Nursing Voices

Monday, February 26, 2007

Go Ask Mother

It’s snowing like crazy outside, and I’m getting ready to go into to work. Ordinarily, the bad weather wouldn’t bug me, but I just got a phone call from my unit. I was told that my boss wants me to be prepared to work throughout the night if the next shift can’t make it in. Of course, my boss isn’t interested in coming in to help us out. That’s not her management style. Perhaps I’m being too judgmental, but good leaders don’t ask someone to do something that they aren’t willing to do themselves.

I’ve worked under some very good nurse managers in the past, and I’ve worked under some who must have read this book. Actually, this is a good book, but as you know, Attila the Hun has a bad reputation. He always got the job done, but it was always at the expense of his followers. He was a heck of a guy.

I’ve been receiving mail from my some of my readers, and they have been asking me some very interesting questions about the nursing profession. In today’s edition of Go Ask Mother, I’ll be responding to your questions.

When describing the ideal job, many nurses talk about the softer attributes of nursing such as teamwork, managerial attitudes and feeling valued. Why do you think that is?

ANSWER: Nursing is a touchy-feely profession, so it doesn’t surprise me that nurses would describe the ideal job in those terms. Yes, teamwork is important. Look at the two nurses in the picture. They look like they can beat anyone because they are working together as a team. Like I’ve always said, nurses have to stick together or they hang separately. If a manager were smart, he or she would understand that if they treated their nurses with respect, they would get hard working, loyal employees in return. Unfortunately, it’s been my experience that managers “don’t get it.”

What do you look for when you are looking for a job?

ANSWER: The type of work is one of the most important things I look at when considering a new job. I have to like what I’m doing or I won’t stay in a position. But I also take a critical look at staffing ratios, and how acuity plays into staffing numbers. Frankly, when I leave work, I want all my patients to be breathing. I’m not being sarcastic (OK, maybe a little) but I’m a psychiatric nurse, and I don’t want a suicidal patient to slip off and hang himself or herself because there wasn’t enough staff to watch everyone. The nurse in this picture looks happy. I wonder if her hospital is hiring new staff.

What is the single greatest attribute in a boss?

ANSWER: A good boss is someone who acts as an advocate for the nurses on his or her unit. I’ve been in healthcare for almost 30 years, and during that time I’ve had bosses who were saints. I’ve also had bosses who reminded me of Satan’s older, meaner sibling. In the view of most hospital administrators, bosses don’t need outstanding clinical skills to run a unit. Hospital administration wants managers who are good bean counters, and someone who can stay on budget and turn a profit for the hospital. I think that to be truly successful, bosses need good people skills, as well as a mastery of the specialty practiced on the unit.

What manager attributes do you think younger nurses prefer compared to the seasoned? For instance, do you think younger nurses may seek a manager to help them with their clinical skills while a seasoned nurse likes a manager to have good listening skills?

ANSWER: New nurses need a boss that won’t eat their young. This boss looks like he is about to yell at the new nurse. Hey, you, get your hands off of that young woman! I’ve seen so many kids get run out of the profession because bosses were too harsh. Bosses need to support new nurses while they learn new clinical skills, but they also need to mentor them on a more personal level. Reality hits new nurses right between the eyes when they take their first nursing job. A boss needs to be supportive, not a bully. I think older nurses just need to be shown respect, period!

What can administrators do to make nurses feel valued?

ANSWER: If you haven’t noticed yet, I’m full of opinions. I feel valued at work, not because of what the hospital thinks of me, but because I value myself as an individual, and because I’m valued by my co-workers. A few years ago, the morale on our unit was in the toilet. The hospital routinely put the psychiatric nursing staff in a dangerous working environment. One day, after telling hospital administration we needed more staff because of the unit’s acuity, I was severely beaten by a dangerous patient on the unit. Instead of crawling into a shell or quitting my job, I took action, and found a mentor who taught me how to legally protect myself while making changes on the unit. The nurses on our unit were the first to use our state’s whistleblower law to improve the safety on our unit. Things still aren’t perfect, but I no longer feel powerless.

Remember, you don’t need anyone’s permission to value yourself as a nurse. Every nurse deserves a trophy.


Blogger poody said...

Words to live by Mother! I find the new nurses are not as willing to work the night shifts or the holidays or even to stay over if the next shift is not available. I know we do eat our young but coddling them is not the answer either. The last hospital I worked told us old timers they felt the time and resources should be spent on the new nurses and not wasted on the old ones. We knew what we were getting into when we did it but the new nurses are not used to the rigors of nursing and they didn't want to run them off! No kidding they said that!

12:48 PM  
Blogger poody said...

PS somebody got those side rails up on that kid's bed!

12:49 PM  
Blogger FetchingGal said...

MJ, I cannot believe your unit manager would do that... well, actually I can but that is still just wrong. I have weeded out the riffraff for choice places and am down to two hospitals I am looking at when it comes to starting my little nursing career... one is small-town and I worship the ground walked upon by the person who would be my mentor there... the other is a large hospital in a bigger city but it's been really impersonal there so far and I have yet to find out which floor they'd put me on, what they offer etc. Decisions, decisions.

Hi Poody. Not all students hate nights, hate holidays and whine when the next shift is late. :) You just haven't gotten any like me yet.

1:36 PM  
Blogger Jean-Luc Picard said...

A good boss, in my opinion has got to be able to emphasise with the people they are working with.

2:06 PM  
Blogger Impetua said...

This is all good stuff for us students to read up on ahead of time. I'm finishing up my pre-req's and hope to start nursing school soon, and for starters while I do hope I get good mentors and kindy, twinkly-eyed seasoned pro's to work with, I haven't got a lot of illusions as to the true nature of the soulless bean-counting administration.

I work in mental health and have watched my agency go from an earnest, hard-working little group of people who truly wanted to enhance the lives of the clients they served, to a bloated sack of corporate bullshit emphasizing money, money, money. (But oddly enough, not much money for those of us in the trenches.)

So yeah, I know all about administration.

But it's good to know nurses like you exist, and that I can become one myself. :)

3:37 PM  
Anonymous Cinder said...

Hi Mother!
I'm a seasoned pro and the last hospital I worked at chewed me up and spit me out in favor of new grads.I don't blame(new grads) them and it's not right b/c they needed to learn from someone,not just thrust into situations w/ patients crashing in a critical care area. Most of them don't stay,they leave hsopital nursing and go work in clinics and the like.
I'll venture into hospital nursing one more time.I'm not so much worried about my skill level and such it's the horrible horizontal violence some nurses inflict on others.
If I walk out of this hospital w/ a knife buried in my back again that's it!I'll become a gardener. I'm worried about the future of nursing anyway.
New grads,just don't let them put you in critical care situations w/o proper orientation,preceptorship and a good mentor.Follow your instincts.

5:28 PM  
Blogger Bohemian Road Nurse... said...

I'm glad you reminded me that I need to be understanding with the baby nurses. Jane-Anne took a home pregnancy test yesterday---and today I found her discarded her urine specimen cup in my office trash can. (And I was going to whup her butt--but instead, I will try to take a soothing deep breath before giving her my "haz-mat" lecture for the 384th time...)

9:13 PM  
Blogger Bohemian Road Nurse... said...

I meant to add: As for me, I was thrown to the wolves as a rookie, chewed up daily, and I swore that I'd never do that to rookies myself. And I don't--I try to help them develop confidence in themselves. (But really, can you believe that Jane-Anne threw that dadgum urine cup in my office trash????)

9:19 PM  
Blogger The Angry Medic said... got beaten by a patient? You poor thing! I never knew you were a psychiatric nurse. Working without adequate security staff must have been hell.

Still, I know my Mama Jones is a tough cookie, so I have no doubts you rcovered well. I read one of your comments about some nasty mail you received after becoming a Blog of Note, and I was shocked, but the way you took it revealed your inner tough-cookie-ness.

Looking forward to the next edition of Go Ask Mother!

9:54 PM  
Blogger girlvet said...

Nurse Ratched: you are an inspiration to the rest of us. I love strong nurses! You go girl!

11:34 PM  
Blogger ERnursey said...

But why is it that it takes a nurse being severely injured before something is ever done? Cheers to you guys for being whistleblowers, wish more nurses would do that.

11:46 PM  
Anonymous Anonymous said...

Thank you!
I work in a dept that when the manager is not there - they are not there. During certain situations they are available by phone - but come in and help out when the place is sinking? NO WAY! Lots of excuses - but primarily just no response back.
I have been spoiled by previous jobs - where the managers felt that this was their job - to take care of the unit 24/7. And yes, they did still have time off and away. Those managers were less bothered by phone calls because the staff knew that if they truly needed the managers - they would be there - so the staff would handle as much as they could for them.

1:14 PM  
Blogger Nurse Practitioners Save Lives said...

I work as a floor nurse and I also charge when the regular charge nurse is not available. I have been lucky to have wonderful co-workers on the rotation that I work on. They have supported me in my endeavor in becoming a NP. Hurrah for them having to listen to me bitch and moan about how tired I am. I think that I have been a good manager when I've taken that role. I pride myself in being very hands on and it shows by our nurses coming together when times get bad. They are the only reason I will miss the floor nursing when I become a NP (except for my great patients over the years!)

4:31 PM  
Anonymous Anonymous said...

Management is a double edge sword, it can be and is rewarding but at the same time it is difficult and challenging. Many staff do not realize that their manager, one has a boss themselves and must remain accountable to their boss, and two, they do not realize what is done behind the scenes everyday, the phone calls, email, etc, that come across the managers desk the he or she must answer in defense of their staff. Put the staff in the managers job for one day and most will be glad that they are on the other end, taking care of patients.

9:27 PM  

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