Managers can I change your opinion of them?

I read threads about managers and how ineffective they are I would like to see if I can change readers minds about how their manager is performing and what barriers there may be. Nurses Announcements Archive Article

It is a very lonely world out there for managers. I became a manager of a dialysis facility in august 2010.

I was promoted from within, not the best way to start out in your new role! why-because everybody has certain expectations of you which you cannot live up to. You start out with the best possible rationale which quickly turns into realization that in the big bad world of management that 'behind the scenes' is not as it seems when trying to look in.

Everything and I mean everything works very slowly, to get even the simplest task takes for ever to implement. To get a huge project under way takes forever and ever amen

An example of this is when you know an employee is not performing at their job description you cannot just fire them! (this is not what i want to do just for the record this is just an example-and not a very good one!)

No matter what we read on here 'normally' and if you work for a company who is actually cares about their employees there are huge hoops to jump through to fire somebody.

In my company you have to have a paper trail it starts with

  • a first negative anecdotal
  • a second negative anecdotal
  • a step one corrective action
  • a step two corrective action
  • a step three corrective action
  • suspension pending investigation
  • termination

If you don't have all your ducks in a row then you cannot ... I repeat, cannot fire/discipline an employee.

You can however depending on the severity of the issue progress the employee through the steps faster and if a danger to a pt then jump to suspension pending investigation.

This whole process can take 6 months which is a long time when there are severe concerns about an employee. Everything has to go through human resources and approved once you get into the step actions. HR will advise how to proceed and will consult with lawyers.

Why you ask-this is to protect the company from litigation and also as I learned recently help to reduce the unemployment payouts!

Meanwhile the bad behavior continues and the other staff think that an unproductive, mean, non-compliant work colleague is getting away with behaving badly or has poor performance! they think if he/she can do it then so can I.

They start to lose faith in you as a manager because 'there is no point in going to see her she does nothing'. When in reality you are working your butt off to try and improve bad situations.

It takes 100's of hours sometimes to get one piece of work completed because of the red tape and the hoops.

You cannot tell the rest of the staff what you are doing as this would not be fair, so you have to smile and hope they will one day have the results needed.

When I first became a manager I would stress every night that i had not completed my work. s an RN I hardly ever left work for somebody to complete I went home in the evening satisfied I had done what was expected! now I left piles of work half completed and something to look forward to when i got back in the next day. Now 8 months on I no longer have nightmares about uncompleted work, it is all part of the job description.

My day is never boring and never predictable, I do however miss the patients because I really never have any time to work on the floor I know my skills are going rusty I know I could not perform as a nurse in the same level I did before because I am now a paper pusher, a therapist, a sounding board, I am a boss, but am bossed from a higher level, a financial expert, a scheduler, a kindergarten teacher, a referee, a swing door, a borrower, a lender, a sponge, an executioner and a friend when somebody needs a shoulder.

I read threads on managers and I have to ask am I like that? do i do that? And what is the bigger picture?

It is such a huge topic and I would like to deal with each role individually.

Nothing and I mean nothing is as you see it! A poor performance which has a impact on a team may not be just that the staff member is trying to be troublesome or nasty or not able to complete a task!

We all have the problem that we tell an 'ugly story" about somebody else to justify why they are behaving in such a way, and we already have that story in our heads, if we just asked or discussed we may find out the true picture and it will probably be different that what we had told ourselves.

Many times I have staff telling me a story about another staff member sometimes I just listen and other times I ask the other person to come see me in the 'dungeon'-because if you pop in my office, it is ok but if I ask you to come into the office and see me, then I become the executioner immediately!

When you ask what is going on and if everything is ok, then a quite different story emerges.

A huge lesson I learned early on as a manager was to hear all sides of the story and not act before you have considered both! another huge lesson I have learned is, if an employee is having an issue with another employee I ask questions like, "What do you think the solution is?"

I am encouraging the staff to come to me with solutions not just problems. After all, nobody woke up and made me god! I don't know everything and I don't have all the answers I am just a person like you!


Added 4/14/2011

I would like to add when starting this blog article I was trying to reassure people that you cannot just get fired in good companies-but it does look like I am trigger happy when I re-read! So I apologise that was not my intention.

However, I did need to correct some very bad behaviour which needed immediate action very soon into my job and that how I know how hard it is to make sure things are dealt with fairly and correctly.

I'd be interested to know what state u live in to have to go thru so many 'loopholes' to get someone fired! I am currently residing in a 'right to work' state. There doesn't have to be a reason to fire someone. You could fire a employee for looking at you crosseyed! another tactic you might want to try is 'asking to resign.' Don't do it to their face - it is best done via telephone and then you can just deny that you talked to them. Make horrible vague comments to them about how they are putting a burden on the unit, jeopardizing their license, tell them their coworkers don't like them, ect. If u are in anyway concerned about having to still pay unemployment bennys, just ask them to 'seek other employment, then give resignation.'

Nurses in my locale get no warning there is a problem w/job performance - just get fired at the whim of administration or are subjected to the above described situation.

I believe what you describe is a problem with an organization (or more than one organizations), not a geographical region. I've spent nearly all of my career (>25 years) working in "right to work" states, and the only times I've seen any behavior by management even approaching what you describe was within specific organizations which were known to be bad employers. I've worked for plenty of organizations that would never consider treating an employee like that, and would get rid of any manager within the organization who mistreated her/his subordinates. Even though organizations may be free, under state law, to treat people like that, that doesn't mean that organizations and managers necessarily will treat people like that.

Specializes in RN, BSN, CHDN.
I don't think I need to have my opinion of managers "changed" -- I've been in healthcare a long time now, in a few different states, in a bunch of different jobs in different settings, and I've had good (some really good :)), bad, and mediocre managers. I start a new without any preconceptions (as much as humanly possible) about the manager, and wait to see what kind of a manager s/he is going to turn out to be over time.

Although I've never had any interest in moving into management/administration myself, and have valiantly resisted efforts over the years to push me in that direction :), it's not because I don't respect or appreciate all that is involved in those roles and positions, and I have a great deal of respect for the people who are good at doing them.

I know a lot of nurses come on to allnurses.com to vent about their manager, what they do and what they dont do so I guess I thought I would try to shed some insite into what could be going on behind the scenes.

I miss nursing to be truthful but due to bulging next discs am unable to work the floor at the moment.

Specializes in RN, BSN, CHDN.

kcmylorn

I cannot disagree with a lot of your comments I do think that it is a managers responsibility to ensure that all staff have good training and are educated further as neccesary. My staff are very competant some being in dialysis 20 years or more. Only one member of staff comes to mind who is not performing and we are working with her to upgrade her computer skills, to focus her on time management and revamp her documentation. We have talked about what she feels is the issue and she feels that the mixture of shifts we have are 'killing' her so we are going to look at the shifts together next week to see if we can stabilise her schedule.

Each member of staff is supported to what he or she needs, child care being an issue.

You have a lot of advice and suggestions so maybe you can help me with this one-I have an employee who calls off once a month, every month since November-we have a no question call off policy. I asked him this week if he was ok, did he need to do a different pattern of shifts to both he says no he is fine.

What would you do next?

Specializes in LTC.

Ok well I look forward to hearing your side of the story. I'm sure you've read mine as I haven't had a good experience and our new administration really gave us a "bad taste of their new recipe." They are locking up resident care supplies, including soap. The soap to wash the residents with. Not going to get into details because I'm calm right now. But its ridiculous. Theres no rationale that will provide any good to anyone in that. Not a blip.

I believe that managers of today do not really see entire issues. I do believe that the managers of today have a hightened sence of entitlement. I feel alot of them put their faith and trust in a certain chosen few who have adgendas of their own that the manager fail to see. I do not feel managers stick by or support their RN's. I fell that the recession and the glut of new grads begging for jobs have only brought out the selfish evil "me" in the contemporary manager.

I personally feel the opening blog is a" feel sorry for me" I'm the poor burdened manager. After being around nursing for 30 years- this crop of management that we staff nurses are forced to put up with is pretty poor. And it is this crop of management that makes me want to leave nursing and not with a good opinnion of the profession. Unfortunately, I'm not alone. Ive seen too many decisions to get rid of nurses for the most demeaning and outragous concocted reasons that we all know are not the truth. The getting rid of staff nurse with over 20 years experience to cut a budget- that hospital now has such a poor reputation that the providers I now work with will not send their patients there( and I never opened my mouth) I was quickly seen and widely stated- they don't have enough experience to the point where they are dangerous. I know of old nursing buddies of mine who a manager tried for 18 months to get rid of because of her age and cost of insurance benefits. This old colleage of mine had worked that hospital for over 30 years- yes, she is entitled to her pension and retirement benefits. Just like you managers would expect if the shoe was on your foot! Your younger nurses are not going to stick around that long - read these posts from younger nurses!! Your going to be forking more money out in orientation and recruiting than ever before- these younger nurses have no sence of loyality to you or any other employer. I say good, you asked for it, you got it. You have alienated us older experienced nurses with demeaning and disrespect to the point where just let us find a way out- we are gone and are not looking back. I know I'm not and I know plenty other who aren't either. We don't want to help teach this younger generation or you either for that matter- you made your dirty deceiptful beds, lay in it!! You are the ones who are losing- we had our older nurses around to help guide us, you're not going to be able to make claim. We did not disrespect our older nurses, we may not have liked them but we knew where to go when we needed help and we were not so full of ourselves that we didn't ask. We never 'devalued' them like old shoes. Our managers in those days viewed them as their resourses- that's what make this new breed of management atrousities and disgracing the title nurse. This is where nursing has changed and not for the better. I feel no piety for you. So stop snibbling to the masses.

I think she actually portrayed pretty well how frustrating it can be to be a Manager. It's just as she said - you don't see quick change of bad behavior, so you think she is not addressing a problem.

Your comments on loyalty to employees are, of course, so very correct. But I don't think the OP, as a low level Manager, has anything to do with company disloyalty.

For OP: I think you could say to those who think you're not doing anything about a problem employee - "I'm aware of it, I'm working on it. That is all I can say. But do understand - I am aware and working to make things better. You just keep all you can and you will see the problem solved in time."

Specializes in RN, BSN, CHDN.
Ok well I look forward to hearing your side of the story. I'm sure you've read mine as I haven't had a good experience and our new administration really gave us a "bad taste of their new recipe." They are locking up resident care supplies, including soap. The soap to wash the residents with. Not going to get into details because I'm calm right now. But its ridiculous. Theres no rationale that will provide any good to anyone in that. Not a blip.

It is unreal what some companies are doing to their staff and patients!

Is it a management issue yes but I imagine if your manager raises objections to the 'people' who hold the purse strings then he/she may well be in a position where their job is in question!

What I have discovered is I have 3 Regional directors, I director of Nursing, 1 COO, 1 CEO and then there are board directors, ChIef Medical Director -the list is frightening.

I am lucky I am able to raise objections and have opportunities to fight for the staff, I have to remain positive when things are bad but I don't have to lock up anything it is a matter of trust and respect, all the staff have pulled together to try and limit the amount of supplies we use because we were free and easy with them.

The lastest problem we have in dialysis is the blood draws-we have them drawn once a month on each pt I wont go into the list-but we cannot unless its emergency, draw them more frequently. Medicare will only pay us so much for each patient and everything is including in what we call 'bundling' so all their dialysis care comes out of that money! So when Dr's or NP's want extra blood drawn we have to say no and it is causing huges problems.

We do not get paid for any other blood draws, so if we draw them and it is connected to ESRD then we get paid nothing. For example our monthly blood draw costs $88 per pt, one extra blood draw per month upwards of $110.

We are a small company and do not at this time have the luxury of our own lab, I know the big companies have their own labs so I am imagining this is not a problem for them.

kcmylorn

I cannot disagree with a lot of your comments I do think that it is a managers responsibility to ensure that all staff have good training and are educated further as neccesary. My staff are very competant some being in dialysis 20 years or more. Only one member of staff comes to mind who is not performing and we are working with her to upgrade her computer skills, to focus her on time management and revamp her documentation. We have talked about what she feels is the issue and she feels that the mixture of shifts we have are 'killing' her so we are going to look at the shifts together next week to see if we can stabilise her schedule.

Each member of staff is supported to what he or she needs, child care being an issue.

You have a lot of advice and suggestions so maybe you can help me with this one-I have an employee who calls off once a month, every month since November-we have a no question call off policy. I asked him this week if he was ok, did he need to do a different pattern of shifts to both he says no he is fine.

What would you do next?

is once a month really bad? What is the aim?

good that u care about child care

I have recently been hired as a personal care home administrator. I have been on the job for 4 months. I am very frustrated and annoyed. My co-administrator is not training me properly. I have asked to be trained, asked many questions etc. Still only given bits and pieces of information. When I make a decision about the staff or the care of the residents she changes it.

I recently received my evaluation and it was poor. I was told that I did not abide by the budget. Hello, I never ordered anything(she did). I was told that I do not watch the staffing budget. That I am to cover vacant shifts. Which I have, however, we are so short staffed that I would be there 24/7. She is the one that did the scheduling. I was told that when I complete work I am to do it with her. She has redone any paper work that I have done. Any work I do is a waste of time. I was very insulted, I have been a nurse for many years and always got praise and awards for my documentation. Especially care plans.

And she changes my support plans. If anyone has done DPW support plans they are very simple to do. It never fails to amaze me how evil people in health care can be. I was basically thrown under the bus to save her ASS.

So, I will go into work do what I have to do. Have them pay for my administration course, get more experience and go else where. Do I feel guilty to use them. No. Did she feel guilty when she blamed me for her mistakes. No. Very sad place healthcare is in.

Specializes in Med/Surg.

As a staff nurse, I must admit that my eyes were not welling with tears of sympathy when you complained that it is not easy to fire your staff nurses. I found it a strange topic considering your audience.

Specializes in RN, BSN, CHDN.
As a staff nurse, I must admit that my eyes were not welling with tears of sympathy when you complained that it is not easy to fire your staff nurses. I found it a strange topic considering your audience.

So you don't want reassurance that in some places it is not easy to get fired?

Specializes in RN, BSN, CHDN.

mystoryRe: Managers can I change your opinion of them?

As a staff nurse, I must admit that my eyes were not welling with tears of sympathy when you complained that it is not easy to fire your staff nurses. I found it a strange topic considering your audience.

I live and work in a right to work state too, and I thought you could just fire somebody for anything but you can't where I work! Which is good for me too because I have managers and more managers and a boss above me!

So hopefully I can't get fired either LOL

Specializes in RN, BSN, CHDN.

Is is not amazing how different people read things differently.

I was trying for reassurance that in some companies you can't just fire your staff nurses willy nilly-yet some readers read it as I want to fire nurses!

I went back and re-read my blog and yes it could be taken either way

I want to say I hate writing people up. First time was this year! I want a solution but you have to have documentation for the State who when pts make their complaints you have to have a paper trail and we had an RN who was having inappropriate relationships with patients and the State found out-believe me you have no choice but to document and interview!

I have once had to be involved in the process of firing somebody and I have to tell you it was the worst experience in my career! I felt physically sick to my stomach, I would hope I never have to do this ever again.