Help I Am Losing Control Of My Unit

[skay]

I NEED ADVICE AND ANY INPUT YOU CAN GIVE ME. I HAVE BEEN A UNIT MANAGER FOR 7 YEARS ON A 26 BED MED UNIT. I HAVE HAD GOOD TIMES AND A LOT OF ROCKY TIMES. I WAS A STAFF NURSE ON THIS UNIT PRIOR TO BECOMING THE MANAGER. MOST OF MY EMPLOYEES ARE LONG TERM STAFF EXCEPT ON THE DAY SHIFT. AT PRESENT I ONLY HAVE 3 RNS OUT OF 20 PEOPLE WHO HAVE BEEN THERE LONGER THAN 5 YEARS. 2 OUT OF MY 3 LONG TERMERS ARE VERY SET IN THEIR WAYS AND PRACTICE NURSING FROM THE DARK AGES (PAMPERING,ETC), ONE OF THESE 2 IS A BIG THORN IN MY SIDE AND HAS BEEN FOR OVER 20 YEARS. SHE HAS OVER THE LAST YEAR DECIDED TO STIR UP AS MUCH TROUBLE AS SHE CAN BY UNDERMINING ME, CONVINCING NEW HIRES THAT MANAGEMENT DOESN'T CARE, AND CERTAINLY I DON,T CARE AS ALL I DO IS GO TO MEETINGS AND SIT IN MY OFFICE. MY UNIT IS A VERY BUSY UNIT WITH MULTIPLE DISCHARGES AND ADMISSIONS. MY NURSE RATIO CAN BE AS HIGH AS 6 OR 7 PER NURSE IF I AM SHORT STAFFED .WE HAVE 2 AIDES USUALLY WHO THIS NURSE COMPLAINS ABOUT ALL THE TIME THAT THEY NEVER DO ANYTHING THAT THEY DON'T DO IT RIGHT ON AND ON.WE HAVE UNDER WENT MULTIPLE CHANGES OVER THE LAST 3 YEARS.THE FIRST CHANGE WAS SWITCHING TO COMPUTERIZED CHARTING WHICH FOR SOME REASON HAS MADE LIFE HARDER THAN EASIER. THE NURSES TAKE 2 X LONGER TO CHART THE WHEN DOING PAPER CHARTING, WE ALSO BECAME UNIONIZED WHICH THIS NURSE IS VERY PRO UNION. MY NEW NURSES ALSO SEEM TO COME IN WITH AN ATTIDUDE THEY DON'T GET THEIR HANDS DIRTY BECAuse they are rns. I JUST SPENT 2 DAYS WITH MY WITCH NURSES ALL ON THE SAME DAY AND AM SPENDING A HORRIBLE WEEKEND QUESTIONING MYSELF. I DO NOT WANT TO GO TO MY DON AS WE JUST LOST OUR CLINICAL DIRECTOR AND DON EXPECTS THE MANAGERS TO HANDLE THE PROBLEMSTHAT OFTEN THE CLINICAL DIRECTOR HELPED WITH SHE WAS OUR BUFFER THE LIFFER NURSE CAME TO ME YESTERDAY TELLING ME WHY MY CHANGES WERE NOT WORKING I SAID OK WHAT DO YOU THINK WOULD BE BETTER WHAT SOLUTIONS CAN YOU COME UP WITH TO MAKE OUR UNIT HAVE MORE TEAMWORK SHE LOOKS AT ME AND SAYS I DON'T KNOW THATS YOUR JOB. LATER SHE COMES TO MY OFFICE AND TELLS ME THAT EVERYTHING ON THE UNIT IS FALLING APART AS ONE NURSE IS CRYING BECAUSE SHE IS DOING AIDE WORK AND THE AIDES CAN;T BE FOUND I GOT UP TO GO CHECK THINGS OUT AND SHE TELLS ME OH YOU DON'T NEED TO GO NOW I DID ANYWAY SPOKE TO THE CRYING NURSE WHO WENT OFF ON ME GAVE ME THE FINGER AS SHE FLEW OFF THE UNIT I FOLLOWED HER INTO THE ELEVATOR ASK HER WHAT WAS GOING ON AND CALLED HER ON HER GESTURE SHE HANDS ME HER NARC KEYS I ASK HER IF SHE WAS QUITTING AND TOLD ME TO TAKE IT FOR WHAT IT WAS WORTH I ASK AGAIN SHE DID'NT ANSWER ME BUT WAS ON THE VERGE OF TEARS I TOOK HER INTO AN OFFICE WITH A SHIFT COORDINATOR AND WE TALKED. POINT I AM TRYING TO MAKE IS WHAT CAN I DO TO MAKE THESE PEOPLE START WORKING AS A TEAM 1/2 OF MY DAY SHIFT PULLS AGAINST EACH OTHER I HAVE SEVERAL UNORGANIZED NURSES MY GOOD ORGANIZED NURSES DON'T WANT TO HELP THE OTHERS AS THEY GET DUMPED ON. i FEEL THIS ONE NURSE IS THE ROOT OF THE PROBLEM BUT I DO NOT HAVE ENOUGH TO DISCLIPINE HER NOR CAN I TALK WITH HER I HAVE TRIED. HER AND I CAN NOT COMMUNICATE WELL AS NEITHER OF US LIKES THE OTHER I HAVE TRIED TO PUT ASIDE MY FEELINGS ABOUT HER BUT SHE WILL NOT BE RECEPITIVE TO ME.HELP HOW CAN I GET THINGS BACK ON TRACK

[live4today, RN]

My advice would be to ask God to change you. Some years ago, I read a book titled "Lord, Change Me!" It made all the difference in how I viewed others. We cannot change other people, we can only leave an aroma with them that brings them back for more; one that has them desiring to change like their leadership. To be a good leader, one must be a good follower.

Just in reading your post, I sense that you are no more happy with the position you are in than your staff are happy working on the unit. Give them something to hunger for. If you cannot resolve your attitude and feelings towards staff that you manage, why expect your staff to know how to do it.

Call together a meeting of your staff. Let them each voice ways in which the unit could become a better place. Trouble usually begins within and not without. Each person must commit to becoming a better person inside, and learn coping skills to deal with issues that they can't change, and learn to embrace those that they can. Encourage your staff by being an encourager yourself. Change the way you approach your job, the difficult staff, and hear why they may feel you are not available to them.

A manager cannot manage if they can't be managed themselves. Attitudes come with us to work. We're born with our own individual attitudes. Some of us have to work hard on finding out who we are, and what makes us tick. I don't think it has anything to do with the difficulty of your unit, but with each individual's personalities that are clashing because a leader who represents safety, security, caring, calmness, assertiveness yet gentle in tone and manner is what they may need. Your staff look to you to guide them, and when you fall into the same trap of confusion as they do, nothing positive will come from that....as you have already learned.

Determine to change that which is negative. Recognize when it's time to turnover the reigns of managment if you come to learn that it just isn't your cup of tea. Ask yourself why you chose to become a Nurse Manager, and if you've grown since that time as a manager. Self-reflection will answer a lot of your questions about what to do at work as well as away from work.

I hope this helps you. The clashing and the finger pointing will not resolve anything. Realize that it takes more than just wanting to be a manager or leader to be able to do so. Management may no longer become you. :icon_hug:

[Turk182]

Dear Skay,

I know you posted this last month, and don't know if there has been any change, but as cheesey as it sounds I swear I wish I could give you a big hug. Sometimes management does really suck... sometimes it sucks a lot! But I'm sure you've had some rewarding moments no matter how small.

If you go to the "Calling all directors/managers" post by "Patrick", you can read my post (Turk 182). I totally relate with some of your issues. I have an LPN who has been on my unit, since the day she started, which was Sept 1961 ( I was born in 69). She is on personal social terms with all of the doctors (except for 2, which are American, the rest Indian), and is even going to India with them in a year. She is the stereo-typical does what she wants, how she wants, when she wants... and she doesn't want to do a whole lot. She has the "tell it like it is" personality with no regard to how it sounds or may be perceived, especially with patients. She starts everything with " How come" " Why is it," " Why should we", etc.; I think you get the picture. She should be able to run the unit for as long as she has been there, but I still have to tell her to piggy back her solumedrol,lasix, what not when it is crazy busy instead of bugging the charge nurse every time she turns around to push it for her. She routinely used to say real loud (when she didn't like what she was made to do or told) " 543 days until I retire. I hope I can make it." I used to get so mad at the disrespectfulness of it and ignore it, then I started countering with " 543? You said 443 the other day. Don't tease me like that." A thorn in my side would be putting it mildly.

BUT, when she hurt her back at home and got a doctors note saying she couldn't stand or sit for more than 15 minutes at a time, no lifting, etc. that was it. I spoke with HR and since she couldn't do her job in any sort of way, she was forced to take vacation and she was ticked. Now she doesn't push me as hard, she comes to my office to complain, she isn't anywhere near as disrespectful as she was before. When I did her evaluation about 6 months ago, she was hot! That was because she rated "satisfactory" for the first time ever. The previous managers gave her "excellent" and she thought she was. If you spoke to the other employees they would agree with me, but didn't want to tell her. I knew this was going to cause great drama with her so I ran it by my boss and HR first. They agreed as well. My point is, regardless of how anyone feels, you have to be honest and you have to do what is right for the unit. Sometimes I feel like I'm just getting rid of people because I have fired 3 people and I've not been the manager for quite a year yet, but they had to go for the good of the patients and the staff, and the staff are glad, appreciate it (but would never say so publicly).

The other LPN who has been there one year less than the first, she can run circles around any RN, can run the unit and is a GODSEND!!

I make sure I'm fair, that I jump in anytime it is crazy on the floor, and that I do as I enforce them to do.

My suggestion: deal with this thorn in your side. Document every conversation you have regarding what the expectations are and what the unacceptable behavior is. I have found that when you ask HR to "sit in" on a counseling, people tend to take it much more seriously. Be honest on the evaluation. I look at everything with the "This is professional not personal" attitude.

It'll be 1 year this March 29th, that I've been there a year. The unit is running more efficiently, less wasted cost, Overtime way way down. We have our bad times ( right now I'm down 2 CNA's who were also ward clerks, one had to go for extenuiating circumstances, the other.... she refuses to take her nails off..... after multiple warnings, over the last 4 years it turns out.) But for me personally and for the morale of the unit, its better to be frustrated because we are short staffed than because poeple will not do their jobs and nobody takes care of the issue. You've been a manager for 7 years, so you must be doing something right and there has to be something positive in it for you. Focus on that and get rid of the walking negativity(ies), those who buck you just for the sake of a pissing contest!

Hope this helps, or at least lets you know you are not alone. Good Luck!

[EricJRN, MSN, RN]

Do you communicate with your staff in all caps? I don't mean to sound silly, but it's kinda like the printed equivalent of yelling and might cost you some respect and credibility if you do it at work.