Published May 7, 2002
I have read several threads where people have stated that they work in a good unit and staffing is good. What do you think the secrets of your units' success are? Is it great pay, great teamwork, great management???? Are there any suggestions you can offer to those of us who are struggling to make our work environment better?
The secret is, having a manager who could (and does) step in and help out when the going is rough, complementing staff regularly, keeping the doctors mouths in check, taking care of unit problems before they become major.
Whether she does or not, our manager seems to care. If we have a call off that absolutely can't be covered and we are busy, she does it. She steps in and does the job. When the going is easy, she is not so quick to cut our throats and downstaff, and when the going is rough, we pick up the slack without grumbling.
I can't wait to go to work everyday (I can't wait to go home too, but I am happy to go to work which is half the battle).
She treats us as if we have a life outside of the hospital. She makes it clear that staffing is her #1 priority, but works with us to make us happy. As adults we realize that our job is important, but sometimes home is important too. For the longest time my hospital didn't care about my home. They lost a lot of good nurses over their attitude.
I guess my manager is someone I can admire and respect. I like that.
We staff according to ACUITY, not NUMBERS. It makes a big difference in pt. outcomes and on a busy night, we feel as though we have been able to actually make a difference in how they do.
The unit was designed by us nurses; and we had input in where everything was, even down to the different outlets and where the NG canisters would be. We have most of our supplies right at our fingertips and at the bedside. Computerized charting has helped streamline documentation. And the layout of the unit is such that strong assertive critical care personalities can get along without too much conflict.
We have a good Nurse Manager who knows her staff and gives encouraging words and also listens to us. She does what she can to make the workplace tolerable; but she also encourages us to get involved and find our own solutions to problems. She has an open door policy for all of her staff. Each shift has an Assistant Head Nurse whose personality seems to match the various shifts' personalities.
Out of a staff of 80 (including RNs, secretaries, and aides), we have 31 that have been there longer than 10 years-- and we received very nice recognition pins this past Skills Day so we could wear them at work.
Are we perfect? No, we have about 3 witches who can make life miserable for some of the newer staff (funny, they never do this in front of those of us who will tell them off). We don't have an Intensivist yet (but I keep hoping). Some of our personalities clash; new clunky IV pumps are a real PIA; some of our chairs are threadbare and the foam is coming through (we are in the process of getting those fixed). Our monitor system is in need of replacement (supposed to be done within the next year). And we have some old and outdated other pieces of machinery (sat monitors, etc.) that need replacing also.
Part of the problem in my unit, most of the problem really, is a total lack of leadership. We have physician directors with private practices who really don't take their resposnsibilities seriously. In fact one saw me at another hospital when I was there with a family member and he said "you should come to work here. It is so much nicer here." Nice coming from a unit director huh? We have needed an intensivist for years. We have a new NM who is really clueless and a group of assistant managers who are so burned out that they couldn't care less. One pits one nurse against the other, another sits in her office all shift, another disappears all shift and the other is so busy kissing suits and MD's butts all day that she forgets she has staff drowning out on the unit. Our Aides get away with doing absolutely nothing, some even yell at the nursing staff when we ask them to do their job. Mgmt. does nothing about it. But if one of us screws up just once in a while, you can bet we hear about it. It would be so simple to turn things around and make it a great place to work but administration is totally unsupportive. They always answer our concerns with "you don't know how hard their job is." I think I have a pretty good idea of how hard a GOOD managers job is! The inmates have taken over the assylum!!!!!
My facility is the best staffed l.t.c. in the area at this time. Bottom line-salary and benefits attract many and the good staffing ratios retain them.....My unit is the best-the charge nurse is awesome,very knowledgable ,a hard worker and willing to hear all of our suggestions.We are a TEAM...I am very content and look forward to going in daily...Our DON is very fair- and our adon's/supervisors on my shift will jump right in and help you bail if your boat is sinking.Having been on the other side of the fence I can really appreciate what I have now...
We've got a great unit manager who tries to ensure that we're always adequately staffed , but I think that the main thing that makes our ward great is teamwork.
I work on a haematology ward, where the acuity of the patients is highly variable (very ill neutropaenic to ambulant chemo), and can change almost in an instant. Every team member is aware of that and pitches in to assist if something happens.
The ANUMs are often (tho' not always) supernumary to act as a support, a consultant and/or an extra pair of hands, and mostly the people on the next shift realise that the day from hell isn't due to slackness. As Jenny P said, we have a couple who make you feel like having a bad day is a crime, but even they are much more supportive if you're actually working with them, rather than handing over to them.
I work in ICU, the head nurse is pro-union which is a big plus so nothing gets over on her. She expects and demands the best from all of her staff. She treats us respectfully, listens to what we have to say and will stick up for us if necessary. There is great teamwork, all I have to do is ask politely one time for help and I have more help than I need and sometimes the help is there before I need it. We are expected to attend one outside seminar a year and if we don't it is mentioned in our yearly evals. Yes the hospital does pay for it. Right now payment for these things is on hold as my hospital is recovering from an 8 million dollar defecit.
We are expected to give 100% at all times. My head nurse is a nurse that I can respect and admire. She is very intelligent and a devoted wife, mother and nurse. She volunteers so much, I don't know how she finds time to sleep. I have not heard one bad thing about her since I started in ICU back in February.
The pay is good at our facility , I believe because of the union. The staffing is good for the same reason. The other hospitals in my area pay at least a dollar less an hour than what I am making plus staffing isn't nearly as good. Sure unions have good and bad points but I believe that the union at my facility is a good one and I will never work at a non-union facility again.
Our manager is very fair in all she does. she never plays favorites in staffing or scheduling, she is always willing to pitch in when her help is needed. She has carefully selected those who are to be in charge when she is not there ( with a few exceptions) The staff i work with are also great. We work very well together. I work on an OB floor where the patient load is always changing. When ever we have a new admission every body who has a second is in the room and everything is done in minutes.
The day shift has a different manager who "does" play favorites in scheduling and staffing. The morale on that shift is horrible, several staff would rather come to Nights (can you believe that) to be able to work in a better environment
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