What Nursing Leadership Doesn’t Look Like

A small, belated Christmas tale on how not to manage an emergency department. But first a few preliminary points of information.

First: in Ontario, front line nurses are generally forbidden from taking vacation over the Christmas holidays, usually from some point from the first or second week of December to the first or second week of January. There are a couple of reasons for this: first, there are always staffing issues over Christmas. Secondly, if vacation time is granted by seniority, and if it werepermitted during the Christmas break, the most senior nurses would always get Christmas and New Year’s off, making merry while leaving their more junior colleagues to toil through the happiest time of the year. Hardly fair, and scarcely a morale booster.

My emergency department, Boxing Day

Most hospitals in Ontario will arrange scheduling in this way: nurses work either Christmas or New Year’s (either we pick or alternate each year) but we get five or six days off in a row over the holidays. Like any compromise, it inconveniences some people, but most seem happy about this arrangement.

Second: most Emergency departments over the holidays look like a merger of Bedlam and a random circle of hell from Dante’s Inferno. High acuity and high volume. I might add this holiday season war zone ambience is as predictable as, well, Christmas falling on the 25th of December. We just gird our loins and sally forth. Nevertheless, even halfway through January, we’re all a little crusty and stressed out.

So what would you say to a manager who takes vacation — and not a short one either — over the Christmas holidays? One of my minions has informed me that an ED manager at one Toronto-area hospital took vacation from roughly the middle of December to the middle of January. Needless to say, given all of the above, her staff are not impressed. They are angry. They felt abandoned at a time when leadership was needed. They resent the double standard, the flaunting of the no-vacation-over-Christmas rule. Some of them, I’m told, are so disgusted by this behaviour that they are actively seeking positions elsewhere.

I understand that managers deserve and are entitled to their vacations, and that from a staff nurse’s point of view of there may be no good time for a manager to take time off. Even so, taking vacation when staff cannot, and over time period when volumes and acuity are notoriously high indicates a certain amount of  — what? — cluelessness?

Management does have its privileges, but also has responsibilities. To me responsibility means sticking it out and providing leadership to your staff, even when it’s personally inconvenient. It might mean delaying a vacation for a month. It means not bailing out when you know things are going to be awful. This is good nursing leadership. Or am I completely off base about this?

UPDATE (22/01/12): Minor edit of mispelling. I need an editor, but can’t afford one.

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  1. #1 by Ali on Monday 16 January 2012 - 1147

    In BC it’s allowed to take vacation over Christmas, which was very surprised after starting my career in Ontario. Some nurses do, and nobody faults them for it. We still have enough people to work both, and our contract says we must have one of them off. There’s never really any hard feelings about people taking vacation around that time.
    I do agree with you, that taking a month of vacation around the known busiest time of the year is not good nursing leadership.

  2. #2 by SM on Monday 16 January 2012 - 1254

    So, one manager took holiday time for one month, between mid Dec and mid January, and you write a blog slamming this person for it. Do you know why? Not all holiday time off is spent on a holiday. And sometimes, if you have family in the southern hemisphere, if you want to visit on their summer holiday time, it’s in our winter months. Lots of maybes there, but no possibility that this person had a family need for the time off, just immediately slamming this person for “abandoning” the er. Really? The ER completely fell apart without this one person? Yikes. A nurse’s outlook is extraordinarily critical, isn’t it.

  3. #3 by Beth Boynton, RN, MS on Monday 16 January 2012 - 1307

    I think you have a very valid point. I believe ledership is or I guess should be more about SUPPORTING staff to accomplish the organization’s mission.

    How can I help?
    What do you need to meet this goal?

    I wonder sometimes how and where nurse leaders are disconnected from staff.

    Happy New Year!

    Beth
    P.S. If you have 12 min to check out my YouTube: “Interruption Awareness: A Nursing Minute for Patient Safety”, I’d be grateful! http://www.youtube.com/watch?v=PGK9_CkhRNw

  4. #4 by Joni Watson on Monday 16 January 2012 - 1859

    If it is not customary for people to take vacation during the holiday then management should be no different. Managers set the standard, not abandon it.

  5. #5 by Angry Nurse on Monday 16 January 2012 - 2146

    If I have an issue with any manager taking a full month off (regardless of the time of year) it would be because they themselves do not grant any of their staff the opportunity to do the same. So I have to agree with both that while as RHIP may apply, so equally should the also aforementioned lead by example.

  6. #6 by Angie on Saturday 14 April 2012 - 1831

    Hey there! just bump into your blog by accident.
    I´m an argentinian nurse, also working in a triage room in my hospital, in buenos aires. and it´s amazing to see that even distance, patients are the same in every place of the world.
    hope to read more experiences more!
    Take care!
    Angie.

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