My Manager…the Epitome of the Idiots…
I am irritated by the following e-mail I received from my manager. Instead of discussing these issues in a recent staff meeting he sent updates that affect everyone’s life via the net. I do not think this man knows how to communicate unless it relates to stuffing things under the carpet…
“We held department manager meeting today and there are a few things I need to remind you all about:
1. There will be a mock JCAHO survey some time in the next two weeks. I asked all of you to come bring your binders into me so we could go over them, so far I have only spoken with a couple employees. Please try to talk to me sometime this week. Please do not ignore alarms either the surveryor will want to see that all staff. tele tech and med surg staff are responding to the patient tele alarms.
**This irritates me for a few reasons…he never asked us to bring our certification/inservice binders to him he left a note on a POST IT with instructions that we had until the end of December to see him…now with plans for a mock JCAHO he wants it sooner? Furthermore, we the Tele’s, watch those alarms and per corporate aren’t allowed to ever silence or turn them off…even when the computer mistakenly calls an irregular heart beat A-Fib or when the patient is dying and has a DNR/DNI status… Also, I HATE JCAHO protocols…it seems to me that it is just a bunch of extra paperwork and protocols to follow (that never have much to do with the patient, but more to do with cya and liability issues) which convolutes methodologies for caring for a patient while at the same time ensuring a rating that the public could care less about….
“2..I will be re-working the staffing matrix. We will try to add to the support staff at night and balance it out elsewhere. Please keep in mind not everyone will be happy and someone will have to give something up in order for it to work. Initially you told us that the most important thing to you was that you were never here alone. We gave that to you and now it is apparent that lack of support staff is a bigger issue. Feel free to offer any suggestions and we will try to incorporate them into our new plan.
**The newest matrix, released about a month ago, caused everyone to rebel. Nurses allowed support staff (i.e. the Unit Secretaries and the Aides) to work entire shifts when the census didn’t call for it according to the staffing protocol. They did this because we would be down to 2 patients and then get slammed with 4 admits right at shift change…the nurses couldn’t do vitals, total patient care, assessments, med passes, med mixes, AND input orders…Hmmm ya’d think you would have a clue as to why new matrix didn’t work. DUH! Not that I expect the new one to be much better, but maybe management will rethink the 6 patients 1 nurse – 1 aide; send aide home upon 7th admit, bringing another nurse in and thus, placing aide on call until there are 11 patients….RIDICULOUS!!!!
“3.. Our rapid response team is in place and ready. To initiate their involvement page overhead anytime of day “Rapid Response Team to Med surg” two times do not review by the team. This is a team that responds to any worsening change in the patient’s condition. They are the pre-code team and their involvement is
strictly informational.
**What friggin’ legit hospital has a PRE CODE team? This was implemented because in Med-Surg, the new nurses, right out of nursing school only get 3 days of orientation instead of two weeks and have been calling code blue status on patients when they should have just notified respiratory because the patient was having labored breathing. WHAT THE HELL???? I really am annoyed by this one above all because isn’t it the manager’s responsibility job to engage the employee when mistakes are made? Perhaps give advice when one’s newness doesn’t dictate the correct protocol?
“4. Please don’t become so frustrated of the difficult things at our work that wedon’t appreciate the things that are going well. Please see the article in our med room regarding recent changes at other hospitals and be appreciative that we are not there (yet) The economy will continue to bring changes to everyones work
environment. The trick will be in finding happiness in the things we can do well.”
**This last one is because my manager does not know how conflict negotiation works. He just removed our best Tele and relegated her to work Med-Surg as a full time C.N.A. He did this because his regular C.N.A had many patient complaints and wasn’t working with two of the day-shift nurse’s well. Instead of suspending the aide for bad behavior, and conduct; and, enforcing a customer service training or dealing with the toxicity between the employees…he rewarded the aide that was acting up and punished our wonderful Tele. It is an egregious action and so many are fed up and complaining…so much so that corporate has made all of us watch a “disruptive behavior” video. Comment 4…another insult to my intelligence…”let’s just cause chaos and pretend we didn’t by wrapping it in a nice fluffy Christmas bow.”
So…admist all of the dumb shiz going on we are told it is all because we are over budget. Then a week later we receive a brand new copy machine and the hospital gets signage… WHATEVER!!!
But the thing that probably irks me the most about this e-mail to me is that the guy didn’t even bother to capitalize things that should have been capitalized. I know my grammar and punctuation is not stellar but it is because I choose to be a creative writer…I am not in a Professional, Technical position..this guy IS and fails (in my mind anyway) to even have a Professional Presence in his writing. I AM SOOOOO BUGGED!!!!! And I know it is really petty to be bugged, I just can’t help myself….
December 3,2008 at 18:34
He sounds like a dope if you ask me.
However, I have to agree to disagree on one thing. There has been a lot of research done regarding “Pre-Code” or “Rapid Response Teams” and the findings are in favor. As I’m sure you know, in Med-Surg, pts can crash within minutes. Since the initiation of the team, I believe our last employee newsletter said we had only 2 Code Blues (cardiac arrest), compared to 13 in the previous quarter or whatever time frame they use. That’s what…a 70% decrease?
The idea of a RRT is not to get more experienced nurses in the room to help a flaky new nurse before her pt crashes. For instance, our rapid response team is 2 ICU nurses, an ER nurse, an RT, and the Pulmonologist or ER doc on call. It is an excellent thing. I’ve seen many “rapid responses” in the past year and all ended with the patient alive. Granted, it’s not always this way, but sometimes when a patient is about to code and the nurse is so flustered, it really helps to get a bunch of brains in there.
I also remember the administration saying that JCAHO (now the Joint Commission) has proposed this as a patient safety goal: Pilot and implement a rapid response team. Maybe they are just getting a head start?
However, the fact that new nurses are receiving 3 days of orientation is absolutely CRAZY. At our facility, they get at least 4, but I think it is 6 weeks.
It seems that this is probably always going to be an ongoing conflict. Administrators telling clinicians how they should take care of patients, what policies should be enforced, and how to do their jobs, but administration does not take care of patients so they typically are not aware of the impact of their decisions.
Hope it gets a little better.
December 4,2008 at 18:34
I had no idea that Rapid Response or Pre-code teams were legitimate and utilized resources. I honestly thought this was something my ineffective management contrived because the new nurses aren’t getting an appropriate orientation to the Med-Surg unit. I trust your opinion and will try very hard to be supportive of the movement, and less ignorant about it. So your RRT sounds like a very effective team. I am just wondering in our small hospital how this will work. At night we only have one Respiratory Therapist for the entire hospital, and he or she is always busy because they cover all of the floor treatments, the ER EVERYTHING. Also, we only have one ICU nurse who really can’t leave the unit…I’m wondering if our RRT will consist of all of the ER staff? It will be interesting to see how my management has set up the team and how the team evolves…because anything new undergoes change until it runs at its most efficient. Thanks so much for enlightening me..I always feel knowledge is power, so to speak and it seems I need to work a little harder to ensure I am in the know. Have a beautiful day!
December 8,2008 at 18:34
It sounds like it will probably consist of ER nurses (ACLS certified), the nursing supervisor who usually does all the documentation, and either an ER doctor or a PA or NP who is on duty for the ER.
I felt the exact same way when we initiated our RRT. I thought it was just a team who knew what they were doing, helping those who didn’t. So you’re not the only one…
At my facility they have considered assigning a CNA to the code team and rapid response team to play the role of runner for supplies or take over chest compressions. I think this would be a great addition to the team because it really takes time away from the urgent even when the key staff (ICU nurses, RTs) have to leave the rapid response for supplies.