What do you think?

[morr4336]

Good day to all of the hard working nurses out there! I really appreciate all that you do! I have read in many of the threads about management not caring about the staff. Are the managers nurses, or are they persons with degrees in health care administration. Being in the military medical system, the majority of the managers come from within, meaning that if I start out as a new employee (Hospital Corpsman) some time down the line, with promotions, I will eventually become a clinic administrator (at least it is this way in the Coast Guard) so I would have a good idea of what the issues and concerns are, therfore I am more in touch with whats going on. From what I have read, there is an "us vs them" mentality in the civilian sector. I also realize that a big difference in the two systems is money. We try to work within our budget, but if we run out of money, we just ask for more and usually get it (From my prospective we do not manage wisely because of this). I am the assistant clinic administrator of the hospital that I work at and am surprised by the wedge between nurses and management in civilian facilities. At my facility, we let the doctors, nurses, and hospital corpsman perform their duties while we the admin folks prepare the budget and keep staffing level adequate ( along with maintaining HIPPA, and keeping AAAHC, JACHO, CLIA, people happy!) I will be starting nursing school soon and hope to join you in the real worl. I am sure that it is going to be a culture shock working outside of military medicine.

Do you think hospitals are more concerned about the bottom line than patient care? Its a shame that our health care system worries more about the bottom line, than the health and well being of the patients. I know, long thread, but thanks for reading and sharing. I do value all of your opinions!

Gerard

[Tweety, BSN, RN]

I think a lot of management are caught between a rock and a hard place. Unit managers are nurses. Most directors and vps of nursing are nurses as well, although far removed from the bedside.

Most managers care about patients first and foremost. (There are plenty of egomaniacs who care only of their own egos, and I'm beginning to think I'm working for one of those.) However , they aren't given the adequate resources. They have a small budget because of many issues like reimbursement, etc. that makes it look like that's all they really care about. They have no staff and are constantly having to ask the staff to do the impossible, making them look like monsters.

There's a lot they can do better, and I bitterly complain about management frequently. But I could never do it. It's a tough job. As a charge nurse I try to be as supportive of my manager as I can be.

Yes, it's going to be a big shock for you in the civilian sector. And yes there is an "us against them" mentality at times.

[kc ccurn]

There is a big us vs them, which is a shame because in the long run patient care is compromised.

When I read about the threads and posts of how other managers are unsupportive of their staff it makes me cringe. I am very proud to say that I work for a very supporitve and professional manager. She supports us as charge nurses, bedside nurses and is a liason between us and administration and the physician groups. Her job is one that I would never want because I could never do as fantastic a job as she does. As a bedside nurse it is easy to complain about what is going on in your unit. When I became a charge nurse and have gained more "management" experience, I've learned that there are aspects of the job that the bedside nurse just doesn't understand, but is, nontheless, affected by.

There are battles that Ann has been fighting for us for years but is loosing to administration and some of the physician groups. So far we have been able to compromise and haven't lost entirely.

Money is unfortunately an aspect of health field that has to be dealt with. Having a strong unit director that can balance the units need to make money, the hospitals need to stay competitive with the necessity of delivering high quality nursing care is unfortunately a rariety. I admire and appreciate my director more the longer I have worked for her. (over 10 years now)

[ceecel.dee, MSN, RN]

Regardless of how well you think your nurse manager does her job, rest assured she is working for the floor nurses, doing what is within her power to do for you. ANY middle management job at ANY business can be a difficult one to maneuver around in. Just know that she is privy to information that all don't have, so in questionable situations, it very well might be difficult to understand her reasoning. The best you can hope for is an ethical and intellegent person with decent people and leadership skills.

[Spidey's mom, ADN, BSN, RN]

Actually I think this mentality is everywhere, in all walks of life and all jobs. Us vs. Them. And it is mostly undeserved. In my opinion.

Our DON is a nurse who worked at the bedside throughout the years she and her husband raised two daughters. She continued her education, eventually getting her Masters. There are times I disagree with some of the things she does but that does not mean that I don't admire her or that I cannot go to her with a problem and not be heard. Or that things don't change for the better for the nursing staff and patients.

Unfortunately I've noticed that people seem to love to gossip and spread a negative attitude and make blanket statements and blame the other guy.

steph