I am an unlicensed therapist

I have a nursing degree; some nursing specialty certifications, and heck I even have a master’s degree in management. What I don’t have is a degree in psychology, or a certification in counseling. I definitely don’t make the salary of a therapist. So how do I find myself, consistently, being approaching with… ‘I need to talk to you about something.’

Oh good lord here we go. Close the office door, make sure tissues are available, yes please have a seat on my couch.

It typically STARTS with something work related. ‘I was wondering…if I could take a day off next week.’ [The conversation COULD totally stop here! Yes, looks like we have PTO available. Yup – staffing looks good. Which day?] but no. This is where the long story starts.

Sometimes I’m hit with some personal tragedy, other times it’s to tell me something quite inappropriate about their marriage. A lot of times it’s just straight up complaining about first world problems. Then right when I’m thinking it’s time to cut this person off, tell them they don’t need to tell me these things, or let me refer them to our department that’s actually paid to listen to them – the tears start rolling. It’s probably not common courtesy to cut someone off when they are crying about a personal life issue, or letting you know their deep dark secret. Pass the tissues.

I would like to interject here that I do care about my people and want to be helpful and supportive. HOWEVER…these vent sessions, cry sessions, bitch sessions – whatever you want to call them….are emotionally exhausting. And they are very time consuming! I don’t want to sound harsh or uncaring but the fact is…I got shit to do! More on my plate than I can manage on a non-therapy day and these therapy session hold me up fer realz.

Do leaders in other industries face this? Nurses in particular do deal with a lot of stress, pulled in a million directions a day, dealing with unhappy patients and families, experiencing moral distress, death and dying, constantly doing more with less. I get that sometimes you just need to talk to someone. And if I’m the person that helps alleviate that stress and makes this person feel heard and supported – I will do it.

This being the case – that nurse managers will continue to provide therapy, empathy, and encouragement; I would like to make a proposal. Okay 2 proposals for my office. 1. stocked wine rack 2. therapy dog.

The Schedule.

You have a job, you need to know when to work, the schedule tells you when to work. You’d think it would be an easy topic.

Nothing causes more headache, drama, or complaints than the unit schedule. It is the bane of my existence as a nurse manager.

Nursing units must be staffed 24 hours a day, 365 days a year. Weekends, holidays, special occasions – you got patients, you need nurses. This should be no surprise to those working in healthcare. The hospital has a mantra much like a committed gym rat #nodaysoff

I staff the unit based on a par of nurses needed for the average daily census of patients. Nurses self-schedule themselves in our scheduling application, and then the schedule gets balanced by the leadership team so there’s not 15 nurses working Tuesday and 3 working Friday. There are rules – you work your scheduled weekend, you work a certain number of Mondays and Fridays, you trade or ask for PTO if you want a day off. Seems simple.

Sike! As a manager, apparently other people’s schedules and lives become my problem to fix.

“I need every Wednesday night off for my yoga class” “I can’t work Monday’s for the next 6 weeks because of my church group” “I really need this Saturday off, can I just move to Monday?” “My family is going out of town for Christmas, and I know it’s my holiday but I really can’t work” “I have worked here for 10 years and I just think it’s not fair that I still have to work weekends”

If I can help and be flexible – I do. For the most part, I encourage the RN to work with their peers to find trades and figure it out. Its a big team with a lot of nurses. Despite being consistent with this – the questions and complaints do not end.

And my favorite…the schedule police. “So I just wanted to let you know that I heard some people complaining that Sarah only works two Fridays this entire scheduling period” “I saw that Janet was moved off of Saturday and I noticed that she wasn’t placed on another Saturday that I could see and you know, that could seem like favoritism” “I saw that Tiffany called in sick on the holiday and I was wondering what the rule is on that”

so you’re not a real nurse?

Yes I am a nurse. No I do not directly care for patients. This is something that has been hard to explain to the average person who is not in healthcare. And honestly, many times other people IN healthcare don’t understand the role. My own grandma is still confused.

I am proud to be a nurse. I think most nurses feel this way. It’s a difficult yet rewarding job, and in general nursing is viewed as a meaningful, noble profession. Usually when the random person asks me what I do – I say I’m a nurse. People understand what that means. Once specifics start to get asked – I know I’m in for the confused look and questions that make me feel like a fraud.

Nurse = care for patients. When a person finds this isn’t the case, the next question is typically: so what do you actually do? This is a tough one to answer! What I DON’T do would be a shorter reply.

I would bet that the responsibilities of a nurse manager span farther than managers in many other industries. The shear amount of direct reports is much greater. I am responsible for 80+ staff members.

Officially I have to keep up with competing priorities such as budgets, patient satisfaction, scheduling, staff satisfaction, performance management, hiring and firing, process improvement, patient outcomes, and ensuring compliance with multiple regulatory bodies – CMS, Joint Commission.

Unofficially I am a chaos coordinator, therapist, fire fighter, life coach, and what sometimes feels like a mom to toddlers. I have no children of my own but I think I will be well prepared for it.

Someone needed to say it

I am starting this blog because I truly cannot find another one out there with the words of a nurse manager. There are so many blogs and platforms for nurses, but when I go to find someone who understands the daily grind of the nurse manager – I can’t find anyone out there who relates!

I am going to fill what I feel is a void and be the person who says what needs to be said. Being a nurse manager is no joke. I hope that my blog will draw in others who live the life of a nursing leader and maybe, just maybe, we can help keep each other sane. I can say from experience that being a nurse is hard – but being a nurse manager is like being a ringleader. My circus my monkeys.

#who can relate? WOOO

I also plan to make my own memes because every nurse manager meme out there makes us look like the bad guys.