Published Apr 12, 2005
mydesygn
244 Posts
My question is this -- as an administrator, how would you approach mentoring and oversight of a new clinical manager. At what point are staff concerns more than the usual nurse complaining.I am addressing this issue based from a staff perspective. I recently transferred from a management position (non-clinical) to a staff position on an inpatient unit. The manager who hired me was dismissed shortly before I began working on the unit. An interim manager was put in place. Unfortunately. this interim manager was not "mangement material" although she had a long clinical history, her only leadership experience was as charge nurse. Shortly, after she began working, she began critcizing staff for minor issues, unable to seperate "real issues" from simple nursing pettiness. She would "follow-up" on every complaint brought, typically without doing adequate research into the merits of the complaint and would address it with the employee by "writing-up" rarely making any attempt to listen or verify the information beforehand. Within 6 months, 5 of 7 nursing assistants had left, 2 nurses had left or transferred, 2 others choose not to return after pregancy leave (which happens despite management, I know). Many of the staff have begun to lose respect for her and have lost patience and "snapped" back after being told what they need to do. She does not have mean or nasty dispostion but tends to come across rather quiet and unauthoratative. After 1 year, the institution appointed someone new to her position from an outside unit. Needless to say, I couldn't wait it out and transferred to a new unit within 6 months.
kitty=^..^=cat
140 Posts
I approach new manager mentoring from the perspective that there has to be a lot of open communication between the new manager and whomever is supervising or "mentoring" them. Routine conversations on a daily basis regarding what's going on in the unit with lots of sharing of "experience stories" by the seasoned manager. Choosing the right people for positions at every level promotes the kind of environment where true mentoring can occur. New managers don't need to feel intimidated by their supervisors and be capable of accepting constructive criticism without jumping to the defensive.
(When I'm interviewing management candidates, I always ask a provocative question or two to "measure" the defensive response, since that's not a characteristic you want to bring into management.)
Willingness to trust in the knowledge of others from both the leadership and staff sides of the "manager role" is also a "gotta have it" trait for candidates.
The seasoned manager in the "mentor" role is responsible for making sure that the "newbie" is handling the role transition well -- If not, reporting any problems further up the chain of command so that they can be addressed before the new manager does any damage to the staff OR to the department's budget.
As with any other position, establishment of measurable goals with frequent progress checks has to be a meaningful process to assure real development of the new manager.
Thank you for your input. I have one other question? Have you ever found yourself having to "demote" or remove a manager and how would you determine when enough time has passed before it's clear that significant damage to the clinical unit staff has occurred. I've recently accepted a position as a new clincal manager at a different facility. I am fortunate (I hope) that the facility employs a "team" management concept. There is a day manager from 7a - 7p and a night manager from 7p to 7a. Having recently left a facility where all the issues from my prior post occurred, I don't want to find myself caught in a trap with a similiar type person in a mangement position.
Yes, I've recommended that one of my managers "step down" into a staff position. I'd had on-going discussions with her throughout her 90-day orientation period, so she wasn't caught off-guard at about day 75 when I had to have a serious conversation with her.
She'd interviewed well and seemed to have the traits and skill-set that were appropriate for the job, but it did not work at all...
Live and learn...
:):):)
In making that decision, how did you come to the conclusion that the manager was not going to succeed in this role, that it was not a matter of needing more time to develop? How much importance did you place on staff complaints prior to making that decision as opposed to personal observations and judgements? I have been fortunate prior to this last postion to have had good clinical managers and I wonder if my feelings are based on the fact that those managers were primarily "transparent" in the day-to-day operations of the units (i.e. peeked out periodically between meetings but rarely seen otherwise). I am somewhat apprehensive as I start my new role as a clinical manager since this management structure is clearly designed to be visible on the unit (i.e. 12 hour shifts coupled with patient care expectations in addition to management functions). Fortunately, this facilty pays their clinical managers well.
I have really clear-cut goals, and I make sure they are evaluated routinely -- it's important to me as a nursing administrator to make sure that the managers are "managing". They take too much out of my budget to be screwing up, you know?
The damage that one bad manager can do in three months generally takes a year to fix AFTER a stable replacement has been established. There's no way to really attach a dollar figure to it, but in looking at other statistics -- patient fall rate, med error rate, staff sick call-in rate, OT utilization, patient complaints, patient satisfaction scores -- you can generally spot problems and estimate organizational impact, if you know to expect them and care enough to be watching for them.
As far as staff complaints are concerned... There are always two sides to every story, and in hearing one side of it, you can generally figure out what the other will be. I've told my staff that unless they're willing to document a complaint, they might as well not even tell me about it, because there's nothing I can do unless the correct party starts a paper trail that I can follow. If a complaint isn't worth my follow-up, it isn't worth my hearing-about. I encourage them to keep their own personal notes of "little things that can add up" -- stuff that by itself is piddley but lumped together is significant. My philosophy on that is "Cataloging your information is your job. If it ever should need to become my information, I want it organized and ready for me to do something about. I don't expect you to do it all, don't expect me to do it all."
Since you're new in your role, spend some time looking at historical data from your unit. What are the problems? Where are the errors? What are they? What are your strengths? How aware are your staff members of their strengths and weaknesses? How can you have the most impact on the unit as a whole? Your staff? Your patients?
It's going to be hard work, but it sounds like you're happy with your compensation. :)
barefootlady, ADN, RN
2,174 Posts
This may not be the approiate place for this question, but please explain why managers seems to lose sight of the "importance of bedside nursing" so quickly? The last 2 managers I have worked under seemed to have no clear understanding of our job requirements. On both units nurse turn-over was unreal, 6 months was an old staff position. How are issues like this addressed when interviewing a new manager?
" as far as staff complaints are concerned... there are always two sides to every story, and in hearing one side of it, you can generally figure out what the other will be. i've told my staff that unless they're willing to document a complaint, they might as well not even tell me about it, because there's nothing i can do unless the correct party starts a paper trail that i can follow. if a complaint isn't worth my follow-up, it isn't worth my hearing-about. i encourage them to keep their own personal notes of "little things that can add up" -- stuff that by itself is piddley but lumped together is significant. my philosophy on that is "cataloging your information is your job. if it ever should need to become my information, i want it organized and ready for me to do something about. i don't expect you to do it all, don't expect me to do it all."
i am curious about the reverse. what if a manager is fielding constant complaints from other staff about their co-workers. items as minor as not totaling i&o's or starting report late or attitude. items that basically pose no threat to patient care but are reported none the less. my personal opinion is that approaching staff with minor complaints brought by co-workers particularly if i am not a personal witness to these will ultimately lead to (1) an attitude of "two-faced" co-workers on the part of the staff which leads ultimately to poor teamwork and (2) low morale and resentment among essentially good nurses after feeling constantly criticised and never praised (the main reason i left that floor). how do you seperate what's actionable from what ought to be for the most part ignored without appearing to not take concerns seriously? i have worked with indiviuals who spend an awful lot of time reporting other's shortcomings. are there good ways of gently discouraging that behaivior? at what point should the "accused" be made aware that 1 or more staff are making a collection of documentation of minor issues? i would be stunned and disgusted to be confronted out of the blue with a list of trivial issues. it seems that a new person or someone who doesn't quite fit in could become the target of what is essentially a smear campaign.
I am not sure what issues your previous managers neglected to understand? What actions or behaivior did they exhibit that would lead you to beleive they lost sight of the importance of bedside nursing. My personal opinion is that some managers are often good clincians but lack the important skills to be effective managers. Among those would be the ability to listen effectively and without bias and judgement, organization in terms budget, scheduling, etc.., the ability to not just tell you "what needs to be done" but to have worked a reasonable and effective way of accomplishing it as well as most importantly evaluating whether it was effective, and the backbone to "stand-up" for their staff when it is needed. My very best managers had at least 2 out of 4 of these characteristics but each person places more importance on any one over the others. For you, what would need to do to earn your respect not your undying devotion but your respect