nurse leaders at the bedside

[livdream1]

Does anybody work at a hospital where they started a program where nurse leaders took on bedside shifts as part of their role?  Not just filling in but actually having an assigned weekly/monthly shift?

[Hoosier_RN, MSN]

I don't know about hospital, but in dialysis in my region, managers, both nursing and non nursing, are expected to work as techs, which I think is a good thing. It helps with staff shortages as well as understanding the "patient experience " that they harp on so much about

[JKL33]

It's interesting and there have been polls and discussions here before regarding people's opinions about whether a direct manager should be helping with the patient load, taking assignments, jumping in when things are busy, etc.

I personally don't see it being that helpful mostly because it isn't the main thing we need and because I don't see direct managers as the root of any of our worst problems. And not only that but the root causes of our problems are not things that direct supervisors/managers can easily change.  Very generally speaking I feel nearly all energy should be aimed at the root causes of problems and that things would have half a chance of changing if we stopped pecking like our pen-mates like hens instead of asking why are we ALL here in this pen to begin with.

So I'm curious about the OP scenario/the context in which this is being considered.

[klone, MSN, RN]

At one hospital where I was the director of Women/Children's services, all the managers and directors were expected to take one shift (7a-3p) as house supervisor. We rotated through M-F, so it ended up that we each had a shift every 10-12 business days. I did find this valuable in being able to see how things are in other areas of the hospital, and get an up-close view of how staffing works outside of one's individual realm of responsibility.

I've never been a manager where it was an expectation that I actually *work a shift* although I certainly HAVE. I definitely think there is value in a leader SEEING THE WORK of the frontline staff. It's hard to be able to identify inefficiencies, what's going well and what's not, unless you're doing it. For example, at the first hospital where I was a manager of OB, it wasn't until I actually worked a few hours as a bedside L&D nurse and saw their monitor and computer setup, which was across the room from the fetal monitor, and only one screen. Very inefficient, but it was all the nurses who worked there knew, so they didn't know any other way. I was able to advocate for a 2-monitor setup in every labor room, and was able to have them mounted to the top of the fetal monitor cart. That is not something I would have recognized if I had not been in the room, doing the work. 

That said, as I have become a seasoned manager, I see my value more not in the ability to take a patient load when they're short-staffed, but rather, in my ability to spend time with the frontline staff, talk to them, create relationships, and never forget my roots as a floor nurse. A good leader does not have to be able to take a patient assignment. A good leader is someone who always remembers that their primary job is to be the advocate for the people they're leading, and to never believe that there is any task that is beneath them. I don't have to be able to take a patient assignment (and frankly, with it being 4 years since I've been up close and personal in an L&D room, it would no longer be safe for me to do so, sadly) in order to help out staff that are drowning. I can answer phones, respond to call lights, empty a foley, empty trash, take away food trays, draw labs (that is one task I will NEVER be okay with losing my skills in, and I regularly do the hard sticks for my staff in the clinic I manage), run specimens to the lab department, etc.