This will be my first post here on allnurses, though I have been a frequent reader for years. I'm hoping to reach out to the community for some advice dealing with issues in my current position. This is a bit of a long message, but I'm trying to clearly explain the situation and I want to give enough details and examples that everybody can clearly understand my predicament. Please forgive me for writing a novel here.
Three weeks ago today it was announced that I had been chosen as the new coordinator of the emergency department at my hospital. While I have no prior experience with nursing leadership, I am "battle tested" in this field. I was a paramedic for 7 years before becoming an RN, I am a certified emergency nurse (CEN) and I have spent the past few years building a strong reputation amongst/rapport with my peers in the ED. I have worked in this department for two years and, up until three weeks ago, I would have said that I had a very good relationship with every other staff member (from physicians to trauma surgeons to housekeepers.)
The hospital I work for is a major tertiary care center. We are a 32 bed ED and we see around 50,000 patients annually. We are a trauma center, a stroke center, a chest pain center, and pretty much every other kind of center there is. We are the "big hospital" to which every other hospital in this region of the state transfers their extremely sick of injured patients including the other trauma center 10 miles down the highway.
Despite our many accolades, we are not without our problems. The hospital we are attached to has a surprisingly small number of beds for such a massive facility, resulting in many admitted patients held over in our ED at any given time of the day or night on a daily basis (less than 10 is considered a good day for us.) This is extremely damaging to the staff's morale, since none of us signed up to be med/surg, tele, or ICU nurses. Our staffing is dismal. There was recently a "mass exodus" during which nearly a dozen veteran ED nurses took positions in other departments throughout the system. These spots have been filled, but most of our new hires are fresh out of school with little or no nursing experience. Add to this the fact that we are understaffed at least 75% of the time as a result of the "mass exodus" mentioned a moment ago, and you can imagine that we're in a difficult situation. Staff are reaching "burnout" very quickly, with some leaving the department within months because they are sick of dealing with high nurse/patient ratios (understandably.)
So, in the midst of all this chaos, I have emerged as the new department coordinator. When it was announced that I had been selected, I was extremely enthusiastic. I had big plans for making sweeping changes, improving morale, improving patient satisfaction scores, reducing left without being seen rates, and making the place better for everyone (patients and staff alike.)I have been assured by high level administration that the "wheels are turning" on the inpatient holdover issue, but these changes take time. There is talk of building a holding area or another inpatient floor but obviously these are not things that will happen overnight. Staffing has also been addressed. We have several travel nurses starting soon whom I hope will provide some immediate backup to the staff, as well as 4 new hires that will eventually be a significant help as well (I say "eventually" because they are mostly inexperienced nurses and will probably be on orientation for the full 6 months that we generally allow.)
In general, the staff have begun to treat me like the enemy. They no longer converse pleasantly with me like they had done throughout the past two years. They scatter when I approach them. They are very cold and very short with me. They look for any opportunity to complain about decisions I make, and they always seem to have excuses for not being able to do tasks I ask them to do. They complain to my operations manager about perceived wrongdoings on my part, i.e. "I asked for help and was told no help was available" when I myself spent at least an hour of my time at the bedside assisting the individual who sent the complaint since no other nurses could break free.
I have been pulled aside by two different friends in the department and told that emails I have sent are being re-mailed amongst the staff with various negative comments and nasty remarks attached. One particular email drew the ire of nearly the entire department, apparently. I sent out a message that I thought was a "rally the troops" pep talk email. I spent the first half saying how great a job everybody was doing and how positive the feedback has been from all the patients I have spoken to. At the end of the email I essentially said "You guys are doing a great job. As we move forward, here's a few things we should all try to keep in mind to raise the bar even higher and be the best we can be." I proceeded to mention a few things about being mindful of patient satisfaction issues, keeping the department tidy, etc. Apparently the first half of the message (the "you guys are doing great" part) was lost on all of them, and the message they took away from it was "You guys need to do all these things on top of what you're already doing." I've had people tell me that it was "condescending" and "the worst possible thing I could have said to a bunch of people that were iffy on me to begin with." Really? Condescending? I have reread that email a dozen times and I can't think of any way it could possibly have been perceived that way. The whole focus of the message was "You guys are doing a great job, let's focus on these areas and continue setting the standards high for the rest of the hospital."
I never experienced these problems when I functioned as the charge nurse, which I did very frequently with this same group of people. I have double and triple checked myself to make sure that the things I ask of them are realistic, and I genuinely believe they are. I know they are being worked extremely hard. I know they haven't got a lot of help because of our current staffing issues. I know they are trying to juggle inpatient caregiver duties and ED nurse duties since virtually every staff member has at least one or two holdover patients on top of some ED patients. At the same time, though, I know that I would never ask anything of any member of the staff that I myself would not be willing to do. Unfortunately we work in a very large, very busy hospital and there simply is no such thing as a "quiet day" here. I think that the environment here is so profoundly negative and morale is so very low that the group will tear down anybody who opens their mouth at this point, regardless of what he or she has to say. I'm just not sure what I should do to get through to these people. All I want to do is make things better for them, but they are fighting me every step of the way.
I registered on allnurses in the hopes that others who have walked this path before me can share some wisdom. I knew that accepting this role meant I would no longer be able to just be everybody's friend all the time since there would be difficult decisions to make sometimes. Several people warned me that becoming the leader of a group that already knew and established relationships with you as a peer would be difficult. The "right thing" isn't always the popular one. I never thought, though, that the entire staff would turn on me within a matter of a week when I haven't changed a bit. I still treat everyone with respect. I don't walk around like a big shot and act any different than I was before I got this job. I just do what I did when I was charge nurse before. I understand the need to 'choose my battles.' I don't go around giving people a hard time about every little thing (i.e. a drink at the nurses station.) What can I do to get this group to stop trying to scare me off and work WITH me instead of AGAINST me in order to benefit all involved?
