Managers can I change your opinion of them?

[madwife2002]

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.

[mystory, BSN, RN]

Okay fair enough. I suppose I interpreted the context differently than you intended.

[madwife2002, BSN, RN]

For the record I do not want to fire anybody and I hope a solution to any situation can be found, either by discussion, education or a way round problems

What cannot be swept under the carpet as a manager

Infection Control

Inappropriate professional relationships between staff and pt's

Throwing things around the work environment and losing your temper infront of a pt.

No documentation

The 5 R's

Safety

No I would not dicipline for a first offence but I would implement further training, help and support

I would be concerned if there was a pattern of behaviour occuring

[direis09]

What a timely topic. As a staff nurse, our unit is struggling with many of the issues mentioned. We have people that are chronically late and some have discussed this with our manager. On the staff side, we see no change in the behavior so figure that nothing has been done. To make matters worse, the manager has formed out-of-hospital social friendships with some staff. The perceived favoritism and lack of acknowledgment and communication has created a large group of very unhappy staff. What could be a wonderful working environment has sadly become frustrating, with many looking for other positions. So many hard feelings could be soothed if she would take the time to talk to us and let us know that she is working on things; we all understand privacy issues and don't require detail, just need to know that we are listened to. Communication.

[bladams04]

I just went per-diem at a dialysis clinic. I was hired full-time 9 months ago. I wouldn't want to be the manager of a clinic, nor do I want to be the RN any longer. Responsible for 16pts on machines at one time! Yea and totally frustrated that management has allowed 'bad-apples' to keep working there. We have a new manager and I understand that she is taking these steps you talked about, documenting unreliability and pt complaints.

Still, I just was unhappy with the hours, the huge responsiblity and liability, and the strange employee dynamics. I just talked to an Acute Dialysis RN, that left the job of manager at a clinic. She is sooo happy to be out of it. Save yourself!!

[barbyann]

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.

Let me get this right, you were a nurse and now in management and the worst experience you had is a firing? Ever been in a bad code? People die in bad codes, in bad firings people just yell and holler.

[madwife2002, BSN, RN]

Let me get this right, you were a nurse and now in management and the worst experience you had is a firing? Ever been in a bad code? People die in bad codes, in bad firings people just yell and holler.

You are seriously considering comparing a code to firing somebody!

[ronsrn]

Agree with Madwife

Also if you got into management to "fire" people your definatley on my list of unfriendlies. Try leading by example and finding solutions to problems with that thing on your shoulders. The "need" to run to HR is a cover my butt im not good at what i do analogy. Tell me somthing proactive and no "YOU have not changed my opinion".

[justalpnwmg]

Yes, hurt your back and see how quickly you they find a spot in bed placement for you. . . . the old worn out shoe after 15 years. . . we will offer this to her. . . she will give up or quit. No, I didn't quit someone tried to save me by offering me a position in another dept. but they found a way to still get rid of me. . .my position was eliminated in connection with the operational 2008 reduction in workforce speal. Yes, I was given 5 weeks seperation pay, plus my accumulated paid time off-----after I signed a letter stating I would not sue. Yes, a very christian organization don't you think!!!!!

[nfler]

as a nurse manager, i tell my employees that i want them to be satisfied with their jobs and perform well. i want my employees to know that i am working for them, trying to provide the best possible work environment-because quality patient care will be a result.

my first job is to try to provide my staff everything they need to perform quality patient care (staffing, supplies, education, resources, process design and keeping unnecessary issues off their plate). i also need to ensure that we meet state, federal, and organizational standards (and budget) so that we can continue to serve patients and have jobs.

i would guess that most managers hate dealing with performance issues the most (probably neck and neck with budget issues in reality). performance issues take large amounts of time and focus away from the rest of the staff. most quality organizations do not fire readily (in my organization, the first assumption is that any errors are the result of a process problem) and this is a good thing as it ensures that people are not unemployed without being given the opportunity to improve. performance issues are not comfortable for people to deal with and nobody wants to have to tell another adult professional that they need to show up on time, respect others, shower, don't dress so that patients, staff, and families can see your underwear, or do your job as outlined. yes, these challenges are a part of the job description, but they are challenges. making those challenges more difficult, as the post mentioned, is that you simply cannot talk to your other staff about the performance issues that you are addressing, making the manager look ineffective while you are working hard to solve the issues.

i know that there are people who do not see managers as people trying to make nursing units run well-just as i am sure that there are managers who see staff as "assets", not people. i believe that the spirit of this post was trying to convey a sense of understanding about the challenges that nursing managers face behind the scenes.

[Wishinonastar, BSN]

I have been on both sides of the fence. I agree with most of what you said. I am amazed at how hard it is to make a change. I always thought if only I was in charge... But reality is very different. Here though people get fired whenever a manager feels the urge. I think it is wrong and firing should be a process like you described, but not in my state.

I also agree with some of the posters who feel managers seem to have an attitude of self-importance and entitlement. Many of the ones I have seen are this way. It is a rare manager who remains humble, honest and low key. I don't know why it is that way as some of them are at high risk of losing their jobs too.

[justalpnwmg]

how would you feel about getting rid of someone who is beyond their 54th birthday and got hurt on the floor caring for patients after leaving a "management position" after 15 years of too many hours and too much stress. there are other ways of getting rid of people. it is like getting kicked in the gut . . . you feel like an old worn out shoe. management offers you some horrible job like the hated bed manager. . thinking you will quit or give up, but i don't but someone who you helped along the way tries to help you out by offering you a job less money less stress in another dept. was working but suddenly i am called in the office and told. i have to let you go you are the last hired in the dept. when questioned i asked am i being fired "oh no your position is being eliminated in connection the operational 2008 reduction in workforce.":o i was told to go to hr upon leaving and sign the necessary paperwork, no way i'm not signing anything in this state of mind. about 2 weeks later i go to hr i am told you must sign paperwork stating you will not sue or disclose any confidendtial or proprietary information concerning employer; in exchange i will be given seperation benefits . . . 5 weeks plus paid time off accumulated. i should have fought it but who wants to work for people like this . . . . christians /

p.s. sorry, i thought the first one didn't go through!!!!! see above

[cdsga]

Having been in management several times during my career I feel I can give a good idea of what staff nurses feel. I use staff nurse as any nurse who is not in management. Employees do not appreciate a elitism that accompanies many people in management positions. They for the most part understand the hierarchy of managers and respect that position until they are given repeated experiences where they grow to disrespect that manager or group of managers. Most employees want to vent-they want you to listen not necessarily give advice or solve the problem. Most good managers will listen to what is being said, then ponder what is not being said. Sometimes the nonverbal cues of frustration are not addressed long term. Employees respect managers that get in the trenches with them from time to time-to get a view of what they are experiencing on a day-to-day basis. The goal of the manager is to take some of the burden off of the employee. Get rid of hurdles. Employees can come up with good solutions when given the opportunity. This has been proven in flex staffing, quality and through-put issues. Employees can give managers good insight into interdepartmental struggles that prohibit efficiency. Managers who do not engage employees in the process CONSISTENTLY, and who do not FOLLOW-UP with progress on issues of importance to employees disregard the employee and lose credibility very quickly. Performing surveys without giving the results of the survey about employee satisfaction is cowardly-and the employees sense that. It's hard to look at surveys and read what is said about the supervisory level, but you have to let employees know that you hear them and you are dedicated to doing x,y, and z to work on issues and that you will follow up at such and such a time and let them know what has transpired. The irony of management is that managers are fearful of their employees, but the very employees they fear are the ones that have the key to their ultimate success or failure. Releasing control, especially hard for those new to management, is scary, but if you try it, evaluate, follow up with the tasks that you release--you will ultimately work on tasks that actually mean something. You will free yourself to do other things like building morale, getting your MUST DO tasks completed and in on time without working overtime. The investment upfront is time consuming and energy draining, but the rewards are engaged employees, less turnover in staff, better respect for you as a manager and the institution as a whole (for choosing you to be in that position), and a morale booster for everyone. Managers who can walk the walk and talk the talk, are the best ones that I know. You don't get credit for anything, but you do get intangible rewards of being tough but fair, consistent and knowledgeable, a good listener, communicator and a good defender for quality care. I know it works--I've tried it, but let it be known that other managers will not like you! You will threaten them and their management style. Most just want to do the status quo, mediocrity is rampant. So understand to be a good manager does not mean an easy life. You better like politics and learn the art of persuasion and communication.