ChaosCoordinatorRN

This is THE BEST, most well-articulated article I've seen on these topics.

Yep! That pretty accurately describes the company!

Our unit is definitely not staffed well enough. Most of our staff are brand spanking new to L&D. We rely heavily on travelers. The experienced staff are leaving, fed up with seeing everyone but them get bonuses. I was in this manager's interview and asked her specific questions about her L&D experience. She has postpartum experience, which I can tell you from having worked PP, is NOT the same. I posed questions about specific OB emergencies and she could not answer them. She said she can start IVs. That's adorable.

Exactly...out of desperation for a manager, they hired someone without the experience. I figured they would give her time to orient to the floor but they did not. They have not put her through fetal monitoring training. Nothing. We are not unionized. In fact, our hospital put out a POLICY threatening us against even mentioning unionizing. They threaten to immediate terminate us if we even whisper about it. They threaten us against talking about what other people are paid, etc. Pretty sure that's illegal.

Ah, but I agree with you! The manager should never have to worry about working the floor! Yet, a corporate-level CFO recently said that managers needed to work the floor because the company didn't have to pay them more!

I agree with most of what you said. The specialty in question is obstetrics and the manager has no experience with high-risk antepartum patients or actively laboring patients. More than half of our staff is new to OB. 25% of our staff are travelers. The hospital is for-profit, so we are often understaffed. On the understaffed, high-census days, the manager has historically been expected to fill the role of charge so that the charge can take patients. When you don't have experience with obstetric patients, how would you know how to manage an obstetric emergency? Because, believe me, the charge nurse, too, gets pulled into depositions. In my book, it is a patient safety issue.

Yep, I wouldn't at all be surprised if this happens to all healthcare soon.

Thanks for your perspective, klone! I do appreciate the willingness to learn in a manager, etc, but IMHO, I believe in a specialty that requires a 6-month orientation for staff nurses, the manager needs to know how to perform the function of a charge nurse and that requires years of clinical experience in a specialty. Charges often have to take assignments lately and a manager with clinical experience is critical in such situations. It'a awesome that you did well in the clinic when you were new to that area!! ?

Oops...meant to say...when over 70% of the staff is new to the type of nursing...

Hi Davey Do! I think there are areas of nursing which do not require boots-on-the-ground for a manager. But, in a field like obstetrics or ICU or OR or emergency medicine, I do believe clinical experience matters. Especially when over 70% is brand new to the field. Kudos to you for rocking that methadone clinic, though!!

I think so, too. My unit has a new manager who has never worked our area before as a bedside nurse. She's very nice and takes care of issues such as supply problems, maintenance issues, patient procedure scheduling issues, does the usual hiring stuff, etc, but has no idea what we do from the perspective of having done what we do. She's SEEN us do our jobs. She shadows charges and techs, etc, but I remain firm in my opinion that clinical experience is important when you have a job like manager.

What are your thoughts on having a manager who is completely inexperienced in the type of nursing they manage? Let's say they have great administrative skills but have never worked your field of nursing as a bedside nurse and you work in a highly specialized area like obstetrics, for example. What are your thoughts on this?

I am actively looking for new employment. I have never felt so undervalued in my life. It sure feels like they are trying to get rid of those of us with experience. I agree 100%!!

AWESOME piece you wrote!! LOVE it!!

Now THAT is an organization for which I'd like to work!

Sad, isn't it?

Ahhhh...they could, but at our hospital, they are paying new grads at a higher rate than their experienced people.

What excuses have your hospitals given you for why they WILL give sign-on bonuses to new and even completely inexperienced nurses, but WON'T give RETENTION bonuses to those of us who have shown loyalty and ARE the experienced backbones of the hospital?? Do they not realize that those of us with experience will just go work elsewhere and get that bonus $$$ somewhere else?

Yes, and those used to be what we had for unit goals, as well. Those unit goals (which I am OK with) have now morphed into hospital goals, over which we have very little individual control. Yet we are rated individually.

Brandy, I need like a Congressional Medal of Honor emoji for what you wrote. ????⭐️⭐️⭐️⭐️⭐️?????????????????

I get CAUTI/infection prevention measures, but bring it down to an individual level by quantifying # of 2nd RN sign-offs or whether the patient on whom you inserted a catheter developed an infection, etc. Measurable things. Things like employee retention are not individually quantifiable, therefore should not be used in individual performance appraisals. I, personally, influenced two nurses' decisions to stay vs. handing in their notices and STILL received a failing mark for retention. That tells me that, no matter how hard I try to help nurse retention, I will always receive a failing mark. Giving nurses failing appraisals will drive even more nurses away.

Great comment, Brandy1017!! I don't want to say what company it is because they could potentially figure out who I am, but they are a for-profit company based out of TN. We are actually threatened with termination if we so much as mention the "U" word (union). The stuff that goes on is absolutely incredulous. I can't believe they think they are going to keep staff with their current practices....

Yep, that's what I figured. I love how they blame us, on an individual level, for their corporate shortcomings. I'm sure even more staff will leave due to the baseless poor employee reviews (and already lowest pay in town), and we are already desperately short-staffed. Those of us who stay will be blamed next year for the staff turnover again (and again and again, etc)

"Likely to recommend" was one of the four markers for which we were all given a 1. Good times! ??

I bet you're right about that. Eager to learn about such processes as my MSN education progresses...