Manager expects me to stay once I graduate

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This website is so great and helpful. This is my first post so please bear with me. I'd greatly appreciate any input!

This Fall I'm going into my senior year of Nursing school, which is all clinical-based. I've been working as a Nurse Extern (which, to the hospital, is basically a glorified tech who will be graduating from a Nursing school soon) on a Medical ICU Stepdown floor for a year. I feel like I've seen and experienced a lot and I already feel well ahead of my peers at school. The greatest part of the job, though, is that it's confirmed my desire to become a nurse!

So what's the problem? Our Nurse Manager does a horrific job of "managing" the floor in nearly every way possible. She plays favorites, tries to be everyone's friend, she takes patient's family's sides and finds fault in the care that our nurses are providing, etc. She treats techs poorly and pretty much makes them feel unvalued. She'll pay a nurse $350 to work four hours and will offer a tech $25 to work eight hours. I absolutely understand the value of education and experience, but these actions also deliver the message that techs are unnecessary on the floor. A dangerous division between nurses and techs has developed on the floor over the past few months over this issue and she states she just cannot afford to pay to staff techs on our unit. I stay late all the time, sometimes until 1:30AM to help midnight shift with first rounds just because they are never staffed with techs on nights anymore. The only reason I've made so many sacrifices for the floor is because I love the people I work with on night shift and I think it's ridiculous how little management cares about staffing the off shifts.

I was ignorant to a lot of this for quite a while and was working tons and tons of overtime until I recently decided that I was making far too many sacrifices in my personal life. I know that my NM values my presence on the floor as she has been having me precept several new hires. She is well aware that I will be graduating next May and always checks in with me to remind me that she's "already reserved a spot" for me on the Nursing staff. She even makes comments like this when there are several people around. She has the expectation that the Externs she has will all come back onboard as RNs. A large majority of them do, and when I've asked some of them why, they've mentioned that our NM bumped up the starting salary a bit and they were comfortable with the floor and the patient care.

It makes me extremely uncomfortable when my NM makes these comments because I'm fairly confident that this is NOT the kind of Nursing I want to do. The patients we care for are mostly vent-dependent patients who require complete care. Most are well over 300 pounds, don't help with turns, push back when you try to turn them, are incontinent around the clock, and are just plain needy and demanding. I've been kicked, punched, spat at, sworn at, and the list continues, more times that I've ever cared to be throughout my entire Nursing career. Everyone ends their shift with sore backs, and while the ceiling-lift slings are great, they are not the magic answer that the hospital was hoping for! Nurses leave all the time because of the large toll it takes on the body. I know someone needs to care for these patients, but I can easily see myself becoming worn out after only a short amount of time on this floor. This doesn't even include my lack of desire to work for a NM who acts the way she does and who treats her staff as inappropriately as my NM does. I've learned a lot and I love the staff on the floor, but the patient care does not appeal to me.

I know that Nursing opens up an entire world of opportunities for me, and I feel like I want to try everything! I've had my eye on the NICU for as long as I can remember, and that is what I truly, truly want right now. I realize that there will be management issues no matter where I go in the hospital. I suppose I'm just needing to vent somewhere about how I feel. I'm also just looking for any suggestions on how to handle the uncomfortableness when these situations arise.

I know this was long, but I feel better now that I've been able to sort out of my feelings. Any thoughts out there on how to best handle future situations like this?

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Follow your heart... You sound like a wonderful person to me, and I hope that you find that place in nursing that will make and keep you fulfilled in your career... Best wishes.

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Specializes in L&D, PACU.

You are under no obligation to work there after graduation. I can see why it would be uncomfortable. Maybe you could just smile and say something like "isn't wonderful that there are so many options for new grads" or something like that. You probably don't want to directly contradict her, but you don't want to perpetuate the idea that you're going to be there, or she might make you feel obligated after all.

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How to handle it? Tell your NM that you've been giving alot of thought lately to different kinds of nursing, and that while the experience you've gotten on her unit has been incredible, you feel that you would be cutting yourself short if you didn't look into ALL options available to you. And for you, that means pursuing a different avenue of nursing, one that has really captured your interest, yada yada.

It will serve absolutely no purpose to make her defensive (as in "I don't want to work here because you're not the kind of manager I want to work under"). She is not about to change because of anything you say, rest assured. You can only make an enemy, and that does no one any good, especially yourself.

Keep the conversation as constructive as possible, focusing on what is DIFFERENT about the XX Unit of Hospital Z that draws you to them, NOT on the deficits on her unit. Again, really no point, even if someone tells you that she won't change unless she's told.....bottom line is she's been at this long enough, YOU are not going to change her. You can only give yourself the best start possible, and that is WITH her support, in case you need a reference, and you probably will. Yes, she can be spiteful and refuse, but that's on her. Do what you can to keep the break clean and upbeat. It's far easier for her to keep her pride (and your reference) intact if she feels that it isn't her downfalls, only the other unit's plusses, that drew you there.

Most of all, remember your value and keep diplomacy upheld at all times. You can only come out the winner.

Best of luck to you!!

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Specializes in ER/ MEDICAL ICU / CCU/OB-GYN /CORRECTION.

Sounds as if you have played emotionally right into what she seems to thrive on --manipulation with a guilt trap. It is a simple business decision your life professionally or her staffing issues.

I would allow her to vocalize all that she wants about her plans for you until you have graduated then simply resign or transfer where you want to.You have paid your dues and sounds like then some.

Of course at that time I would have a private non emotive discussion about your professional needs to grow and expirience varied type of nursing.

Do not comment on her ways of management but make it about you growing professionally and personally in a way that this unit does not allow you to. I would adorn her with thanks for all the trust she has in you clinically but keep in mind your not under a life contract.

I would even ask her help in securing another position using the fact you have been there all along and now need to grow like she did at one time.

However do not allow her ongoing positioning to lure you into feeling bad or disloyal -- that is exactly what she is trying to do.

Turn the tables if you can with your inner self -- find the strength inside to know that you are not long for this type of management and soon will be free.

Been there done that it is not worth trying to please those who you can not -- the fun is learning you cant and finding a way out of the manipulation without the manipulator realizing you know thier game.

Keep the focus on you. I wish you all the best.

Marc

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This has been some really great advice so far, all of which I will keep in my mind over the year to come. I feel much more validated for feeling the way I do, and for wanting to gain new and different experiences in Nursing. I think sometimes we need the extra support and guidance, and I knew this would be just the place to find it. Thank you again to those who responded.

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Specializes in ER, ICU, Infusion, peds, informatics.

you might want to look around and see if you can get an extern job in a nicu. it will give you an idea of what it is like there, and you will have a better chance of getting a job in one when you graduate.

even if you decide to stay put for the remainder of your nursing school days, i don't know that i would make too much noise about leaving when you graduate. if you do, you might suddenly find it difficult to get shifts. i've seen that kind of behaviour from nms before, and yours sounds like the type to do something like that.

i guess what i am thinking is that she is treating you really well right now because she wants to make sure you stay when you graduate. if she finds out that you arn't going to be staying, she may lose that incentive to help you out.

when she makes comments about you working there as an rn, i would just smile, or make a very neutral comment. don't tell her that you will be working there, but don't tell her that you won't either.

though i know some will disagree with me, i really don't think that is being dishonest -- she is the one making the assumption. but i do think the best option -- for you -- is to find a unit that you do want to work on when you graduate, and try to get an extern job there. an extern oreintation is so much easier than an rn orientation. but, being an extern in a unit before you graduate makes that rn orientation easier, and maybe a little quicker (things make more sense more quickly).

good luck.

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Specializes in Home Health.

I agree with Critterlover. I had a student precepting on a medsurg floor. He wanted ICU and felt bad because our NM kept talking about he "owed " her and needed to stay. He asked my opinion and I said go where you want, the manager was not one to support the nurses on the floor when they needed it. He kept quiet until it was time for him to decide. He went to ICU and while the NM was not happy and told him so, he is very happy with his decision.

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Go where you think you need to be. I had a situation like this before where I was a tech during nursing school. I knew I could get a position on that floor right out of nursing school with nothing flat. I would come in extra shifts and stay late. When I decided that I couldn't do the hours anymore. They were short and I was up to 54 hours per pay period, when I was only supposed to be 32 due to my school rembursement plan. I didn't get so much as, "Thank you for being a good PCA". Or anything. I put in my notice a month in advance. It was amazing to me. The nurses was saying, "Oh stay as casual!", I told them about I haven't even been talked to about leaving. This was after 2 years on the worst floor in the hospital.

I know how you feel. Go with your gut! Nursing is alot different than PCA or tech. You need to go where you want to be or your life will be miserable. Also it is sometimes hard for people to know that now you are a nurse and an equal. It can get wierd sometimes. I hope you find what you need out of your professional life. Keep your head up and whatever decison you make stick with it and don't turn back! :)

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I worked as an extern on an oncology unit during school. I was never expected to act as a tech (I would help with pull ups and cleaning incontinent patients, but I never did baths, patient rounding for vital signs, etc.) My preceptor let me do everything except give chemo. I loved her and all of the staff on my floor. You know what? I still left, and my manager was definitely expecting me to stay. I did feel very uncomfortable, but you don't have to stay if you don't want to. I didn't even stay in the same hospital, I switched to another hospital in the same company so I wouldn't have to pay back the money they gave me for school. ;) The most uncomfortable part was that I needed to get my manager to sign my transfer slip, since I was still considered an internal transfer since I was coming from a sister hospital. That was weird. lol

I just didn't want to do oncology. I wanted critical care. My manager and the staff were disappointed, but they understood. My suggestion is to try to get into a NICU, and leave on a good note. Write a lovely letter of resignation, compliment the coworkers that helped you, etc. If it turns out you don't like the new place you may be able to come back to this one. Good luck! Remember, this is YOUR life. The only person you owe anything to is yourself. You are the captain of this ship.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

what i got from your post was that you love your co-workers, don't like your manager and seem to dislike the patients even more. i'm wondering why you're even wanting to continue in nursing school.

i worked on an medical icu stepdown for many years. it's no picnic. how can you not be sympathetic toward the situation the patients are in? the things you said about your encounters with patients have me bothered--a lot--because you said nothing positive. and the patients are the reason that we are there. i've been an rn for 32 years and worked in a number of different types of nursing units. guess what? we had patients who were over 300 pounds, didn't help when you turned them, resisted being turned, were incontinent around the clock, were just plain needy and demanding, kicked, punched (one patient broke a nurse's arm), spat at (by a confused little old man who was in soft restraints), sworn at, and more. had a 600 pound man on a neuro unit who got out of bed by himself after being asked to call for help, proceeded to have a seizure and fell. took over an hour and 6 security guards to get him lifted back up. you haven't lived until you've had to work with a bipolar patient who went cold turkey on their lithium and is totally symptomatic and in a manic phase. had two patients in the same semi-private room code at the very same time. still, i saw every one of them as an individual who at one time lead an independent life like you and i do and were just experiencing the most awful health crisis in their life. it was my privilege to help them no matter how demanding they were. i don't, for the life of me, understand why you think nicu is going to be any different. you won't have 300 pound patients, patients resistive to care or who spit at you, but some of your little patients will be vent-dependent, incontinent around the clock and plain needy and demanding in other ways! is it because they're littler than you that you think is going to make the difference? you'll run into parents who will be vocally demanding, swear at you and try to throw their weight around.

i'm not trying to be mean here, but i'm pointing out some things that i don't think you are seeing. this is a service industry, nursing is a nurturing art and learning to cope with the behavior of other people is a skill you need to learn to get through every day of work life. i understand that you need to vent. i understand that you want to try new things. all that you've experienced is actually going to help you as you progress in your career. i don't think for a minute, however, that you have been able to sort out your feelings on all that you posted. but for the grace of god, that next incontinent, swearing, belligerent patient you take care of could be one of your or my relatives. i would like you to challenge yourself and put yourself under the same circumstances of some of your vent-dependent patients for just a few hours with a friend to act as nurse to you so you can get an idea of what life is like on the other side of the side rails.

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Specializes in Emergency Department.

I also worked for a nurse manager before I graduated who was not very good at her duties and expected me to come on board as an RN. She would staff our 33 bed floor with 2 RNs and a Tech, then write you up if the pt. didnt get pain meds within 10 minutes of asking for it. I went to a diffrent unit when graduation came. I did not tell my nurse manger I was interviewing somewhere else until after the fact. When I did tell her, I just simply said that I had enjoyed my time on that unit and learned a lot but was wanting to spread my wings but i would be glad to cross train up to her unit. It satisfied her....i will cross train...i wont work up there often though

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