Suggestions related to issues.

Nurses General Nursing


Specializes in ER, PACU, OR.

I work in an ER with almost 100 staff members. Our census has increased each yeah by 1,000-2,000 patients, until last year. In 2000 our ER census increased by almost 10,000 patients.

Anyways, there seems to be a wide variety of employees that work there, as far as personalities. For example, I'll list the following people by letter:

A- Works hard, gives 101% all the time, and complains about some of the others once in a while.

B- Good nurse knowledgable... works well when busy....but other times needs a push to get going.

C- Comes in late, takes an assignment and no matter how busy or slow, always is just doin what they want. Always has time to eat, when others dont, and falls behind on patient care.

D- Good nurse works their behind off. However, the person s very moody and tempermental, can cause problems with others.

E- Good worker......excellent nurse, never complains, does the job well and apparently likes it.

Anyways, the bottom line is.........others see each other in the same ways I see these people, I know because I get the complaints. Why does this person always get away with coming in late, this person only takes care of their people and doesn't help others, this person is nasty to me, etc etc.

I have worked in our ER for 4 1/2 years, and due to growth some new positions were added. So people moved up the ladder (so to speak), leaving nurse manager positions open. I took one of these and was told, I will be real good at it.

Being new to a position like this, I would like some different suggestions from those that might have input. How do I handle some of the friction or situations appropriately, without making them worse. The one thing that adds to the mess, is nobody says anything to anybody else......they just pile their thoughts up on me.

I have some thoughts of my own, but would like to see what other ideas are out there. Things that might smooth over the situation as a whole, and maybe make things a little more fluid in the department.

Thanks for any input I might recieve.


All valid complaints need to be put in writing, dated and signed. The supervisor and DON/ADON can then have a chat with the offender and the complaintant.

As a manager, your priority is to decide what your priorities are. Put them in writing. Be precise and succinct. Such as "Team players will be expected to report to work when shift officially starts". Once you have identified clearly what your basic expectations are and it is in writing, you have a tool to implement improvement in individuals. It is also easier to allow for individual personalities and gifts. It gives you the basic tool for evaluations. It precludes the tendency to micromanage. It is a stress reliever for everyone when we know what is expected of us. Then we can concentrate on working as a team and get to the important thing - which is to have some fun and enjoy our work. Good luck!

Specializes in ER, PACU, OR.

Thanks for the replies up to this pint, ecspecially Mustangsheba, whoo apparently replies to many of my


A-Human Being

B-Human Being

C-Human Being

D-Human Being

E-Human Being (Nurse manager's dream I'm sure...but still human none the less!)

My point is this, all of these nurses are people, and different people respond differently to stressfull situations. We all have ways of dealing with stress...some more effectively than others. Even the "perfect" nurse is capable of having a "bad day". If you consider someone a "good nurse", then why not leave it at that instead of portaying another human being's nuances as a fault of somekind. If nurse A has to complain every once in a while so be it. That doesn't automatically make them a "bad nurse". Not everone is going to fit your ideal of what you think a nurse should why not focus your energy on being the best nurse that you can be.

Hi CEN35. I think you've received good advice from the previous posters. I agree that making a priority list for you is foremost then making a priority list for your employees with their input. Documentation, as other posters have pointed out, is very important. Communication and measurable support is even more important. When your employees routinely fail to work up to the agreed upon standards, they will have no one to blame but themselves for the consequences.

As one poster pointed out, it's best not to try to micromanage the situation. The evaluation of personalities is very subjective, and I feel that the really good managers take that characteristic in stride. Personalities, in my opinion, become a problem when they dramatically interfere with providing quality patient care or decrease employee morale.

Congratulations and best wishes in your new position. Your post indicates that you want to be a responsive and responsible manager.


Mustangsheba always has good advice as far as I can tell. During the 2 year period I was amanager, I found that it is impossible to do it the way someone else has. Diferent people manage are are managed differently. I found it helpful to always remind myself that only strong personalities work in ER and ICU. We are the only one sho survive. When I had two people who seemed to be using me as a means of bickering at one another I offered to meet with them together and resolve the problem. Sometimes they accepted and we worked things out. Sometimes they refused. Then I would ignore the complaints because it was just venting. Good luck.

Specializes in ER, PACU, OR.

Thanks for the input......I'll ride it out and see what happens.


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