nurse manager-request to work on the floor

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Our unit is stressed out with high acuity, barely adequate staffing, and management telling us we are the reason for our low patient scores, therefore our hospital will not get reimbursed. We have a new manager (since august) and this is her first management job.

Our unit wants to challenge her to work 2 day shifts and 2 night shifts, during the week, to see how our unit works. We came up with this during our shared leadership meeting. We feel she is far removed from the floor, and still does not understand the processes of our unit.

She is on the floor more than other managers (which was never), but mostly to see if we are hourly rounding, writing names on boards, etc. Never jumps out there if its 2pm and no one has had a break, or we are getting hit with our 5th admission.

What I wanted to know has anyone ever suggested this before? How do I go about it? Im trying to find articles online to support this.

I regret not requesting this when she was first hired, but its never to late... Also would like to get our 'nurse educator' we never see on the unit to work as well.

Thanks for your advice.

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Specializes in ICU, M/S,Nurse Supervisor, CNS.

I think that's a great suggestion, but am not sure how well it would be accepted by your manager. Your manager should have a good understanding of her unit and its problems, including the staff's frustrations. Working a shift or two would definitely give her a great deal of information about the unit. I have had managers work the floor on a rare occasion where we were critically short-staffed (with full patient load, not just as charge), but then again, these managers had previously worked the floor and had been promoted from within. However, in my current position as a house supervisor, the only manager I've seen actually work the floor with a patient load was the ICU and that was because every nurse would have had three patients including the charge nurse. Every other manager will do charge if their units are short, but not take patient assignments.

In any case, I would suggest having a back-up plan in case your manager refuses to work the floor. Would you be satisfied if she just did charge for a shift, or was on the unit for the entire shift, but not doing patient care? Is the unit council willing to compromise? Not saying to offer these alternatives initially, but just to have an alternative if you don't get the response you want. Good luck!

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Specializes in Maternal - Child Health.

It shouldn't have to be suggested. It should be the norm.

In my first management position, I worked as an assistant manager under a manager whose background involved years of running a family business in addition to nursing.

She taught me everything worthwhile about management in about 3 sentences.

1. Never ask anyone to do anything you have not done yourself first. (This includes working off-shifts, holidays and weekends. Every manager should work at least 1 non-day shift per pay period, if not more.

2. Never mess with people's schedule. See rule #1. Work for them if needed, to accomodate their reasonable requests for time off.

3. Never mess with people's pay. If an error occurs and it is your fault, fix it yesterday. If an error occurs and it is the employee's fault, fix it tomorrow. Never expect an honest employee to wait until the next pay period to receive their money.

These rules served me well as a manger. I hae n idea if my former boss reads this board, but if she does, I hope Cathy R. of SC recognizes herself :)

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Thanks, You are right, it should be the norm. And the latter 2 rules have been violated.

I think she is stressed, she came in at a time when the hospital is barely staying afloat, is trying to initiate changes too late, with little support, and not much money. Now our organization is selling our hospital. Shes trying to save her job I think, and is getting desperate with threats and write ups.

But still, its not productive for an already over stressed unit, who feel we are not being recognized by management.

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Specializes in SICU,CVICU,ER,PACU.

Ever thought about starting a "SMART management course/center" with your former boss?

we need more managers like you!

"1. Never ask anyone to do anything you have not done yourself first. (This includes working off-shifts, holidays and weekends. Every manager should work at least 1 non-day shift per pay period, if not more.

2. Never mess with people's schedule. See rule #1. Work for them if needed, to accomodate their reasonable requests for time off.

3. Never mess with people's pay. If an error occurs and it is your fault, fix it yesterday. If an error occurs and it is the employee's fault, fix it tomorrow. Never expect an honest employee to wait until the next pay period to receive their money.

These rules served me well as a manger. I hae n idea if my former boss reads this board, but if she does, I hope Cathy R. of SC recognizes herself :)"

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Another possibility would be to challenge her to shadow nurses for a few shifts. That may be safer and more practical than asking someone to take on a patient load without orientation, and I suspect she may be more likely to take you up on it. And I think it would be just as educational an experience for her, as long as it's done thoroughly. That is, she's not just watching you give care to your own patients - she's also watching you chart, listening to you make phone calls, tagging along when you answer a call bell for another nurse. That way she can get a feel for all the little things that add up to a horridly busy shift.

Hope that helps.

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Another possibility would be to challenge her to shadow nurses for a few shifts. That may be safer and more practical than asking someone to take on a patient load without orientation, and I suspect she may be more likely to take you up on it. And I think it would be just as educational an experience for her, as long as it's done thoroughly. That is, she's not just watching you give care to your own patients - she's also watching you chart, listening to you make phone calls, tagging along when you answer a call bell for another nurse. That way she can get a feel for all the little things that add up to a horridly busy shift.

Hope that helps.

Having the manager shadow for some shifts assures some quiet shifts. :lol2:

That's the good news.

The bad news is that she'll think you are all crazy about being overwhelmed with Pt care. :eek:

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It might be unrealistic to expect your manager to do actual patient care in and area that she is not used do working. More importantly, it might be a patient safety issue if she is not used to the medications and treatments those patients receive. She would have to be oriented like any other nurse. Many nurse managers have never actually done patient care and would be a risk if placed in that position. My manager has NEVER done direct patient care and I wouldn't want her doing it in our unit for safety of the patient.

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Specializes in ER, ICU, Education.

I think its an excellent idea and one that the manager should have thought of herself. Unless she previously worked on that particular unit she'll never really understand how things work.

Suggest it. What harm will it so? What's what worse she can do but

make some excuse not to do it, which then will prove to you that she really doesn't give a hoot about the unit or the staff. At least you'll know where she stands.

A good leader never asks their staff to do anything they would not do themselves.

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Specializes in Critical Care, Education.

I can certainly understand your frustration but I would encourage you and your colleagues to take some time to reflect a bit more on the overall dynamics of this situation. As a bedside nurse, you have to try to provide quality care under difficult circumstances - and this can incur a heavy emotional toll. But if you really want to change the organization,you will need to take a more objective & strategic approach. This may not be as satisfying as the 'misery loves company' tactic of compelling your manager to work as a staff nurse, but will be more effective in the long run.

Staffing levels are dictated by the organization's labor budget. Labor budgets may be developed by a wide variety of methods but in the end they have to be approved by the Senior Leaders.... a group that does NOT include unit directors/managers. I would suggest that a more effective use of your manager's time would be to develop the higher levels of skills, knowledge & influence that are needed to increase your labor budget.

You and your colleagues should ask your manager to teach you about the financial structure of your organization & department - what is your fiscal year? How many FTE/positions have been approved for your department? How many nursing hours per patient day? What is the approved skill mix? Join forces with her by asking her how you can help influence Senior Leaders to increase staffing levels.

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I have often felt that management and JAHCO should walk in a nurses shoes to really see what the job entails. Seems like there are a lot of people that can come up with ways that things should be done but many protocols are unrealistic. Our current manager went from staff nurse to nurse manager. A couple of weeks after becoming manager I noticed her new set of nails. It was at that point I realized she would not be a "working" manager. In fact there have been days when we are so busy and she has turned tail and walked out.

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Specializes in Nursing Professional Development.

Many staff nurses share the view that all managers should "work the floor" on a regular basis. But most don't realize the full ramifications of that expectation.

1. As someone above said, it could be a huge saftety issue. Was your manager fully oriented to your unit as a staff nurse? If not, then to expert her to step in and function fully as one would be unrealistic, unfair to her, and unsafe for the patients, for her, and for the hospital. Nurses need to be propoerly oriented to their jobs before being expected to perform well in them and that includes nurse managers.

2. If you expect her to work on the floor with any regularity, then you need to provide the resources for someone to get her management job done while she is working as a staff nurse. Her manager work doesn't go away when she is out on the unit. The resources to do her manager work must be available while she is not doing it. What resources are available for her to essentially "leave her post" and come work in the unit? It's one thing if the manager job is designed to give the manager time to be on the unit regularly -- but it's a different thing completely if the manager job is designed to be full time, with no time allotted for working as a staff nurse. If her management job doesn't get done while she is on the floor ... your unit may suffer.

3. Keep in mind that she is salaried, not paid by the hour. So, if she has to work extra to fulfill your request, she will have to do it on her own time for free. Are you and your colleagues willing to work for free in the same way that you may be asking her to work for free? If this is an issue (which it probably is), the fact that you expect her to volunteer her time for free when the staff is not willing to may cause her to resent the request -- and resentment isn't good.

4. Be careful what you wish for: you might just get it. You may not like what she concludes about her staff's practice if she spends some time on the floor. She may see things that you don't want her to see. The changes she decides to make based on what she learns will probably include some things you don't like. Be careful when "shaking things up." They don't always settle down the way you would like. Sometimes it is best to work with the "devil you know rather than the devil you don't know."

So ... I would approach it gently, as a suggestion and not as a challenge or demand. I would say that you would like to show her some things she may not be aware of -- and that the best way for her to see and understand what you would like to say is to spend a few hours with you (shadowing you). You could point out the things you would like her to see without causing the problems I pointed out above. You would volunteering to help ... and would be showing a willingness to participate in problem-solving -- rather than being challenging and "difficult" as an employee. There would be much less risk for everyone involved if you took this softer approach.

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