I'll stand by you, I'll stand by you...won't let nobody hurt you, I'll stand by you, take me in, into your darkest hour and I'll never desert you, I'll stand by you...

There have been really difficult moments throughout my career in nursing management that I have turned my head to the sky and said "Why?!?" And the "why" always comes with "what were you thinking going into nursing management?!". Managing people is not at all an easy job. There are so many facets and nuances to people that managing a large group of them can be a great challenge. I'm currently managing a department with almost 80 employees reporting directly to me. I've been there for 4 months and until last night, worked diligently to build the trust and respect of my team. Now friends, I've got their trust, their respect and their love.

Emergency Departments across the country are constantly faced with the issue of labile censuses (we try to track data, but so many things can factor in on the number of people checking in on a given day, at a given time). The random influxes make staffing an emergency department a tremendous challenege. Unlike an inpatient unit (like I had when I was managing ortho) which is closed when the unit meets capacity, an Emergency Department can never close.

Last night our department experienced a perfect storm of events, boarding patients (those that have been admitted that don't have a bed upstairs-usually a 12-40 hour hold time, in general) taking up the bulk of our ED beds- these would be the beds that we use to see emergency patients. If you've only got 25 spots for patients, and 18 of those spots are occupied by admitted patients...and you've got a barrage of patients checking in to be seen for emergency care- we've got a big problem on our hands. This friends, is what happened last night.

I received a phone call from one of my most experienced, cool and calm charge nurses. She explained the situation and said "Steph, quite frankly I'm not sure what to do." We were at a stalemate. No one going out, meant no one coming in. And that then begs the question 'now what?' Realizing the brevity of the situation, I agreed to come in last night, around 1030 to help assess and get creative about our situation. Once I got there I got straight to work, I ran my tooshie off all night. I needed help from the staff because this was not a role I typically function in, in my position as manager for the department. The staff were happy to assist me with whatever I needed and were patient when I asked questions that it was clear they were proficient in. I apologized a few times throughout the night for my short comings and  they said to me "None of that matters, we're just so glad you're here." Even writing these words, I have tears in my eyes. I truly felt like I was in the trenches with these people, and we did exactly what needed to be done to survive the night, and then some. Under immense pressure my team showed their true colors and flourished. I often thought about becoming a military nurse and caring for our troops on the front line, last night I was serving my team and the patients that were seeking care at our ED and I have never felt more at peace with my decision to go into nursing management.

A few of the staff made the comment "in all the years I've been here we never had a manager come in and do this. Thank you." And the 'thank you' I could tell was just so genuine, it touched my heart. Then, around 4 or so this morning, I was in a room with one of the nurses' getting the room cleaned up for another patient and she came up, gave me a huge hug and with tears in her eyes said "Thank you so much for being here. This means so much to all us. I love you." Her words will stay with me always, and any time I start to feel frustrated or wonder "Why me?!" I'll remember her face and her sincerity in that moment all the days of my life. The timing of all of this is so ironic, and I can only assume that it must be God's timing, because just last weekend I was talking to a friend about being a great leader, and he said that "Love is the key to leadership. The best leaders are those that truly serve their followers. That's why Jesus took the time to wash all His disciples feet." I hope that my staff feel like their feet have been thoroughly washed.