What happens to your integrity when you go into management?

Simplepleasures · Dec 28, 2006

Bumped to top. I have wondered about this for years. :idea:

yupyup5 · Dec 28, 2006

Bumped to top. I have wondered about this for years.

Can you explain your comment?

pickledpepperRN · Dec 28, 2006

I think the organization for nurse managers needs to nurses only

Now their organization is, I think, a sub group of the American Hospital Association. There is a conflict of interest when shareholders and building/expansion projects are the top budget items. The AHA considers nurses pay an expense rather than the only way to provide the service for which the hospital exists.

AONE: AONE/AHA PAC

An association of ONLY nurses who are managers could work together to insist that patient care be the priority.

That those who actually do the work, not only administration and consultants, must be budgeted to do what needs to be done.

Why pay others to figure out how to do more with less. Use that money to pay those who do useful work. From top surgeons, to all nursing staff, and those who cook and clean the hospital the true mission of the hospital is fulfilled.

Nurse managers need to get together with their colleagues from the private sector, public, profit and "not for profit" (just means they don't pay taxes), and all countries they need to stand up for patient care together.

Individually the best are just too weak. Too many fine managers quit. Some go back to direct care or education and contribute.

Others are lost so patients and staff suffer.

Just my opinion

medpsychRN · Dec 28, 2006

Our middle mangement nurse "graduated" to the unit manager about a year ago. Although she will usually take your side with the docs (although conflict is rarely a problem) she jumped right on board with the rest of hospital management.

Staffing is the major issue. We work with minimum staff, get called off regularly, floated or are forced to leave early. Job responsibilities have increased. I understand the need to watch the budget but when safety is compromised it's hard for me to be silent.

I finally accepted "she went over to the other side" when she told me at my annual review I have to volunteer (on my own time - not necessarily for the hospital but encouraged), serve on a committee and keep a portfolio of all my accomplishments for the year.

I can't believe anyone in management believes in the merits of this policy and can actually enthusiastically sell it. My husband had a stroke 2 years ago and my brother is dying of cancer. They are out of their minds if they think I am going to volunteer what little free time I have for the hospital. When it comes time to list my accomplishments, I'm going to tell her it's a miracle I made it to work without calling in.

Simplepleasures · Dec 28, 2006

Can you explain your comment?

My comment is pretty self explanitory.

RNPATL, DNP, RN · Dec 29, 2006

Bumped to top. I have wondered about this for years.

This is a very old thread, but one that merits additional discussions. I have not been on in a while, but feel compelled to respond to this thread.

Nurses that become managers often do so because they feel they can impact change for the unit they work on. Too often however, once in the management role, they are bogged down with administrative work, staffing issues and patient/physician issues, and issues relating to budget. Faced with these challenges, nurse managers can easily forget the reason they joined the management ranks. But even if they did not forget the reason they became a manager - they are often unable to effect any real change because there simply is not enough time.

As a nurse that has worked (and continues to work the floor) in both management and on the floor, I can totally relate and understand about the challenges these men and women face. Now - I will agree that there are some that get into management because the money is excellent. But, I really believe these are few and far between. Most nurses get into the management role because they really want to make a difference.

The other challenge nurse managers face is that they have never been educationally prepared to run a nursing unit. Running a nursing unit takes skills that are not only learned through experience, but also skills that are learned through education. The financial end of managing a unit is very challenging and the ability to balance quality care and still meet a budget can be something that few can achieve.

From my perspective - I give my nurse manager the benefit of the doubt before I think ill of him or her. Just my 2 cents on the topic.

cardsRN · Dec 29, 2006

thanks for bumping this guys- a great read. i too have worked for the truly sucky and now work for a truly great manager. my old boss would not take the time to get to know any of her staff, never had meetings, never saw off shift/weekends, handed down decisions and dictates in a very top down kind of way, no room for discussion or opinions. i never saw her in scrubs. oh, yeah and she left at 2 pm EVERY SINGLE DAY. knowing that 1400-2100 were the busiest hours for admits on our post cath floor. no staff support.

my current manager has regular staff meetings, makes an effort to get to know staff and talk to off shift and weekends, pitches in when truly necessary, and here's the big one- lets us know what she's working on, and lets us know that she appreciates our hard work. really, that's all it takes to make a person feel appreciated- an occasional email saying good job! i think the big difference between a good manager and a bad one is communication. let your staff know what you are doing- for the hospital, for them, for your PATIENTS.

to all you managers out there who do your job and do it well, i salute you. managers have pressure from both sides- staff and admin. as we all know you can't please all the people all the time. :lol2:

cookie102 · Dec 29, 2006

not sure you all would classify me as management, but as a clinical supervisor in HH, i have been caught in the middle more times than i can to mention, having worked in the field for many years i felt my "loyalty" was to make it better for the field nurses, if i did that the administrator called me a trouble maker, i always have stood up for what i believed and of course many times that has gotten me in trouble....well being called a trouble maker and too easy on the nurses, one time too many, has led me to resign.!!! let the administrator deal with it all!

burn out · Dec 31, 2006

I couldn't even begin to tell you what our Nursing Director does, I don't even know if I would want her job.

cisco · Jan 25, 2007

I agree with most all the posters statements. I was a manager of a 34 bed med/surg floor. Mostly surgical pts with minor med overflow. Sometimes we would have 10 to 12 surgeries between day and evening shift. I was responsible to work as charge nurse 50% of my worked time which left very little time to do all the paperwork involved with management. I constantly fought with administration about improving our care hour so that we could get better staffing. I always believed in keeping our supply carts and linen carts well stocked...to the point of having to put locks on the supply rooms to prevent other floors coming to our room and taking our supplies. I started out as a new grad on this same floor so maybe this helped me to never forget what it means and how hard the work is being a floor nurse.

I would have face to face disagreements with doctors who chose to yell and use intimidating tactics with our nurses or myself. And it does take incredible courage and self-integrity, ethics to continue to do the right thing for the patients and for all the staff that provides safe and competent care. I chose to always be there for staff, helped with walks, hang blood, lift, turn, trouble shoot, second assessments, assist with codes and again discuss, argue with administration about the unfair, unsafe staffing ratios.

Also, it's true that by the time you add up all the extra hours that good managers put in, you are making less than a newer floor nurse. I finally quit because it was a hugely thankless job, stressful, frustrating and very sad when you see that corporations/businesses only care about the bottom line dollars. I won't go back into management, I figure 7 years was enough. And even though I got along beautifully with most of the staff there was always one or two nurses that remember me as the new grad, they were always going to admin with one complaint or another...and this would only add to the stress of the job.

There are so many other options in nursing that are actually very rewarding and far less stressful. Although, I did learn amazing things about what really goes on inside a hospital, the politics, etc. priceless knowledge!! If you choose to go into management, get a thick skin right away. There really are no friends even with the other managers, as sometimes admin will use the divide and conquer technique to put managers against each other or too afraid to speak up. Good luck!!

Bluehair · Jan 25, 2007

Hear hear, Cisco! I am currently a manager of an 8 bed ICU in a rural community. We see a little bit of pretty much everything here. It has been a great experience, and like you I have learned a great deal about the workings of a hospital that I never would have known otherwise. I too am ready to step down. With the hours I put in I calculate I am making between 1/2 to 3/4 of what most my staff make per hour. We recently had some bad weather here that prevented some of the staff from making it to work. Somehow the patients can still make it in. I have clocked over 100 hours over a 12 day period with only 1 day off. It is not that severe every week but boy are those weeks a drain. I believe in working with the staff, not against them, and do as much as possible to make sure that their job supports their life outside of here, not the other way around. I am fortunate to have a supportive upper managment team but I know not all managers have that sort of support. Like you, trying to support the staff by helping in the unit on these very busy days makes me behind on the other things I need to get done to keep JCAHO happy, etc. And then still find time to set up education for staff, perform evaluations, etc. etc., all the tasks a manager must complete to keep things running smoothly. I would encourage any nurses to walk even just half a day in your managers shoes before being tooo critical. I think some managers response to the seemingly overwhelming amount they need to accomplish may be to sometimes just shut down in a certain area in an effort to cope.

Managers have lives too. My staff see me here at all sorts of hours, but since they are only working 3-4 days a week they don't necessarily see that I have been here more than they are. And Cisco I agree also, managers do not in general have other manager friends. Partly because they may be too busy, and partly because of the politics involved. That was one of the more difficult things I found when I went into managment, the loss of comraderie with my co-workers. It tends to be a bit of a lonely position.

I too am going to be stepping down from my management position (current count down is 6 weeks!). Not quite sure what I will do next but I know there is something out there and I definitely won't starve! I do want to encourage anyone who reads this to a) say thanks to their manager once in a while. It is rare most managers hear that from anyone and it really is appreciated! b) offer to help out with some little task here and there. It is amazing how even small amounts of help (and caring) can make a managers day go better. And if your managers day goes a little better, I would bet yours will start going better to.

I know there are managers from hell out there, but it certainly isn't all of them and there are a lot of great ones too. If you have a good one, give them a pat on the back! It's always good to give positive reinforcement for desired behavior!! (chuckle!)

cisco · Jan 26, 2007

Bluehair, thanks for the positive comments...always appreciated!! I hope you find the perfect new position. Cisco