What did your manager do for you?

[KerriMcDaniel]

I am moving from an inpatient nursing position as a charge nurse on a Pediatric oncology and bone marrow transplant floor to a supervisor/manager position in a Pediatric/NICU Stepdown unit. Making the move after getting my masters and the hospital I currently work at would not let me advance and use my new degree, so I am going to a hospital that will. I have been a charge nurse for 3 years now but this position will be a little different. Please tell me what your managers do that make a difference in your lives? What do they do to help? What do they do that brightens your day? I want to be a good manager and it's important to me to make my nurses I will be managing feel respected and feel that they are making a difference. Any suggestions would help!

[LadyFree28, BSN, LPN, RN]

Be visible, step up for all shifts, communicate effectively, don't hesitate to get your hands dirty.

[sadiemae1123]

Advocate for your staff. If there are staffing needs, a piece of equipment, or education/inservice training that are needed make sure administration is aware of it and don't back down until you get what your staff needs to practice safely.

Don't let physicians dictate how a floor is run. For example, at my current job we are severely understaffed, but no one is willing to stop the physicians from overbooking elective procedures.

Make sure policies and procedures are updated regularly to insure EBP and communicate with your staff on why these policies are important and to not just keep doing things "the way they've always been done".

Best of luck in your new job.

[NotReady4PrimeTime, RN]

One thing I can't stress enough is to understand the pressures your staff operate under. When patient turnover is rapid, with transfers only happening because of emergencies outside the unit forcing patients out so new ones may come in, the workload is ridiculously heavy on the nurse doing the transfer in order to accept the admission. When assignments are already heavy, and the same people are doing the crisis transfers all the time you will have unhappy people.

Another thing to be aware of is staff mix on your unit. If you have a disproportionate number of junior nurses, your senior staff will feel like they're responsible for all the patients in their general vicinity (and possibly quite rightly so) and they'll tire of that quickly. When we point out that issue, being told that we're replaceable - in so many words - is like a kick in the teeth when we've given years of blood, sweat and tears to our unit and our patients. You'll need to ensure your new hires are properly educated before they take on patient care, and that they're properly precepted by someone who has been on the job more than 5 minutes so they're actually ready to take on patient care at the end of their orientation.

Please don't become one of those managers who treats errors as a group activity. I'm sure you know what I mean... a med error is made by one person but everyone on the unit is required to undergo remediation. Or a small number of people are seen texting on their phones while on the unit so everybody has to turn their phone in to the charge nurse to be locked up for the shift. That kind of thing. Please deal with problem people individually. Make them accountable for their actions instead of punishing everyone else too.

If you're able to provide positive feedback and appreciation without sounding patronizing, that'll go a long way. There has to be a better way than a mass email that says, "You all are such a great team. You pulled together and really got things done this weekend. Good job!" when the unit has been severely short-staffed, supplies and equipment are scarce, there are multiple admissions, deteriorating patients and all those things that are familiar to all of us... while the management team is off for a weekend at the lake. Sincerity really goes a long way.

[llg, PhD, RN]

While it is important to be visible to your staff -- and to help them out occasionally when they are busy -- too many new managers fail to strike the right balance between "out on the unit" and being in their offices doing their managerial work. Staff don't always understand this, but it takes time away from them to do your job well. For example:

1. You can't be gathering the data and writing the report that will get you a bigger budget to hire more staff if you are on the unit taking care of patients.

2. You can't be preparing the documentation, consulting with mentors, etc. to have a disciplinary meeting with an employee who is causing problems for everyone if you are similarly in the unit all the time.

3. You can't be thoroughly interviewing and carefully secting new employees if ....

4. You can't be meeting with that troublesome physician if ....

5. You can't be meeting with that troublesome patient family member if ...

6. You can't be solving a problem with getting the right supplies easily available on the unit ...

7. You can't be representing the staff's needs/interests at hospital-wide meetings it ....

8. You can't be learning new ways to organize your unit and help the staff if ...

etc.

etc.

etc.

Many managers spend so much time/effort trying to be their staff's best friend that they don't have enough time left to actually do the things that will improve working conditions on the unit. So they get a reputation of being a "nice person, but totally useless manager who just pushes the paperwork around." By all means .. get to know your staff, help them out ocassionally, communicate with them regularly, and give them ocassional treats. But don't forget to budget enough time to do the work that improves their working conditions and the patient care they provide. Don't fail to discipline those who need disciplines (even fired) because you "don't want to be the bad guy." Maintain high standards while remaining fair. Let them know that when you are at meetings or in your office, you are doing work that will help them and the patients in the long run. Keep them posted on your progress with initiatives. But by all means, take that time away from them as necessary to work on those things that will lead to improvements. Then you can have victories to celebrate with your staff as you all see the improvements.

[HouTx, BSN, MSN, EdD]

Best advice I ever got @ management?

"Don't make any arbitrary changes for at least 6 months. Take that time to really get to know your staff & find out how everything is working. Most of that stuff was working find before you got there. If you go stomping around spreading 'management' everywhere just to show who is in charge... chances are, you will make a mess, lose credibility and have a much more difficult challenge to gain any respect".

[classicdame, MSN, EdD]

get to know your night staff.

Little things mean a lot. A former manager developed my schedule to make it easier for me to get another degree. Years later I still appreciate that gesture.

[brandy1017, ASN, RN]

Make sure there are adequate supplies to work with. It is a major frustration when things are missing and broken and the response is it's not in the budget! Don't keep the budget down just to get a bonus, remember the staff need supplies to properly do their job!

[Madras]

get to know your night staff.

Little things mean a lot. A former manager developed my schedule to make it easier for me to get another degree. Years later I still appreciate that gesture.

THIS!!!! I second this!

As a chronic night shifter..... It would be nice to NOT be forgotten about sometimes!!!

if all else fails just transform yourself into Jada Pinkett Smith from HawthoRNe! I dream about her being my manager lol!!

[applewhitern, BSN, RN]

My pet peeve is the manager who plays favorites; the one who wants to socialize with the staff nurses who are her own age, sits and texts them all day long while they are at work, plays on facebook, etc. Also a manager should not give special consideration/privileges to the NEW staff member, and refuse requests by the ones who have seniority. That is a smack in the face to the ones who have worked steadily for years, filled in the holes, and the new nurse gets any day she wants off, including holidays.

[jcbhappy]

Don't focus on the negative, add a positive to every negative. Thank randomly for a job well done. Buy a coffee/tea/pop randomly. If possible answer a call light and complete the task, don't find someone and report the need if not necessary. Be a goat herder, not a dictator.........

[Dane Meyer]

My experience in management has been outside the medical realm. Nonetheless, I always operated with the philosophy that my job was to see to it that my staff was provided the tools, training and materials to perform their jobs. And to stay in communication with them to ensure that this was happening You cannot manage in a vacuum; some of the other comments posted noted that you must have a presence on the floor; you can't supervise people behind a closed door. It is possible to be present without being intrusive, to be available for questions, insights, problems. Finally, know your staff. They have lives, families, hobbies, in the other 2/3 of their lives that affect job performance, motivation and attitudes.

[paganoid]

In one of her first speeches as Harvard University's first woman president, Drew Gilpin Faust quoted Nelson Mandela: “A leader. . .is like a shepherd. He stays behind the flock, letting the most nimble go out ahead, whereupon the others follow, not realizing that all along they are being directed from behind.” My best experience with a manager was like this; she directed the team subtly, allowing us to 'find' our own answers to problems as they came up. It's very empowering and contributes to high morale, but must be exhausting for the manager.