By Debbie Moore-Black, RN

I was an assistant nurse manager (ANM) in a 24 bed ICU in my younger, energetic years. Before that, I was a manager in a very small emergency department. I must say, I loved it. I loved the thrill and the challenge. I was able to work with the Joint Commission; I ordered EKG monitors and defibrillators, any equipment needed for the emergency department. I worked with the health department and social workers. I helped develop protocols and talked to leading cardiologists in the city to create new protocols. I created an information pamphlet area for patients and visitors. I did evaluations and planned scheduling.

I went to the intensive care unit from the emergency department and found my true love. Before long, I graduated to the ANM. I was everyone’s friend. But I was also a rabble-rouser. Should an intensivist not follow a protocol properly, I reported him or her. Should our manager on call be missing in action for 24 hours, I reported her. I was an advocate for the underdog. An advocate for my nurses and nurse-patient ratios. An advocate for the patients.

I sounded the alarms no matter what. I didn’t “pick” my battles because almost everything was my battle.

I learned through the years what was worth fighting for. One of my managers was once deemed “an unassigned leader,” and “this could be good, but …”

Eventually, I was demoted to a staff nurse. I was told that I was not “one of them.”

So now I’m a little over a year until retirement. I don’t want to be a charge nurse; I don’t want to be a leader. I want to do my job as a staff nurse and then drift away into the horizon.

In my 35 years as an ICU nurse, I can sadly say that I have had only one good manager.

But what values did this manager have? She was fair and honest. We respected her greatly. One minute she’d help us with a code blue doing CPR, or passing out emergent medications during the code. Other days in her “spare” time, she helped us clean up a patient, bowel movements and all. If there was bullying in the unit, she squashed it. If a nurse was not up to par, she’d bring him/her into her office. She knew our names. Our children’s names. She’d ask about our sick grandma. She was smart and professional. And not only did we respect and cherish her, the Intensivists and hospitalists loved her also. Our ICU was a well-oiled machine. Sadly, this type of manager has happened only once in my 35-year career.

A new manager comes in with all of his/her titles and degrees. She has a bullwhip in one hand and a microscope in the other. She’s going to kick ass and take names. Every day we hear how terrible we are. How awful we are. That we don’t know our roles. That we perform below mediocrity. There is no light. Morale drops, job satisfaction is at an all-time low, and then comes the nurse turnover. Negativity does not promote a positive reaction. It festers and brews.

So how can a leader, a manager, turn herself around? How do you create a good workforce? Good camaraderie.

Professionalism and accountability? Good question.

We are a family. There’s no way out of it. We live and breathe each other for over 12 hours a day. Besides knowing your clinical skills and critical thinking skills, planning, and budgeting. Evaluate yourself. If you are in this managerial role for control, power, or self-gratification, you’re in it for the wrong reasons. Start with staff relations. Learn and know your staff. Keep communication open. Be honest. Answer your emails. Encourage positive behavior. Give kudos to those who go above and beyond or even those steadfast in good quality nursing and patient care. Encourage education. Ask about their children, their mom or dad.

When you beat us verbally with constant negative ridicule, we crawl under the bed. We underperform. And eventually, we disappear. Delegate, be honest. Open communication. Have goals. Positivity. Correct poor work in privacy. Make nurses want to work for you and with you.

After earning your master’s degrees and PhDs, please take off your mask and remember we’re all human. We’re all in this together. And create a positive light through the tunnel of a very difficult profession called nursing.