Issues with Mgmt (Long Rant)

canesdukegirl, BSN, RN · Nov 25, 2011

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.
do you know for a fact that she is scrutinizing your patients more carefully than the others? when she catches a mistake, what does she say to you that makes you 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.
the first priority in our profession is always safety. since you knew this pt was a fall risk, you should never leave them, no matter how well they have demonstrated compliance in the past.
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.
just to put this scenario in perspective, what do you think the correct answer would be on the nclex:
a. instruct your pt to pull the call bell if they need assistance. leave the room and take the phone call.
b. delegate toileting duties to an unknown hospital staff member, assuming they know how to assist with a falls risk pt.
c. stay with the pt until they are properly seated on the toilet, assure that there is another hospital staff member in the room, leave the room to take the phone call.
d. ask the unit secretary to take a message and stay with your pt in the bathroom. assist them back to bed.
you probably understand at this point that you cannot delegate your duties to another member of the hospital staff, unless the staff member was another nurse or a cna on your unit. phone calls can always be returned. your priority was making sure that your pt was safe.
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.
your manager was absolutely correct. you should never have left your pt alone. one of the reasons you can't delegate to another hospital staff member is because you have no idea what kind of training this person has. so let's say the hospital staff member is standing there, waiting for the pt to finish in the bathroom. the pt finishes and politely asks the staff member to help her off the toilet and back into the bed. the staff member likely will not say, "uh, mrs. x, i have been instructed to just stand here. i don't think i can help you back into the bed." of course the staff member will try to help. s/he is more than likely worrying that s/he will be written up themselves if they refused to assist the pt back into the bed. since the call light was on, i suspect that the pt did exactly as you instructed and pulled the call light in the bathroom.
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.
if your argument to b was that your priority was addressing the fever, you should have done so when you assessed that your pt was febrile. you could have done this prior to rounding on the rest of your pts. i agree with you, it is a priority. when you did your initial assessment, did you ask the pt or the family if they had any questions?
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?!
yes, you should have caught that. again, our first priority is safety. i agree with you...the night shift nurse and the oncoming day shift nurse could have restarted the iv. but you were the one responsible for doing so. an iv check should be part of your daily documentation.
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.

it isn't easy to begin your nursing career. we all want to do the very best we can. i think that your manager doesn't 'have it out' for you; rather i believe that she is making sure that her unit runs smoothly and that the nurses on her unit are practicing safely.

the incidents that you list aren't smacking of bullying tactics. your nm sounds like she is running a tight ship. she has very clear expectations and seems to be following up on the expectations dictated by policy. that is her job.

trust me, a manager that has no idea what goes on is far worse than a manager who wants to ensure that safe practices are implemented by staff.

if you have any questions regarding policy, ask your nm. she will be glad that you opened a line of communication, and will furthermore respect you for seeking advice. she will see that you are trying and will likely hold you in higher regard.

i sincerely hope that things get better for you on this unit.

bleverett · Nov 25, 2011

Pandapixie, thanks for posting. I too went through something similiar. My lesson was things are not always as they seem. You can shift your thinking. You don't have to be crazy about the learning process and it doesn't matter who you learn it from. It is difficult and painful to learn on the job but we nurses do it. This is a great forum to get great feedback and keep some of your frustration away from the unit. The silver lining: you will pass this testing period and become a more seasoned nurse and a better nurse mentor for it.

Bortaz, MSN, RN · Nov 25, 2011

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.

And when the manager comes to vent in an.com tonight, and sees this very specific thread, she'll KNOW there's a personality conflict.

Been there,done that, ASN, RN · Nov 25, 2011

The "manager" definitely has it out for you. Who knows why?? Maybe you look like her husbands girlfriend. :uhoh3:

For 28 years , I have gotten the patient to the bathroom, gave them the light... and went on with my work.

There is NO way I can stay in there if they are taking a 20 minute poop!! If management wants you to stay with every patient that is on fall precautions, staffing levels should PERMIT this.

She is running many people out.... recruitment and training is EXPENSIVE. The people on the pedestal above her are slow.... but they will catch on.

Start looking for another position now... that is a very slow process. You are on track with the "one day closer" mentality.

Work on controlling your anxiety at bedtime. Sleepytime tea and meditation work for me. You must force it out of your mind so you can rest. Try counting backwards from 100 by 3's. Talk to your doctor... rest is your priority.

Until that happy day smile and nod.... make her wonder what your up to. Good luck.

Ruby Vee, BSN · Nov 25, 2011

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.

i'm not sure why you feel as though your manager has a grudge against you, but the examples you give aren't proving your case. maybe your manager does have a grudge -- all i know about the situation is what you wrote. but it could also be that she's trying to coach you into fine-tuning your prioritizing, critical thinking, multi-tasking or interpersonal skills. it could be she's trying to help you to become the best nurse you can be. you say you haven't even reached the one year mark, so i'm sure you have plenty of room for improvement -- that's true of everyone at your stage. it could very well be that your manager is trying to point out areas in which you could improve because she sees potential in you.

i'm suspicious of the statement that "if b catches it, b will hunt me down and try to belittle me until i feel as low as dirt." it's been my experience that new nurses have difficulty with criticism -- any criticism, whether it be constructive or not. if you're used to be praised all of the time, any sort of criticism can seem unduly harsh to you. but step back and think about whether there's a kernal of truth to what b is saying, then ask her how you could have done better. it's good politics -- she is your manager, after all -- and you'll probaby learn something. plusses all around!

if b is any sort of a decent or even fair to middlin' manager, you won't know if she's also speaking to other nurses about the same things. maybe you're not the only nurse she called about the hep lock. or maybe she did call you and only you -- because she thinks the other nurses are a lost cause and you're not. since you're deterined to stay until the one year mark -- admirable -- why not take the criticism from b in the spirit in which it may have been intended -- opportunities to improve yourself?

julieanneb · Nov 25, 2011

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!

She doesnt like her!?!?!?! She is a work force bully and she will try to take you down. You will begin 2 spend your days off worrying about this. Read he nursing article on here about work force bully's. And let me tell you,I never used the word bully in my life,not even on the playground,bu for the 1st time in my 10 years of nursing,ive been dealing with one of these types. I say run.....go to a diff. floor....get away.

maelstrom143 · Nov 25, 2011

It is the little things that get us. However, we need to be able to own our mistakes. It does not matter what someone else may do/get away with. What matters is our own actions and responses to those actions. If I hang an IV tubing and fail to label that tubing, then I am wrong. If I get caught or if I do not, it does not make me any the less wrong for not following policy to ensure tubing gets changed out in a timely manner. If an IV needs changing, then it will be caught at the beginning of the shift when you do your primary assessment. Either you or someone else (ask for help?) needs to restart it. Did not get to it, at least pass it in report and ask next shift to do it (worst case scenario) so they are aware that you at least attempted to address the issue.

I have often come on shift to find 75% of my people needing new IV sites. Pretty discouraging way to begin a shift, esp if any of the "old" IVs have already infiltrated. Painful for the patients, too.

It sounds as if you are having a lot of things pointed out to you. You might want to take a good look at what is going on, what could be done differently, and what things you cannot influence (i.e. your supervisor's actions). It sounds as if by being more vigilant, following procedure/protocol more closely, you might get rid of some of your supervisor's issues with your work. JMO.

When I first started, things were also pointed out to me...in the end, it makes you a better nurse, because you become vigilant and doubleback to ensure you have not missed anything.

hiddencatRN, BSN, RN · Nov 25, 2011

She doesnt like her!?!?!?! She is a work force bully and she will try to take you down. You will begin 2 spend your days off worrying about this. Read he nursing article on here about work force bully's. And let me tell you,I never used the word bully in my life,not even on the playground,bu for the 1st time in my 10 years of nursing,ive been dealing with one of these types. I say run.....go to a diff. floor....get away.

This is a little extreme. Maybe the manager IS focused on her, but the examples shared are all things that need to be addressed. And even if the manager is totally unreasonable the OP needs to work there until another job offer comes through so the best move would be to make sure you i's are dotted and your t's are crossed. In the end, focusing on the details will only help your practice tighten up.

There are folks at my job who complain about being hounded by management but then they give details of things that have been called out and it starts to seem like there's maybe a pattern of mistakes that justify increased scrutiny. And as others have pointed out, we don't always know who else is being spoken to or written up. I'm not saying that's what is going on in this specific situation, but it doesn't jump out at me as management out to get the OP. But we don't have all the details.

Either way, I'm sorry you're having a frustrating time, OP. I hope you're able to make the best of the situation. Even if your manager is truly evil, I hope you can find a way to benefit from the experience.

Guttercat, ASN, RN · Nov 25, 2011

Oy. Difficult for us who haven't worked with you to give constructive advice.

I'm going to approach this by assuming you want to do a good job, care about your patients, are proficient in the basics, have reasonable problem solving skills, and are open to learning:

Newbs often mean well, but lack the experience to prioritize. Some managers absolutely stink at bringing along new grads. Some managers, are only managers because they know how to nitpick the weak... someone, at some point, noticed that they have an "ability" to see what is wrong and voila, that person is now a manager. Gag me.

Those types of managers have their pet projects ("Problem Nurses") that they hone in on, thereby justifying their existence to their own superiors. It's called railroading.

If, your manager is "one of those" it can make life hell, especially as a new grad.

Here's my suggestions:

Listen to her and your coworkers, and take into account what they are saying. Weigh what they say, toss out the BS, and use the good advice to your advantage.

Have confidence and pride in yourself and your abilities. You are NOT an idiot, you are new to this.

Help your coworkers on the floor when they need it. Periodically ask them throughout the shift if they need any help. Let them know you are available, but also know your limits. Apologize if you can't help at some point. Gaining their confidence as someone they can rely on when the poo hits the fan, will go a long way to preserving your sanity, as they will become your support, and will want you to succeed.

Ride it out honey, there's no way through it, but through it.

And yes, since you live alone, hearing that alarm clock in the morning can be a very lonely experience. I also lived alone as a new grad, in a new town, and worked with a bunch of vipers.

Not fun, but keep looking forward.

pandapixie · Nov 27, 2011

Thank you for your kind and sympathetic comments, as well as your suggestions. I will take these advices and work on my weaknesses. Please keep me in your thoughts that I'll be okay.