Leaving Management

Naomi, RN · Mar 7, 2000

Hi Daisy.....I sincerely hope that you, or any other nurse manager that has stepped down and shared your feelings here, feel that I have looked down on you or disparaged you. That was not my intention at all. I too work in a very busy, understaffed unit with a great person as my charge nurse who is totally ineffective up the chain of command; and our nurse manager, who we never saw, also resigned 3 days ago.

I have great respect and admiration for those nurses who are braving management in this changing time of healthcare reform, HMOs, etc. Yes, the bottom line does seem to be the ultimate goal. Maybe we should be getting business degrees with our nursing degrees. I saw this only half joking. We need to be more, do more, and have more diverse knowledges to stay in the game these days.

I do not believe there is a nurse out there now who can survive in a management position, especially middle management, with the conditions and climate the way it is now. It must change, and nurses need to be the visionaries and the catalysts to this change. It won't work the way it is now.

That is evident from the sad and angry nurses that started this discussion. To all of you, I tip my hat. Thank you.

Naomi, RN

Nurse Entrepreneur · Mar 7, 2000

The hospital where I worked had gone through a merger and was not the happiest place to work. I was being asked to do more than my 40 salaried hours week in and week out and never getting to use my comp time. My children were spending more time with babysitters than they were at home with me. My morale was sinking and I found out I was expecting my third child. I had to decrease my hours at work due to pregnancy complications and my boss was less than supportive of this.

I started thinking about what type of work I could do from home and then I realized I could use my talents as a nurse educator. I am certified as a childbirth and breastfeeding educator. I am also a perinatal nurse author and consultant. I was asked at least a couple of times a month to do writing, consulting or training for hospitals and nursing organizations on topics relating to maternal-child care. Other health professionals had heard me speak, read my articles or had heard about the comprehensive maternal child education and support program I had developed at our hospital. Working 50-60 hour work weeks, I had to graciously turn them down and refer them on to others.

I began hearing more about home based business in the news and I began thinking about how nice it would be to work for myself from home and be home for my kids. In my spare time (which there was little of), I began to research what it would take to get started in a home based business and began to think about what I could do from home. I loved maternal-child nursing so I decided to stick to that.

Six months after the birth of my third child, I resigned from my more-than-full-time job and work 90% of the time from home. I do contract my services out as a L & D nurse at our local military hospital, but I am not their employee and it helps me keep my clinical skills up-to date. My business provides full-scope pregnancy, birth and postpartum support and education. I present continuing education seminars for health care professionals and I also arrange for the continuing education credits for other lecturers. I also am the contributing editor for Pregnancy and Childbirth at Suite101.com, a Vancouver, Canada based website. I took my experience as a nurse educator, author and consultant in the hospital world and took it with me to the entrepreneurial world.

My advice to anyone contemplating leaving the corporate world for a home office is do what you know and do it well. I knew how to coordinate the many numerous details of a continuing education or prenatal education program and budget planning and preparation. Marketing, communication, customer service and computer skills were already well known to me from my former job.

As a nurse, I didn't know much about running a business. I had no training about cash flow, SBA loans or the like in my training as a nurse. I relied on my local SBA office at Kansas State University, which offers free advice on writing a business plan, taxes, getting a business license, registering your business name and all of those other things you just don't know if you have had no training in business.

If you have the motivation and basic skills to do what you know and love it, with careful planning, the income will follow.

Nancy1 · Mar 11, 2000

Dear Naomi,

It was very distressing for me to read all the negative responses that were in this listing.

It makes me realize that my employer is WONDERFUL.

Nancy1 · Mar 11, 2000

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Originally posted by Nancy1:
Dear Naomi,

It was very distressing for me to read all the negative responses that were in this listing.

It makes me realize that my employer is WONDERFUL.

I accidentally cut myself off.

I work in LTC and have been out of nursing school since Dec. 1993. In March, 1994 I became a Unit Manager. Stayed there for 3 years before decidng to leave for all the reasons others have listed. But the job I took after the poor experience is great. There is a true collaborative feeling throughout the entire facility. We are a team and we are aware that we all need each other to succeed. My immediate supervisor, the DON, is giving me opportunities to grow because she knows someday I want her job. She is not threatened, which I think is a problem with a lot of people, not just nurses. They are afraid someone will take something away from them, and we need to realize that we will need someone to take our place eventually as we will all move on at some point in our life. We need to work toward making transitions better for our clients and their families.

I hope that there are others out there like me who are able to enjoy and grow in the field of nursing NA

jtfreel · Mar 15, 2000

You asked a very good and hard to answer question. For me, it was the realization that nursing has been caught up in the "business" of health care and is still, predominately, controlled by elements outside of the profession. In some for profit organizations, nursing is a cost center not a revenue producing center and the bottom line is sacred. The power brokers were the physicians and elements of administration that could grant or withhold favors. Empowerment? Those who give can take away.

My personal choice to leave was to avoid supporting practices that diluted patient care standards (in my opinion). I could not support practices which forced overtime during high census (with the resulting caustic memos from finance) periods and FORCED time off during other times. I watched nurse managers attempting to provide professional care, achieve professional development, implement change and support their patients and staffs only to be ignored by Administration. I watched other units (who had learned the game) provide substandard care (as evidenced by medicattion errors, patient complaints, high nosocomial infection rates, etc.) brown their way to secure administration's and physician support. It really isn't how well you do the job of nursing in some organizations: it is how well you make the power brokers feel you are doing the job regardless of evidence to the contrary.

Pattybrn · Mar 16, 2000

I also know where you are coming from. I am in management on a skilled Nursing facility. With the PPS in place, this has become the most stressfull thing I have ever done. I am considering very strongly to go back to floor nursing. I would like to take care of my patients and leave when the job is done and not think about it until I am scheduled to return. Any Feedback?

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Originally posted by jtfreel:
I know where you are coming from. I not only stepped down, but left nursing management entirely when I could no longer support policies and agendas that continuously and adversely (in my opinion) impacted upon the patients and the nursing department. In this organization, the primary customer was not the patient-it was the physician; the bottom line was the driving force and nurse patient ratios were viewed as a scalable item (adjusted according to profits). Even so, many dedicted individuals gave 100% daily. The personal toll was high for them and for me. I only hope my successor is more successful in achieving the professional goals than I was. I chose to leave because of my love for the profession and for the individuals in the profession-and for the patients. The result? My enthusiam is back, the future is brighter and my hope for the future of the profession is renewed.