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Old 12-10-2007, 07:48 PM
Posts: n/a
Default Middle Management aka "The Bad Guys"

Before everyone wants me thrown from a car into the path of a locomotive listen to what I have to say. Today I spent some time re-reading some of the threads here at Nursing Voices and noticed something that I had not noticed before. There seems to be a underlying tone that Middle Management (Nurse Managers/Supervisors) don't care about the day to day frustrations that the floor nurse goes through. The tone of some of the posts indicate that Middle Management's major concern is the budget, making them more Upper Management than the floor nurse thinks they should be.

First, I need to say that I am not Middle or Upper Management. I am straight-up a floor nurse. I am a floor nurse because that is what I choose to be. I don't think, for the most part, that I am Middle Management material because there are too many times that my mouth engages before it should. If you want an opinion on a specific problem, I have no problem giving it to you. You may not like what I have to say, but if you ask, I'm more than willing to tell you. This makes me "not so good" at being in the middle, which, in fact is where Middle Management is.

Middle Management are those nurses who are in between a rock and a hard place. They are suppose to be the staff nurse's advocate while being under the sometimes crushing thumb of Upper Management. Often times, it is Middle Management that takes the brunt of everyone's anger; from both the staff nurse and "the powers that be." While I think that Middle Management's heart is closer to the bedside than Upper Management, it is often hidden from the staff nurses view because of the controversial decisions that they, out of necessity, have to make.

If the truth be told, I would imagine that every Nurse Manager or Nursing Supervisor would like their departments to be staffed better than they are right now; but they walk a fine line between what they want and what reality has to offer. I have to admit, there are times when I don't make their job easier to do. Often times I don't see the big picture, but only the small patient that lays before me. I am not the one that is held accountable for a budget or a nurse to patient ratio, but I may be the first one to voice my upset when I don't have the things I need to take care of my patients immediately at my disposal or I feel short staffed eventhough our "staffing pattern" is what it should be.

It seems that I have forgotten that Middle Management are nurses first and management second. They have the same compassion that I feel only from a different viewpoint. Upper Management is often times composed of administrators who have never spent time with a patient. They are not nurses but businessmen and women who are concerned with the "bottom line" of the business. For the nurse, the bottom line is the patient, for the businessman, the bottom line is the dollar.

I, for the most part, am very fortunate to have Middle Management who, if I stopped and looked at things from outside of my own little box, really care about our patients. It must frustrate them when their hands become tied and they are no longer able to give the staff nurse what she wants and needs to take care of the patients in a way the patient deserves.

So, to all of you Middle Management out there. I'd just like to say that I appreciate what you do and I'm sorry if I don't say it often enough. Forgive me when the only view I have is my own. I know you are right in the middle and by the mere fact that you are in the middle means that you are being squeezed by both sides.
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