Manager expects me to stay once I graduate

[nickikh23]

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?

[talondora1]

It sounds like you have really thought this through for quite a while. If you are able to privately share your concerns in a respectful yet direct way with your manager, it may help.

If you feel that you must leave your facility, do so. Give a proper notice and when you give reference to your new employer don't say anything negative about your manager.

I too had manager issues at my old facility. I know how difficult it can be to the point where you start losing sleep at night. You are much too young in your Nursing career to get this burned out this quick on a floor.

It's also inappropriate for a manager to discuss "placement" with you in front of others. A good manager isn't everyones friend, nor should she always believe family. One can still maintain professionalism and tact without resorting to manipulation and bad politics.

Do what your heart tells you to do, Honey. And Godspeed.

[talondora1]

Stop eating our young!!!! She will see wisdom in time. It isn't fair to stand on your soapbox and ream her out when she is still finding her place. Knock it off.

[nyapa, RN]

couldn't say it better myself. you are under no obligation to her; i suspect she realises this and is talking to you like this simply because she knows you are an absolute asset to the place - she doesn't want to lose you. sounds like she already has :balloons:

[nursenpnk, RN]

Hey Daytonite please rethink before posting such cruel responses to a nurse that is open and honest and is saying i do not want this area of nursing. I worked in a MSICU for a year and decided it was not for me. I did love my patients and I was a very empathetic person, but my back couldn't handle it and it was not my calling in nursing. Each area of nursing has its pros and cons and each individual nurse needs to find out which area suits them best. The great thing about nursing is that you DON'T have to suffer in an area of nursing or hospital ect that you find is NOT making you happy. There are too many options out there for nurses to be unhappy in their position. Each nurses needs to accept the fact that not everyone is going to LOVE their particular focus area and thank goodness because we need nurses in all areas, shapes, sizes personalties! Best of luck to the OP in your nursing career! Go with your heart and learn from the experiences at your current job :-)

[Daytonite, BSN, RN]

Hey nursenpnk Please read the OP and my posts carefully. The OP was talking about her boss, coworkers and patients. Never said anything about loving her patients and being empathetic, like you.

[caliotter3]

There is no reason to discuss your future plans with anyone until you know for certain what you are going to do. Then give the proper notice and continue to do your best until your last shift. You do not need to go into any lengthy discussions with your NM. Simply inform her that you are leaving to pursue an area of nursing that you find appealing and that you would appreciate a good reference from her. And make no mention of your true feelings, but thank her for everything you have learned while working with her. Anything else, would probably cause you discomfort and grief before you go. Why bring that on yourself? Good luck in whatever you do.

[nickikh23]

Daytonite –

I appreciate your response, as I know you must feel passionately about it or you would not have taken the time to type it all out. I reread my post and understand where your concerns are coming from. I did not realize how negative my comments would come across until after rereading my post. I think a majority of what I had to say in my post was me being upset with my job and needing somewhere to vent about all of my frustrations, and only my frustrations. I can see why you would ask why I would even want to continue in Nursing school as I highlighted only the negatives of my job.

I view my floor as a very challenging floor to work on. Nurses look at me like I’m crazy when I say I still want to be a nurse. I know that I’m young and that I haven’t seen anything in comparison to the experiences you’ve had, but I do know the importance of putting my patients first and caring for them as I would my own family member. As I said at the beginning of my original post, even at my most frustrating moments, my job has confirmed my desire to become a nurse. I hate some of what we do. I hate what patients are put through. I can’t stand to see the pain on their faces, but I do my best to support them and to provide them with the absolute best care.

The patients we care for are living some of the most miserable lives possible. Many will never wean off the vent, many are receiving dialysis every single day. A majority would probably rather not be living. You can see the sadness in their eyes. It’s a miserable life. I would never, ever want any of what I see on a daily basis to happen to my friends or family members. While I do hate a large amount of what our patients go through, there are so many things that I do love about our patients. Many remain on the floor for longer periods of time and it’s nice to get to know the person behind the illness. It’s nice to learn about them, about their families, about their hobbies and the things they like. Many patients have cried after I’ve bathed them because other people didn’t bother washing under their nails or washing their hair or putting lotion on their hands and feet. The smile on their faces when you get them sitting up in a chair is priceless.

I am an extremely sympathetic person and am conscious of the way I make patients feel. I often find myself to be the one who calms other staff down after they become upset or angry with a patient. It upsets me when some of my coworkers shove patients across the bed, jamming their faces into the side rail. It upsets me when I see a patient grimacing in pain while we’re turning him and hearing the nurse say he doesn’t need pain medicine. I've asked these same coworkers to be more gentle when caring for patients, at the risk of them yelling back at me. I’ve seen nurses scream and yell at patients. I’ve seen nurses with horrendous attitudes. I’ve seen nurses yell across the unit that they refuse to care for patient XX after this day. These are not the coworkers I admire. These are the coworkers I will strive to never be. I can see how easy it is to become that way, and for some it takes a lot of strength to look past it all.

I don’t think NICU will be any easier or any less challenging. In fact, I would expect for the job to more than likely be far more emotionally and intellectually demanding. I want to try everything in Nursing.

Nursing is a passion and it requires a large amount of dedication. I hope to one day have the experience you have and to become more solidified in my nursing role. I have a lot to learn and a lot to see and I’m excited for it. Family members and patients have both expressed their satisfaction with my patient care. I am confident that I make patients feel good, and I am also confident that they know they will always have someone cheering for them.

So, thank you for the kick in the butt. Please don't feel the need to response to this. I responded to your post to help myself sort out how I feel. I knew I would find some good advice here, and you've offered plenty. Nursing can be tough and the advice and support from fellow nurses is important. I hope this second post offers some further insight.

[nursenpnk, RN]

Being in a similar situation, i suppose i understood where the OP was coming from :-)

[Altra, BSN, RN]

Daytonite, I respect your lifetime of experience and your willingness to share your experiences with other nurses and students.

However, I feel this particular post was unnecessarily harsh. The OP's post addressed her desire to move on after graduation vs. her manager's repeated comments that she hopes to keep her as a nurse on her current unit. Though some of the things OP mentions (understaffing, difficult patients, etc.) are endemic to nursing in just about all settings, I see no lack of compassion, lack of aptitude for nursing or any other shortcoming on the OP's part from this post.

OP: Career decisions are ideally made with a mix of dispassionate analysis and gut instinct. As your senior year progresses, take the time to critically analyze your options and purse them methodically. Also listen to your gut. During your interviews, open houses, etc. take the time to pay attention to the "feelings" or "vibes" you're picking up. Every decision in life has risk, and no job is ever perfect.

You've gotten some good suggestions here on how specifically to handle your manager's not-so-subtle recruitment comments. If you do accept a position elsewhere, tell your manager immediately - don't leave her "hanging."

This is an exciting time for you - good luck! :)

[GadgetRN71, ASN, RN]

My NM was unhappy with me because I gave notice, and had worked there for a year after school! So no matter when you decide to leave, someone will be unhappy about it...I don't feel like I owe them anything-I worked 32 hours a week during school and took call on the weekends(which was difficult-I wonder how I got through it) and they did not pay for my education. They did not take my 5 plus years of surg tech experience into account when paying me. I was told they had to treat me as any other GN-but yet I was running the board on evenings when I hadn't been out of school a year, and they pulled me to scrub numerous times when I was trying to learn circulating...I made the decision to do what is best for me, and you have got to do the same. These people do not own you. And I don't think any nurse should tolerate being a patient's punching bag-I don't care how sick or unhappy they are. If they are elderly with dementia or severly mentally ill, that's one thing. But because a patient had a hard life. Nope!-I think the OP is smart and if anything we need more nurses that are willing to look out for themselves as well as patients. We don't need anymore "Martyr Nurses" Just my 2 cents..