Yes, You Can Have It All

Yes, You Can Have It All

You can have it all. Decrease the stress in your life. Stop to smell the roses. Be in the moment. Great words of advice, but how does that happen? I don’t know about you, but I have found it almost impossible to accomplish! Almost.

I am the manager of a group of neonatal nurse practitioners in a level 3+ NICU of a large, urban Midwestern university hospital that provides care to an underserved population.  Yikes! Talk about stressors.

There are 18 women all ages, experiences, and personalities in our group. The question is: How do you create a cohesive, compassionate, supportive, and clinically excellent group of practitioners? Well, it took years of trial and error, strong faculty support, and the unexpected loss of our previous beloved manager—and then to find our feet again over the next three years. I hate it when people say “it’s a process.” Really? Of course it is, but it’s hard to see it in the beginning. We all want instant gratification, whether it’s from new sources, TV, retail, or work. I want it NOW! Yeah, well, that’s not going to happen.

First, you must have individuals of amazing talent, drive, personality, and intelligence. No short order for anyone. I’m not sure how we achieved this dynamic, but we did. Every person in our group is unique in their interests and skills. We foster and encourage the differences. We celebrate the differences. Thank goodness there are NNPs that are the ultimate in PICC insertion skills—not me! I will do anything for you if you get my line in—I will see all the other babies! (Just a note, my other procedural skills are awesome.) Thank goodness we have some young energetic women that love to go on transport. I am getting too old for climbing in and out of ambulances.

Second, you must have the unwavering support of the faculty of neonatologists. Without the clear dedication of the physicians it’s like fighting upstream in the spring run off.  I’m not talking about money or time off or even the gift at Christmas. I’m talking about standing for you and beside you to the bureaucracy of administration. We all face shortages of staff, long hours, and extremely difficult patient care situations, but when you know that the medical staff is with you—and you with them—it means everything.

Third, and most important, you need to see the problems that cause discord, anxiety, and anger within the group. In my first ten years here, the NNP group was growing in numbers and responsibilities, especially when we moved into our new, larger NICU. Often when a need arose in the unit the response was ”the practitioners can do it.” Sound familiar? Five years ago we unexpectedly lost our manager. This was a stunning blow to our group and unit. The next two and half years were a struggle as the section and department leadership changed, thus leaving the NNPs in limbo for their own leadership. In many ways the group was rudderless. We had no goal or focus. We reacted to the needs of the unit without any professional growth for any of us.

Last, you must have a manager/leader who believes. Believes in themselves, the members of the group, the faculty, the staff nurses, and staff support members. I know it sounds hokey, but it is absolutely essential. When I became the manager, I held a dinner at my home so we could come together as individuals to talk, laugh, cry, and plan.  I met with every practitioner to discuss their goals, aspirations, and what they wanted from me as the manager. Since we cover the unit 24/7/365, the NNPs are never all together at an event. I insisted that the NNP group have an annual retreat so that we could all be together to continue the discussion for our group. With a facilitator, we identified several issues that had been troubling us for many months. We designed a plan to address these issues. We also affirmed our commitment to each other as colleagues and friends.

We continue the “process” to grow and change. But it is not all the big stuff, the retreats and meetings. It is the seemingly small things, like making our collective office a little more cozy, posting funny and inspiring quotes, putting a seasonal wreath on the office door for all to enjoy, and remembering that this is our job, not our life. We are not always perfect, but we strive to be. You can have it all — just not all the time.



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