The curse of ward managers in mental health

What do ward managers do on mental health wards

Ah, here’s the rub

Each ward had a manager who worked 9-5 and was expected to split their role 50% managerial and 50% clinical. What p’d me was the fact that most managers sat in their office 99% of their day. Tho’ they did pop their smug faces around the nursing office on their way out to get coffee or lunch.

Crikey, like most nurses, I’d forgotten what a lunch break was.

And heaven forbid, Managers might get their hands dirty. Or their neatly pressed shiny trousers, if they dared to sit with patients at mealtimes. Managers should have been out there on the floor, supporting nursing staff to do their jobs effectively.

What could managers do?

They might have noticed the patient with false teeth who was choking on a large chunk of beef and nearly died. Or that a nurse really did break an elderly patient’s walking stick over her knee then hid it behind the filing cabinet. Why believe the lady with psychosis, eh?

A manager on the floor might have spotted (when a nurse didn’t) an elderly patient sneaking out with the lunch trolley. They’d be contacted at home later to be told that this poor man died. The next day it would be all about filling in paperwork for the impending investigation. Never mind the poor patient or his family.

Oh, and the manager would be looking for someone to blame. Why did nobody notice? What were all the staff doing? Where was everyone? Who opened the door and let Archie out? He actually snuck out. The video footage from security didn’t detect him behind the lunch trolley either.

Perhaps they could’ve stopped the gullible junior doctor unlocking a side door to let a patient out. She was yelling through the door that she was a visitor and had got locked in. He didn’t think to check. And he didn’t notice her slippers as she shuffled out? She was found, safe but causing pandemonium in the local market, throwing wet fish from a stall at anyone who went near her. The not too friendly police stank of rotten prawns when they returned her to the ward.

How Managers could sit on their fat lardy arses in their back office with the door shut was beyond me.

What managers should do

The following is a shortened version from my previous Job Specification for Ward Manager. In it, it states that a Ward manager must:

• promote a therapeutic environment that is conducive to recovery and the development of independence.
• lead and be responsible for the clinical management of a ward, where patients may present with complex behaviour that challenges services.
• allocate and support individuals with delegated work
• coordinate and monitor the delivery of evidence-based person-centred healthcare.
• be accountable for the provision of appropriate physical care to support the general health needs of service users.
• be responsible for ensuring that services are responsive to individual customs and beliefs, age ………. and that service users and staff are supported to fulfil these.
• be responsible for the provision of and access to a range of therapeutic activities, emotional support and stability to clients to ensure effective engagement.
• support and supervise staff to ensure the maintenance of professional boundaries.
• create, develop and maintain professional supportive relationships with all members of staff to enhance service delivery and recovery.
• ensure that all documentation is robust and that audit is undertaken to evidence this.

Job spec doesn’t apply to management

That all seems clear enough to me. However, I get the feeling that once managers have the job, the job spec’s shredded, never to be referred to again. I think all managers should have this framed, or at least laminated, and displayed in their office. And just for good measure, they could add a great big arrow pointing to this “Please let me know how I’m doing.” and stick it their office door. That way nurses, patients and family or carers can pull them up when they’re not doing their job.

Love your enemies

While perhaps I didn’t call my managers out directly, I would let them know when I was unhappy with their suggestion or directives that went against Trust policies. As a Band 6 Charge Nurse (assistant manager), my manager would tell me to have staff plan the dates for their entire year’s annual leave, including me.

Er Errr, the policy says no. Staff didn’t have to do this and many couldn’t or didn’t want to. Mostly, as our rotas were distributed each month, I would plan my holidays prior to the following month’s rota.

When I relayed this back to my manager, he whined: “I’m going to have to tell Miranda (our local nursing director).”

“Ooh, scary. Tell Miranda,” I’d grin.

Nope, he wasn’t best pleased, “Oh come on. Don’t make me do this. Miranda won’t be happy.”

“Tell Miranda to speak to me then. I’m not pushing staff to do this.” And he did tell her. She came up to his office, arms folded and grimacing, “What’s all this nonsense about? Who the hell do you think you are?” without letting me answer she raged on, “I’m your boss and I’m telling you………”

With my hand up, “Let me stop you there Miranda. If we take our badges off, we’re just the same, me and you. We’re both human and I’d appreciate it if you treated me so.” As I watched her eyes bulging and the fumes flaming from her nose I continued, “The Trust Policy states that staff can plan their holidays whenever they like, so I’m not going to do as you ask. I can’t plan for a year so I don’t expect twenty-eight other staff to be able to either.”

“Do you know what. Just bloody leave it,” she snapped, “Mark will do it,” nodding at him before storming off the ward. She absolutely hated me. She’d ignore me in corridors or in meetings, even though I’d always smile at her and say “good morning Miranda.”

“Love your enemies, it will drive them crazy.”

Anon

I won’t even start on about our Modern Matrons, I’ll leave that for another post.

You might be interested in the following articles:

• The ugly truth about mental health nurses here
• Poor nursing in mental health here
• Bad manned nurses on mental health wards here
• Should we report our mental health colleagues here

Over to you

Have you ever worked with ineffective and impossible managers? Would you have called your manager out? I’m interested in your thoughts and I look forward to any comments or questions.

This is a true account from my perspective and all names have been changed to protect the lardy arsed, ineffective and impossible managers — and save them from any embarrassment.