For those of you who are in a managerial or supervisory role at work, do you answer work phone calls on your days off, even when you are not on call?
In my role, I work Monday through Friday anywhere from 8-20 hours a day (usually ends up being 16-20). I am not designated as the weekend nurse manager or supervisor.
Yet today, my phone was blown up with calls and text messages from nursing staff wanting assistance with call-ins, how to deal with a fall, and how to handle a verbally abusive patient.
I slept in late this morning, so missed any opportunity to 'assist' with any call-ins. I simply ignored that text message since it was already too late in the day to do anything about.
Later, I got a text message from a nurse wanting to know the steps to take after a fall. Although this nurse has worked at the facility for awhile, they had a question as to who should be contacted. I had no problem answering this question.
After this, I was hoping that any contact from work would end for the day but instead at dinner time, I was called because a patient was being verbally abusive to the point that some of the nursing assistants were too upset to work with her. I really wanted nothing to do with this drama, as it is nothing new, it was my day off to be free from this nonsense, and I am technically not the manager overseeing the care of this abusive individual. Yet, I felt guilty by not responding, so I ended up calling back and spoke with the concerned nurse about possible solutions. I also did recommend calling my colleague/co-manager to see if she had any suggestions since she knows this patient better.
The thing is, all of this communication from work stressed me out on a day that I was supposed to have to myself and work on other things, or just relax for once. I was also not hired to work on weekends or to be on call. My pay/salary does not include compensation for on-call duties since it was not in my original job description. Yet, it seems as if the facility/staff members expects that I am available at any time, any day of the week even though I am not the DON and therefore, not responsible for the facility 24/7.
I really don't mind answering questions or helping out every once in a while, but my work weeks are already long enough without having to be pestered on my days off as well.
I worked in a similar situation, where if I didn't complete the work, not only would tasks not be done but also protective oversight would be lacking. Breaks and meals are nonexistent. Is like a bomb went off. Carry over from the overwhelmed previous shift of incomplete tasks, left mounds of work.
Staffing of the state requirements leaves no room for consideration of acuity and patient needs. Patient's are harmed in various degrees in these situations. Additionally, some pass their boards and I am clueless how.
Are board exams lenient with nursing shortages? MUCH inservicing, education, time management skills and hourly rounding are required. However with answering patient needs, phone (Yes nurses are expected to answer the facility phone after hours) plus admissions, IV's, pain management, families... the tasks are overwhelming. Standard of care is always an issue here. The nurse has goals to care for patients. The system is set up to fail.
These issues are more prominent in many nursing jobs I have had, within the approximately last 10 years. The American health care system has changed and not for the good of the patient or employee.
Someone has to be concerned for promoting a standard of care. Older patients find themselves in a dog pound for people otherwise. The system is set up this way. Is a very sad state of affairs. Do your job the best you can. Make written scenarios for staff interventions with patient change of conditions, chest pain, vital sign criteria, saturations, entering and ordering procedure for labs/ urine collections and expectations of completion time. Assign job duties, especially making sure meds are started promptly& labs done within a time frame.
Good luck. It isn't easy. My guess is work overload with staffing per state are making issues, with packed on patient acuity. Delegaate in writing.
This is ridiculous. It’s your day off so why would you worry what others might think. Your working hours are out of this world. Are you new in this role? Is lack of experience your reason for working those long hours? So many questions need to be answered in order to understand your concern. You need to learn to delegate and that’s that. You are only one person and nursing is a 24 hr job. There’s no way I would be taking all these calls on my off days knowing there are other managers available. Not taking calls on your off days does not mean you’re bad manager. You’re the only one who can stop this so it’s up to you. Good luck.
Dear GraduateRN2016 BSN Some people have families and need to support them. Thinking you can fix the problem you are in and try to attain that goal. Many CEO's and DON in ancillary facilities have numbers for staffing and profits, leaving nothing left for the care of patients. Experience with the current trends comparing to the past is a let down. One instance in a hospital the similar situation occurred, a union voted in and at this point retaliation by management became a daily method of torture. The staffing ratios and finally a voice in patient care meant improved patient care. Perhaps a Union is the answer.
Lack of exposure to these situations and staying in one safe position will not gain the experience you need to appreciate wrongdoings and necessity to be a patient advocate. Another instance is the nursing shortage then lack of ability to hire. Location is a factor.
Look at the poor geriatric population. They have bare minimum staffing.
Once I was in a position where 24/7 salary availability was a must. All issues were worked out with this situation after the homes were set up and running efficiently, authority to take call and documented guidelines made the world of difference.
There is no need to state, "Your working hours are out of this world. Are you new in this role? Is lack of experience your reason for working those long hours?" These issues have are off the table here. Be appreciative of this issue as a reality and Unions exist because of them. Not being a Union fan, they did make a difference.
I resolved the issue, as you describe a mirrored circumstance. Realizing it will never be remedied and the job being a risk to my precious personal health, I resigned.
The week after I left 7 patients died. Guilt still surrounds me. The state was called in from the unusual number of deaths. Perhaps you need to bite the bullet and move on. No one can be help you, if you don't take care of yourself and realize this job is a losing battle. This place will need to suffer conditions out citations to make a move in the right direction and fix their long standing wrongly accepted practices.
Good Luck! Make the right choice for your well being. Only then will you be enabled to give the best patient care to your patients.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
The on-call aspect is why I did not last in management. I wanted my life back. Maybe this is true for the OP. I don't know. But if you can't establish healthy boundaries, this is NOT the job for you, OP. Best of luck.
Specializes in ED, Tele, MedSurg, ADN, Outpatient, LTC, Peds.
It is normal to second guess yourself as a new manager. That being said, if you have been proactive in solving issues while being a floor nurse, that is the kind of training you need to provide to your team. Few things you can do.
1- Identify nurses that are proactive like you and train them to handle common issues.Go over chain of command in case they need to step it up.Go over what would be an automatic dial 911 versus call the supervisor.
2- Have a conversion with your boss on expectations after your 8 hours are done. Who is responsible for the off shift and once you are off duty? Get the plan in writing and post it on the units you cover. Go over it with staff especially on the off shift who don't have a lot of support as everyone has gone for the day.
3- Set boundaries and clear expectations. On off hours the house supervisor is in charge and there is a provider on call. They should be contacted.Always have something written that is available to the staff in their phone book on the desk for easy access.Tell them that your cell is off, when you are off duty. Go ahead and turn off your cell when you are home! You will surprised that the sky will not fall!
4- Get phone numbers (official and personal)of the on call folks. If you get a call ( if you don't turn off your cell), direct the staff to call them at the official number. You could call them on their personal number and brief them to expect a call. Don't solve the problem even if you are tempted!
5- Management is tough. To keep it together, you need to be kind to yourself. Don't solve it all and fix it all. Teach a man to fish and not feed him/ her always!
As a new manager, I was in a similar situation for 6 months as I was beyond burned out! My BP was through the roof, my kids would tiptoe around me as I was always stressed and the phone never stopped. This was after a promotion that was given to me as the CEO and CNO of this complex LTC facility saw my "efficiency" and made me the supervisor of the supervisors! I was reluctant but was asked to give it a try for six months. Other than making the supervisors schedules and making sure that there was nursing house coverage, they also wanted me to have the final say on vacation requests and the day to day running of the nursing office! It was a set up to fail! Guess who had to cover the house when the supervisors suddenly started having "frequent emergencies"?!! Yup! Yours truly! I gave my one month resignation, stayed to train one new person Lisa,a 53 year old bubbly lady to run the nursing office schedules for staff, which was one part of my multi-pronged job. When I left, I felt free. The CNO and CEO apologized to me as they "now realized" the amount of work involved. They hired three people to do my job, one being Lisa.The next month, I heard that Lisa dropped dead from an MI in her shower after 3 weeks on the job from the stress. I went for her wake. I told hubby, if I didn't quit, that would have been me.
So much as I sympathize with the stuff that's coming your way, I would say, you need to make concrete changes(as suggested above) to have a relatively normal life.
Best of luck! You will get there. Practice makes perfect!
As a manager, you are responsible for the competence of your staff. Educate them, be clear about what you expect regarding their abilities and quality of work, then take corrective action when your expectations are not met. They will do less as long as you expect less.
Take No Chances
9 Posts
I worked in a similar situation, where if I didn't complete the work, not only would tasks not be done but also protective oversight would be lacking. Breaks and meals are nonexistent. Is like a bomb went off. Carry over from the overwhelmed previous shift of incomplete tasks, left mounds of work.
Staffing of the state requirements leaves no room for consideration of acuity and patient needs. Patient's are harmed in various degrees in these situations. Additionally, some pass their boards and I am clueless how.
Are board exams lenient with nursing shortages? MUCH inservicing, education, time management skills and hourly rounding are required. However with answering patient needs, phone (Yes nurses are expected to answer the facility phone after hours) plus admissions, IV's, pain management, families... the tasks are overwhelming. Standard of care is always an issue here. The nurse has goals to care for patients. The system is set up to fail.
These issues are more prominent in many nursing jobs I have had, within the approximately last 10 years. The American health care system has changed and not for the good of the patient or employee.
Someone has to be concerned for promoting a standard of care. Older patients find themselves in a dog pound for people otherwise. The system is set up this way. Is a very sad state of affairs. Do your job the best you can. Make written scenarios for staff interventions with patient change of conditions, chest pain, vital sign criteria, saturations, entering and ordering procedure for labs/ urine collections and expectations of completion time. Assign job duties, especially making sure meds are started promptly& labs done within a time frame.
Good luck. It isn't easy. My guess is work overload with staffing per state are making issues, with packed on patient acuity. Delegaate in writing.