Hospital nursing or bad management?

[JocelynM]

I am 8 months into my nursing career. I started on a pretty heavy med surg floor at a large, well known hospital. Since starting this job in February, I have not once felt like the managers were professional. I would say 75% of the people on our floor do not like management. I am just curious if this is how hospital nursing is, or if there really is an issue with the way they run things. For example, they OBSESS over call light numbers, if we don't meet goal, our unit director will say things like "wow y'all suck!" even if we tell her we got slammed with admissions, etc. They are having us round at 3 am to purposefully wake our patients up and say things like "Let's go to the restroom while I am here." so they don't call out to go and make our call light numbers go up. (We already round, but they are wanting to us to wake up our patients up.) So much so, they have contacted Lab and told their manager to quit having the lab techs press the call light for us to pause the IV pump.

Other things they do is only schedule staff meetings or required meetings at 8 or 9 am. They will stop us in the hallway on our way out in the morning to do evaluations which causes us to stay late. It seems disrespectful to night shifters to keep them late consistently like they do. They will text you and call you during the day knowing you are sleeping from the shift before. From what I have heard from other float nurses is that we are the only floor out of about 12+ floors that does morning and evening huddles where both shifts are required to go. That in itself is not bad, but they will call you until you show up to huddle even if you are in the middle of doing something for your patients. The director and manager are there every morning in huddle and they typically last 25-35 minutes. So there will be nobody on the floor for 30 minutes in the mornings. Our evening huddles are a little shorter because the charge nurse runs it. Is this normal at at all?

Several other things occur on a daily basis. They will write you up for small things. Constant meetings and audits on everything you could possibly thing of. I could go on for days. It's very frustrating. I have worked at other hospitals as a PCT and even on my clinicals and when I have floated to other floors in the hospital, I have never seen things run this way. Float nurses will come to our floor and say they always hate coming here because we are the only floor that does things different, and they think our director is ridiculous, as well. Anyways, I am just fed up with walking on egg shells constantly. Sorry for the long post.

[canoehead, BSN, RN]

Sounds annoying, but not toxic. Every unit has annoying issues. Do what they want, and know that the patient care issues that come up are not your fault.

[Penelope_Pitstop, BSN, RN]

Remember that in every line of work, crap runs downhill.

Chances are, your management has received negative feedback pertaining to these issues, so of course, your managers let the crap slide down the hill to the floor staff.

I had a manager OBSESSED with bed alarms. Everyone needed one, even a young person who wasn't a falls risk and was otherwise independent. Turns out she'd been chewed out by her boss because we had a spike in falls for a quarter or something like that.

To me, this doesn't sound like a deal breaker. But that's me. Everyone has a different deal breaker.

[BlinkyPinky]

What is a " huddle!?". Is that report time?

Never heard of this except in football

?

[Davey Do]

What is a " huddle!?".

A huddle is a time when the supervisor can meet with both shifts at shift change and discuss areas of concern.

Wrongway Regional Medical Center administrators behave in a similar way, JocelynM.

When a certain manager sent out an email to staff on appropriate behavior, I responded with a critique of this manager's specific inappropriate language during training sessions. I did not receive a reply but noted that the manager's language improved considerably thereafter.

We have saying around WRMC that I believe I authored: "Management can do whatever they want whenever they want".

I go by the saying "Lack of planning on your part does not necessarily constitute a priority on mine" when last minute mandatory meetings are called. This saying has served me well.

Good luck to you, JocelynM!

[applewhitern, BSN, RN]

Thankfully, I have never worked at a hospital that expects you to wake a patient up in the middle of their sleep to toilet them. I have worked in hospitals for 30 years. If anything, we try to AVOID waking our patients. They don't get much sleep in the hospital as it is. We don't keep track of how many times a call bell goes off, period. We ENCOURAGE our patients to use their call bells for any needs!

[applewhitern, BSN, RN]

Remember that in every line of work, crap runs downhill.

Chances are, your management has received negative feedback pertaining to these issues, so of course, your managers let the crap slide down the hill to the floor staff.

I had a manager OBSESSED with bed alarms. Everyone needed one, even a young person who wasn't a falls risk and was otherwise independent. Turns out she'd been chewed out by her boss because we had a spike in falls for a quarter or something like that.

To me, this doesn't sound like a deal breaker. But that's me. Everyone has a different deal breaker.

That's what I was thinking, too, that there is someone above them directing some of this. However, some managers get BONUSES for numbers that fit the requirement; maybe that is what is going on.

[JKL33]

As to the original question, it's a bit of both.

This is what is going on in hospitals. And there are managers who keep things in perspective and those who don't. I tend to think that at least some of what determines that is the amount and type of pressure they get from above and then their own abilities/willingness to work through that with their superiors. Some are very good at negotiating from both perspectives/sides of an issue, and some just turn around and throw the whole load downhill and get very angry when it isn't magically solved.

If your manager is the second type (kind of sounds like it) that very well may be a deal-breaker. These people have no real answers, their solutions usually involve exactly what you're seeing - getting so angry and militant about a metric that they're willing to demand interventions that are worse than the original problem. Or refusing to understand that something has to give somewhere. You can't waste 5x longer on huddles than you should and then turn around and wonder why there is/[or may be] a problem with call lights. The time that is actually being wasted yapping is a problem, and so is the fact that both shifts are forced to start off every day by already being way behind - which pretty much will affect the whole day. (??) This is such a typical example of the insanity it could make anyone's brain explode.

You have to work hard, try very hard. But in my mind there is a stopping point, and that is write-ups (or lukewarm evaluations). The employment/performance record of people who are trying to provide good care should not be tarnished just because hospitals, CEOs and CNOs refuse to duke it out with CMS over some of the metrics.

[cleback]

Wow, that's pretty bad management. I complain about stuff too but I'd say you win, OP.

[JKL33]

A huddle is a time when the supervisor can meet with both shifts at shift change and discuss areas of concern.

They were originally supposed to be just basic shift plan and basic information sharing with a few "go team!"s thrown in. They were supposed to be conducted by staff. They have morphed into various things: Staff meeting, b*tch session, lecture about failures, etc.

I'm familiar w/ them taking about 5 minutes, passing on information from shift to shift, etc. Not too bad.

[FolksBtrippin, BSN, RN]

Huddles should be 5 minutes long. Go over DNRs, name alerts, pertinent info for that shift. Fast. No way should a huddle take 25 to 35 minutes. Thats a meeting and it should happen monthly.

Sounds like you have a dumbass manager who doesn't realize that telling her staff to wake up pts at 3am will eventually come back to her in a bad way.

What I would do... While pt is awake state "we have a policy to wake you up at 3am to toilet but many patients choose to refuse this service and instead use the call light if needed. What would you like?"

Then chart pt refused.

Also, if float nurses hate your unit I would put in for a transfer because it's obviously better elsewhere.

[Sour Lemon]

Smile and nod when you're told to do stupid things, "forget" about meetings, turn your phone off while you're sleeping, don't answer their calls while you're awake either, agree with them when they say you suck, etc. None of what you're describing sounds particularly strange, although there are much better places out here.