What girl in the 50’s and 60’s could resist dressing up like a nurse?  Donning something white and a homemade cap transformed me into a fantasy world of caring.  A backyard picnic table became a hospital complete with an array of medical ‘instruments’. Lined up, waiting for expert care were my patients, dolls missing an arm, leg or eyeball.  I’ve spoken to many frontline nurse managers over the years.  This incredibly competent, smart and well intentioned group of people from almost every state in the union has something in common.  It seems that although we may have dressed up like nurses as kids, a firefighter suit seems like a more appropriate uniform now.

Debbie's granddaughter, Theodora, age 3.

During the planning stages of CHAMP, a focus group of frontline nurse managers was convened.  We wanted to hear about their work lives.  Managers told us that they felt like they were putting out clinical fires on most days.  Despite their best intentions, they found little time to do much else.  Although I no longer work as a frontline home care manager, I remember experiencing these very same feelings. I also remember feeling very resourceful solving day-to-day problems.  Putting out fires makes us feel useful and important.   It also seems that many of us know no other way to work!   Just like firefighters, the frontline manager is expected to drop everything and respond.  Some frontline managers I’ve spoken with know how to control their day.  They’ve developed a work style that ‘allows’ them to set aside time during the week for practice improvement efforts for example.  If you’re scratching your head and pooh-poohing this, think again.  If all you ever do is put out fires, you’ll be spending little time preventing them!  Our meaningful work lies in embedding and sustaining nursing practices, which will improve the care we give our patients.

Many of us need to feel needed.  This may be the reason why most of us became a nurse.  The job function of a frontline manager is very demanding.  Sandwiched between upper management and direct care staff, you are the conduit of policies, protocols and operational efforts dictated from ‘Above’.  In addition, overseeing direct care staff and all that goes with supporting their efforts can be daunting.  Although chasing a doc for a 485 or finding a nurse for an unexpected home visit is important, we must also strive to end the cycle of putting our own professional development and the development of our staff on the back burner. Setting limits and designating a portion of time for improvement will give you control of your day. Efforts redirected in this direction will re-kindle the flames of true job satisfaction for you!

Debra Bertrand, CHAMP Facilitator