RN administration...remember from where you came.

[livinthedreamRN]

I was wondering if any of you direct patient care nurses feel that the nurse administrators should put on some scrubs, say, a couple times a year or so, and really see whats going on on the units. I think once a nurse climbs the ladder to the tippy top, they lose sight of what is happening at the "front lines".

I was charge nurse on a busy 3-11 shift. We were, as usual, short on staff when we started getting slammed with admissions. When our nursing supervisor asked our director of nursing if we could call someone in for some extra help, her reply was "NO...IT IS WHAT IT IS"

Sometimes I think they just lose touch.

[Moogie]

Some of the best nurse managers I've ever known do this. They might not work the floors very often but they occasionally do work bedside, not only to understand what it's like for their staff but also to keep their clinical skills current. The worst managers I've ever known---well---they don't. The longer they're in management, the more disconnected they are with the realities of the floor---and their clinical skills get rusty.

I think it takes a tremendous amount of commitment and talent to be an effective manager. Other than living up to the Peter Principle, I honestly don't know why so many are willing to settle for being mediocre.

[fungez]

Most admininstrators do bedside for a year or two, decide it's for the birds, and waste no time getting their master's so they can tell us wage slaves how it's down.

But the best boss I've ever had still puts her scrubs on from time to time. She still only worked bedside for a couple of years, but she'll still do a shift here and there.

The rest watch us boil around like a kicked anthill, pick the busiest part of the day to complain about the most trivial things, then wonder why their turnover is so high.

[pielęgniarka, RN]

If you want the administrators to put on scrubs to see all the BS you work with, then you should be willing to put on business casual and work as an administrator and see all the BS they have to deal with. Personally I think each department has their own job duties to make a place function. It is hard when someone is not understanding your circumstances though, and I'm sorry you had a rough evening.

[fungez]

If you want the administrators to put on scrubs to see all the BS you work with then you should be willing to put on business casual and work as an administrator and see all the BS they have to deal with. Personally I think each department has their own job duties to make a place function. It is hard when someone is not understanding your circumstances though, and I'm sorry you had a rough evening.[/quote']

Oh, I'd love to shadow an administrator. They've never offered to let us, though.

[pielęgniarka, RN]

Yeah I wouldn't wait for the offer.....You should ask!!! The place I work at has mandatory shadowing as part of orientation now. New employees get to shadow nursing, management, dietary, billing dept, social services, spiritual services, therapy, activity! There is a sheet to check off, new employees spend an hour with each dept and ask any questions they have.

Oh, I'd love to shadow an administrator. They've never offered to let us, though.

[livinthedreamRN]

Yeah I wouldn't wait for the offer.....You should ask!!! The place I work at has mandatory shadowing as part of orientation now. New employees get to shadow nursing management, dietary, billing dept, social services, spiritual services, therapy, activity! There is a sheet to check off, new employees spend an hour with each dept and ask any questions they have. [/quote']

That is a great idea!!! One, however, I could almost guarantee would never happen here.

[caliotter3]

I bet it would be really eye-opening to shadow the manager I had one time who would come in at 10 am and be gone by 1 pm! Much to learn there. :doh:

[fungez]

Oh, I did ask. She said she'd get back to me. Never did.

I realize every job has its own stressors and I understand that the higherups have their neck on the chopping block, so to speak, when the budget isn't being met. But I still maintain that administration is woefully out of touch with what bedside does. If you get a chance, google and read "why hospitals don't learn from failures" written by Anita L. Tucker, a Harvard Business Professor who shadowed (and not for an hour, for an entire shift) several nurses for several shifts. She concluded what made our jobs difficult was not direct patient care. It is missing supplies, meds delivered late by pharmacy, etc - in short, poor working conditions. And she also concluded that when nurses brought this to managment's attention, they were considered to be "mouthy," "troublemakers" or "bad attitudes." It's a long read, but it's a real eye opener.

http://www.npsf.org/standup/members/download/articles-whyhospitals.pdf

[RN1980]

at our hospital the don is just a person with a fancy name. the 3 ceo's run everything..they state the budget and how the hospital is to be ran and the don just implements it. its funny cause she has the title cheif executive nusrsing officer on her door, the only real executives in our hospital wear the suit and ties and not scrubs. and like many other don's she is very aware if she don't follow the ground rules given to her by the ceo's she would be canned. so the choices are, please the ceo's and let the nurses work short and keep my job or anger the head bean counters and increase staffing and get canned along the way...well you have a idea which she'll choose.

[CNL2B]

I am really interested in upper level healthcare administration. I'm not sure if I really want to GO there, though (or just observe from afar) ... still thinking on that. I think it would be an incredibly difficult challenge to try to meet today's shrinking healthcare budget and still deliver top notch care. Is it even possible?

I think I have identified some qualities that successful nurse leaders/CNOs/executives need to be good at their jobs, and those would be 1. an extensive clinical background, so they really do remember and keep in mind what it is like to be at the bedside 2. guts to listen to their nurses and stand up for them, and 3. a way to creatively problem solve within budgetary constraints.

Do these people exist? I am thinking maybe not, which is why we have such a hard time with our nurse administrators these days.

[wooh, BSN, RN]

She concluded what made our jobs difficult was not direct patient care. It is missing supplies, meds delivered late by pharmacy, etc - in short, poor working conditions. And she also concluded that when nurses brought this to managment's attention, they were considered to be "mouthy," "troublemakers" or "bad attitudes." It's a long read, but it's a real eye opener.

It's like she followed ME around!