The Enemy... The Nurse Manager

[I.Am.A.Nurse.]

Do you know what it's like to not have anyone like you? To know that everyone hates you? That's my life as a nurse manager. They now see me as the enemy. I have to deny vacations, write people up, give not so good performance evaluations, tell people how to do their job better, short the unit. They think I am sitting in my office everyday doing nothing when I am drowning in work. Blah!!!! I spend almost all my time in meetings. Sometimes I literally have 30 minutes outside of meetings. So then I work at home or on my days off. When I am in my office, sometimes I close my door. I literally cannot get a thing done when my door is open because people always come in to talk. I cannot send people away because I don't want to unapproachable.

What they don't know is how hard I fight for them. They forget about all the new equipment I fight for. They forget all about the changes I have made so they have it easier. I talk about these in our staff meetings but very few people come. I send out weekly emails but people don't read them.

I was so happy to take this job. It has proved to be the hardest job ever. I have senior leaders handing never ending tasks down to me and staff level employees complaining so much. It's exhausting. Was I like that as a staff nurse?

Balancing the schedule for 70 people is nuts. No one gets 100% of what they want. That makes people very angry but someone has to work!

People complain and gossip but refuse to get involved. They won't come to staff meetings, they won't join committees, they won't offer solutions.

I love my job and I love the team. However; it is so exhausting. I am on call 24-7. People tend to forget that too. I respond to calls and messages all day long.

I just want people to meet me in the middle.

I try to get to know the staff members, send thank notes monthly, ask people what they think.

I can't seem to get ahead. I think a big part of the problem is that I came from this unit. People wonder why I got the job. I'm sure some people even hate it. No matter how hard I try, I can't get them to understand that I work for them. I want them to grow and succeed. I want us to be a great unit that everyone wants to work on.

Any tips??? Any advice???

[Footballnut]

It is not an easy job and it takes a certain kind of person to do it. Knowing how to be clear about what top management wants and be fair to your staff is a difficult tightrope to walk. I have been a middle manager in the past and right now I am enjoying working at the bedside.

I have the heart of a middle manager, always wanting to support staff, make things go well, support and challenge the goals of the organization and create a more professional practice. So now I am chair of the practice council for our unit. Not only has our council done some things that have made a big difference but we have been having a lot of fun doing them. And our manager appreciates it.

Look for people who are supportive among your staff, emotionally for you and also for those who can take the ball and make a project go. As long as the project is consistent with the principles that guide it, it doesn't have to go exactly as you might envision it. In other words, look for the good always. There is a lot there and it will lift your spirits.

As a staff nurse I really do need to know that the manager is there for me. It makes a big difference when the manager stops briefly and shows that they know what I am doing and appreciate it. I understand that the manager works mostly with the charge nurses to keep the unit moving well but it still makes a difference to be acknowledged as part of the team, as a person.

I have quit and I will quit working for a manager who throws me under the bus, especially without even talking with me about a situation.

Our hospital/unit has a clear policy about how to resolve conflicts about PTOs. As long as you stick to those you should be ok. If you decide to grant anything outside the guidelines you will need to figure out how it is being fair. Our unit has an open board for a full year to see who has already been given time off so staff can request time knowing that it will meet the guidelines for time off. That takes part of the stress off the manager's plate. And the holiday schedule is done in rotation from year to year.

No one attending staff meetings can be demoralizing. The important thing is that everyone gets the information, right? I have seen more than one solution for this. Our unit makes videos and puts them up as mandatory education online. Also, the meetings are scheduled at times when people are most able to come. On another unit the meeting minutes were posted in email if you couldn't attend and a reply showing that you read them counted as attendance. Also quick daily huddles with new information were quite helpful.

Make sure people have full information. It makes it easier for them to understand what you are doing and easier for them to find ways to help you meet your goals.

Our unit manager came from our unit. It was clear that she could be fair and consistent. I thought she was a good choice. I know it has been an eye-opening experience for her but she has done well. And yes, she has a couple of annoying characteristics but I don't dwell on them. I am grateful for all that she does and how well she keeps us informed about the process of upper management, our unit and what she is doing for each one of us.

Let staff know the best way and times to contact you. My boss keeps her schedule posted on her door so I only have to knock and ask if it is a good time to run something by her if her schedule looks good.

Take heart. This is a learning experience that will give you skills, a different point of view and a better eye on how you want to proceed with your nursing practice. It is all good!

[RNMgrSarah]

Been a NM for 6 years. It's really hard! Here's some things I've learned to keep my sanity...

1- You are never going to please everyone and that's not your job. Keeping your unit safely staffed is.

2- Yes, there will be people that hate you. There are some people that hate what they consider "administration " . Makes no difference what you do.

3- I had a 90% turnover when I took over my unit. That's ok. I hired new staff and moved on.

4- You will never please DONs all the time. Don't be negative! Don't promise what you can't realistically do. If you have a problem and need help, come prepared with ideas.

5- Be consistent. Never give preferred treatment to anyone. Either enforce the rule for everyone or don't at all. On that note, document everything. My documented conversations saved my butt during unemployment hearings. Also, make HR a close friend.

6- Be tight lipped. If your going to vent, do so to a trusted peer. Some of my RNs went on a vacay and invited me. Looked really fun but no way could I go. No hanging out, face book neutral, and no drinks after work.

Hope this helps. It's a lonely job but the pay keeps me here. Btw- your first year is the hardest. It gets easier!

[Jules A, MSN]

Did the OP not respond or even acknowledge the time members spent on the large variety of comprehensive replies to their thread? 

[Supernurse17]

Where do you work? I want to come work there! We need more positive people like you. We need to be treated fairly. It's not about who your friends with but about patient care and working together as a team to make all strong together! Gotta get to work or I'd love to write so much more. I love my work as a bedside nurse I will not let the bullies push me out

[sunny time]

you and me sister nurse

[BeenThere2012, ASN, RN]

I cannot speak to all of your post. I understand the dilemma. I have 2 things to suggest...

Ones who have commented about the managers who try to spend time on the unit I agree with wholeheartedly. There are many reasons why this is good...in particular, spending time on the off shifts as well as days. That is half your staff who often feel "unheard"...by all, not just management. Yet, I do understand your time limits...even if it is a shift a month, or part of a shift....it shows you really do want to know what life is like for them.

The second is this...when staff have a hard time getting time off or the schedule they need, that is a big issue which impacts their personal life and families as well. What I have found successful is self-staffing. I don't know why more units don't utilize this method. It's simple, it takes a big load of time off the manager, and most staff are very happy with it. However, clear guidelines are important to be successful.

1). Guidelines need to be clearly written and posted in the book for everyone to refer to when signing up.

2). Minimums and maximumums for each shift with delineated skill mix slots should be on the sheets. For example: 8 total with at least 2 who can be charge. Make slots for those or other reguirements.

3). First come first serve, and those who do not sign up get inserted wherever and have to live with that.

4). Staff can switch with each other as long as the same skill rank and it is put in writing 2-3 days ahead (or whatever is needed by the staffing office to make the changes on the master), and as long as it does not put someone into OT.

5). Use pencil and come back from time to time to try to fill wholes by making changes. (There will always be some who never do that and some who do it regularly)

As professionals, if they want the ability to set their own schedule, then they must step up and take the responsibility to make sure it is done correctly and try to be flexible when needed. Holidays and weekends can be determined ahead of time based upon seniority or the previous year holidays worked. Pick 2 out of 3 designated big holidays, for example.

This worked well in 2 large institutions I worked in and everyone was happy. Staff can plan ahead for vacations etc...make sure they get their husbands birthday off or whatever...Vacations of 7 days or longer sometimes had to be worked out by the manager, but usually it wasn't a problem. When there is a tie people could draw straws or whatever.

All in all, it worked as long as everyone was properly trained on how to do it.

made for happier staff for a lot of reasons.

[Mokiler30]

WOW Lord have mercy. I feel your pain. Being in a manager position is not easy. I am on the other end of the spectrum I am a staff nurse I look to my manager for problems. But I do get touch of what you go through xing out the meeting and I rather be a staff nurse. Management is not for everyone. You sound like you are trying hard to work with everyone. Did you try maybe having a meeting just to have the staff vent maybe ask them what can make things easier for them. True enough you are not gonna be able to give everyone a day LOL but it help when you hear their point of view and work from there. You are not there for the staff to love you or pat you on the back and tell you how great you are but you are there to push them and the unit to their true potential. You are doing great from what explained. My grandfather told me when I was younger "You are doing somethin right when they don't like you. I ain't here for you to like me but I hope you are here because you love what you do"

[Kooky Korky, BSN, RN]

WOW Lord have mercy. I feel your pain. Being in a manager position is not easy. I am on the other end of the spectrum I am a staff nurse I look to my manager for problems. But I do get touch of what you go through xing out the meeting and I rather be a staff nurse. Management is not for everyone. You sound like you are trying hard to work with everyone. Did you try maybe having a meeting just to have the staff vent maybe ask them what can make things easier for them. True enough you are not gonna be able to give everyone a day LOL but it help when you hear their point of view and work from there. You are not there for the staff to love you or pat you on the back and tell you how great you are but you are there to push them and the unit to their true potential. You are doing great from what explained. My grandfather told me when I was younger "You are doing somethin right when they don't like you. I ain't here for you to like me but I hope you are here because you love what you do"

No disrespect to your grandfather, but why would you want them to dislike you if you could have them like you instead?

[Kooky Korky, BSN, RN]

If the meeting were scheduled well in advance and was mandatory, you can work something else for child car, transportation or whatever.

Yes, that could be done,Ruby, but it shouldn't always be the Night nurses who feel the pain and bear the brunt of being "flexible".

I think the meetings should be held at 0100 sometimes, not just at 1300. Let 3-11 and 11-7 nurses feel the pain that the other shift nurses feel. Or let the meetings be at 1900, not at 0700 sometimes.

[AnnieOK76]

Have never been a nurse manager, in 40 years of nursing. Always at the bedside, because I have never wanted the 24/7 responsibility. So I can only speak as a long time staff nurse. The best nurse manager I've ever had was just a few years ago; I appreciated her because she LEFT US ALONE. By that I mean, she trusted us to manage our schedules after she put it out; if we needed to make a trade we did it and left her a note. She didn't have to "approve" it. If we got to work and the census was low and someone wanted to go back home, or leave in the middle of a shift, we let them; took turns. Didn't have to call to get approval. In fact, we tried to not take advantage of her generous staffing, and not ride the clock. We didn't have an endless stream of memos, emails, etc, about what we "couldn't" do, or "must" do, or need to "try harder" on. She seemed to stay in the background, and I learned later that much of her time was standing up for us in hospital board meetings, doctor meetings, and admin meetings. She always fought for good staffing. She had been a staff nurse. She staffed us well; and I don't ever remember having a request for time off denied. She didn't work on the floor very often, but if the ER went crazy she was there. We also didn't have "mandatory" meetings; I don't really remember many meetings at all. If there was some info that we needed to know she put a typed note in the break room so we would ALL eventually see it. Some would probably call her very "hands-off" or a "do-nothing" manager. I however, found it very refreshing, after 35 years of nursing and feeling like we staff were treated like junior high age people, that we were treated like professional adults. And I believe it caused us to rise to it, and we took care of many problems on our own.

This was in a very small rural hospital, and might not be possible in a large hospital. All my work had been in large teaching hospitals before I moved back home and began working there. She was very approachable, and I really appreciated being treated like an adult, instead of a juvenile who had to be told "how to act." Just my $0.02. And I am not accusing the OP of doing any of the things I mentioned that I didn't like. Just giving a staff nurse description of the best and most effective nurse manager I've had.

[Natasha A., CNA, LVN]

Hi, I am a LVN and never worked as a NM so my advice is from a nurse perspective. Have you ever been in a relationship when both parties want the same thing but don't know it? lol....You want change and I'm sure the floor nurse want change. The thing is possibly before you came in the picture the floor nurses have had some disconnect with the previous NM. It's like a guy or girl you meet who has been cheated on many times and a good one comes along...well it is going to take some time to knock down those walls-- It's possible. :)

[Rnwaymack]

I could have written this verbatim! I came out of the staff into the manager position in my first manager position and I thought that was what made it so hard and why people suddenly seemed to hate me. Now I am in a position where I am new to the organization and it is no different! It is the position they really hate. I have found when you talk to staff one on one, they realize many of the things you mentioned and almost always say they would never want the job, but most of them don't realize that they are part of what makes the job so difficult. Being a unit manager is one of the hardest jobs there is. You are squeezed from both sides. Try to not take things personally. Make time for you. The work will be there the next day. Hold people accountable for following rules and treat everyone equally. Do your best and realize you were chosen for this, so there are people who thought you were "the best"!