Has anyone ever stepped down from a role?

[SilverBells]

As I’ve mentioned previously, I was recently promoted to a Nurse Manager role at my facility. After a text message tonight, I’m now questioning my ability to perform my new role. I was just informed that a patient was being sent in to the hospital for a possible bowel impaction. I’m upset that I didn’t catch this sooner, although really the nurses should be reporting any issues of constipation. I don’t know...it just seems that no matter how nit picky I am, I still miss things. And it seems that the other manager does her job perfectly, even though she comes to work later than I do and leaves earlier. Somehow, she doesn’t mess up, and I’m angry that I did. I’m doing everything in my power to be a good manager but this event proves otherwise. Would you step down from your role if you were in my position?

[Tweety, BSN, RN]

Trust me when I say that the other manager doesn't do her job perfectly. Maybe on the outside it appears this way but that is not what's happening.

Trust me when I say expecting perfection from yourself is going to lead to a life of frustration.

Glad the patient is okay. We live and we learn and we move on.

[FolksBtrippin, BSN, RN]

6 hours ago, SilverBells said:

Not really. There would be no managers left since it is not uncommon for a resident to require transportation to the hospital. My concern stemmed from the DON stating that bowel impactions are reportable since they are also preventable. Not only is the condition not good for the patient, reportable events do not put the facility in a positive light.

You say that you made a mistake in not reviewing bowel alerts, but you also state that you had to prioritize other things and that your staff responded with appropriate interventions in a timely fashion. So are you sure you really made a mistake there? Would a reprioritization of bowel alerts have stopped this impaction? Seems unlikely. So don't go there.

Is EVERY bowel impaction really 100% preventable? It's a reportable event, but is it a never event? Aren't we to expect that these things will happen sometimes? Why is it reportable? Is it remarkable if it happens once in a while or is it reportable so that we can fix it if it is happening more frequently than normal?

I appreciate that posters here are encouraging you not to step down, but I do want to caution you against overreacting to normal situations, because that is where your true mistake is.

A good nurse manager takes appropriate responsibility, owns up to mistakes, does not overreact or under react and knows how to support staff. A good nurse manager has an understanding of why we record the data-- it's not to self flagellate but to find out where we are going right and where we are going wrong.

Now I'm going to be a little tough, but I mean you, your staff and patients well.

I'm not going to tell you not to step down. You need to keep learning and growing and you need to never respond to a normal event like it's cause for you to throw in the towel ever again.... or you do need to step down.

[JKL33]

7 hours ago, SilverBells said:

My concern stemmed from the DON stating that bowel impactions are reportable since they are also preventable.

Was the impaction diagnosed and did the patient require manual disimpaction at the ED, or just an enema? What is the criteria for reporting the event, besides staff sending the patient for r/o impaction?

[SilverBells, BSN]

13 hours ago, JKL33 said:

Was the impaction diagnosed and did the patient require manual disimpaction at the ED, or just an enema? What is the criteria for reporting the event, besides staff sending the patient for r/o impaction?

Impaction was diagnosed, but patient only required an enema. I am not entirely familiar with the specifics of reporting (the DON handles any incidences requiring state reports), however, it sounded like because the patient was sent in for a "preventable" condition, it would need to be reported outside of our facility.

[SilverBells, BSN]

Tomorrow I’ll return back to work after a few days off. My mindset going forward will try to be that my job isn’t about me being perfect, it’s about ensuring residents are getting their needs met.

[TriciaJ, RN]

I'm glad you're not going to step down over someone being a little FOS. Places would be burning through managers like crazy.

[klone, MSN, RN]

Silverbells, I'm going to share with you one of my favorite quotes, that I think about often in my professional life:

Quote

Good judgment comes from experience. Experience comes from bad judgment.

I'm not saying that you used bad judgment. But just know that every mistake, or bad outcome, or thing that doesn't go as planned, is a learning experience. Leaders will make mistakes. But being able to learn from them, and do better - that is what makes a good leader.