Friday, September 20, 2013

Horrible Bosses

Why, specifically with nursing, do the most unprofessional, disorganized, dysfunctional, mildly retarded, socially inept @$$holes unfailingly become middle management? Is this Affirmative Action for jackasses, or are they hiring the handicapped because they're fun to watch, or is it just that senior management can't, in my father's memorable turn of phrase, actually and reliably "tell $#!^ from Shine-ola"? I confess to feeling uncharacteristically baffled.

Do an experiment: think of the co-workers you'd least like to work with, and the ones you'd be most inclined to fire for their shenanigans if you were King or Queen For A Day, (or for students, the ones you consider deadweight on clinical and lunchmeat during lectures), and for any position you stay in more than 5 years, keep track of how many of them become charge nurses, nurse managers, and clinical coordinators.

If you find someone who's so gratingly annoying the whole department wants to smother them with a pillow, congratulations, you've just met your future supervisor. If they want to fill the pillowcase full of IV pumps and beat them with it, you may have identified a future CNO.

I bring this up because, surprising me not a whit, yet another terminal management failure has been inflicted upon my work unit. She's a legend in her own mind, and clearly, at some point, she was allegedly a decent nurse.The problem comes in that when handed any slight amount of authority, she defaults to Genghis Khan-like management techniques, that probably didn't even work for Genghis, back in the day.

Which leads not only experienced me, but utter newbies on the staff to recognize in 0.02 seconds, that she's scared spitless because she's too insecure to shut her piehole and work with people, actually listening to them and MANAGING them, because she clearly lacks the wisdom, experience, competence, self-confidence, or basic 3rd-grade-level human coping skills to not dictatorially try to micromanage everyone like they were Barbie dolls at her tea party 24/7/365.

That style didn't even cut it in the Marine Corps among fresh recruits with room temp IQs, so it sure as hell isn't going to cut it with trained degreed professionals and experienced support staff.

I mention it because it's a wee bit off-putting.

And a corollary, which I'm sure shows up somewhere on a managerial training curriculum is that when you hire and promote the least competent people, it not only destroys morale and lowers productivity, it also demonstrates to everyone down to the janitorial level that you have your own head so far up your @$$ that you can't tell the difference between someone who's good and someone who sucks, and that you're - theoretically, at least - the very supergeniuses who sign the checks and direct the affairs of the entire facility. Which scares the hell out of we, the employed.

So somewhere in the Rules For Big Wheels, there has to be written the caveats:
1) Don't pull your pants down in front of the entire staff every day by hiring management morons
2) Try and demonstrate some basic level of bare competence unless you like the sound of laughter behind your back pretty much in perpetuity.

At this point, I've seen upwards of a dozen various management folks come through, and go out the other door. I could count the keepers on my thumbs. (And one of those two handed the promotion back to them after a year to go back to bedside care, because it was corroding his mind and destroying his soul, not to mention starting to hurt his marriage because of how it was affecting him.)

And as these personnel decisions are invariably made by the same people who make clinical decisions for the hospital, one is left to wonder how, other than bare good fortune, we don't kill people like the Black Plague going through Europe in the Middle Ages.


  1. It is pretty simple, really.

    Middle management has to support/enforce stupid decisions that upper management makes.

    Decisions that *good* nurses would never make and would find very difficult to support/enforce.

    The only people that are willing to go into (and stay in) middle management are those who recognize that they are completely inept at the beside, and therefore have no other option.

    (Please realize that this "recognition" of one's ineptitude might well be purely subconscious; and there are plenty of *good* nurses who may make an attempt to make a difference in the world of middle management, but quickly realize the follies of that decision).

    I say this as a current supervisor who looks at the employment opportunities in my city on a daily basis, because I just can't deal with the decisions upper management is making any longer.

  2. I love this post because we are going through this constantly! We currently have someone who started off decently, but has defaulted to micromanagement styles too. Somehow reading your gloriously sarcastic and hilarious posts takes the stress out of the situation. This whole system seems to be highly illogical, but it is what it is until we can get enough smart people to start finding ways up the managerial ladder in order to fix this huge problem. Unfortunately, like you said, we need the wise, competent nurses taking care of the patients so that not everyone that comes through the doors die that very day.

  3. "If they want to fill the pillowcase full of IV pumps and beat them with it. . ." That's hilarious!

  4. Back at ya.
    I'm stealing your latest "Knock, knock" joke and riding it until it's dead.

  5. Oh, you're welcome. Never gets old. (Except for my poor preceptor who has now heard it 20,000 Times).

    Your post motivated me to giggle the word "shinola" - only because my pops used that phrase all the time. It's a watch, made in Detroit!

    I can't wait to get one so I can differentiate it from, well, you know...

  6. In Google-fu, vowels count.
    It's not "shinola", it's Shineola. A popular brand of shoe polish once upon a time, and the reason why it might be hard to tell the difference at a glance.

    And yes, I'm a future Jeopardy! finalist, because useless facts stick to me like cat hairs on a clean set of scrubs.

  7. Actually, I belatedly realized that the company in question's primary, original product was shoe polish - Shinola, not Shineola (Google agrees - "Showing results for shinola - Search instead for shineola"). Led me to wonder. . .did mothers once have difficulty determining the difference between black Shinola and meconium? Or is the reference limited only to the brown shoe polish? Something to ponder at 0200, I guess.

    I still want the watch, though! (And they still sell shoe polish. . .which I would purchase if I was still interested in breaking my ankles-AKA-wearing clogs to work - but now I wear tennies).

    We all have our talents - usually mine is uttering feats of word power virtually unrecognizable to individuals born in the 80's and 90's (i.e.; most of my coworkers, bless'em).

    My favorite word obscurity was the following, however, uttered by a nice gentleman with hepatic encepalopathy in response to being asked to "teach back" the use of a call light - "Ah, this is the device I use to summon my odalisques!" Simply my favorite patient quote of all time.

  8. You might enjoy my "Profiles in Nursing Administration" post about some of the characters I have dealt with many moons ago.