What happens to your integrity when you go into management?

teeituptom, BSN, RN · May 4, 2004

I did nurse managing for probably oh about 18 yrs

you caught between the doctors, the pts , the staff, the higher ups. No matter what your intentions are it will appear that youve sold yourself for 30 pieces of silver, no matter what you do.

been there

done that

refuse to do it anymore

debRN0417 · May 7, 2004

Please don't make a value judgment until you have walked a mile in my moccasins.
I have been a nurse manager for the past eleven years, prior to that I had been pushed towards assuming a leadership role for five years, so I decided that perhaps somebody or something was trying to tell me something and perhaps I had better listen.
It is frustrating to have to balance needs of different groups, juggle budgets, listen to people who do not want to see you until they have a problem and then expect you to fix it, preferably five minutes ago. I have been in the position of working for some really bad nurse executives who are so busy sucking up to hospital administration, wealthy contributors, and the medical staff that I doubt they can even find the floor. I am not salaried (I am overtime eligible, but administration has a way of making your life miserable if you try to claim overtime,) and routinely put in forty-eight hour workweeks.
The only reason I stick with this job? I get to be a role model. I'm not above picking up a bedpan, starting an IV, or covering for breaks and holidays. I would miss patient contact if I didn't, and it provides me a chance to maintain my skills, assess patients, and assess nurses' performance. Once in a while I get a chance to impact the system by working with it and improving things in some small way for the nursing staff I am privileged to work with. I despise it when I hear nurse managers refer to "their nurses" (after all, they outlawed owning people in this country in 1864) and I do not ask staff to do anything I would not do myself. I have informed upstart physicians that I was doing surgery when they were fingerpainting, have formed some collegial relationships with other departments, and yes, I have some enemies. I almost enjoy the young nurses who present themselves stridently as "advocating for patient care" and sometimes make my life a little more difficult, they remind me of myself so many years ago when I thought the mean old supervisor never worked at the bedside herself and was clueless as to what it took to do so.
As a child of the 1960's I learned that the best way to change the system is to work within it. That is why I took this job. Sometimes I get real lucky and can do something really positive. The high I get from that carries me for a good six months, through the times when the overtime budget is off the chart, there are eight people out on sick leave, and a struggling orientee who doesn't seem to "get it" and leaves me no alternative but termination.
I decided a long time ago that I am the one who has to look at myself in the mirror, and that as long as the Creator and I approved of my actions, it didn't really matter who else did or didn't. I go to work and do my job, which sometimes means confronting a nurse who should not be supported. I don't like this but don't shirk from it. I guess I have set limits enough that the physicians we encounter do not throw temper tantrums, and I recall pushing one sexually preoccupied attending into the treatment room after he pawed me, getting into his face and telling him that if I ever caught him doing that to any nurse under my supervision never mind the human rights committee, I would get on the phone promptly and call his wife. (The look of terror on his face was priceless.) I do not play games like screaming on the phone to other people in front of the staff so that staff will think I am supporting them, but I try to resolve issues one on one with other managers and departments. I'm no saint. Sometimes I hate my job and want to just hop a jet to some tropical country and sip a Mai-Tai. Sometimes I get good ideas and can implement them. Sometimes I'm successful. Sometimes I'm not. Sometimes I make mistakes. I admit them, learn from them, and move on.
So I don't know where I'm going with all this, and I volunteered for this, so I don't pity myself. I just ask that those of you who do have aspirations toward nursing leadership to remember that the manager peering over his or her reading glasses at your documentation, your schedule, or your sick leave usage is a human being and an RN.

Thank you...well said.

barefootlady, ADN, RN · Jun 6, 2004

Have not had a nurse manager who rolled up her/his sleeves and jumped into the fray in years. The last 2 managers I worked for talked about team work, unity and support, they did not practice these virtues. I heard today that a former nurse manager was chosen leader of the year at a facility I worked at, she almost killed a patient by ignoring insulin orders, she could not do simple nursing tasks, and she played favorites with her staff until most everyone was at certain nurses throats. What an outstanding leader. My last head nurse was absent 2 or more days a week, but if you had a problem, you had better get over it and quickly. I do believe there are some good managers out there, I just have not had a good one in a few years, but I am still looking. I will go the extra mile for a good manager, so please tell me where one can be found. P.S. The insulin incident was the only time this particular manager ever worked the floor in over 3 years.

teeituptom, BSN, RN · Jun 6, 2004

the old saying holds true

Those that can, do

those that cant, manage

Celia M, ASN, RN · Jun 28, 2004

It is sad to see so many people upset and frustrated with their managers. I have been a manager for 1 year so I remember being on the other side. I left behind a dreadful manager who would not and could not help on the floor, I vowed not to follow her example. Every day at work I roll up my sleves, assist with all aspects of patient care and provide break relief. I have always judged my managers by their willingness to "muck in". If the sitiaution is so bad you should express your concerns to your manager or to the next person up in the command chain or HR if you are not comfortable meeting your manager. I know I'm a good nurse and i intend to be a good manager too. It takes courage to be a manger because you can't always be the good guy and you often are caught in the middle of the nurses v management or doctors battle and it can get bloody.

purplemania, BSN, RN · Jun 28, 2004

Stereotypes are never a good thing. Perhaps the manager has information and problems of which you are not aware (and don't need to be). I sit in meetings with managers and directors and, no matter the issue, the bottom line is THE PATIENT. Sometimes this means alienating staff. But if there were no patients, we would not need staff. I have wondered about the integrity of some staff members too, so it must come from a certain perspective.

teeituptom, BSN, RN · Jun 29, 2004

It is sad to see so many people upset and frustrated with their managers. I have been a manager for 1 year so I remember being on the other side. I left behind a dreadful manager who would not and could not help on the floor, I vowed not to follow her example. Every day at work I roll up my sleves, assist with all aspects of patient care and provide break relief. I have always judged my managers by their willingness to "muck in". If the sitiaution is so bad you should express your concerns to your manager or to the next person up in the command chain or HR if you are not comfortable meeting your manager. I know I'm a good nurse and i intend to be a good manager too. It takes courage to be a manger because you can't always be the good guy and you often are caught in the middle of the nurses v management or doctors battle and it can get bloody.

I got the wounds in my back from a lifetime of it

quoth the raven "Nevermore"

**canoehead, BSN, RN** · Jun 29, 2004

Problem being that the upper crust is controlled by the budget, and the lower is motivated by patient outcomes. Sometimes the two are mutually exclusive. I think for-profit healthcare should be illegal, or alternatively, that hospital statistics for consumers should be available to the public and reviewed by publications like "Consumer Reports"

Gompers, BSN, RN · Jun 29, 2004

When a nurse goes to mgmt, I call that going over to "The Dark Side".

LOL!!! :rotfl:

This is all precisely why I refuse to even consider management. My father has worked in medical administration for as long as I can remember, and it REALLY SUCKS. He's actually one of my biggest supporters when I say that I want to stay at the bedside.

teeituptom, BSN, RN · Jun 30, 2004

Problem being that the upper crust is controlled by the budget, and the lower is motivated by patient outcomes. Sometimes the two are mutually exclusive. I think for-profit healthcare should be illegal, or alternatively, that hospital statistics for consumers should be available to the public and reviewed by publications like "Consumer Reports"

They arent mutually exclusive in any way

you go to a budget meeting

bottom end is always the dollar

been there seen that

CraigB-RN, MSN, RN · Jun 30, 2004

I don't think it's a change, it's more seeing another side of someone you didn't know was there. The stresses of management bring out the hidden side of people. and then there is the perspective changes. Things I used to hate as a staff nurse I now understnad differently and have to enforce it.

llg, PhD, RN · Jun 30, 2004

I don't think it's a change, it's more seeing another side of someone you didn't know was there. The stresses of management bring out the hidden side of people. and then there is the perspective changes. Things I used to hate as a staff nurse I now understnad differently and have to enforce it.

I'm not going to say that every manager is perfect and that there are no "bad ones," but I agree with you 100% on the perspective issue. There are usually many sides to an issue, and many times, the staff only sees one or two sides. When you become a manager, you suddenly see a lot more of the situation than you saw before.

One of the most common comments I hear from people new to leadership positions is, "I never knew all this went on before!"

llg