Issues with Mgmt (Long Rant)

[pandapixie]

Hi All,

I just need a place to vent where people understand what I'm going through. I've been working on a med-surg floor and am a few months shy of a year. Lately, I've been having some "personality conflicts" with my manager. Long story short, my manager (let's call this person B). has somewhat of a grudge against me, and (in my opinion) has been trying to find all my mistakes and get me in trouble for them. When B and I are both working, B would round on the floor and scrutinize my patients more carefully than the others to see if I've made a mistake or left something undone (that should have been done). If B catches it, B will hunt me down and try to belittle me until I feel as low as dirt.

1. I left my pt who is a fall risk pt in the toilet, and told them to press the button to call once they are done, they've demonstrated compliance with calling before. While I was waiting in the room for the pt to be done, I had to take a phone call. None of the nurses or nursing assistants were any where in sight. A hospital staff was nearby waiting to do a procedure on the pt. I asked if they could just stay in the room with the pt and to call me once the pt's done. When the pt was done, they called. Apparently B saw the pt's call light and wrote me up because I left the pt in the bathroom "alone" and per department policy, we're supposed to stay with the pt during toileting. First of all, the pt was not alone, and secondly, I never asked the hospital staff to help the pt back to bed, merely stay there and make sure the pt doesn't try to get up by themselves, and to call me if they do.

2. The other day, after assessing my pt, I noticed my pt had a fever, but wasn't in any acute distress. I wanted to quickly round on the rest of my pts before I went to pull this pt's PRN med. Well, B rounded on this pt and apparently the family had questions that they didn't ask when I first came into the room. B finds me and tells me to go into the room to explain the pt's plan of care to the pt. I tell B "Okay." 10 minutes later, as I was just about to pull the Tylenol and go into the pt's room, B comes to me and says, "Did you go into the pt's room? The family member had a lot of questions and was very anxious. It's been 10 minutes." I told B that the pt has a fever, and that I will explain what's going on when I go in the room with the Tylenol, but then she said, "Well I want to you to tell the pt what's going on first and then pull the med." Basically, B wants me to go to the pt's room to update them, come back to pull the med, and then go back to the pt's room and give the med. I explained that my priority right then was addressing the fever first, and while I'm in the room giving the med, I will explain what's going on. It doesn't help that our unit is a long hallway, with med room in the middle and the pt all the way down the hall. I'm not lazy, but I like to cluster my care so I can cut down the amount of unnecessary trips I have to make up and down the hall. Also, when I went into the room, the pt and family were not anxious in the least. I explained everything fully, and they were satisfied with my explanations. I think B was the one who was anxious.

3. A while ago, on rounding one morning B found one of the pt's heplock had expired (past the 72-hr mark). I was on the day shift the previous day. B emails me a few days later telling me about this. True, I should have caught that, but since I didn't, the night nurse could have easily restarted another. Or what about the nurse that day? Why does she keep doing this to me?!

I really want to quit, but I can't because I haven't reached the 1 year mark. I feel stuck between a rock and a hard place. Coming to work is so painful sometimes. I've never slept well the night before coming to work, never more than 5 hours (sometimes even 2-3 hrs). The worst part is, I generally enjoy working with the pts, and like my coworkers. If management didn't give me this much trouble, I think I might even enjoy my job. Work is torture right now, and the only thing that gets me through each shift is the thought that with each shift, I'm closer to reaching that 1 year. I have to constantly remind myself that this job isn't permanent, but sometimes I'm so scared that I won't get a job elsewhere and will be stuck in this place for much longer. My coworkers who say they're going to stay for 6 months didn't leave until 2 years later.

By the way, in case you're curious, my floor has a very, very high turnover rate. Since the beginning of this year, there have been at least 10 nurses (not including nursing assistants) who has left. Every 2-3 months, a group of new grads begin their training here. Once people get their experience, they leave.

I'm sorry I made you read all that, but it's nice to get it off my chest. I live alone so I don't really have any one to talk to about this.

[brandy1017, ASN, RN]

When your asked to go to a patient's room and this by your manager that should be a priority ASAP not ten minutes later. You may be creating your own problems by appearing insubordinate to your manager. Is this a passive aggressive way of dealing with your manager. I can tell you it is infuriating when you ask someone to do something and then they delay and take their time. It is disrespectful.

If you couldn't see the patient right away then let the manager know that and why re priority of other patients and when you will be able to do what is asked of you. Don't drag your feet, it may be contributing to your conflict with the manager.

If you want a different job there is no reason you can't start looking now, just be aware as a new grad and later as a new employee, you will probably be scrutinized more closely to make sure you are doing things right.

[nola1202]

u know she might like u and be trying to make a good nurse a great nurse. It's a pain in the bottom to deal with this kind of stuff but u will grow and learn. If no one says anything to me about my work, I figure I did it right.

It's hard to assess, have to be there. I'd encourage u not to quit, stay a little longer, then move on. I do get how u feel and I'm glad u vented...Nsg...bah!

[Imafloat, BSN, RN]

I get what you're saying, but look at it from her point.

She may sense your personality conflict and every time she talks to you, she feels like you argue with her. The bottom line is that she's your boss. Maybe the patients family was anxious when she was in there, wondering why the NM is in their room.

Every example you give is something that she is within her right to call you out on. The patient wasn't alone, but you delegated to someone that you shouldn't have delegated to. The piv was expired, maybe she wants you to be more proactive in the future. Your actions, whether positive or negative impact her and her job. She probably is trying to break you in now that you've got yourself together as you get close to the 1 year mark.

A lot of times in life I've had personality conflicts with people that I've had to overcome. I've overcome them, only to realize it's harder to overcome them in people with a similar personality than you. I can tell from what you are typing that you are independent, intelligent, and may have a wee bit of a strong personality (that's not a bad thing ). Your manager sounds like she's got a bit of a strong personality as well.

If she wanted to get rid of you, she could, she could be writing you up for all of these things and counseling you and making you miserable. She seems pretty smart too and chances are, she's trying to put you in line. It's too expensive to hire someone else and train them, and they may not be as smart as you.

Not sure if you want advice, but I'm going to give it. When B says something, use it as a teaching moment. Be all like, " I'm sorry B, I'll get right in there and talk to that family" or "what would have been better than leaving that patient on the toilet, should I have made the phone call wait?" use your manager as a resource, she has a lot of experience and knows how she wants things done. Chances are she's establishing boundaries with you and once she gets you where she wants you she will back off.

She actually sounds like a decent manager, my manager wouldn't know an expired piv if it slapped her across the face. She is so far removed from patient care she has unrealistic expectations for her staff. If you like your job except for this I think you should stick it out.

[DixieRedHead, ASN, RN]

This is a set of circumstances that you will have to deal with all of your nursing career. Managers change, some you get along with, some you don't. Some are more demanding than others.

It is up to you to meet your manager's expectations, not the other way around.

A little communication goes a long way. If you want to address the patient's fever first and then answer questions, that's fine. Just tell the family, "Let me get some Tylenol for the temperature and I will answer any questions you might have then."

Pointing out mistakes that have been made (I didn't see any reference to being written up) is not "belittling" you, it's her job.

If you continue to look at going to work as just a way "to get through" your year so you can transfer or quit the circumstances will continue. The turnover will remain high. You have the opportunity to become the go to nurse on that floor. Make that a priority. It's a great position to be in.

[MomRN0913]

have you thought about applying for a transfer within the hospital, to a different floor? Something to consider.

[Pepper The Cat, BSN, RN]

Your manager is pointing out things to you that you are doing wrong, like it or not.

You left your patient unattended against policy. If the pt had fallen, you would have been wipe open to a law suit.

You made a family wait. 10 minutes may not be long to you, but to a waiting family, it can be forever. She was trying to show you how to prioratize better.

The saline lock needed to be changed - yes other people missed it too. How do you know she didn't speak to them about it too?

In order to grow and improve as a nurse, you need to know not only what you are doing right, but what you are doing wrong.

[morte, LPN, LVN]

what i am seeing is a passive aggressive manager, manipulating staff. going to see the patient and having to double back to get the APAP would be rather stupid. was the manager challenging OP to stand up to her? and explain why she wasn't going to drop every thing and be a 'good" little girl and do what mommy said?

The heplock situation is not clear, was it expired on her previous day shift or not? If it was, yup, got got on that one. And be careful , if the night nurse reported it, watch your back there as well. Good luck and look for new job.

[poopprincess]

I think that you should talk to "B". You guys need to find a happy work together medium because right now she has her eyes on you and you are so defensive that even if she did offer constructive advice to help you grow, you wouldn't be receptive. So the working relationship is not a productive one.

I see everyone elses point about going into the room first, but I would have done what you did. Grab the med and talk to the family while you are in the room with the med. It is time consuming to run all over the place and if you had to do that with all your patients, you would never complete your med pass, or anything else for that matter. 10 minutes is NOT that long. As far as leaving the patient in the bathroom, you stated that the patient was not alone. You had someone watching them. If you left them being watched I am not understanding how policy was broken?

You stated that if you and B got along you may even like your job. So talk to her-come in and have a chat to diffuse the situation. It shows initiative on your part and B should be receptive to it. Just do it tactfully. :)

[Do-over, ASN, RN]

Switch to nights... Sorry, just kidding. Or not.

A manager you respect is a precious thing, and makes life so much better in my opinion. I am lucky to work for a good one.

If you want to stay there, I would recommend toeing the line until you can go elsewhere. Sounds like a battle you won't win.

[pandapixie]

Not sure if you want advice, but I'm going to give it. When B says something, use it as a teaching moment. Be all like, " I'm sorry B, I'll get right in there and talk to that family" or "what would have been better than leaving that patient on the toilet, should I have made the phone call wait?" use your manager as a resource, she has a lot of experience and knows how she wants things done. Chances are she's establishing boundaries with you and once she gets you where she wants you she will back off.

She actually sounds like a decent manager, my manager wouldn't know an expired piv if it slapped her across the face. She is so far removed from patient care she has unrealistic expectations for her staff. If you like your job except for this I think you should stick it out.

Actually, she did write me up for leaving the pt in the bathroom. I can't transfer 6 months from being written up (it's my hospital's policy), so that's out the window. I suppose the main issue I have with mgmt is that B doesn't seem like they had very much hands-on experience. B will pick up on the smallest details but will neglect the big picture, and prefers to focus on the "customer service" aspect of patient care rather than the clinical. When I come to B with certain clinical questions, they will always defer the question to a more seasoned floor nurse.

And I've made the mistake of having a talk with B (and this was before the incidents I described above). B goes around in circles and never resolves the issues that I bring up. I've asked my coworkers, and all of them have said that they've had similar experiences with B. To be honest, I really don't think I'm an unreasonable person, but I truly feel suffocated when B is on the floor. It feels as if B is breathing down my neck when I'm working and that's just not how I operate.

Thank you for your comments and suggestions, by the way. :)

[anotherone, BSN, RN]

The manager can point out EVERYHTING you did wrong and it is part of his/her job. some of these policies are very hard to carry out in the real world like don't leave your pt "alone" in the bathroom with pt/ot (not what the op said, i know) when your other patient is having chest pain and you have 5 other patients one with q15 vitals and getting blood........................................ 10 minutes may be long to the fmaily but SO WHAT. nurses have other patients and other priorities. the priority is getting the tylenol for the fever not the family's anxiety. however many nurses and doctors cater to the "wrong" priority to keep the family/pt happy. there are managers/assistant managers like this on my floor. some of them seem to "target" some nurses more frequently and point out all of their mistakes while letting others skate by with pretty big ones. (some managers point out errors equally in all employees). i don't have any advice except to look for another job or try to do everything per policy. maybe the manager really just doesn't like you and wants you to quite, maybe that is his/her mangement style, or maybe they think this will improve your nursing skills, as the manger thinks they should be....