Where's the Beef when it comes to your Nurse Manager?

oneLoneNurse · Oct 18, 2009

Fortunately, I don't have one. I work nights and they usually leave me alone.

One characteristic I seek in a manager is that he/she does not micro manage. Makes sure you have the training and skill set you need then puts his/her faith and trust in you and leaves you alone. It has been my fortune to work with two nurse managers for the last 10 years that have this technique.

flightnurse2b, LPN · Oct 18, 2009

a good nurse manager is willing to get their hands dirty and help out when they are needed. also, they care about their staff and what is going on with them.... that we aren't just a warm body on a staffing chart.

my last nurse manager that stepped down would come in and work if we were short a nurse instead of letting us drown, and she was like a 2nd mom to me, i could tell her anything. i really miss her!

tewdles, RN · Oct 18, 2009

Nurse managers must actually know how to do the job you are doing, AND they must have a clue as to how to manage a group of people. Putting the micro-managing pain in the butt nurse in the managers role pretty much insures that the rest of your staff is going to be sick to death of his/her management within 6 months. Unfortunately, too many first level managers are "promoted" into those positions without ever demonstrating that they can manage a group of people...they are often not leaders but are instead bossy. They often lack good communication skills, and are clueless about team building. Some of them self-promote to the extreme of back-stabbing other nurses to insure that they are the "apple of the eye" when it comes to administration. To make matters worse, the upper level management often has no plan to mentor the newbies into proper management practice, rather, they hang them out there with little to no support or education and then wonder why the units/departments/service lines struggle with EVERY issue. Things in nursing have changed so much over the last 30 years.

diane227, LPN, RN · Oct 18, 2009

There are many qualities that make a good manager. I have been fortunate to have worked for several exceptional managers throughout my career and have found several factors to be common. First of all, a good manager has a good grasp of what people under his/her supervision do. The supervisor may not be the very best nurse (in fact you don't want your best nurse to be your manager) but they should have a good knowledge base and certifications and training that make them qualified for the position they hold. Second a manager has to be fair and impartial. This means that no matter how they feel about someone on a personal level or what their relationship is with a person away from the hospital, when at work, it is professional, fair and everyone is held to the same standard. This topic requires a great deal of discussion which is too long to discuss here. But to sum it up, you must be able to terminate a friend if you have to. I have had to do this and it is not easy. But where patient safety is an issue, you have to make patient safety and patient care the priority. This is difficult, especially for a person who is promoted from within the ranks.

You cannot micro manage your staff and you have to learn to delegate. You want to grow your replacement so you want to teach people what you do. Your job should not be a mystery. A good manager is up front with people and direct. A good manager lets people know right away if they have made an error and what they can do to correct it. The manager offers to assist them and gives them an opportunity to make a change. Depending on the problem, immediate action may need to be taken such as suspension or termination but those times are rare and should not be taken lightly and should never be made without consultation with another manager. A manager should LISTEN to the staff. Allow them to vent and allow them to give ideas on how to make their job better and easier. It is MANDATORY that a manager understand human behavior and have some understand of mental illness. You will have staff who are under stress and have mental health issues that have to be addressed and you have to know how to get them help. Be very familiar with FMLA and your employee assistance program and how to get a referral for your employee. There are times when they make an error but instead of a counseling form they need your help. I recall a time when I was called by the charge nurse at 3 am when one of the unit secretaries simply "went off" in the middle of the work area. She started screaming, cursing and throwing charts at people. When I arrived, she had calmed down. I spoke with her privately and learned that she was bipolar and had been off her medication. I drove her home and gave her a week of emergency vacation. She saw her doctor the next day, got back on her meds and was fine. I kept a good employee (she was very good at her job) and helped her get better. Remember, when you fire someone, it will cost you a lot of money in time and orientation to replace them.

When it is time to do the budget, the manager should meet with the staff and ask them what equipment they need. When a new form is needed the staff should develop the form after given the information about the standard that has to be met that requires the form. After all, the staff will be using the form so they should have a say in the end product because they will be using it. I also believe in peer evaluations (this takes a lot of time to explain so I won't do it here). Also, the manager should be evaluated by his/ her staff on an annual basis.

There are other items that make a good manager. The job is hard and there are times that you want to pull your hair out. Getting called in the middle of the night is not fun. Having to clean up a mess made by someone who made a stupid mistake is not fun. Trying to get people to get along with each other is not fun. But it goes with the job. And most of the time you will not get paid more than your highest paid nurse.

But if you read and you try to learn, take classes in management and get yourself a few good reference books and a mentor you can learn to be a good manager and when you do you will find that it is one of the most rewarding jobs you can have. You have to be able to laugh at yourself, communicate with people, problem solve quickly, hold a hand, be a resource, find answers when you don't have one, tell a joke now and then, let someone cry on your shoulder and when times are tough you can get in the mix and do the work with the rest of the crew, not being the supernurse who shows up to "take over" but just coming out and doing what ever needs to be done from cleaning up a patient to serving dinner trays. And keep calm. You set the tone for the unit. If you are not in control of yourself, you will not have control of your unit. Calm chaos is what you strive for.

thegreenmile · Oct 18, 2009

Wow Diane, I can see that you possess the qualities of a great leader!

flygirl43 · Oct 18, 2009

I wish I had your manager

diane227, LPN, RN · Oct 19, 2009

You know, I did try to be a good manager and I think my efforts spoke for themselves because I never applied for a job, I was recruited away and when I would leave an old job some of the nurses would go with me to the new job. I was willing to stand up for my staff and I had a lot of fights with administration because of it. But you just can't roll over and you can't be two faced. You have to be up front and to the point. The people who worked with me always knew what I expected and knew that I had their back. If they screwed up they would just usually come and tell me themselves. People don't make errors on purpose. There is no need to try to whip someone into submission. Did I have to take disciplinary action--Yes. Did I have problem employees--Yes. But I never terminated anyone without trying to help them first except one time and that was when I had a nurse who broke the arm of a patient.

I was lucky to have great nurse managers to manage their areas and a boss that backed me up. Times were good and I was a lot younger then. But you get older and you have seen and done it all and it is just not interesting any more. Plus you do get tired of the calls in the middle of the night. Having to come in in the middle of the night because someone was hurt or some event had occurred that brought out massive news media and it required that I be there. Management can be learned but a person has to be willing to learn it and to give up a few things. You can't carry a grudge and you have to be fair, and you have to SHUT UP and listen. I found it very helpful to record my staff meetings so I could hear how I was coming across to people. I always knew I had a Texas accent but until you hear yourself on the recorder, you don't know how much.

If you are the kind of person who wants to control everyone or who thinks that a problem will go away if you just ignore it, then you probably won't be a good manager. And, least I forget, NEVER let yourself be pulled into he said- she said, where they come in the office talking about each other and expect you to fight their battles for them. I got caught in that web a couple of times as a new manager. I learned that if you have two people who can't get along, you bring them in a room together and let them fight it out face to face. You don't run back and forth between employees. If they can't resolve it then you have to let them know that if they can't get along and it causes a problem with patient care then they are going to be back in your office and the disciplinary action is going to start. And as for doctors, the same applies. They have to follow the rules too. In the ED it is a team and the nurses and the doctors have to get along. I had to come in one night at 3 am because the ED doctor on duty and the charge nurse where about to get into a fight. They HATED each other. And they were acting like children. I had never seen anything like this. The medical director and I sat down with the two of them and tried to get them to come to some type of agreement but they were like two year old children fighting over a toy. I finally just told both of them that if they did not stop fighting that they were going to be fired, period. They stopped after that. They wanted me to change the schedule around so they would not have to work together. Please!!! Act like a grown up.