We all know the general view that nurses have about nurse managers. They are, on the whole, not liked. They are the enemy. All they seem to do is cut staff and try to save dollars right? They are lacking in compassion when compassion is needed. And, why do they never seem to back the ward nurses when things are going tough? They don’t have to work rotational rosters or have to look after a ridiculous amount of high care patients. So, what is it that they do all day? Why is it that they treat us this way? What has made them so bitter that they have forgotten what it is like to be a nurse on the floor?
I have been a registered nurse for 8 years and a manager for 4 of those years. I am young enough and new enough to nursing to remember what it is like to be a nurse’s assistant and an RN. And, I have made the cross to the “dark side” of management. Thus, I am able to see both perspectives. So, let me break it down for you so that maybe you will have a better understanding of your manager and maybe – just maybe – not hate us so much.
Let me start by saying no manager particularly middle management WANTS to cut staffing levels. The unfortunate thing about middle management is that it is a position of power with no actual power. The decision to cut staff is made by the powers that be up above. This call comes from either lack of government funding (if it is a public facility) or the CEO of a company (if it is a private provider).
We all know that our government is not giving enough funding to our health system. And unfortunately, this is going to be felt most on the wards. Believe me, behind closed doors to the administrators, we are fighting for you. It may not seem like it but we are. The many arguments middle management has with top management over the disgusting conditions nurses have to work in, unfortunately, most of the time it falls on deaf ears. The reason you don’t feel like we are fighting for you is that as managers we have to remain professional. There is nothing worse and more unprofessional than a manager who bitches about the company (after all, what kind of an example would that be for the junior staff, right?).
So, we are forced to pass on the message with a smile. Why don’t we find you a solution?
Well, we wish we did have a solution. But, all anyone can do is work smarter not harder (and that goes for managers as well). We work well past our shift hours and sometimes take our work home at night and on weekends. You have no idea how much red tape fills our days in the office that we have not much time left for anything else like budgets, protocol reviews, etc.
As middle managers, we get a lot of pressure from top management wanting to cut funding for all sorts of things, coupled with the grizzling and complaining from ward staff that there isn’t enough of anything. Imagine you have a complaint. Now, multiply that by all the people that work on your ward (casuals, day shift, afternoon shift, night shift, weekday staff and weekend staff). That is what your manger has to absorb, take and try to find an answer for. Now, add complaints from patients and angry relatives about the staff shortage every now and again (more often than not). So, it seems like when we are not attending to mindless audits, and the other red tape forms, we are on damage control and the complaints department coupled in one. Then, it’s time to hand in your expenditure to admin and we have to find a creative valid explanation of why we are so much over budget. Whilst you have gotten away with being over budget this time with little more than a grilling and a long winded lecture or yelling at, next time, you may not be so lucky. And, there is every chance you could be put on micromanagement and yet not one person has thanked you in a really long time. Do they not even realise that the amount of stock on the ward is actually meant to be half of what is currently there?
Now with people calling in sick at the last moment and the no shows how are we going to find staff? Chances are, at this late hour the agency is booked out. Not to mention that even calling the agency to replace the shifts could put you on the line with top management because it is going to blow your staffing budget. Why oh why do we even bother doing a roster if half the staff aren’t going to turn up? Pressure from all sides Ahhhhhhh! Compassion? How can you be compassionate when majority of the staff take advantage of you when you show a little compassion? Everyone wants time off and takes time off whether you allow it or not.
This is just a small snippet into a small portion of what a manager does. If I went into it in detail and cover all of it, we could be here all day. The truth is, we become managers in hope that we can try to make things better for our fellow workers. We enter the position with great ideas, hopes and dreams for our patients and collegues to make a better work place and environment for all only to be hit with this brick wall called admin and top management. It is not only frustrating for us, but it is down right difficult as a sense of professionalism has to be maintained so that you come across uncaring to ward staff and are portrayed as the enemy.
You see, it is not easy being the middle man. We do understand and recognise how hard you work. We remember how hard it is to work understaffed, under resourced, and with little thanks. But, please remember that your manager is also overworked and underpaid for what they have to deal with. They are trying to make things better for you (even though you don’t see it) – and they do it all without the chocolates and thank you cards. And sometimes, even without the smiles.
What are your opinions? Do you think this has helped you understand or do you still hate management?
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Managers Thanks for the enlightening blog .None of us really hates Management I think sometimes we just get really frustrated and they are the only ones we can vent to .
On being a middle manager! Shirley every word you write rings absolutely true. Middle management is the “meat in the sandwich” and every body takes a bite out of you! That’s why I’m changing my career direction – there is no thanks, just complaints and critisism from above and from below and no one can or should take that for too long .
Thanks Illawarrior It is nice to know you know have a little insite into the life of a nurse manager, I couldn’t imagine you not liking anyone he he
however you are a rarity most have quite a disliking to managers but I think that is because of bad experience and a lack of knowledge into what they actually do.
Patience… Yes you are right everyone takes a bite out of you, but I think as a manager you need to have broad sholders and just keep working through it ( eventually we are bound to make some sort of a difference somewhere) But it is true you can only take so much before you snap and either leave or become bitter and horrible ( the type of manager that gives us a bad name)
I don’t ‘hate’ managers but they do seem to be more interested in covering their own backsides than in supporting their colleagues. We are still colleagues, right?
For what it’s worth, I think that these days we have far, FAR too many managers and not nearly enough doers. And it’s always the doers who are left understaffed.
SHOLLS Just to let you know I know being a Maanager must be a tough job .I had something unusual happen to me tonight after a small incident at work my DDON rang me at home .She rang me to see if I was ok .I can tell you that this meant a lot to me .Its nice to know that the supervisor and DDON were concerned for me and showed me .This has helped to restore my faith .My DDON listened to my viewpoint and I have been able to be up front and honest with her .
I have requested a move to another area .I really believe there should be more support networks in place for people who have realtives in NURSING HOMES and then maybe STAFF such as myself would not be the butt of there distress.We all do a great job under the conditions we work in
love em or hate em..management? From 13 yrs of being in Health Care and reading the above’between the lines’ it sonds like a cat-fight.
Managers are required and on the whole do their very best. Some do not however jsu to ‘vetn-off’ at them is incorrect I suggest.
If you are reading this you are a NSWNA Member. Call your Union Rep.Get the matter heard by persons away from ‘your work face’. Managers are not just there for us. Look at their work-loads, consider they are human as well.
At times they have to sit on the fence or not agree with you or the Team.
I do agree there are too many managers and far too many non-productive meetings they all attend. Systems in place do inhibit swift action and resolutions to simple matters.
Nurse Managers, NUMs, DDON’s etc When I first commenced nursing some 30 odd years ago I never wanted to be a ‘sister’ charge, Matron etc. I just wanted to help people. 11 years ago I rejoined the nursing workforce and again I didn’t aspire to any management position. I just wanted to help people. I have been the NUM of a unit for 20 months now and I find that I am helping people not just patients but staff also and not only in my unit but in the community. As for being the meat in the sandwich, yes we are but I don’t really think we would have it any other way. It is good to see both sides of the story, it really improves your inpartiallity and insight. Yes it gets frustrating some days and you just want the simple life. But simply, somebody has to do the job and I’m one of those somebody’s. I love the stimulation to my brain that it gives me and I love to see the smiles on the staff faces when they have done a great job. It is about sharing and communication.
Will the Health System implode? In 25 years in the health system as a RN I have never seen things as bad as they are right now. I agree with Shoils that complaining to management may achieve little or even be counter productive as it wastes the time of both the manager and the nurse. Managers should not forget that they are paid at a higher rate as they are expected to shoulder a greater responsibility.
Is it time now to be speaking more to the politicians? After all they are the ones controlling the purse strings and from where I sit all the problems seem to relate to cutbacks on top of chronic underfunding.
Rich
We must become the change we want to see.
Mahatma Gandhi (1869 – 1948)
Bloomersgirl, I really don’t think the problem is with NUMS. By and large, they do what they can for the benefit of their patients and the nurses under their management.
The main problem, as I see it, is with the bloated level of upper and middle management. There are WAY too many chiefs these days and they seem a lot more interested in protecting their own cushy positions than in promoting patient care.
Being a manger Good insight explanation (but who wrote it?) – no name on the item! I spent over 35 years in this game, and still work on average 60-80 hours most weeks in intensive care, cardiothoracics, emergency etc. The comments go both ways on opinion re managers. Many staff support and understand.
I ran intensive care units from 1979 to 1984 and then did 2 years as ‘night matron’ ( Assistant Director of Nursing-Nights) in a 450-bed hospital in Sydney. I was the ‘NUM’ but still stepped in and sent staff for breaks, taking their patients for an hour or two. I worked through agencies, moonlighting (‘illegal’) at intensive care units across Sydney while employed as NUMI was the educator, did rosters (‘please can I have the weekend off?”) – and often worked my roster to enable nurses to get their requests in. No-one abused the system. I preferred the system to today’s, where NUMs seem to lose touch with clinical care. I spent more time ‘protecting’ my nurses from the Nursing Adminstration, and fought for them anywhere. At one time, where a registrar pulled a nurse from the ward by her ear, I punched him to the ground in the corridor. He never touched the nurses again, but we did become friends! He was frustrated with the system and a lack of support!
Now, I work as an agency nurse, and tell those who want to be NUM, that One overtime will get them more money than a NUM, and two overtime shifts gets more money than a Nurse manager (Supervisor) , and all without the garbage attached, or the enemies. I recommend that they should try and do a stint as NUM, but not for as long as I did. I enjoyed it, and only gave it up when the stairway collapsed (I was on it) when trying to get to an emergency. I blew out L5-S1 and was in traction, then rehab. The treatment by the hospital put a sour taste in my mouth. The Union at the time wasn’t any better with their opinion about nurses who complained about back injuries. They seem to have progressed over the years since then.
HI Bernhard,
I wrote the piece
I was finding that there was a lot of people on NU with a bad taste in their mouths about their managers. Being a manager myself I felt that maybe some of the members had it all wrong and perhaps they don’t understand the demanding roll. I wanted them to know that infact middle managers do understand and fight for ward staff, it is just not as transparent as they would like it to be. My hopes were that the ward staff would think before they bad mouth managers and to think about their manager in particular before they have a go at them. You know the saying “If you walk a mile in someone elses shoe……etc”
managers are human too Thanks ‘Shoils’,
Doing rosters becomes a battler, and often when staff don’t get their desired holidays, that is when managers become demons. I kept the friendly morale going, but had a small few who saw managers as ‘evil aliens’. If you don’t accept authority, managers will always be aliens. If you don’t accept authority, nursing (and armed forces) are not vocations to enter. I had some pretty stern charge nurses, but still respect most of them. I think I always learnt some great lessons from them, even if they really were aliens!
Where I work agency, I still tell the nurses who whinge ( usually for good reasons, though not fully understood by them) that the job is a lot more demanding ( and not reimbursed for the insults) than a nurse should have to put up with. Are you getting Christmas off? Is this your first Christmas off out of 20 requests?
Frontline Managers are the glue that binds Much management research and many years of experience illustrate the value of frontline managers in hospitals. The problem, as I observe it daily in my role as a management coach working with nurse managers is that very few managers have developed the ability to provide leadership. They confuse leadership and management. When they are completing forms, fighting bureaucacy and chasing up people to fill in those staff that unexpectedly take the day off they are managing. When managers say they need to work smarter this means they need to become smarter at dispensing the management tasks so that they can spend more time on leadership. This is where they spend time ‘walking the talk’, observing issues in the workplace, facilitating discussion, coaching people in their roles. I am greatly impressed by the DDon that phoned a staff member to enquire how she was. This is leadership and it will be remembered long after any management task. If you are a manager and you want to be remembered for all the right reasons then spend more time amongst your team, not doing their job for them, instead helping them develop the ability to do their job better by reducing workplace stress, minimising conflict and increasing collaboration.
John Coxon
http://www.johncoxon.com.au
Here’s a radical thought – instead of having a single NUM, why not rotate all RNs and EENs through the position. That way no single person would shoulder all the responsibility and everyone would have the perspective of manager and floor staff.
Unfortunately you only need a business degree or similar to get the position now. Our NUM cannot manage the essential things like a leave roster. Granted we have a very large number of staff but she doesn’t seem to have organized any kind of assistance with it. She doesn’t deal directly with the staffing roster. A rotation of senior team leaders do that and enter our hours into the pay system whilst actually running the unit shift to shift. I cannot understand why we pay for someone else being chronically overwhelmed by the one task.
A large number of staff has resigned. As far as I’ve heard it has been due to the impossibility of getting annual leave. Forget about long service leave you will only get that as a payout when you retire.
I understand it is a demanding job.However,our NUM’s people skills need more than fine-tuning. She will target certain staff members and treat them badly for no apparent reason.I’ve already experienced that personally.What she did to me I cannot forgive? I’m trying to move forward but it one steep,steep mountain. Trust is something she will never receive from me again in this lifetime. If she is such a wonderful NUM why for the first time since the unit opened have so many staff left together. I would say they have voted with their feet. Why do people like this continue to be pat on the back by upper management. Our upper management is a real `boys club’. The more psychopathic you are the higher you get up the ladder. All of course through treading on the heads of others to get there.
What about those who do the “splitting” thing. Anyone witnessed that? Playing staff members off against one another. “Good cop/bad cop” scenario. rewarding the good cops and punishing the bad cops. I’ve seen the annual leave thing as well. This lasts until they are called to account by THEIR manager for allowing staff to accumulate excessive leave. There are many subtle ways to bully staff ……
I thought they rewarded the ‘bad cops’ more at some places. My wife is an RN (better in many ways than I ever intend to be in the general care sense. She does ‘everything’, including full after care, organising community nursing, pharmacy, follow-up appointments etc , where I refer all that to social workers etc. She always fights for better care of patients, and I always tell her that when working in the private sector, if she pushes too hard, and shows off the DON and management, they’ll nail her to a tree. Both employers set up false accusations of incompetent care, or ‘complaints from family members’ as an effort to get rid of her, and one place saw the DON call her in for disciplinary hearings where ‘action would be taken’. She was allowed one ‘observer’ (who isn’t allowed to talk). I arranged an ‘observer’ and during the procedings the observer stood up and objected to the treatment of my wife, only to be shouted down and threatened. We were prepared, and he was the CEO of the ownership group of the nursing homes group. My wife was cleared, then resigned, and the DON was ‘removed’. My wife wasn’t in the NSWNA, but should have been, but had the DON also been in the NSWNA my wife would most likely have been deregistered. At the end, it’s all about power-play.
I agree about there being too many middle managers and nurses who have these cushy jobs doing some hospital projects Monday to Friday earning $60,000 just by sitting in their offices and informing staff where they are going wrong. How these former clinical nurses forget what it’s like to be at the bedside with an heavy workload every day where it’s impossible to complete all your work. The higher up you go up the ladder the less you do and therefore can hide in your office.
i agree with volly – far too many mangers and project officers – never sween a project result and we don’t need to be told how to get on with the job some earning over $60,000 – what a terrible waste
Most are out of touch twits. To get a great manager is wonderful. They seldom last long because of the twits above them.
I am absolutely in agreement with your statement about middle managers. The NSW health system can be likened to a spinning top…bulging at the top with middle managers, CNC’s, special project managers, auditors, “co-ordinators” and other non-essential titles, all balancing on the few staff actively caring for increasingly high acuity patients while trying to stop the whole top from tumbling over. I would feel ashamed to enter a ward to perform a handwash audit (as I saw 3 special “handwash auditors” – former NUM’s – do on our ward….and follow staff around with clipboards whilke staff ran around) when the floor staff were working 2 nurses short. I am personally very close to resigning out of frustration over constant short staffing exacerbated by movement of staff off the ward and into these paper shuffling positions.In 5 years in our oncology ward, I have seen CNC positions increase from 3 to 11(!!!!!!!) to the point where there are double the amount of “nurses” sitting around the desk talking about patients than there are looking after those same patients. Enough is enough!!!! A corporate enema STAT please!!
The NUMs that are most respected are the ones that are true leaders who at all cost to personal agenda stand behind their staff 100%. I am not talking about the odd staff member who is generally not committed nor an asset to the unit, but the nurses who are skilled, knowlegable and committed to giving excellent nursing care, particularly under the so-called strained healthcare system. NUMS that focus on doing the best they can to provide and fight for adequate staffing to give their nurses the opportunity to excel is a NUM worth keeping happy. NUMs that prioritize to provide fair and flexible rostering is worth their weight in gold. People have lives outside of work and balancing is healthiest. NUMS who encourage staff to have a voice in how they would like to see their unit running is one that will hold the staff’s respect. Staff will support this type of manager and work more positively and get more job satisfaction. It is a shame that these type of managers are rare. The ones that are out there often are bullied out of organizations by upper management.
I don’t hate managers “much”. I just wish that ours would have common sense and back the staff. Seems there are still too many jobs for the girls and boys. We have had new managers dumped on us far too often to generate any respect for the area health service. can’t wait to retire bring it on.