Private Grumbling but NO Open Discussion!

[CardiacRNLA]

Okay, so I have to wonder, I hear nurses on my unit complain about working conditions and new (ridiculous) patient satisfaction directives. However, when they are brought up in a group setting with the manager everyone stays silent. Example: we had an staff energizer on our unit to bring up our "pain scores." Two new directives: if a patient calls for pain medication, the unit secretary will call the patient's room after 5 minutes to ensure that the nurse has made it to the room. Then, they will pull reports and if a patient's charted pain level is more than 2 levels above their pain goal, charge or an ANM will meet with the nurse to see if he/she has a plan to control pain.

Frankly, the first directive is insulting. A nurse needs to be "checked up" on? The second directive is bogus because I KNOW that patients will continuously rate their pain as high so the physician does not take their medications away. Of course there are exceptions to that, but in my experience, I have seen many more incidents which I described.

The nurses grumble, complain and gossip (I won't lie, me too) but say NOTHING to make it better or speak up with suggestions to the manager. I did and I felt all alone and left out to dry. I don't know if it is because Florida is a non-union state? Maybe nurses are scared of losing their jobs. Because in NY, this never would have happened.

Why don't nurses speak up? There's supposed to be power in numbers. But yet, it doesn't seem that anyone wants to challenge the status quo. Thoughts?

[heron, ASN, RN]

The almighty CMS has spoken. This has trickled down to your management, who will ride you to fulfill GOVERNMENT decree. Of course, with no additional personnel. Big corporate will not allow additional expenditure for that.

Any verbalization of discontent from the WORKERS will not be tolerated.

How would YOU change CMS regulations?

That's what your CEO would like you to believe. If you actually investigate you'll find that the bulk of CMS regulation is a response to vendors' efforts to game the system.

[Been there,done that, ASN, RN]

That's what your CEO would like you to believe. If you actually investigate you'll find that the bulk of CMS regulation is a response to vendors' efforts to game the system.

Really didn't want to go as far as discussing lobbyists.

[heron, ASN, RN]

Really didn't want to go as far as discussing lobbyists.

Good, because I wasn't.

[kbrn2002, ADN, RN]

I used to step up and say something. After 20+ years I don't bother anymore. Not because I am afraid of retaliation, heck after that much time I have tons of unemployment available if it came to that. It's because I have learned that speaking up doesn't do a darn bit of good. Management is going to announce whatever boneheaded plan of the week is to be implemented and the staff will decide if they will follow it. Particularly boneheaded plans tend to get ignored and after a time of nobody following the new directive it just quietly goes by the wayside until somebody else, maybe a few years later when the revolving door has replaced most of the management somebody else comes up with the same boneheaded plan. So wash, rinse, repeat.

At least in LTC there are fewer of us, so it is easier to present a somewhat united front by just not following through with implementing a stupid plan. At the worst we will try it if management is adamant that we must do this, but after a relatively short amount of time things go back to the way they were if the new policy doesn't work as intended. Oddly enough once in a blue moon a new policy slips through that ends up making sense.

[Hoosier_RN, MSN]

I used to step up and say something. After 20+ years I don't bother anymore. Not because I am afraid of retaliation, heck after that much time I have tons of unemployment available if it came to that. It's because I have learned that speaking up doesn't do a darn bit of good. Management is going to announce whatever boneheaded plan of the week is to be implemented and the staff will decide if they will follow it. Particularly boneheaded plans tend to get ignored and after a time of nobody following the new directive it just quietly goes by the wayside until somebody else, maybe a few years later when the revolving door has replaced most of the management somebody else comes up with the same boneheaded plan. So wash, rinse, repeat.

At least in LTC there are fewer of us, so it is easier to present a somewhat united front by just not following through with implementing a stupid plan. At the worst we will try it if management is adamant that we must do this, but after a relatively short amount of time things go back to the way they were if the new policy doesn't work as intended. Oddly enough once in a blue moon a new policy slips through that ends up making sense.

😂 truth!

[JerseyTomatoMDCrab, BSN]

The beatings will continue until morale improves.

[RNperdiem, RN]

Trouble is the person issuing the directives is just middle management. Complaining to them does no good; they were given marching orders from someone in a higher position and if the middle manager wants to keep his job, he needs to follow the directives given.

[kbrn2002, ADN, RN]

Trouble is the person issuing the directives is just middle management. Complaining to them does no good; they were given marching orders from someone in a higher position and if the middle manager wants to keep his job, he needs to follow the directives given.

Which is exactly why it would take WAY more pay than that position offers for me to even consider it. No winning there, the people above you are not happy, the people below you are not happy. No way do I have a thick enough skin for that job.

[mander]

This made me want to post a long rant... but TL;DR I don't say anything anymore. I was shy, found a voice, and was shot down for daring to have an opinion and demand to be treated with respect.

Our LTC facility was bought out by a new company last year and an administrator was put in place that was possibly the most manipulative human being on the planet.

He had half of the company loving him and the other half hating him. At first I was nice. He acted like he was young and hip and I just went along with it. If he suggested a random change I was like "yeah sure" and if he asked what time was good to meet I said "whenever". I really was that flexible in my day.

He kept asking us for more and more work. This of course led to us staying later and later. We were all salary, and we were getting frustrated. Everyone complained but never to his face.

I asked to speak with him in private and he denied me that chance. He told me whatever I had to say could be said anywhere. So I politely told him he was putting too much work on my shoulders. I told him I was a relatively new nurse (1 1/4 years) and that I had a lot of work to do from the previous unit manger who didn't update her care plans at all. (Lady that was there for 10 years and can't walk was still care planned to walk to dine. She's been nonambulatory for 4 years...). He told me I was salary and that it was expected that I do my job, regardless of how long it took. We were in the lobby at the time and he made it a point to be loud when he said "If you can't handle this job maybe I should find someone who can."

I was upset but I worked hard and updated all of the care plans. I probably put in 60 hours weeks not to mention sitting home on the weekend at my computer. He then approached me in the hallways and asked me to be on a committee that met every week at 3 pm to go over the dining procedures. He accused us of not feeding the residents in the morning because they were losing so much weight. Each incidence was either desirable (resident needed less calories or needed lasix) or unavoidable (resident was on hospice and clearly dying). He ASKED ME IF I WANTED TO. I told him I couldn't meet at 3 pm because at the end of the day it's chaotic, I need to give report and finish up some things at the end of the day. He then became irate because I was declining his "offer". I then got annoyed and told him I didn't appreciate being manipulated to do something by him making it sound like it was my idea. I told him not to ASK ME but to TELL ME. I asked him to stop trying to use buzzwords (SPEARHEAD THE PROCESS OF CHANGE!!!) and get into my head because he wasn't motivating me to do anything, he was just being manipulative. I told him I had no problems taking orders from a superior but asked him not to insult me by pretending it would be my idea. (Those meetings by the way... I did a lot of research into how to get residents with dementia to eat more... but all of my ideas were shot down and instead we focused on making it look good with tablecloths and other fluff. The residents got even more confused because we took away trays to make it seem more home like and they didn't know where their "space" ended and another resident's began- they ended up taking each others food and drinks).

After that we were at morning meeting the next day and he asked us how the supplies were coming in. Everyone started whining about the new woman in charge and that they were getting too small bottles of saline. I said I liked them because being on my unit, everyone wandered and rarely had open areas and we didn't use the larger bottles like everyone else. He immediately said "I need to talk to you in my office at 10 a.m. sharp."

At the meeting he told me, in a very nasty way, that I needed to learn to "bite my tongue". He told me that morning meeting was not the place to "pick on the new commissary employee" or complain about things. (I wasn't?) He then accused me of not being a member of the team.

I was absolutely destroyed. It took me so long to work up the courage to speak up for my staff and residents. It took my a long time to learn to speak up for MYSELF. He made me feel like the smallest person in the world.

I was never more frustrated. Why did I go to school and get my RN? Why did I continue on to my BSN? Why am I considered a registered professional if my opinion doesn't matter and if my input isn't valued? And WHY IS IT THAT EVERYONE HAD SIMILAR COMPLAINTS OF HIM PUSHING US TO OUR LIMITS AND TREATING US LIKE GARBAGE BUT I WAS THE ONLY ONE TO EVER DEFEND MYSELF?

He "resigned" aka was asked to leave a while later. I pretended to be upset but I was so happy.

I keep my head down now. It's not that I really CARE about my job anymore... I could go anywhere, really but I do love my job. I just can't handle being shot down one more time. After working up so much courage... I had it all drained away. And I feel betrayed by fellow staff who acted like they were sure as hell gonna tell him how they felt but never did. If you want to commiserate, that's fine. But don't talk the talk and let me walk the walk alone.

[martymoose, BSN, RN]

Because speaking to a brick wall yields no answers.

Dont waste your breath.

[Hoosier_RN, MSN]

This made me want to post a long rant... but TL;DR I don't say anything anymore. I was shy, found a voice, and was shot down for daring to have an opinion and demand to be treated with respect.

Our LTC facility was bought out by a new company last year and an administrator was put in place that was possibly the most manipulative human being on the planet.

He had half of the company loving him and the other half hating him. At first I was nice. He acted like he was young and hip and I just went along with it. If he suggested a random change I was like "yeah sure" and if he asked what time was good to meet I said "whenever". I really was that flexible in my day.

He kept asking us for more and more work. This of course led to us staying later and later. We were all salary, and we were getting frustrated. Everyone complained but never to his face.

I asked to speak with him in private and he denied me that chance. He told me whatever I had to say could be said anywhere. So I politely told him he was putting too much work on my shoulders. I told him I was a relatively new nurse (1 1/4 years) and that I had a lot of work to do from the previous unit manger who didn't update her care plans at all. (Lady that was there for 10 years and can't walk was still care planned to walk to dine. She's been nonambulatory for 4 years...). He told me I was salary and that it was expected that I do my job, regardless of how long it took. We were in the lobby at the time and he made it a point to be loud when he said "If you can't handle this job maybe I should find someone who can."

I was upset but I worked hard and updated all of the care plans. I probably put in 60 hours weeks not to mention sitting home on the weekend at my computer. He then approached me in the hallways and asked me to be on a committee that met every week at 3 pm to go over the dining procedures. He accused us of not feeding the residents in the morning because they were losing so much weight. Each incidence was either desirable (resident needed less calories or needed lasix) or unavoidable (resident was on hospice and clearly dying). He ASKED ME IF I WANTED TO. I told him I couldn't meet at 3 pm because at the end of the day it's chaotic, I need to give report and finish up some things at the end of the day. He then became irate because I was declining his "offer". I then got annoyed and told him I didn't appreciate being manipulated to do something by him making it sound like it was my idea. I told him not to ASK ME but to TELL ME. I asked him to stop trying to use buzzwords (SPEARHEAD THE PROCESS OF CHANGE!!!) and get into my head because he wasn't motivating me to do anything, he was just being manipulative. I told him I had no problems taking orders from a superior but asked him not to insult me by pretending it would be my idea. (Those meetings by the way... I did a lot of research into how to get residents with dementia to eat more... but all of my ideas were shot down and instead we focused on making it look good with tablecloths and other fluff. The residents got even more confused because we took away trays to make it seem more home like and they didn't know where their "space" ended and another resident's began- they ended up taking each others food and drinks).

After that we were at morning meeting the next day and he asked us how the supplies were coming in. Everyone started whining about the new woman in charge and that they were getting too small bottles of saline. I said I liked them because being on my unit, everyone wandered and rarely had open areas and we didn't use the larger bottles like everyone else. He immediately said "I need to talk to you in my office at 10 a.m. sharp."

At the meeting he told me, in a very nasty way, that I needed to learn to "bite my tongue". He told me that morning meeting was not the place to "pick on the new commissary employee" or complain about things. (I wasn't?) He then accused me of not being a member of the team.

I was absolutely destroyed. It took me so long to work up the courage to speak up for my staff and residents. It took my a long time to learn to speak up for MYSELF. He made me feel like the smallest person in the world.

I was never more frustrated. Why did I go to school and get my RN? Why did I continue on to my BSN? Why am I considered a registered professional if my opinion doesn't matter and if my input isn't valued? And WHY IS IT THAT EVERYONE HAD SIMILAR COMPLAINTS OF HIM PUSHING US TO OUR LIMITS AND TREATING US LIKE GARBAGE BUT I WAS THE ONLY ONE TO EVER DEFEND MYSELF?

He "resigned" aka was asked to leave a while later. I pretended to be upset but I was so happy.

I keep my head down now. It's not that I really CARE about my job anymore... I could go anywhere, really but I do love my job. I just can't handle being shot down one more time. After working up so much courage... I had it all drained away. And I feel betrayed by fellow staff who acted like they were sure as hell gonna tell him how they felt but never did. If you want to commiserate, that's fine. But don't talk the talk and let me walk the walk alone.

60 hours? Every salaried nurse that I know works 70-80 hours a week and if they don't like it, quit. Its the norm around here 😞

[nutella, MSN, RN]

Speaking up can be a two sided sword.

While most companies will advertise that they have an open door policy and are receptive to constructive criticism fact is most of them are not. Some will take complains and actually try to change something but I feel that most companies are stuck within their structures and do nt attempt serious change.

In my salaried position that was tied to productivity I was constantly asked for more work. I set boundaries around it but it was not easy and the peer pressure to constantly work more is high. When coworkers try to say "no" to after hour work or more work they are being pressured by using the word "team", "teamplayer" or "well - than somebody else has to do it..." trying to have nurses fall for the old stereotype of "being the helper". After some while in that environment I realized that nothing will ever change unless people unionize, which they won't. They allow management to continue with unreasonable requests. There is non clinical personal that tries to bully people into working more and over productivity - the manager does not even ask - it is left to non clinician. Realizing that nothing will ever change I packed up my stuff and will start a different job.

I learned from 20 years of working that while it is good and necessary to give feedback to management and bring up concerns, nobody really wants to hear it and it can make you a target. When things in my current job went south I did "nod and smile" and looked for another job...