Nursing management necessary?

[Sarah2018, BSN, RN]

Can we nursing exist without hierarchy?

It is disgusting.

My charge nurse doesn’t help us by participating in work when we are busy or when we have staff shortage. Think of it like your brother/friend is watching you cleaning and washing and lifting heavy weight repeatedly but he does not help. It is not his work.

Who is more moral, the one who helps you or the one who supervises you without helping ?

Also, nurses are health care professionals which means we shouldn’t have a nurse in charge who does not care for the patients and take patient assignments and we shouldn’t have a nursing supervisor either roaming around and doing nothing.

Professionals are autonomous and we are professional. Doctors do not have a supervisor or in-charge and they always care for patients. The CEO of my hospital is a cardiologist and he still treats patient and perform procedures while nursing director never care for patients.

What do they do all these people, charge nurses, team leaders, nursing supervisors?

The hospital installed a new calling system for outpatient clinics and my charge nurse made us nurses to monitor what ticket given to what patient and feed the information into an excel sheets. It is unfair, we care for patients and we don’t need extra assignments. Also she asks for manual writing for all patients who attended any clinic with arrival times despite having a an online system( because she is not through with it)(because no direct care for patients). It is disgusting. Why are those mangers there at all?

[Nurse SMS, MSN, RN]

Nursing managers need to exist because someone has to be accountable. Someone has to lead the team and establish the priorities. Otherwise it is just chaos. That yours isn't good at it doesn't mean all managers are bad or unnecessary. Quite the contrary. Can you imagine the chaos if each individual nurse was trying to establish priorities?

A good manager will help you grow your career, foster strong team dynamics, create a culture in the unit that breeds loyalty and leads to job satisfaction. They will also advocate for their team to executive leadership, carry the feedback to the same and help foster initiatives that improve the unit. That yours doesn't do these things says a lot about them. But don't sweep them all aside based on the fact that you are frustrated with them.

[OldDude]

In the night shifts of yore, when I graduated as a GN on a Friday and went to work in a busy pedi ER the following Monday, I had the soooo fortunate experience to be accepted into the best group of nurses I have ever had the pleasure of working with. Every nurse stepped up and helped every other nurse all shift and every shift. We never saw a supervisor at night and we didn't need one. We problem solved, adapted, and worked through critical thinking on our own. The unit was self contained and operated without the need for supervision. The ER manager assigned a "charge" nurse but we never new who it was because there wasn't a need for one. The only time we saw the ER manager was when there was the millennium scare when 1999 turned into 2000. He was there for about 30 minutes at midnight and left when the world did not end.

Beyond that, if the place is busy enough, it's a good idea to have someone in the "control tower" to keep things organized but in many cases, as you have experienced, "managers" just withdraw from the overall patient care mission and that is frustrating for their peers still out there swinging the hammers.

[Davey Do]

16 minutes ago, not.done.yet said:

Nursing managers need to exist because someone has to be accountable.

Yes! And sometimes, like the proletariat, they do just enough to get by.

However, Sarah, It's too bad we anarchists don't organize well!

[Nurse SMS, MSN, RN]

I just read your reply to another post that any position that isn't bedside nursing is "BS". And that is about all I need to know about you and your post.

[OldDude]

11 minutes ago, Davey Do said:

Yes! And sometimes, like the proletariat, they do just enough to get by.

However, Sarah, It's too bad we anarchists don't organize well!

Now this is a true statement. On the flip-side. There are those on the front lines who are not self starters and can't figure out how to pour "urine" (PC replacement for p#ss) out of a boot if the instructions were written on the heel...those guys need managers...?

[JBMmom, MSN, NP]

You have two separate questions here, many of the positions you mention- charge nurses, team leaders, nursing supervisors and managers have specialized aspects to their roles designed to support floor nurses in their job. What if you had responsibility for handling bed flow, staffing and administrative activities in addition to providing patient care? It would not be possible for floor nursing to carry on without many of the roles you are questioning, each organization has a job description that should clarify the roles. For example, our charge nurses are responsible for overseeing the flow of the unit, and they have a lighter patient assignment because they are a resource for other nurses on the floor. Our nursing supervisors are responsible for coordinating bed flow of the whole hospital, and addressing staff and staffing issues as they come up.

As for the how and why of your specific charge nurse, there are people that are ineffective in their position throughout all professions and work environments. Unfortunately, there's not much you can do, other than go above your charge nurse and express your concerns. You may just be stuck with her in that position until she moves on to something else.

[guest52816]

34 minutes ago, not.done.yet said:

Nursing managers need to exist because someone has to be accountable. Someone has to lead the team and establish the priorities. Otherwise it is just chaos. That yours isn't good at it doesn't mean all managers are bad or unnecessary. Quite the contrary. Can you imagine the chaos if each individual nurse was trying to establish priorities?

A good manager will help you grow your career, foster strong team dynamics, create a culture in the unit that breeds loyalty and leads to job satisfaction. They will also advocate for their team to executive leadership, carry the feedback to the same and help foster initiatives that improve the unit. That yours doesn't do these things says a lot about them. But don't sweep them all aside based on the fact that you are frustrated with them.

Mine doesn't do any of these thing either.

Perhaps the good ones, are surrounded by so many bad managers, that nurses lose sight of their true purpose.

My current manager, is useless, when it comes to advocating for staff, or pitching in during shortages.

She is VERY good, at implementing anything that those above her deem necessary.

[Golden_RN, MSN]

Someone has to write policy, work with public health agencies, decipher (and write!) legislation, work with software vendors, hire & fire, discipline staff, work with HR, contribute to committees, review workflow to increase efficiency, be accountable for accreditation, educate staff, etc. There would be chaos without the hierarchy.

[Sarah2018, BSN, RN]

On 5/8/2019 at 10:01 AM, not.done.yet said:

Nursing managers need to exist because someone has to be accountable. Someone has to lead the team and establish the priorities.

Why doctors don’t have the same?

[Golden_RN, MSN]

On 5/8/2019 at 11:39 AM, Sarah2018 said:

Why doctors don’t have the same?

Apples and oranges. Nurses aren't the same as doctors. Our roles and responsibilities are not the same. That said, physicians do contribute to some of the list of responsibilities that nursing leaders take on that I mentioned in my comment above - contribute to committees, work with software vendors, be accountable for accreditation, education. I'm sure there is more that I'm not aware of because I don't see all that physicians do first hand.

[Sarah2018, BSN, RN]

Now my hospital is working to fix the grade for nursing staff. Bedside nurses and those who deliver care to patients will be higher in professional grade and will receive more money than nurses in the managerial pathway like charge nurses and supervisors. Charge nurses and supervisors will be called nursing coordinator or nursing secretary.

Nurses will be autonomous professionals in reality.

I am happy!