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Here it is, the end of the year and I can’t think of anything to write about.  I am sitting here at my desk looking at all the stacks of papers on my desk demanding my attention.

Schedule requests and changes, incomplete performance evaluations, a list of employee issues I need to address and now a subpoena (that will be a story for another day).  I am looking at all this stuff trying to figure out what needs to be done immediately and what can wait, but as you can see by the fact that I am writing this, I have no intention of doing any of it.

Stacks are what guides the day of a nurse manager.  Every time a new project lands on your desk, a new stack is created.  Every time an issue pops up, a new stack is created.  Then each morning it is the job of the nurse manager to determine how to handle those stacks.

Being an ED nurse and having been an excellent triage nurse, I am able to quickly look over my stacks and make a decision.  That stack there is chest pain and needs to be seen right now.  The stack back there has been there for two weeks, obviously it is not emergent, I will deal with it in time (most likely that time will be when I put it in the recycle bin).

Right now I count seven stacks on my desk and none of them are my chest pains, so they can all sit in the waiting room and wait their turn.  I will get to them some day.

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As a parent I let my expectation be known to my child and they can work within those expectations when making decisions on her behavior (note:  it does not always work with a four year old, but it’s never to soon to get her learning).  As an ED nurse dealing with a large amount of psych and intoxicated patients, I let my expectations be known with them (note:  it does not always work with an intoxicated college kid, in fact even less than with a four year old).  And, as a manager I let my expectations be known to my staff.

On the first day I was on the unit, I told my staff what my expectations are.  They were pretty simple.  I expected everyone to be at work, to be at work on time, to do their jobs while they were here and to follow hospital policies to ensure we are providing safe and effective patient care.

I have found that expressing my expectations and listening to the expectations of my staff helps all us focus on what is important in our day to day operations.  They know where I am coming from and I know where they are coming from.

I found this is great practice as a nurse, too.  In the morning when I am introducing myself to my patients, I find out what their goals for the day are, or what they expect to get out of it and me.   And I am able to express my goals for them and I want expect from them to meet those goals.  Usually, are goals are pretty similar and things work out wonderfully.

By giving your expectations of kids, patients or staff, you are able to hold them accountable for their actions or behavior.  If you told them from day one that they you expect something from them and they can not, or refuse to, do that then you can hold their feet to the fire.  That also goes the other way if I am expected to do something by my staff and I don’t perform, I would expect them to call me out.

So, my expectation of all of you is to talk one idea from this and use it in your daily practice….and I will hold you all accountable.

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This was kind of a rough week at work.  I was rushing around trying to get things done since I was going to be out of the office for a few days.  Getting the schedule out to my staff (have I ever told you all how much I truly hate the schedule), making sure everything was off my desk before I leave for this trip I am taking and then having to terminate two of my employees.

This week I had to let two of my employees go.  One had it coming, it was really just a matter of time until he had to move along.  But the other was tough.  The other was a great nurse who was a great leader on my team, was a resource to the younger staff and was dependable.  Unfortunately for her and my team, things in her personal life started to spill over into her professional life and that affected her ability to work.

I know this is part of my job to deal with these kinds of things, that doesn’t make it any easier.  I get paid well to solve problems, and unfortunately to help people move on to another job from time to time.

Just one week I would love to not have any drama.  I would like to have everybody come to work, do their job and get along.  Is that too much to ask for?

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This week I had a big issue with a couple of my CNAs.  I was extremely angry.  Rather than taking them into my office right then and yelling and probably making the situation worse, I chose to wait until the next day.  When I left I told them both, “I will talk to you tomorrow.”

That night when I was on Facebook, one of the CNAs posted the “Top 5 things to being a good Boss” and “Top five things not to do as a boss.”  These were obviously directed at me, and of course angered me even more.  Not that they can’t say what they want, but they chose this venue to talk about it, when they knew I was going to talk to them about the next day when I was calmed down.

This got me thinking, what are the top five things I want my boss to do or not to do?

Here is my list of the five things I want my boss to do:

1. Communicate openly, calmly and rationally with me.
2. Give me the autonomy to make decisions as a professional nurse and leader.
3. Be a resource for me when I need direction.
4. Back me up when I make a decision.
5. Be honest.

I think these are pretty good. I am currently on the committee that is interviewing candidates for the Director of Acute Care Nursing, and these are basically what I tell them too.  I feel that if you had the confidence to hire me, or keep me in this position, then these should be pretty easy to allow me.

Here is my list of five things I do not want my boss to do:

1. Do not talk down to me.  Save the conversation for when you are calm and can discuss it rationally.
2. Do not micromanage me.
3. Do not be unavailable when I tell you I need help.
4. Unless I am breaking a law, a regulation or a policy, do not second guess my decisions.
5. Never, ever lie to me.

As you can see my dos and don’ts are pretty much opposites to each other.  I expect these items from my manager, my staff and myself as a leader.

These are not the things she said about me, though.

This got me thinking about what would be appropriate for a person to post about their work.

Obviously, never, EVER post any patient information.  This could get you in tons of trouble and possibly cause you to lose your job, and even legal issues.  I know we want to post funny things that happen at work, but do not use patient names, describe them or give any information that could identify them to others.  If for some reason I post something like that, I even try to change the sex of the patient.

When it comes to your boss or job, you may want to get online and complain when you think your boss did something unfair, or when you have a bad day at work.  But try not using their name, your hospital and/or unit name.  This will make your boss, unit and organization look bad to others.  Maybe it is just a personal thing between the two of you and your boss will get along great with somebody else.  It can also give patients an inappropriate view of the type of care they will receive or had received there at one time.

What I would suggest…..keep work at work.  The best way to keep yourself from possibly getting in trouble is to just not talk about it in a public forum.

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I recently took a test to measure my strengths as a leader.  This test gives you top five strengths and how to use those to improve yourself overall. One of my strengths is as a ‘relater.’ It stated that I am strong at creating relationships with my employees and maintaining those relationships by getting to actually know my staff and relate to them.

At first I thought that was nonsense, but then I sat back and thought about it. I do take the time to get to know each of my employees.  If they want to sit in my office and chit-chat, I don’t discourage it. If they want to stop me in the hall to tell me about their personal life, I will sit down and listen to every word. I never thought about it as a skill, I was just doing what came naturally…..guess that’s why it’s considered a skill.

But how far do I take it? Should I talk about my personal life? Should I get involved in their lives? Should I allow them to be my friends on Facebook?

This is a tough place for a manager. On one hand you want to be a good boss and help them with whatever you can, even dealing with personal issues, but then you don’t want to become too involved and drag yourself into their issues. On one hand you want to let them know you as a person, but you don’t want the staff to become too involved in your life.

It’s a fine line to balance…being there for your staff while keeping them at arm’s length.

I care about my staff. I know when each of them is down or having problems and I try to support them the best I can. And I celebrate their accomplishments with them as well.  Sometimes they tell me more than I want or need to know….sometimes I do, too.

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I did find a mentor when I was in my final semester of school.  He was my preceptor for one of clinical rotations.  He had only been a nurse for a few years, so he understood what I needed from him in the beginning of my career and he also knew the pitfalls I would find myself in as my career progressed.  When I was thinking about changing jobs or specialties, I knew I could go to him and get his honest opinion, and that I could trust that he would not steer me wrong.

Once I got into management, I needed to find someone that could help me in this transition.  Although he was the one that helped me make the decision to jump from the floor into the office, he didn’t have the experience there that could help me.

I finally found a nurse that had been in management for about 10 years.  Her career was about the same as mine; she went into nursing with a previous career in business and knew that she wanted to get into management as quickly as possible.  She is now the one that is there for me when I need a little pat on the back when I think I am going the wrong direction with my management…..and she is there to knock me down when I am thinking I am great when I am actually screwing up pretty bad.

I truly appreciate both of my mentors for different reasons, but the most important thing they have done for me is just help me stay positive and remember why I wanted to be a nurse in the first place.

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A while ago about I wrote about not burning your bridges with other nurses, because nurses talk to each other.  That goes for managers as well.

This week at work I had something a little different that happened, but still makes the nurse look bad in the eyes of a hiring manager.

I am currently recruiting for a day shift RN for my unit.  Although I have a stack of new grad applications, and many are very good on paper, I really wanted to get a nurse with experience so that I could spend less time orienting and get them on the schedule as soon as possible.  I spoke with two experienced nurses.  One used to work on this unit before I was the manager and had great references from the current staff, and the other was a nurse in the float pool that had great references from my staff.  Both interviewed well, and had great experience.

The one from the float pool was leading the pack and was going to get the job.  She already worked for the hospital, so no hospital or nurse orientation, she knew the computer systems and the staff already knew her.

I still had a couple of interviews left before I could offer her the position, and she called me to tell me she was going to pull her name out for consideration.  I said “ok” and thanked her.  The next day she called to say she still wanted the job after discussing it with her husband.  So, after all the interviews were completed, I came into work on Monday ready to make her an offer, but in my email was a message from her stating she couldn’t do the job now but she wanted to be considered for a future position.

To a manager this is not a good sign of what she will be like as an employee.  She can’t make up her mind.  If she can’t make a decision like this, then is she going to be a flake about showing up to work on time or showing up at all?  Is she going to be difficult about the schedule?  Is she going to fit with my team when she is here on full time basis?

What  I am saying is, how you act during the interview and hiring process will give the manager an idea of how you will be as an employee.  If you act flakey during the pre-employment process, I am pretty sure you will act flaky as an employee.

I hired the experienced one that worked here before, and am happy with my decision.  And…..the flakey one will most likely never get the opportunity to work for me.

I heard rumors going around the hospital about a charge nurse on another unit that was posting negative remarks about his manager and unit on Facebook.  Another nurse came to me to talk about it because she knew that I was friends with this manager.  She even showed me what was posted.

Not only did this charge nurse post these remarks about his boss, but even stated these remarks using her name and the unit name.  Unbelievable!  I can’t believe that a nurse, especially a charge nurse who is in a leadership position, would stoop to that.  He was even having dialogs with other nurses form that unit talking trash about the unit and manager.

I requested to be his friend to make a comment about how inappropriate what he is doing is, but I decided the best way to handle this was to present this information to the manager of the unit.  I felt it was her problem to deal with, and I was not going to sink to his cowardly way of dealing with problems.

Not only did this make him look bad as an employee, but also weak as a leader on the unit.  It is one thing for nurse to complain about their boss in private or in the breakroom, but it is another for one of the members of the leadership team to lead the complaining session.

Also, just an FYI to all you out there that think what you post on Facebook or any other social networking site is private……it is not.  It is out there for the entire world to see.  Just because you think only your friends can see what you post, you will have friends that will show what you posted to others, and eventually that can get back to your employer that can put you in position that may jeopardize your job or at the very least the trust your boss has in you.

Remember, it is normal to complain about your boss, just be careful you who do the complaining to, and how you do it.

What I tell them is; you are now professional nurses, so now is the time to act professionals.  What I mean is, this isn’t an interview for server job at the local chain restaurant, this is the first job in your new career.  So play the part.

My suggestions are:

• Polish up your resume.  It’s the first thing that the interviewer will see and if it doesn’t look good, you’ll never get an interview.
• When you get an interview, show up on time.  If you can’t show up for the interview on time, it shows me that you can’t show up to work on time either.
• Dress like a professional.  Don’t show up in jeans, shorts, flip-flops or any other casual attire.  A professional appears shows a professional attitude.
• Turn off your cell phone.  And if you forget and it rings during your interview, don’t answer it.
• After the interview thank the interviewer for their time.  I am not one that feels a thank you card is necessary, but the card or even an email will keep your name fresh in my mind.
• Follow up….but don’t be a pest.

Although some of these like common things to do…..I have seen all of these things in various interviews.  I always amazed at what applicants will wear or say at an interview and think it is perfectly acceptable.

Hang on while I take this call!