Managers, Nurses and Delegation: Who Has Authority?

Nurses General Nursing

Updated:   Published

So wanted to brainstorm through a situation that came up recently.   At my facility, I am normally a nurse manager for a rehab unit.   Because of the COVID pandemic and fewer patients, I have been moved to assist on the LTC unit.  

The other day, when I went down there, one of the nurses listed off various things they were needing help with down on the unit: med pass, feeding people, vital signs, obtaining daily weights, etc.  I explained to her that I could help out with some things, but that I would still be attending to other duties, such as attending morning meetings and completing telehealth provider visits.  She seemed to understand at that time. 

However, about a day later, a patient had requested an enema in the afternoon. I passed this along to the nurse, who stated she would get to it if she had time.  About 5 minutes towards shift change, she mentioned to me that she had never gotten to it, and that the oncoming replacement was a TMA, who isn't supposed to be giving enemas.  In other words, I believe she was implying that I should be the one to do it.   

I gave her a couple of options: I could help finish up with some of her charting so she would have time, or she could pass it along to the evening supervisor.  I explained that I already had admission orders to review from the other unit.  I believe she ended up passing along the task to the evening supervisor.  From my knowledge, the enema was never  given because the patient ended up having a couple of large bowel movements.  

What I am wondering is who had authority in this situation.  The nurse seemed like she wanted to delegate certain tasks to me, but, as a manager, I would think it would be me that determines who completes which tasks, not her.  I guess I'm not sure what should have been done since we each had different opinions on who should do what.  The patient ended up being fine, but just wondering about future situations like this.  

Who does the delegation? The manager or the nurse?  

So am I understanding you correctly? Your staff is asking you for help but you’re not feeling it today so you’re just going to leave early instead of helping? 

Specializes in Pediatrics, Pediatric Float, PICU, NICU.
23 minutes ago, SilverBells said:

Struggling again today.  The help being asked for isn't anything I am able to give.   I probably will go home early because it appears I'm not really needed today.  The help that is needed requires energy I don't have anymore 

I'm curious as to what help is being asked for if you aren't able to give it? As a manager with an RN license I would think you should have the capacity to give the help that is needed. Also if staff is asking for help the answer doesn't seem like it should be that you aren't needed and are going to go home.

As others have mentioned in other threads of similar themes, and possibly in this one, I think you could benefit greatly from some therapy for yourself. You don't have the energy because you are burnt out, and you are burnt out because of the expectations you put on yourself, not because of others' expectations of you. Speaking to someone might help you realize why you feel the need to do everything and think you do it better than everyone.

4 minutes ago, JadedCPN said:

Speaking to someone might help you realize why you feel the need to do everything and think you do it better than everyone.

This. This right here is the problem. I’ve said this before. This. Is. Not. Normal. The OP needs to explore this with a professional to fix it before it’s too late. 

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I said in one of your other posts, and please take this heart: nursing does not need martyrs. Please, once again, look out for yourself.  You have received excellent advice in all your posts; I would take it to heart and ensure you have boundaries that are firm.

Good luck.

Specializes in retired LTC.

Same old song, different posts!! Sorry to say. You're back again, and explaining why you think you're the rightful employee to be selected for CERTAIN personally desired positions and tasks. NOT what Admin/mgt believes is correct for you. Only what you like and avoiding that which you find distasteful.

On a similar post the other day,  you asked 'what skill sets or personality characteristics would be needed for an Admission Coordinator position (one you covet, but have NOT been offered). Well, I'm thhinking TEAMWORK, cooperation, schmoozability, following directions, non-complaining, etc.  I just don't see this with you.

You become defensive after most posts (I expect some zinger for my post here). You point out others' deficits. How much of this has TPTB seen inn you? It's like you toot your own horn.

Sadly, you most likely have some very good attribute skills that would be very desirable for what you seek. But Admin wants a 'whole package' for its team. I just don't see them wanting you for whatever their reasons. And its difficult for you to get past that.

PPs Wuzzie & Jaded both astutely recommended that you seek some counseling or prof help to determine why you have such peculiar career traits as you do.

Good luck to you.

Specializes in Psych (25 years), Medical (15 years).
1 hour ago, SilverBells said:

The help that is needed requires energy I don't have anymore 

We can all identify with situations like this, just not having the energy to give what it takes.

At times like this, my wise little inner voice says things like, "You don't have to like it. You only have to do it" and "Just put one foot in front of the other".

There were times that I was in the throes of depression and suffered from anhedonia, and had difficulty focusing, due to what was going on outside of my work life.

At times like this, I did an internal narrative: "Now you're setting up meds. Now your pushing the Pyxis button. Now you're looking at the package"  and so forth.

Times like these I felt that everything was tedious- it wasn't fun or rewarding or anything positive, but when I was done with my shift, as "this too shall pass", I felt better that I had persevered.

Some days, I was so depressed that I looked forward to my death so I wouldn't have to do what I had to do.

So, hey, now I'm retired and am happy, so I'm glad that I did what I had to do!

And someday, SilverBells, so shall you be!

Namaste, as they say.

 

 

Specializes in Psych (25 years), Medical (15 years).

When my work wife Eleanor and I had to deal with a patient on their behavior, I often played the part of the Bad Cop.

Every now and then, I got a chance to play the part of the Good Cop!

Specializes in Dialysis.
2 hours ago, JadedCPN said:

I'm curious as to what help is being asked for if you aren't able to give it? 

Must be hands on, as SB only likes doing paperwork 

Specializes in Rehab/Nurse Manager.
2 hours ago, Wuzzie said:

So am I understanding you correctly? Your staff is asking you for help but you’re not feeling it today so you’re just going to leave early instead of helping? 

I did end up helping. Mostly miscellaneous tasks since one of the aides called in and the HUC who usually helps with medication pass was gone.   However, there were nearly no managerial tasks for me to complete today, so I stayed for 8 hours like everyone else and left.   No need to stay for 16-20 hours if there's nothing for me to do.  

Specializes in Pediatrics, Pediatric Float, PICU, NICU.
45 minutes ago, SilverBells said:

I did end up helping. Mostly miscellaneous tasks since one of the aides called in and the HUC who usually helps with medication pass was gone.   However, there were nearly no managerial tasks for me to complete today, so I stayed for 8 hours like everyone else and left.   No need to stay for 16-20 hours if there's nothing for me to do.  

I think you have a very misunderstood idea of what a good manager and good leader (two different things) are supposed to do. You are an RN. You have the capabilities of doing ANY task that the RNs and aides on the floor can do. And part of your “managerial” tasks involves doing those floor tasks when needed. I don’t understand your thinking.

Specializes in Psych, Addictions, SOL (Student of Life).

As I have moved through the ranks of nursing and I have done a lot including being a unit manager and a manger for a company that owned several group homes. I have learned that no duty is beneath me. At 58 I am still learning and refreshing on new and old skills.  As you know I am currently in psych but I sometimes moonlight at an out patient surgery center (starting IVs, putting in Foleys, prepping or dressing surgical sites. I love doing hands on nursing whenever I get a chance. It makes me feel useful. 

Hppy

Specializes in Rehab/Nurse Manager.
26 minutes ago, hppygr8ful said:

As I have moved through the ranks of nursing and I have done a lot including being a unit manager and a manger for a company that owned several group homes. I have learned that no duty is beneath me. At 58 I am still learning and refreshing on new and old skills.  As you know I am currently in psych but I sometimes moonlight at an out patient surgery center (starting IVs, putting in Foleys, prepping or dressing surgical sites. I love doing hands on nursing whenever I get a chance. It makes me feel useful. 

Hppy

For me, performing many hands on skills makes me feel bad about myself.  I feel bad for the patient too, because I always am thinking that if someone else were doing it they'd be more efficient and do a better job than I would.  Whereas if you give me 5 pages of new medications to enter, they will be entered in no time, unless an order needs to be clarified

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