Perfect nurse. Perfect manager. Perfect puppet.

Originally published on KevinMD

Perfect nurse.

Perfect manager.

Perfect puppet.

An ICU physician once told me: Nurse managers have a life cycle of a mosquito.

Fast and furious.

And then gone.

Deleted until the next one shows up.

It was the perfect ICU.

Twenty-five beds.

Dynamic intensivists. Phenomenal.

And they respected us nurses and collaborated with us. We had perfect cerebral perfusion together.

Experienced ICU nurses who knew what to do like clockwork — teaching the younger new nurses. Teaching them the facts of ICU. The intricate signs of organ failures and how to have a second sense when things went wrong.

We taught them how to alert the doctors when a patient’s vital signs and lab work was showing signs of pending failure. We taught them to keep their cup half empty but to never fill their cup with overconfidence and arrogance. The nurse that “knows it all” becomes the most dangerous nurse.

We were a proud ICU. We earned our stripes.

We were the best.

Stephanie had three years of cardiac nursing under her belt. She glowed with knowledge, and she wanted everyone to know that she knew everything.

Her eyes were on the prize: management.

That’s all she ever wanted — to be the top dog. So she pushed her way to the top.

To the vintage nurses, she made us second guess ourselves. To the younger nurses, she increased their insecurities.

And to management … she was a dream.

She was their “yes girl,” and she played the part well.

No matter what she reported any situation that may have gone wrong to management, instead of confronting the nurse and the situation.

She was energetic and positive to management and anything they wanted or asked for she was right there to help.

She already had her BSN and was actively working on her MSN in administration/management.

Stephanie shadowed the manager while achieving her master’s degree.

She learned all of the “top secrets” of management and had them embedded in her brain. Her plan was to become the next manager. She was ready to implement all that she knew.

It wasn’t long after, that our manager of many years, Patty, had retired. And so with all of the bells and whistles, we sent her off with love and affection in our hearts.

She was our mama bear. She was the one that remembered our children’s birthdays, graduations and grandma’s funeral. She was the one that bonded us together and taught us how vital respect for one another was. She was the one that made this unit as our other family.

We worked hard, but we loved every minute.

Stephanie became the new manager, and we immediately saw a change.

During our daily huddle, she was frantic. We always did something wrong. Sometimes she appeared near hysteria. When the bullies joined our unit and degraded the older and new nurses, Stephanie closed her eyes to the truth. Mistrust and bickering and disrespect was a common everyday occurrence. And our ICU became like walking on eggshells.

We first saw the secretaries lose their jobs. The secretaries who watched non-stop 25 EKG monitors. They were given a two-week notice and were dismissed.

One by one, we saw the experienced nurses leave. And the unit was left with inexperienced nurses who were young and bright and jumped on being the new charge nurse and the new “rapid response nurse” (RRT. Code Blue nurse).

And they wore their name badges with pride. They were new and sparkly.

But they didn’t even know what they didn’t know.

And the awesome ICU that we once knew crumbled and lost its glow.

The air was thick and negative.

Our spirits were broken.

And we all moved on towards a more positive environment.

I miss that group of nurses and doctors.

We were family. It was as if we grew up together.

Memories. That’s what we have now.

We at least knew that no matter what, we were there for each other. We were there for the patient.

We could care less about how many degrees you had or didn’t have.

What we did care about was each other.

We knew we had each other.