Management vs. primary care nursing

coffee4metech · Nov 20, 2009

i agree , i agree and yes I agree!

86toronado, BSN, RN · Nov 20, 2009

I used to work on a floor that had, I kid you not 5 nurse managers, plus a CNS... and then the facility announced a hiring freeze.

llg, PhD, RN · Nov 20, 2009

People who have never been managers say the same thing -- in all industries, not just healthcare.

Yes, sometimes there are bad managers ... and too many mangers ... and too many meeetings. But it is also true that problems don't get solved and staff don't get paid unless there are managers working behind the scenes (not on the front lines with patients) to provide the resources, run the system, justify the cost of hiring more staff, interviewing candidates, resolving patient complaints, assuring regualtory compliance, etc. In other words, for staff to do its work, there must be people (managers, educators, and specialists, etc.) to "run the system."

In other words ... if all those people you resent went away, the hospital would not exist, you would not have a job, and the patients would not get care.

RNsharkinaj · Nov 20, 2009

I understand all of that, but still cannot stand when for instance, an assistant manager, obviously chatting randomly about a nonimportant issue unrelated to nursing cannot answer a call light on their own. It makes me pretty angry sometimes. I makes me want to get the saying "Ok, I'll tell your nurse" on a bumper sticker or license plate.

kajunnurse · Nov 20, 2009

Your complaint seems to be that age old battle, management vs. non management. I agree with the previous post, until you become a manager you have NO idea what the job involves. Unfortunately there is always the one bad manager that gives the rest of us a bad name. I have had a floor nurse ask me for help with her work load that she said was just too much for one person. While I was in the pts room changing a foley, the nurse I was helping conveniently went outside to take a smoke break for over 20 minutes. She already had her two fifteen min breaks and her lunch break. I am always willing to help a floor nurse who is truly in need, but she must learn to help her self first. You would be surprised how often this happens. In my experience many floor nurses assume things about management that is simply not true.

canigraduate · Nov 20, 2009

I'm with you, RNsharkinaj. I work as a CNA in an LTC/rehab/ALF and have had bad experiences with the managers there. One took 10 minutes to track me down to pull a rehab patient (who was ambulatory) up in the bed. She then proceeded to chastise me for taking so long to answer the call light, without knowing or even trying to find out why I was delayed. I happened to be performing incontinent care, which is much higher on my priority list than assisting someone who didn't need help.

Also, there is only one supervisor in the entire facility who has ever asked if I needed help when we were short staffed (and I would do anything for her). I realize CNAs are looked down upon and treated like servants, but still... I'd think that the people who profit from my labor wouldn't be antagonistic toward me.

maxthecat · Nov 20, 2009

I'm no great fan of management, but I feel compelled to defend them a little in this case. You as a staff nurse have your responsibilities that you must complete--it's your job and you will be "counseled" if you don't meet the requirements of your job description. Well, your managers have their own set of responsibilities they must meet or they will hear about it from their bosses. Helping out on the unit isn't one of those responsibilities and most executives would even tell you that a manager who helps on the floor does not understand his or her position and needs more management training. Now trying their best to ensure enough staff and enough equipment for you to do your job is their responsibility and I think the majority of mid level managers try their darndest to make that happen--but often their hands are tied because of institutional and financial objectives they must meet.

I think people remember the old days when we didn't have nurse managers, we had head nurses. Now those people did help out on the floor on a daily basis because that was in their job description. But they were phased out when the healthcare system became so complex that it required managers with both a nursing and a business background. In theory a charge nurse can fill the gap left when head nurses were gone; however, that assumes the charge has no patients of his or her own, and unfortunately that often isn't the case.

Frustrating as it is to see a manager taking a break while you're drowning, think how you'd feel if you finally got a break and your manager came up to you and said, "You're just chatting. I have a budget due by 5 PM today. I expect you to get in there and start helping me with it."

Disclaimer: I am not a manager, have never been a manager, and would not be a manager for all the money in the world.

In general I think of management as the "dark side." But I do try to see both sides. You may want to save and print this post, as it may be the only post I ever make defending management !

kajunnurse · Nov 20, 2009

I'm with you, RNsharkinaj. I work as a CNA in an LTC/rehab/ALF and have had bad experiences with the managers there. One took 10 minutes to track me down to pull a rehab patient (who was ambulatory) up in the bed. She then proceeded to chastise me for taking so long to answer the call light, without knowing or even trying to find out why I was delayed. I happened to be performing incontinent care, which is much higher on my priority list than assisting someone who didn't need help.
Also, there is only one supervisor in the entire facility who has ever asked if I needed help when we were short staffed (and I would do anything for her). I realize CNAs are looked down upon and treated like servants, but still... I'd think that the people who profit from my labor wouldn't be antagonistic toward me.

I am sad to read that you think CNAs are looked down upon. Your job is soooooo very important. CNAs are the life blood of any facility. CNAs can make or break a Healthcare facility !!!!!

llg, PhD, RN · Nov 20, 2009

Frustrating as it is to see a manager taking a break while you're drowning, think how you'd feel if you finally got a break and your manager came up to you and said, "You're just chatting. I have a budget due by 5 PM today. I expect you to get in there and start helping me with it."

That's one of the best lines I have read on allnurses in a long time. :yeah:

RNperdiem, RN · Nov 21, 2009

Sometimes the number of managers goes in cycles.

One of our staff nurses used to be a nurse manager.

She quit under the stress that goes with having no assistant nurse managers, 3 units to manage (now there is 1:1), which was about 100 nurses. Scheduling, budget and hiring all fell to her and she burned out.

canigraduate · Nov 21, 2009

I am sad to read that you think CNAs are looked down upon. Your job is soooooo very important. CNAs are the life blood of any facility. CNAs can make or break a Healthcare facility !!!!!

Thank you! I needed to hear that today.