The nursing world is divided into one of two groups. Watchers and Doers.
Doers = Nurses who's hands actually touch the patients
Watchers = Managers, Supervisors, CNS, etc
Why is it that it always seems like becoming a watcher is considered "moving up". It seems to me that nurses who acturally touch patients are looked upon as the ditch diggers of the nursing world.
Realize this, patients are in the hospital because they need help. The kind of help they need requires hands touching them. If they didn't require hands touching them, then they wouldn't need to be in the hospital. That is where the rubber meets the road and the real "service" they are there for.
The service could continue with half as many watchers, but without Doers there is no service.
I am a doer and satisfied with my status. Some doers who want to become a watcher may be very nasty they think they will be promoted faster if they are nasty. I used to work in the biggest and nastiest hospital in my area. Once I wanted to go to a different department and asked my friend from a float pool in which department a manager is good. She replied, "there are no good managers in this hospital. Managers who treat their nurses nicely do not work here longer than a year.
I am an ADON. I do all admissions and admission assessment, deal with pharmacy issues, make bed offers, help turn residents, deal with those irate family members, help lift resident in the shower room, draw blood, feed residents, make CNA track sheets, check orders, chart, call the MD. Start IVs, go to all falls, review all incident reports and come up with interventions, check MARs when they come in, and that is all in addition to my "watching".
I am an ADON. I do all admissions and admission assessment, deal with pharmacy issues, make bed offers, help turn residents, deal with those irate family members, help lift resident in the shower room, draw blood, feed residents, make CNA track sheets, check orders, chart, call the MD. Start IVs, go to all falls, review all incident reports and come up with interventions, check MARs when they come in, and that is all in addition to my "watching".
This is why I don't like the generalization. It's not all B&W. There is no definitition. Your role is what you make of it. As a manager, if I was on the floor and a nurse couldn't start an IV, I gave it a shot, I turned patients. If I walked past a room, I and a patient needed ETT suctioning, i did it.
I consider myself a doer and a watcher. My primary job may be in the "watcher" category, but I am very much hands on and am always willing to help out whenever and wherever possible. I love caring for and interacting with patients and their families...in fact, I still hold a second job as a staff nurse in an ICU to keep my skills up and for the simple fact that I like patient care. Its actually more stress free in the long run...I just can no longer do it full time due to health issues.
Like someone else mentioned, its not all black and white as most of the managers I work with in my "watcher" role are on the floor helping out a great deal of the day. I think that's why their staff respects them because they are not afraid to roll up their sleeves and jump in when necessary.
When i was a patient in ICU I had a 'doer' that was training another 'doer' for ICU. She loved to show off and act smart, even dropped and broke my machine that respiratory brought for me. Thank goodness for the 'watcher'. She came to the ICU rooms everyday to ask how things were going and I asked for the doer to not come back. The watcher also was there to create the schedules so that all the shifts were covered, called my MD when there was a med problem, 'watched' me as I got my third blood transfusion so I wouldn't have another reaction (like before) and was left alone while my doer was busy doing something else.
I think segregation is horrible, its teamwork and as with any profession, there are good and bad. I personally am just as thankful for my watcher as I am for my doer when I was a patient. I try to remember that just because I don't see everything they are doing doesn't mean they aren't doing something.
As a former doer and now a watcher, I am here to tell you that not all doers do it right. Part of my job as a watcher is to make sure that the doers do the right thing. There are lots of doers who do as they see fit and not as is best for patients/facility. Part of my job as a watcher is to enforce policy and procedures which are there for a reason--to provide a certain standard of care. When that standard of care is not followed, there isn't always a bad outcome, but there is the increased likelihood of a bad outcome. My primary job as a watcher is to prevent as many bad outcomes as possible, whatever they may be. Could be a bad outcome for a patient, for the nurse, or for the facility.
Now, would you rather have a watcher who has been a doer--a nurse? Or would you rather be watched and managed by someone who has no idea what nursing is--a physician or other non-nurse? I was once managed in a cardiovascular department by a non-nurse and I can tell you from personal experience that I would rather be watched by someone who knows who I am, what I do, and what I can do.
Don't assume that the nurses in management are the bad guys. Get rid of the "us vs them" mentality. If you feel like they are against you, might want to ask yourself what you are doing from a risk management standpoint that is contributing to that feeling. Assessment is the first step and it begins with yourself.
It seem the longer someone is a watcher the less chance they will ever again be a doer.
My current manager loves to tell stories of her former doer career, but she certainly doesn't seem to truly remember what it was like or want to ever do it again.
As a former doer and now a watcher, I am here to tell you that not all doers do it right. Part of my job as a watcher is to make sure that the doers do the right thing. There are lots of doers who do as they see fit and not as is best for patients/facility. Part of my job as a watcher is to enforce policy and procedures which are there for a reason--to provide a certain standard of care. When that standard of care is not followed, there isn't always a bad outcome, but there is the increased likelihood of a bad outcome. My primary job as a watcher is to prevent as many bad outcomes as possible, whatever they may be. Could be a bad outcome for a patient, for the nurse, or for the facility.
Now, would you rather have a watcher who has been a doer--a nurse? Or would you rather be watched and managed by someone who has no idea what nursing is--a physician or other non-nurse? I was once managed in a cardiovascular department by a non-nurse and I can tell you from personal experience that I would rather be watched by someone who knows who I am, what I do, and what I can do.
Don't assume that the nurses in management are the bad guys. Get rid of the "us vs them" mentality. If you feel like they are against you, might want to ask yourself what you are doing from a risk management standpoint that is contributing to that feeling. Assessment is the first step and it begins with yourself.
I agree with this for the most part, and I understand where you are coming from. However...
...floor nurses rarely hear about what they are doing right. Even if QI targets aren't hit, a kudos for improvement over the previous quarter could go a long way to increasing morale. An explanation of why certain policies are put into place or changed would be helpful. Instead, it often comes across as, "Do this," and floor nurses left in the dark about the issues that led up to the policy change.
We had a new nursing-driven policy implemented that sounds great. However, some of the patient education materials that were necessary to carry out the policy were not introduced along with the policy, were not printed up in a timely manner, and we were never told where they would be kept on the unit. I had to go searching for them one night, and I found them in a stack in the corner of the unit. Since these were forms that we could do at admission, why weren't they collated with the rest of the admission packets?
We're not inherently resistant to policy changes, but half-assed implementations of them defeat the purpose.
If new equipment is being purchased, ask us how we like it. Use the conversation to show us how it can help us if used correctly. We get one inservice and that's it. We have new pumps that are pretty fancy, one inservice was given, and we don't use all the helpful bells and whistles that the new pumps have. One inservice does not a cultural change make.
I've seen new supplies intro'd on a unit--it just appears one day--and nary an explanation is given. The floor nurses don't like it for one reason or another, so we hoard the old stuff until it runs out. No explanation about why the new stuff is better. Just a warning to use the new stuff. But why?!
Don't treat us as robots who don't need to know the hows and whys of things or who only need one exposure to something new to be able to utilize it effectively. Treat us as humans and professionals with brains who want and need to know why changes are taking place.
I whole-heartedly agree with all of the above. Without a doubt. Just wish I could convince the DON of all that as well. I am a huge believer in shared governance. And not just the "everybody takes the heat" part, but the actual "everyone has a voice" part. I hate edicts with a passion and refuse to give them. However, when I ask for input from field staff, I get nothing. When I ask for input from middle management, I get nothing. Both sides are difficult to play on.
llyonya
5 Posts
I am a doer and satisfied with my status. Some doers who want to become a watcher may be very nasty they think they will be promoted faster if they are nasty. I used to work in the biggest and nastiest hospital in my area. Once I wanted to go to a different department and asked my friend from a float pool in which department a manager is good. She replied, "there are no good managers in this hospital. Managers who treat their nurses nicely do not work here longer than a year.