Help! The "Life" of a Nursing Manager?

Specialties Management

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Hello Everyone,

I work about 50-55 hours a week (not incuding work related reading done at home). I have been in this job 6 months- was a staff nurse on the unit prior to this. My staff are unionized and there are provisions made in their contract to be compensated for each hour they work and for overtime they incur. Recently we have lost a few core staff members due to increased job opportunities in the OR that has recently become busier.

It is difficult to get staff to cover sick calls as we have very little extra staff right now and a lot of them are new to the unit and nursing. We are not allowed to mandate staff to come in and I am not sure that mandation would work as people would get good at ignoring their phones. Since Sept. 11, I have noticed a dramatic difference in the number of times people will actually come in at the drop of a hat to cover a sick call. The burden has been falling on me and a couple of wonderful staff nurses.

I am paid a straight salary and with the hours I work, I make less than my staff. On evenings, nights and weekends, there are nursing supervisors who are supposed to take care of things like staffing and other managerial issues when I am not at work.

I really like my managerial job, but I have been called by these supervisors at least once per week to cover the unit in some way.

I don't mind doing patient care (in fact, I miss it), but I feel as if these supervisors feel that I am supposed to "live" for the hospital 24 hours a day and to come in for free. One "supervisor" called me last Saturday to come in to work 7p to 9p since the day girls did not want to stay 2 hours past their shift while waiting for the 9pm person. So...the expectation is there- that I should come in on my weekend off to work 2 hours for free. Managers at this hospital are not compensated for coming in like the staff are. My boss says that I can take compensatory time..."Comp time" is an illusion as the pile of work is always there waiting for you no matter what comp time you take. No one does it for you while you are gone. There are times I have wished for a fairy godmother!!

Sometimes, my working as a staff nurse shows that I care about patients and staff and I feel like a team player when I do it, BUT for the most part- I feel that some of the staff really do not care if I have family life as long as they are getting their 4 days off per week. I also feel that some of them may secretly have some satisfaction in seeing me work all kinds of odd hours.

Most of my staff members have the this lack of understanding regarding the "life" of a manager with the exception of a few. One of my staff members was a manager not too long ago and one of my most helpful staff. Thank God for her and her sense of humor! I need to be careful not to tire her out!

:kiss :roll

Due to the difficulties in covering the unit and for patient safety reasons, I felt the need to initiate a call schedule. I do not think it is much to ask the nurses working three 12 hour shifts/wk to take a shift of call every week or two. They get paid for every hour they work and paid to be on call. When they are called in, they get time and one half for each hour worked. Some of my staff feel that I am expecting a lot- and one member verbalized that I should make myself a part of the call group in addition to my managerial job and responsibilities. She didn't say much more after I told her that my being on call and working the unit thereafter is a "freebie".

For those of you who may be thinking that I should hire more staff: the people are NOT there. I have "stolen" as many of the med/surg nurses as I can and I continue to look for new nurses everyday. On one hand, my staff say that they are "burning out" due to orienting new people to the unit and on the other hand, they ask me to hire more people. I could use per diem nurses, but my some of my unionized staff do not want them in our unit. Administration has also discouraged us from using per diems to cover for vacations this summer.

In light of the national nursing shortage, lack of extra staff in my unit, and the fact that we already have so many new nurses on nights, do you think that I am asking too much with having a call schedule to cover our unit? I feel that the burden of staffing should be shared by the whole team until we hire more staff.

I would like to know what the rest of you are doing out there and if you have a problem with having a couple of days off to yourself or any part of "a life"?? Are you expected to be at the beck and call of the hospital 24 hours a day? How are you handling the nursing shortage?

I am new at this and welcome any comments.

Thanks!

Thanks, Stormy

That is a great idea! I will talk to my staff about this study. It is the only way to increase staffing. Administration bases decisions on numbers and they are interested in recruitment and retention. I will certainly take this path to improve staffing in our unit.

I will keep you posted!

Layna,

I guess there is always the chance that some people might be put off if you hire agency, but I know that the people I worked with were happy to have the help. We are a union hospital and there really was no problem with it. Another thing they did was get together a retention and recruitment commitee. The members were voted for by the RN's and LPN's. The five (I think) highest voted for nurses were asked to be on the commitee (sp?). This helps keep the staff and management on the same page. It also gave other staff memebers someone to go to with ideas for solving the problems. Also, have you considered hiring LPN's to take care of some of the more stable patients on your med/surg? We have a few and they are great.

Do your nurses work 8 or 12 hour shifts? If they work 8, are they willing to work 12's? This may help take some pressure off, if they work less days but more hours. The only down fall we have had with 12's on the weekend staff is when ther is a call in, it is really hard to find someone willing to cover a whole 12 hour shift because the people who work during the week all work 8's.

One other things, you and administration may not like to hear this but, I have found that rural hospitals, in order to compete with teritiary care centers, must offer wages and benefits that are competative with those larger hospitals.

I know that many of the hospitals in the northern part of WI do not offer wages that even come close to what we get here and they are always advertising for help. Just because people live in a very rural area does not mean that they do not expect to get competitive compensation. Many people may be willing to relocate, but may not be willing to take a pay cut to do it. Just FYI.

I don't know, just throwing some things out there.

Specializes in Critical Care.

Did you consider hiring agency nurses. You could also close your unit to new admissions until staff is there. Good luck this is a tough situation

HI BadBird,

Thank-you for your reply. I appreciate it. I have considered agency nurses, but the staff feel that this may create more problems such as resentment over wage disparity, and having to take the time to orient these higher paid staff members. I have instituted an on call schedule which seems to be working well. It spreads the burden on all so that a select few avoid burnout. I am continually looking for new reserve staff as that is where I need help for sick calls and vacation coverage. My core positions are full, thank goodness. Administration has supported me in attaining almost a full FTE to cover nonproductive time. Overall, life is getting better.

If anyone has any other ideas, please let me know. Our unit is an OB unit staffed with 2 RN's per shift (core) with help added as needed. I am trying to avoid closure of the unit. Hopefully we get through the summer without any major problems.

Layna

I was like you for several months and finally decided it was not worth it. While I was working as staff, no one was doing my work. One thing we did was cross train a group of intersted ICU and TCU nurses to the ED. They were assigned to one of our five bed monitoring units, very much like their environment in TCU or ICU. Most of the staff were not working full time and therefore it only resulted in orientation pay not overtime. It has worked out very well and also gives non ED staff a taste of the ED. You may even be able to recruit from this group if they like it enough.

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