Nursing Rant: Am I wrong?

edmia, BSN, RN · Aug 7, 2015

How frustrating, #1. And kind of scary too. You're absolutely right, the nurse manager should be comfortable with the acuity of all the patients.

Sent from my iPhone -- blame all errors on spellcheck

iluvivt, BSN, RN · Aug 7, 2015

I think the nurse manager did the right thing! She did what was best for the patients and what was best for the patients was for

YOU to take the Wing. Nurse managers often are not able to to jump in with the same efficiency and time management skills that a nurse routinely working those units. She probably could mange each individual skill or task. The other piece you are forgetting is that in order to manage a group of nurses or a unit you do not have to be able to actually do the job yourself. In all my years as an IV nurse I have never had a manager that was one! They are nurses and can manage if they listen to the nurse they are managing and acquire the needed information they need. It can make aspects of the job or position more difficult but if they come to their staff when they have questions it can be easily managed as they learn.

ArkansasLPN · Aug 7, 2015

You expected the nurse manager to take the hard group, lol. Remember, you answer to her, and she doesn't owe you any excuses.

The nurse manager on our Rehab unit was forced to step down and take a floor position. She needed a week of orientation before she could work on the same unit she had been managing for nearly a year. I was shocked. She was not a good manager.

Libby1987 · Aug 7, 2015

Even though no one wants to come to work having their assignment changed from familiar to a higher difficulty, yes you are wrong.

By your reasoning, if your own peer can handle the higher acuity side then so should you, much more so than someone in a different position jumping in to help out.

It's actually pretty obnoxious and buttercuppy to expect your help to leave you in the easier assignment and take the significantly tougher one.

As far as a manager being able to do the same work that they oversee, it is completely unrealistic to expect someone to maintain their previous speed and competence (if she even had it before) after moving out of that position and taking on different responsibilities. She should be able to assess her charges' competence in their work but not necessarily perform the same quantity herself.

I have a question, if your coworker hadn't needed to move, why was her assignment substantially more difficult than yours?

calivianya, BSN, RN · Aug 7, 2015

I see your point. I would be a little irritated about being bumped out of my usual assignment, too, if I worked in that sort of environment.

I just wonder if she still had to do some nurse manager activities in addition to working on the floor. I'm guessing she doesn't have a replacement taking over her job for her if she has to work the floor, so she's got to take patients plus answer phone calls and do her own paperwork too, right?

Sounds like she still possibly got the rough end of the deal. I don't know many managers who would have taken a full assignment when they still had their own work as well. If you had gotten really unlucky, you might have had to take the Wing and half of the Hall so she could have taken a reduced assignment to do her own paperwork. At least she took a full assignment, even if it was the easier assignment.

I have never had leadership take patients. I recently had a manager walk around and empty out the trash cans once because we were so busy. :sarcastic: I suppose her heart was in the right place, but it takes all of five seconds to take a bag of trash into the dirty utility, so if she really wanted to help she sure was finding the easiest thing she could possibly do to look helpful.

macawake, MSN · Aug 7, 2015

I think that it's a common misconception that managers need to be at least as good at the specific practical skills as the staff that they oversee. I've seen excellent floor nurses promoted to management and the result has sometimes been disastrous.

Being a manager requires a different skill set. And of course someone who doesn't perform certain tasks on a regular basis will lose some speed and efficiency. I think that your manager made the decision that was best for all patients and as others have already pointed out, she might also have had additional managerial duties apart from direct patient care.

I think that the bigger problem is why are the difficult cases so disproportionately split between the Wing and the Hall if they're normally staffed with one nurse each (same nurse-to-patient ratio)? That doesn't seen neither fair to staff nor in the best interest of the patients.

ixchel · Aug 7, 2015

I think it took courage to admit she didn't think she could handle that set of patients. Likely she still had managerial requirements as well.

Emergent, RN · Aug 7, 2015

A lot of managers are very rusty on bedside care because they don't do it. You're actually lucky that yours will pitch in like this. Yes, you should give her the easier assignment.

Horseshoe, BSN, RN · Aug 7, 2015

I think others have said it very well already, so I'll just give my $.02 and answer your question with this: "Yes. You are wrong."

TheCommuter, BSN, RN · Aug 8, 2015

As a longtime rehab nurse, I've had managers who would refuse to pitch in, essentially leaving the floor nurse with double the usual assignment.

When I worked in the LTC rehab setting, the normal assignment was one nurse for 15 to 17 residents. If a nurse would call off, I'd be stuck with up to 34 residents and a medication aide.

So I think you should be very fortunate that you have a good manager who stepped up and took care of a patient load in the first place.

Ruby Vee, BSN · Aug 8, 2015

I work on a subacute unit of a Rehab/Longterm Care facility that is split into what we call the "Hall" and the "Wing". On a normal day we have two floor nurses with around 12 patients each. Yesterday (as usual) our building was short staffed and nurses from our unit had to float to a different unit leaving one regular nurse (me) and our nurse manager who had to take a side. I regularly work the "Hall" and know those patients. Our nurse manager never takes the floor so she knows none of the patients. The "Hall" is slightly less acute (just based on patient placement - sometimes the "Hall" is more acute) so my nurse manager decided she was taking the "Hall". The "Hall" has 1 trach and 1 G-tube this week. The "Wing" has 3 trachs and 5 G-tubes. According to the nurse manager she isn't "comfortable with the acuity of the patients on the wing." First: I do not get to refuse the "Wing" because I am uncomfortable with the acuity of the patients. In the words of my friend Kristin I have to "Suck it up buttercup" and do my job! Second: She is the NURSE MANAGER! The person we are supposed to be able to go to if we have a question/problem/issue with a patient and need help. If you aren't comfortable with the acuity of the patients in your unit you do not belong in a position of managing the nurses who work in that unit. I personally think that was a cop out on her part because she wanted the easier assignment. FINE. But don't feed me a line of BS about not being comfortable because quite honestly, if you aren't comfortable with our patients then you are useless to me if I need backup or run into an issue.

You are wrong.

Managers have to have a different skill set from the bedside nurses. You are lucky that yours was able and willing to step in.