How long to b/co a head nurse?

fluffwad · Jan 28, 2006

That all depends on what type of facility your are in, how much turnover they have, and if your boss thinks you are the right person for the job.

You don't get there on seniority alone.

Been there, done that........it ain't no cake job. Might look nice having an office, etc, etc until the administrator is breathing fire on you about overtime, family complaints, inspection results or whatever else he's fired up about that day.

crazylilkelly · Jan 28, 2006

thanks, i figured it just depended on all those things. i'm sure it's not an easy task either. just curious was all

Daytonite, BSN, RN · Jan 28, 2006

It took me 15 years. That was only because I really didn't want it. I was in supervision by my 11th year and that was because I had just gotten my BSN. I sort of fell into the head nurse position--I was in the right place at the right time and I gave in to the pressure to undertake it.

I hated it, let me tell you. But, it sure did give me a different perspective on what nursing management does. Red tape has to be followed to the letter. There was more documentation that had to be done on employees than patients. You are where the buck stops most of the time, so you have to learn to deal with problems. The Director of Nursing was very clear about what she expected from her managers. We had to track attendance and tardiness very carefully and give written warnings for infractions. We had to limit overtime. We had to make sure our units were properly staffed (that was a biggy and consumed a lot of time). We had to do employee evaluations, conduct inservices (or at least delegate them), hold staff meetings, make sure broken stuff on the unit was getting fixed, handle patient and employee complaints, be a member of and attend a number of hospital committees, and apply discipline when necessary. Staffing, to me, is the worst. The second worst thing is attending all the committee meetings. One insight I picked up was this. Just because I thought of myself as a good employee (came to work on time every day, followed rules, and tried to be cheerful and positive in my attitude) doesn't mean that everyone else is. The reason people get pushed into management positions (I like clinical nursing better) is because they are good employees. There are a good many employees who are not that at all. As a staff nurse you don't always know that because the wrong doing that comes up is often kept confidential. Some of the things employees did just outrageous and unbelievable. I just had a hard time having to deal with it all the time.

The fact of the matter is that if you want to be a head nurse you will get it faster. Just look for the opportunities or let the management where you work know that you want it. Then, be a model employee. You won't get into a leadership position if you're caught bad mouthing management or you publicly disagree with the rules of your employer. Brown nosing is definitely a must-have characteristic. If you decide to go toe to toe with the real powers at the helm you might as well just write up your own resignation. I've seen people only one or two years out of school getting into nursing management. They wanted it. I don't necessarily want it, so you can have it. Tons of good wishes to you.

TheCommuter, BSN, RN · Jan 28, 2006

It all depends on what you mean by 'head nurse'.

I know of an LVN charge nurse who has been a licensed nurse for only 2 years. In many instances charge nurses are considered 'head nurses' too.

It might take years of experience and a minimum of a BSN degree in order to become a DON (director of nursing).

pedsallergynurse · Jan 29, 2006

I have recently accpted position of head nurse in my office. The former head nurse stepped down from that position voluntarily and is stillworking as staff nurse in our office. I am finding she is badmouthing and trying to undercut my dicisions - very passive resistant. Any tips on how to deal with this?

mich

Daytonite, BSN, RN · Jan 30, 2006

I have recently accpted position of head nurse in my office. The former head nurse stepped down from that position voluntarily and is stillworking as staff nurse in our office. I am finding she is badmouthing and trying to undercut my dicisions - very passive resistant. Any tips on how to deal with this?
mich

Yes. You have to confront her. Take her aside where you have some privacy from the others in the office and tell her the specific things you have been told that she has been criticizing you for to the other employees. Ask her if this is true. Then, tell her that you want her to stop talking about you or any decisions you make that she disagrees with to the other employees. Advise her that if she has a beef or disagreement with how you are handling something she is to come to you first. Tell her that you would appreciate any advice she might have to give you, but you are not going to permit her to continue to badmouth you behind your back. You also need to take each of the other employees aside as well and advise them that you are aware that xxx is saying a lot of negative things about you to them and that you want each of them to stop her from talking like that. Advise them to stop her in her tracks and tell her that she needs to go talk to you about whatever she is complaining or criticizing you for. It is very important that you do this because what this former head nurse is doing is trying to find some people to gang up against you. The other employees need to know that you are aware of this and doing something about it. I am sure some of the other employees are as upset about this as you are. You need to exert your authority now and let the others know that you are nipping it in the bud and what you expect of them. Third, go to your boss and let him/her know what is going on and how you are dealing with it. He/she may have some direction for you with regard to this.

If the bad mouthing continues after all that, you need to do another little private conference with this former head nurse again. First, thank the employees who are telling you about her actions. They are obviously following your directions. At a second meeting, you ask this former head nurse why she is continuing to do this after you told her to stop it. You repeat the same instructions to her again, but this time put some teeth into it. Let her know that you are going to have to write her up or tell the big boss or however you handle discipline in the office. Again, tell the big boss what has happened.

By the third time, if there is a third time, discipline really has to be done. At that point, there is absolutely no doubt that she is being insubordinate (not following your instructions) and definitely intent on causing trouble. You might want to ask your boss exactly how to institute the discipline, but I say she needs to go. I can tell you that it is going to involve documentation of what this nurse is doing. In fact, it wouldn't be a bad idea to document each conversation you have with this person. You just write up what you said and what she said back to you in a memo format. This kind of documentation is not the same as officially writing someone up. We used to call them administrative incident reports. What they do is establish written proof of the actions that have initially been taken with her. Even though in supervision we say that someone has been given a verbal warning, there still is usually some kind of written documentation to record that. Most employees aren't aware that that happens.

This is not uncommon when someone steps down and another person steps up into a leadership position. The fact that this person is bad mouthing you is just an indication of her immaturity and inability to be an effective leader to begin with. It would be very interesting to know why she stepped down and whether or not it was voluntary or forced by her boss. You'll probably never get to know that information though. It's too bad she didn't learn anything from her experience as the head nurse. Oh well, her loss is your gain. You are going to find that some of the hardest things to deal with as a leader are the interpersonal and personnel problems. These were not problems that were given a lot of priority when we were in nursing school so you may have to do a little self-teaching for yourself. Some years ago I had to deal with a lot of this kind of stuff when I was working as a supervisor in a nursing home. It's very exhausting when you are first learning to deal with these situations, but as you get experience with it, it gets easier. You do have to confront her though. Before the actual confrontation make sure you have a very good idea in your mind of what you are going to say to her, so you don't forget anything. If you don't confront her, she is not going to stop. Confrontation is guided by assertiveness techniques and the process of discipline. I use a book called Managing Difficult People: A Survival Guide for Handling Any Employee by Marilyn Pincus as a backup if I want to make sure I'm handling a situation correctly. Although the book tends to focus on keeping a positive attitude toward problem employees it does discuss discipline and termination. I don't know that this employee can be rehabilitated, but you have to at least give her the opportunity to try. Best of luck to you. Congratulations on your new position!