What happens to your integrity when you go into management?

Crumbwannabe · Jan 5, 2005

I have worked WITH many good or very good Nurse Managers. They would try to be fair and supportive of the staff. They obviously try to help keep their unit/ward ect.. providing quality patient care.
I have had to work with terrible managers. They don't participate in patient care decisions, and are then hypercritical of the staffs decisions. They will not support the staff. they have lied , split staff, and have told other staff private details of other staffs personal lives. They won't return pages ever. So the eve, night and weekends they are not available.
In my experience the bad managers are the minority, but they can leave scars and staff will find it hard to trust managers again. If you have been stuck working under an abusive manager that sour memory will overshadow the good ones.

Hi

Well, I'm contract now, and the general attitude/behavior of managers are so repugnant and toady around here that I can not only beat their salaries without comprimising principles, but can work a different shift, and avoid them while they're home drinking cheap tequila and wondering if they'll have a job tomorrow. Just give excellent care, walk away when the regulars get rude, get the baths all done, go home and sleep the sleep of the innocent. Then pick up a nice per diem check the next day. The house supervisors are too busy hiding from work to worry about, and they sure aren't an asset if you have a problem....I think someone wrote a book on 'why I'm too busy to help for the HS', based on my experiences in hospitals coast to coast...why didn't I do it earlier?...life is good.

lossforimagination · Jan 8, 2005

Where are you that the nurse manager's are paid bonuses??
I want to apply!!:)
Sorry, but this practice is not happening in my corner of the world....and I have truly never heard of this. The only people getting large bonuses in healthcare that I have seen are CEO's, not nurse managers.
In my department, it is a struggle to get everything approved that I asked for in the budget-coming under it is impossible!!!

For one, Columbia used the practice of paying bonuses to managers...this is how they lived up to their claims of "better efficiency". I once worked for a Columbia- owned community hospital. I recall in '95 or '96 when my nurse manager got a big bonus and drove to work in a new Cadillac. Of course, the staff was always short as were supplies and equipment. It was a terrible place to work, and an even worse place to be a patient....very often agency staff would only come once and would NEVER return. Everyone called the facility "deep hell".

The bonus practice had to stop for Columbia when they got into trouble with the Feds for Medicare fraud. After that, the Columbia name came off all facilities. Can't say that working conditons improved much though!

medpsychRN · Jan 17, 2005

Worked as a nursing shift supervisor under an ADON who was a royal pain. Critical of staff and had unrealistic expectations.

Lo and behold, she lost her job when the hospital changed hands (I had quit by then) and started working as a staff nurse on the same unit/hospital as me. Absolutely no change. So being a manager had nothing to do with her demeanor. She remained one unhappy lady until the day she quit. In her case it was her personality not her position!

R.T. · Jan 20, 2005

I work as a clinical manager in an 26 bed OR. I have been in management for the past 3 years. I have worked at this facility for 9 years. I started as a LPN in the scrub role in surgery, went back to school to get RN degree and after circulating for 3 years, was given the opportunity to lead my co-workers.

I am a hands on manager. I still scrub and circulate. Just recently during a bad snow storm, I pulled a double shift to let my staff leave during the bad weather. I fight for their rights, we have committees where managers chair, but do not make any suggestions. We facilitate the group to keep them focused on the problem and to find a solution that is good for the department as well as the hospital. I feel I am a mediator. I mediate for patient's rights, staff benefits and better work environment, and mediate for the hospital for a cost effective solution to keep the hospital open, successful, but a place where nurses would be proud to work. I never realized the stress and how unprepared I was for this job. The management courses in nursing school do not prepare you for a role in management. I make mistakes, apologize to the staff, do everything in my power to see I do not make it again, have an open door policy for any staff person to vent or complain in my office. I try to enable my staff to think about possible solutions and not just complain. I work with managers who are polar opposites. They are controlling, demanding, and have run good nurses off. I have felt ashamed to be classified in the same category as a manager at times. My role is expanding and I am spending less time in the OR rooms, but my staff know where my heart is. It is right there with the patient doing everything to make the OR team successful.

brenee · Oct 7, 2005

I've often wondered the same things.
I think once you get promoted to management, administration sends you to some kind of brainwashing retreat.
That's all I can figure.

I am an LPN who went into management (nurse manager) and I lost my job of 5 years because I would not stop fighting for the rights of my staff. I was told "YOU NEED TO BE TOUGH". Well right is right and wrong is wrong. I'd do it all over again and would not change a thing. I HAVE NO REGRETS:p

teeituptom, BSN, RN · Oct 8, 2005

I am an LPN who went into management (nurse manager) and I lost my job of 5 years because I would not stop fighting for the rights of my staff. I was told "YOU NEED TO BE TOUGH". Well right is right and wrong is wrong. I'd do it all over again and would not change a thing. I HAVE NO REGRETS:p

never heard of an LPN nurse manager

guess I dont know everything

mstigerlily · Oct 8, 2005

Yes, sometimes it seems our managers care more about the doctors and administration than they do about us, but now that I understand that it makes things a little easier. Their roles are so different, I think it's hard to understand the pressures they are under.

I think management have a tremendous amount of responsibilities and juggling to do. Hard for those of us to understand who just come in, work our shift and go home with a clean slate. Seems to me, those in management are always on the job, always accountable, always responsible, even when they are not there. I can see how that would start to change your attitude.

Our managers are definitely administrative and sometimes on bad days it seems like their only function is to make our jobs harder - they are always adding things, changing things, worrying about things, complying with JCAHO and other visiting agencies. But our manager still listens when we tell her that her idea of "x" will make our job harder and why. I can still see that she was a floor nurse for many years and still remembers what it is like. And that fact makes things easier for me.

Melissa

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.

barefootlady, ADN, RN · Oct 9, 2005

Most managers have a very self important view of themselves, so the BIG ME, little you syndrome lives well in their hearts, but soon, they realize, the facility will replace them too, unless they keep the budget down, productivity up, and a warm body or two on each shift. :idea:

fluffwad · Oct 9, 2005

I'm currently working under a DON who has a great deal of knowledge and a great deal of insecurity. She really knows her stuff but won't delegate , and gets defensive ( as if anyone really wants her job) when we try to help out, unconsciously sabotaged the ADON.................then the entire staff feels undermined , frustrated, etc..................

:innerconf I can't decide whether to leave, or just stay out of the way until this woman burns herself out and goes away.

Katinthehat · Nov 11, 2005

Ya know...I've worked in a variety of settings...started off in social work, then community services/public health and now as a Nutritionist as well. I've been both front line and management-even senior management. The complaints never change-someone is always bellyaching about 'the leadership' (or lack thereof) or management in general. When I was in Management, I worked hard on behalf of all things (staff & patients/clients included)-to effect change in a positive way, but most of this kind of work is done where staff don't see it. One of my biggest frustrations was the snail's pace at which anything at mgmt level gets done!

However, I do believe that it is the responsibility of everyone to 'step up to the plate' - simply complaining does nothing except add to the already high stress level, both for you and your co-workers.

We rarely go into mgmt just 'for the money' (Ha!) or to 'screw you over'. It's time to stop pointing fingers and shake hands instead. In the end, aren't we working for the same things?

I'm looking to do a MSN in Leadership/Mgmt - anybody out there got any advice on good programs????

Polly53 · Dec 10, 2005

I have been a nurse manager for alittle over one year now after over 20 years of staff nursing. I looked at it as the opportunity to deal with all those problems that really ticked me off as a staff nurse. I also see the business side of the hospital. They have a budget just as we have our own personal home budget. It is a fine line to walk to try to balance the budget. I receive no bonus, maybe some places do this, but not my hospital sysytem. I receive an annual review and the raise is based on the review (too bad that the nursing staff itself as a profession doesn't base their raises on the annual review of proformance-attitudes would certainly be different). What I find the most frustrating is the fact that the staff loves to complain, but doesn't offer solutions. I would love to make things work better, but the staff obviously thinks I should come up with all the answers. I do not tolerate abuse of staff by physicians. Some docs have gotten away with this for years which is absurd. I do not feel I have compromised my integrity at all. I have a handle on right vs wrong and I stand up for what I believe in. I do not view myself as a mamagement kissup. My loyality is to my staff and the corporation, but if I feel either are wrong, I do speak up.

Ruby Vee, BSN · Dec 11, 2005

i've had good managers and bad managers, but the majority were bad. i'm sure there are managers out there with ethics, backbone, skill, integrity and a sense of fair play -- i just haven't met one in a long time.

my last manager had a terrible problem with turnover. new nurses would come, stay less than two years, then leave. at the same time, she had a solid core group of nurses that had been there ten years or more -- nurses who were preceptors, charge nurses and had developed special skills. in october, she announced to fully half of her staff at a staff meeting that she had been working on the turnover problem. "i struggle with this every day," she said. "i wake up at night and i ask myself: should i keep hiring the best and the brightest, knowing that they'll be moving on to bigger and better things in a year or two? or should i lower my standards and hire someone mediocre who will live in the icu for a decade?" then, apparently realizing what she had said, she started giggling, and added. "i didn't mean to say that, guys. you know i didn't mean to say that." and i was left with the impression that while she probably hadn't meant to say that, she definitely did mean it. it explained so many previously inexlicable decisions! i called a realtor the next day.

when i worked my last day, two weeks before christmas, i tried to schedule my exit interview, i was told by the manager "oh, you don't need to do that." interestingly enough, hr called me at home just before my phone was disconnected and the moving van arrived. they wanted to know if i could shed any insight into the rapid turnover among senior staff. and they were surprised that i hadn't scheduled an exit interview.

i went in for my exit interview, told human resources exactly what the nurse manager had announced at her staff meeting, and exactly why i was leaving. as a staff nurse who had happily worked in that unit for 13 years before that nurse manager arrived, i left because of the certainty that i was not valued by management. i understand that the manager's job has been cut back and that she is no longer overseeing the icu. that's a good thing.

if a manager values her staff and makes them feel valued, stands up for them when physicians become abusive and tries to play fair rather than playing favorites, i'm willing to cut her a lot of slack. but when your manager announces that you're not valued, always takes the physicians' side without hearing the whole story and has her "pets" who get the best assignments, their choice of vacation time and any advanced training that becomes available, that's a poor manager.

just my 2 cents.

ruby