Let’s face it: You can’t turn on the news today without seeing how fractured our country has become. Depending on what station you tune into, you’re either watching a far right or far left point of view. It is rare when you find something in the middle, no matter how hard you look. And, honestly, I feel so helpless to stop this roller-coaster that I want to be an ostrich with my head in the sand.

But when it comes to our jobs as managers and department heads, we can’t hide. Nor can we go left or right. We have to walk that middle line and make sure we build a cohesive team, not do stuff to tear it apart.

Sometimes staff will divide up over issues and we can’t let that play out like the political mess in this country. If our staff don’t work as one cohesive team, we will fail at our jobs. As it was written, a house divided cannot stand.

If you are a nurse manager, you have to be sure your charge nurses have your back. Your charge nurses have to be sure they have the trust of the nursing assistants. Now, this doesn’t mean you all have to be friends and hold hands singing “Kumbaya” around a campfire. But you do need to support each other.

Let me give you an example. A DON I know was telling me of an upheaval at her facility. (And, yes, after reading this you’ll know the DON needs some management training, but on with my story)

An evening charge nurse wrote up a nursing assistant for insubordination that resulted in having to get someone else on the team to help the nurse to prevent an adverse event on a resident. The way the story was related to me, write-up was justified and the assistant had been given a warning in the recent past.  

So divide number one: While most on the team took the charge nurse’s position, one on that shift took the other. Because when you have to get someone else to help, in three seconds, EVERYONE knows what‘s going on. (There are no secrets in long-term care!)

But the next day, the nurse manager disciplined the charge nurse for writing up the assistant because she and the nursing assistant were really good friends, and to throw gas on the fire, the nurse manager threw out the write-up on her friend. This, in turn, tore the unit in two.

Because, of course, this not only undermined the charge nurse’s authority on her unit, but the team split up into taking sides. Not only did the “house” (facility) eventually lose a very good RN who would be difficult to replace (and you all know how hard it is to get a good evening-shift RN) but the unit was now a hot mess.  Aides refused to help each other, care went downhill and all for what?

I mean, look at all the parenting books. They say even if Mom doesn’t agree with Dad, they don’t disagree in front of the kids but discuss those differences privately. But instead of the nurse manager going to the charge nurse and asking her for details privately, she just took her friend’s side. No investigation, no asking other staff what happened, nothing. It’s like when my mom would send me to my room without supper (which, if you ever tasted my mom’s cooking, it wasn’t that bad of a punishment), and Dad would get home and sneak me a pudding. I mean, how ridiculous is that? I don’t care how young or old you are, we need rules and guidelines to go by and someone to make sure they stick. Otherwise, we have the chaos that is playing out in our media at this moment.

Seriously, when it comes to leadership, I don’t care if someone on your staff is your baby’s godmother. When it comes to following the rules and they don’t, there are consequences. Friendship is a mute point.

Now here is a totally wild idea: How about team building events on your unit? Or even challenge another unit to a contest? Nothing builds a team more than some good old fashioned competition. (Or making ’Smores over a campfire singing “Kumbaya,” but I realize that isn’t too practical!)

Just keeping it real,

Nurse Jackie

“The Real Nurse Jackie” is written by Jacqueline Vance, RNC, CDONA/LTC, Senior Director of Clinical Innovation and Education for Mission Health Communities LLC and an APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.