Wednesday, April 8, 2015
Profiles in Nursing Administratiion
Head nurses were really in a challenging position- responsible for patient care and keeping the unit running smoothly. You had to be really good clinically to survive. The supervisor level is where most of the incompetence reigned and here is a sampling of the finest examples.
The Sister Supervisor This supervisor came from a religious background and judged events as either good or evil without any grey areas. Suffering on the part of patients or staff under her was a good thing because it guaranteed salvation. She made sure there was plenty of misery for all. I actually worked with one of these characters and she thought open draining wounds were a sign of evil exiting a patient's body. Thankfully, with the corporatization of health care and the Sisters not reproducing, this type is nearly extinct.
The Supervisor in Absentia One of my favorite types. This one is frequently MIA. She attends every in - hospital meeting and every seminar outside the hospital. Frequently a unique blend of arrogance and ignorance. I was at a critical care seminar with one of these birds and she was able to point out p-waves and QRS complexes on an arterial line waveform. I did not have the guts to tell that it was not an EKG waveform that she was "interpreting." Things would be different today! The only thing preventing her causing any real damage is her absence from the clinical area.
The Paula Revere Frequently seen galloping down the halls yelling out, "JCAH is coming in 8 months, JCAH is coming in 8 months" Always on the alert for coming disasters and mishaps. Terrible clinical skills and intuition. Told a nurse pushing a crash cart to slow down- "You're making too much noise with that thing.' Usually skinny and hyperactive and prone to OCD behaviors.
The Barbie Doll. She looks like an escapee from a cosmetics testing lab. Her lifelong dream was to enter nursing and marry a prominent physician, preferably a plastic surgeon so she could get a mammary augmentation at no cost. Makes frequent calls to physicians when there is no good clinical rationale. Once called a doc at 3AM to get a straight cath order on a patient with a Foley. Cannot pass a mirror without pausing to self-admire. This was the type of student nurse to write elaborate, flowery care plans that were a work of art. Unfortunately her disheveled patient was stuck in a huge pile of poop that she failed to notice for hours. Everything looks great on paper though.
The Overseer This supervisor thinks of the hospital as her plantation and those under her supervision as slaves. She makes frequent references to "My nurses" and "My operating rooms."
I worked with one of these characters and it was best to just play along. "Them there lights sure be bright this morning, Miss Rita." was a frequent comment. Little instrument handling tricks served to amuse her. In the neuro room I taught myself how to load 2 Raney clips at a time. She sure 'nuff be proud of my nimble slave fingers.
The Retro Grouch This supervisor was caught in a time warp. Her favorite line was I'm old school and then would proceed to harangue and harass you to no end for your new fangled ways. Thought every piece of equipment should be reused. Once proposed that one time use endotracheal tubes could be repurposed for retention enemas, "The cuff is the perfect caliber for an enema." This supervisor could also sharpen needles and surgical instruments by hand using a whet stone and was critical of anyone lacking this skill.
The Office Sitter This supervisor never leaves her office. Foodstuffs and personnel enter but she never leaves her domain. She decided to get progressive and announces an "open door" policy from 3PM to 3:30PM on the third Tuesday of every month. It's strange how this coincides with the time all nurses are getting report.
It is possible to have a hybrid supervisor. I once had a Barbie Doll - Overseer. She was one of the all time most nightmarish supervisors I have ever encountered. Luckily for me she left to become a drug sales person.