What happens to your integrity when you go into management?

renerian, BSN, RN · Nov 13, 2004

I am leaving my managment position due to conflicts in ethics, treatment of nurses, treatment of anyone in general, stinkey pay, being salaried and working at least 10 to 35 hours per week over 40, you name it. I have read so many angry posts. There are still many of us good guys out there who want to be managers but cannot find somewhere to work that is ethical and respectful. Just my thoughts,

renerian

teeituptom, BSN, RN · Nov 13, 2004

I am leaving my managment position due to conflicts in ethics, treatment of nurses, treatment of anyone in general, stinkey pay, being salaried and working at least 10 to 35 hours per week over 40, you name it. I have read so many angry posts. There are still many of us good guys out there who want to be managers but cannot find somewhere to work that is ethical and respectful. Just my thoughts,
renerian

Dont blame ya a bit

been there done that

Much happier doing staff work and taking care of pts

far fewer meetings

more golfing

Crumbwannabe · Nov 13, 2004

I have noticed how people, with a few exceptions, change when they go into management. Those exceptions usually don't last too long. The price is too high for the raise and false trappings of managership.

Theory: There is always a fall guy in the upper "mahogany row". Just watch long enough and you will see. Same as we go down the ladder, right down to charge nurse. Funny how intelligent people live in this state of denial, knowing this unspoken fact, but thinking it 'can't be me'. They think they have some 'inside knowledge' ,and I've heard this a few times from managers just a short way from the axe.

I have seen entire superbly fuctioning units turned completely over for a higher up to save face. Sun Tzu comments on this, saying more or less, if the troops do not function properly, it is the General's fault. It's like they live in a mass delusion, even down to a cryptic language. For these reasons I always have dreaded seeing a good person lured into management.

I think it boils down to one thing...like it or not, potentially, we are all Tanya Harding.

mattsmom81 · Nov 13, 2004

My venture into management: as a good charge nurse I was once lured into the house supervisor role. I went hoping to show good leadership, appreciate, motivate and support the staff nurses...something I was successful at as a charge nurse and I wanted to help morale across the hospital. Boy was I naive.

I did not feel comfortable with being 'in the middle' of the staff nurses and upper level management. I was a 'nurses nurse' and couldn't partition myself away from the staff.

The unit managers were land sharks in pumps and pearls and I could not believe how they talked about their staff nurses...and how quick they were to blame the hospital supervisors for problems in their own dept that they should have dealt with. Deflection of any blame was their game. Planning and scheming...who to scapegoat, fire, etc...to help them look good in the eyes of the CEO and CFO. I knew there were some mean spirited managers out there...had no idea of how many til I listened to them in groups.

Uggh...just thinking about it gives me the willies and I still feel some PTSD from the experience. I too feel badly when I see a good nurse joining management as no doubt her/his convictions and values will be shaken to the core.

I don't think its possible to stay in hospital management without selling out (unless one finds a unique place that I sure haven't encountered in my parts)

Seems a new manager/supervisor won't survive there long unless you follow the party line. They will literally run you out and it happened to me because I was too naive to see it coming.

God Bless the good people who keep trying and hang in there.

renerian, BSN, RN · Nov 13, 2004

Thanks tee. Nice to know it works out going back to the hands on all the time......for people.

renerian

zenman · Nov 25, 2004

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

Very true. New information changes your perspective on the situation.

OldOR_Nurse · Dec 12, 2004

When your immediate supervisor is seen as ineffective, look higher up. In our facility, our coordinator and nurse manager try very hard to look after staff and morale-however-they are caught between the staff and our administrator. I will admit, I work for "a profit" center, and many of our doctors are investors. It is hard to see the administrator cater to one physician over another-and don't think that the doctors don't notice either. Our administrator has begun making our coordinator a scapegoat for all the problems, and I don't think that she will last much longer--I think she will probably leave the facility. The support goes both ways-if you know that the person above you is doing everything that they can, don't constantly complain. Remember "middle management" is just that-you are caught in the middle between staff and the higher ups.:chair:

RNPATL, DNP, RN · Dec 12, 2004

When your immediate supervisor is seen as ineffective, look higher up. In our facility, our coordinator and nurse manager try very hard to look after staff and morale-however-they are caught between the staff and our administrator. I will admit, I work for "a profit" center, and many of our doctors are investors. It is hard to see the administrator cater to one physician over another-and don't think that the doctors don't notice either. Our administrator has begun making our coordinator a scapegoat for all the problems, and I don't think that she will last much longer--I think she will probably leave the facility. The support goes both ways-if you know that the person above you is doing everything that they can, don't constantly complain. Remember "middle management" is just that-you are caught in the middle between staff and the higher ups.:chair:

This is really an excellent post and I thank you for your insight. There are many times when the nurse manager is the scapgoat and no matter how hard he or she tries to get something acomplished or protect the staff from change, it may fall on deaf ears in administration.

I was very fortunate with my first nurse manager position. The administrator (President/CEO as they called him) was very focused on the patient and really put physicians in their place. Prior to his arrival, we really had some BIG problems with our docs and the way they treated their patients as well as nurses. When the new guy started, he made it a point to hold the physicians accountable not only for their behavior toward nurses, but he expected them to follow policy! I remember him telling one of the docs (who was really rotten to work with) that his business was no longer wanted or needed. He actually types out the physicians resignation for him. Of course, the doc was shocked that an administrator would do this and refused to resign. The CEO said, fine, then behave. He did behave. It is amazing how pohysicians can run amuck if allowed to or they can be a true part of the team if they are made to be part of that team.

I do agree with you when you say stop complaining. If the nurse manager has really worked hard to resolve the issue and no results come from it, then the nurses need to know that they have the option of going higher to get their voice heard. Hopefully that will work.

OldOR_Nurse · Dec 12, 2004

Sometimes it is hard to see the forest for the trees. It is very easy to be a staff member and just see all the sh*tty things that are rolling down the hill, and throw it back. I think that is why so many managers give it up and go back down. When you try to do a good job and you get complaints from above and below-I know what it can do to your self-esteem. I guess the next time a supervisor tells you that they can't do anything about a certain problem or issue, you might want to ask them if it would do any good to talk to the person above them. You have to be careful doing this though, because it could still boomerang on your supervisor. I think that is what is happening at our place, she encouraged us to go above her, and now they think we are complaining about her. :uhoh21:

Pattiecake · Dec 13, 2004

I've been a nurse a long long time and have worked in a variety of roles, now a CNS for the past 10 years. My question is for all those nurses who have chosen administration/management roles. I ask: What happened to your integrity? your sense of what is right? Where is your backbone? Have you all forgotten why you went into nursing in the first place? Are you so desperate for your job that you are willing to give up on your values or do you even know what they are any more? Time and time again I have heard nursing administrators "talk the talk" of "quality" "optimal patient outcomes" and "accountability" . And repeatedly I see these very nurses backing down , failing to support their nursing staff and avoiding a confrontation with physicians . We all talk about things like "shared accountability" but in reality it is all about keeping physicians happy. Lousy physicians are allowed to practice poor medicine without repercussion. All the while we as nurses are put in positions of having to work along side them, risking our own licenses and compromising our integrity. I'm sick of this. No wonder nurses leave the work force in droves. Why should they even pretend they can make a difference when those who have the authority to speak up back down.

Why would you feel you should judge an entire group because of some bad experiences you may have had. Let me assure you, I am in management, and my integrity and all the other qualities you question are all still intact. I find your post offensive. Perhaps it is best not to post if you have had a bad day.

Pat:nono:

Crumbwannabe · Dec 15, 2004

Why would you feel you should judge an entire group because of some bad experiences you may have had. Let me assure you, I am in management, and my integrity and all the other qualities you question are all still intact. I find your post offensive. Perhaps it is best not to post if you have had a bad day.
Pat:nono:

Hello

Are we confusing 'integrity' with 'consistency'? Personally, I have never had the pleasure of shaking the hand of anyone who was 100% consistent in demonstrating their ideals. We may say that we have this 'conviction', or believe 'that', but I'm afraid that regardless of how hard we try, we give in to the situational ethic.

A person who violates something they believe in, or whatever is neither a liar nor one who lost their integrity, but rather, a fallible person...and God please don't use my own measuring stick on me...

Now as far as maintaining integrity, and I am not directing this at Pat, what did one's integrity consist of to begin with? I mean, what qualities did they value. If I have no problem walking over people to achieve my ends, am willing to lie, set people up, et.c. to get where I want to go, I have maintained my integrity if I practice these behaviors. The problem is when you deal with a person such as whom I've described, It's pretty difficult to establish if they are lying when they tell you they are a person of good quality.

Second, a direct manager has little power to change anything except the immediate staff. I'm a great believer in the concept of upper level people having a fall guy or two in their back pocket. Usually a manager can hire and fire if they do it carefully, and the one in question is not bringing an 'apple to the doctor' (or you may substitute whatever you want for the aforementioned apple). The ethic of 'administration supporting management', for some mysterious reason, is a justification for a multitude of blatantly unethical practices. ie, "Yes, we know you are right, but we must be supportive of our managers"([translation]:....never know when the one higher up 'supporting the manager' might need a fall guy....)

Suprisingly too often I've seen an entire department turned over when necessary if the manager's back is to the wall. And remember, this is not a case where burden of proof falls on said manager. Innuendo, lies, pretzel logic or whatever will suffice. Firing and counseling (3 strikes you're out) is just about the only real tool in their box, and as it has been said, if you only have a hammer, everything looks like a nail.

Whew....

Crumbwannabe · Dec 17, 2004

And another thing...

Being as nursing has been described as 'quasi-military' in it's structure (see some of the textbooks) I pose these questions...and I'd like to hear an answer.

1.) If we were Special Forces what percentage of your co-workers would you trust to cover your back in a critical situation?

2.) Same question, and this time, what if the co-workers knew you would distinguish yourself with the upper managers yourself if you succeeded?

3.) Do you recognize limitations on your confidence in your departmental 'friends'? Example: If you needed a witness to a certain event which might go against the grain of a superior, how many stand up co-workers do you know?

In the military, it's called treason or cowardice. In nursing, it's called depart-mental politics.

Thx