would greatly impact your ability to do all the things the OP cites, then you don't understand how valuable a good manager can be.
It goes both ways. Maybe the thread could also be titled, "What bedside nurses fail to see . . ."
BTW - I'm a bedside critical care nurse and have NEVER been a manager. I don't ever want to be. MY JOB IS EASIER.
I've had managers that I thought didn't have a clue. I've also worked w/ many a co-worker that I thought the same thing about. But, I don't put down ALL bedside nurses or equate them all to the lowest common denominator, and I don't think it's fair to do the same to managers. . .
~faith,
Timothy.