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.
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.
You're absolutely right about this. I tend to respond honestly and professionally (with a suggestion for improvement thrown in) to questions of "How is it going?" but I know not everyone does. Breaking the wall of silence is difficult. It definitely needs to be a two-way street.
I like how you think and how you can recognize the barriers. Good luck to you in overcoming them at your facility. :)
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.
LOL, some of those stories sure are "big fish" stories aren't they.
This was my big fear before jumping into a quasi-administration role. I think the point is valid. I still do a lot because of Nurse call in's and uncovered shifts and it's much harder to be in the trenches. Water really does roll downhill. I know a lot of managers with bigger and harder roles than mine will say "hey! My job in management is much harder than being at bedside. I believe you because I see you. Everyday and at odd hours of the evening, night and early am. I know about the unpaid hours at home too. Guess who's on the phone in the middle of the night trying my dam%$t to find a replacement for a call in? Yup and come Monday, I'll be dragging my butt into work just like the trenchers who bailed us out. We really are a team, despite the them/us. Ok ready to get flamed!
Those of you who do shift work will know this, but one typical characteristic of a true watcher is that they are never seen before the hour of 8AM or after 4:30PM or a weekend.
Those of you who do shift work will know this, but one typical characteristic of a true watcher is that they are never seen before the hour of 8AM or after 4:30PM or a weekend.
another poor generalization. I would be there 8-6 and my phone was ringing off the hook on the weekends. Every dinner was interrupted, weekend fun with my daughter was interrupted, i was woken up for not real reason at 6am on a saturday morning.
anyways, if a"watcher" puts in their full-time 40 hour work week, monday thru friday 8am-4:30pm, what's wrong with that? Those are operational hours for management. I WISH i could have done 3 12's in management, then go home and not have to pick up the phone until it was my time to come back in.
Some of the "watchers" are actually "doing" very important work. Just because someone is doing work that is different from yours doesn't mean that they are not doing work that is valuable and worthy of respect.
Until you have done that type of work, you have no idea what it is like -- and therefore are not qualified to judge its performance.
Of course, there are both good and bad nurses in both category. Making broad assumptions about the quality of the work of strangers you have never seen or met based only on their job title is ridiculous.
Specializes in LTC, assisted living, med-surg, psych.
another poor generalization. I would be there 8-6 and my phone was ringing off the hook on the weekends. Every dinner was interrupted, weekend fun with my daughter was interrupted, i was woken up for not real reason at 6am on a saturday morning.
anyways, if a"watcher" puts in their full-time 40 hour work week, monday thru friday 8am-4:30pm, what's wrong with that? Those are operational hours for management. I WISH i could have done 3 12's in management, then go home and not have to pick up the phone until it was my time to come back in.
Thank you for saying what I was thinking, and without swear words.
I bust my butt for 40 hours a week minimum. Everything always seems to hit the fan at 1645---emergencies, new physician orders, falls etc.---so I don't get out of the building till 1800 or later on at least 2-3 nights out of each week. I do paperwork from home sometimes too. Plus, I am ALWAYS on call, 24/7/365---I can't just shut off my phone for the weekend and not have to deal with the job until 0800 Monday morning. I get calls at all hours of the night, sometimes several times a night. The only time I am not available is during Mass every Sunday, and when I'm on vacation (a whole week! wow!).
Sometimes when I've been on the phone half the night and then have to drag my tired old body into the facility on 3-4 hours' sleep, I miss those days when I could leave work AT work and not have to think about it until my next shift. I'm not really complaining---most of the time I really enjoy my job, and I can't go back to floor nursing anyway because of health issues. Still, I'd hardly call myself only a "watcher", and I think labels (and attitudes) like this only serve to divide us more than we already are.
Specializes in thoracic ICU, ortho/neuro, med/surg.
This seems like a really poor way to divide people. My clinical director works so hard, I am truly thankful for her every day. She definitely goes above and beyond what she is paid to do. She has to deal with patients, doctors, nurses, her own bosses, hospital policies, budgets... it's not like she never lifts a finger. She works so hard. I hate to see people talk like one job is better than another. We are all nurses.
I hate to see people talk like one job is better than another. We are all nurses.
But isn't this an example of how a lot of people talk and think when the term "moving up" is synonymous with moving "further from the bedside".
My point being is that "doing" ie doing actual patient care is where the rubber meets the road. Certainly there is a need for watchers, but I think that the number of watchers could be cut in half and it would not have nearly the dramatic effect on quality of care that cutting the number of doers would have.
Specializes in thoracic ICU, ortho/neuro, med/surg.
My point being is that "doing" ie doing actual patient care is where the rubber meets the road. Certainly there is a need for watchers, but I think that the number of watchers could be cut in half and it would not have nearly the dramatic effect on quality of care that cutting the number of doers would have.
Saying things like "actual patient care" and "where the rubber meets the road" sure makes it sound like you think bedside nursing is more important than other roles in nursing. That's my point. We are all nurses, and all the jobs are important. All the jobs serve the patient in one way or another. I hate to see this kind of talk on ANY side.
Where I work, more "watcher" functions are being added to the bedside nurses many responsibilities.
Full time staff now are required to do chart audits. So in addition to taking care of patients, keeping up on the latest requirements, they now have to audit charts for correct timing in restraint documentation, pain reassessments (must be charted exactly one hour later-not a minute later) and tell staff who are delinquent in the exact charting the error of their ways.
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dudette10, MSN, RN
3,530 Posts
You're absolutely right about this. I tend to respond honestly and professionally (with a suggestion for improvement thrown in) to questions of "How is it going?" but I know not everyone does. Breaking the wall of silence is difficult. It definitely needs to be a two-way street.
I like how you think and how you can recognize the barriers. Good luck to you in overcoming them at your facility. :)