Although individual management styles obviously vary, my direct manager focused on rigidly adhering to her own agenda and implemented programs without involving staff members. Any student of change theory knows that creating buy in from those affected by a proposed change is essential. Staff concerns were ignored and it was clear that a great deal of favoritism was directed toward some individuals. Many of my colleagues expressed great dissatisfaction with the management style but, unfortunately there was no mechanism to provide her supervisors with an anonymous evaluation of her performance.
As someone with many years of experience, a higher level of education than my manager, and a reluctance to do things "because we do them", I felt that there was a concerted effort to find reasons to terminate my employment. Being at the top of the pay scale and not accepting "rules" if I felt that they were not in an individual patients best interest, There was no room for any nurse's individual professional judgement about actions if it was felt to not adhere to a "rule". I clearly became a less desirable employee than a nurse with less experience who questions less. Demonstration of age discrimination are often difficult to prove. I feel that this was a definite issue in my relationship with my manager.
Providence has admirable sounding statements of goals and mission. Unfortunately, this philosophy is frequently absent or poorly applied to patient care. It was not uncommon for fellow staff members to make very negative comments about patients and their visitors. This often caused less than compassionate care to be delivered without any repercussions for the staff members. Staff discipline focused on rather trivial issues like being 1-2 minutes late for report (which typically did not start for several minutes after that time). The mission and goals were completely ignored in regards to staff concerns. Your job was to show up, shut your mouth, and slavishly follow directions.
Staffing levels throughout the hospital were too low for the acuity of the patients cared for. I can"t speak to specialty areas, but the loads required for staff in general patient care areas were often dangerous and unsafe. There was no mechanism available to document or report staff concerns.
Many staff members had skills and knowledge that could benefit their colleagues if a formal structure was in place to share it. The area where I worked had great learning needs that some staff members could easily provide. These important resources were not utilized, which was a great waste of resources.
