Where to from here?

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Reply Mon 25 Sep, 2006 09:13 pm
Where to from here?
I recently tried to get a managers job on the PCU. When I did not get it I was really blacked out for a while. Especially considering who did get it. Well I am kinda over that now, having seen what the poor person is having to go through to keep it. Problem is I don't know what to do with myself. If there are any administrators out there could you please advise me? If you had your carrer to do over again what job would you take? Would you be in the medical field at all? What I am seeing has really got me confused. I did want the job to make life better on the unit for everyone. I knew the people and how things worked. Everyone aggreed with that, still did not hep, when it came crunch time. I am wondering if that was a bad thing for me now? I also thought that maybe life would get a little better for me. I never saw anyone put in those kinds of hours as a manager here. How many hours a week do your administrators do in your facility. Admittidly I am not really sure that all of it is neccessary, but I got to admit that some of it really is. I have seen this person put in 18 hours and still come back in the next day, several times in a row. With nothing, but ER experience, life on the floor has become, a bitter awakening for him, wheather he would admitt it or not. I cannot for the life of me figure out how he would solve some of the problems he is trying to tackle with out doing the kinds of hours he is doing. Still I don't think that my old managers were putting in those hou. Or was I just not paying attention then? I have decided to take a critical care course and get some experience there. Ostensively because I wanted the objection that I had not had critical care out of the way. Truth is, I can't take micro management. I could go on about this but, wonder if it is jealosy on my part still? Even though others have said this is a big problem for him. Is moving to critical care a misstake? For any administrator who hires other administrators: does it make a differnce? I have had other managerial experience outside of the medical field. Does that help? Does it hurt? What types of experiece are you looking for? Most importantly if you had to do it again, would you? Or am I crazy, for wanting anything to do with it? And, yes some people close to me and the situation have told me it was a suicide job. The truth is I have many times had the responcability, the keys, the perks, and sometimes the money, but never have I had the title. All non medical. I lost count how many times I was the last man standing somewhere, still I can't seem to get a head. Should I be happy where I am? Thanks, sorry to ramble a bit.
 
Ginger Snap
 
Reply Tue 26 Sep, 2006 08:49 am
I'd say it won't hurt you to get the ICU/ER experience. In some jobs in acute care, you just never are taken seriously until you get that experience. Once you take that under your belt, then you can write your own ticket. While I have solid experience doing high-risk OB (worked on a unit that functioned as an OB ER), I've never done ICU/ER, and it's kept many doors closed for me. If I were interested in returning to acute care (which I am not) then I would do the ICU/ER thing for at least a year, but no longer than that.

As far as the long hours, the best managers (those who were really interested in solving the problems on the unit, and not just pacifying their upper level managers), always work 60-80 hours per week. Especially in acute care, where the operation runs 24/7. Those jobs were always the most brutal, in my opinion.

If you are serious about breaking that glass ceiling, there is an alternative, but it requires leaving acute care. I had an ADON at a psych hospital tell me "you just need to get Director level experience somewhere." She said that being a DON at the LTC level counts, and its fairly easy to break into management there. And it's true --- your responsibilities are the same, and if you work for a facility with a sub-acute unit, your acute care skills are desparately needed. Take a job as a House Supervisor, and make plans on becoming an MDS coordinator, Unit Manager, ADON, or SDC as soon as possible. Once you've survived a couple of surveys, you should be ready to become a DON (and the LTC facilities in my area retain recruiters to find DONs when an opening becomes available, so they will approach you when they are looking for someone).

I would look for a facility that has the right support system (usually part of a corporation, where there are consultants to help you get your feet underneath you).

Right now, I work for a small LTC as an MDS coordinator, but we are transitioning to a model called "Neighborhood Support Nurses". A neighborhood support nurse is much like a Unit Manager with expanced roles, and it is the goal of our parent company to have us function as "Mini-DONs". My current DON is a strong manager, so this is a good opportunity for me to learn how to be a DON form her, but on a much smaller scale (33 beds) than an entire facility.
 
SharpknifeRN 1
 
Reply Thu 28 Sep, 2006 01:51 pm
Thanks for the input. In the process of getting the critical care course done I have learned a few things. First I am reguarded as being so valuable to the team, that they literally can't let go of me, so I can go to ICU. This confuses me a lot. If I am so valuable then why not try to convience me to stay? You can't run the place with out me, but you can't give me a title to stay? And I can't count the number of times I have been thrown under the bus for one thing and another? Yes before anyone asks this was acctually said. They told my wife. I really don't know how to reply, so I guess I wil just lable it under more strange behavior and go on with the plan. Second thing I learned is no one here has a CCRN behind their name except maybe the DON. (not sure of her on that) I was trying to get the strait dope on what it took to get CCRN behind your name? I thought it was more than, a matter of takeing a test, don't you have to do 1000 hours in a clinical setting with in 1 year or something? It has been years since I heard what that required, but that sounds right? Seems doable given the hours I put in now. If it did anything for anyone out there, please let me know. Is CCRN worth it?
Exclamation
 
Ginger Snap
 
Reply Thu 28 Sep, 2006 09:01 pm
Well, yes, you do have to work so many hours to qualify for the certification, but once you've got it, all you have to do is maintain it, usually with some continuing ed. So that DON probably got her certification years ago, and now does just enough to keep it active.

You know, you're caught up in a game, and you don't have to play. Decide what you want for your next career move, and where you want to be. If you can't get what you want with these employers, then go where you can get it. And learn to speak the language of these people.

If you haven't figured it out yet, healthcare is a business, and you have to speak the language of business people to get anything accomplished. It's great that your team members think so much of you and that you are a valuable asset to the team, but if you want to move up the chain, you have to work at changing your image. Early in my nursing career, I figured out if I wanted to get certain responses from MDs, I had to learn to speak their language, and tell them things that wouild trigger the correct response from them. It works the same way with managers and executives in healthcare. They want to hear about "customer service", "workflows" and "cost-effectiveness". So you have to learn how to turn these phrases on their ears, so that you get what you need for your nurses.

The message you are getting from your higher ups is that they see you as good "frontline" staff, but they can't picture you in another role, and some of that has to do with the language you speak. Going away and getting some experience someplace else will go a long way towards changing that.
 
SharpknifeRN 1
 
Reply Sun 1 Oct, 2006 11:18 am
More and more I think you are right. I had not really thought about it that way "good frontline staff, but nothing else". I never liked change, like most nurses, if it is not a change I wanted especially. On top of the back drop of all of this I keep thinking of the fact that I can't see this bunch being here 5 years in the future. Each time a new DON comes in they clean house of midlevel managers and staff, and for that matter frontline personel. They let go two sense I wrote last. They had their problems, still I thought alot of them both. It haunts me a little that when one of them was being walked out she was telling me goodbye, and I was so busy that someone had to explain it to me latter. They are paying for the education. I am going to take it. If they cannot find a place for me then I can choose other hospitals with in the corporation. I will. If they do I will serve out my time in ICU. My guess is I need to keep up with my resume as I don't think they have 2 years. Thanks
 
 

 
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