Unit Manager/RN Supervisor Responsibilities

DDdove, LPN · Jun 10, 2011

There are only two nurses in our facilty at a time and usually only one is an RN. With 64 patients, 19 of them skilled, we need the higher ups to help. If I am the only RN and there are three IV ATB's q4hrs running that need flushed etc on time, 4 pegs, and a couple TPN's plus a regular patient load, treatments, skilled documenting, labs, appts, pham coming, there is no way for me to get the med pass done on time. Them sitting a trying to come up with a plan...... is a waste of time. Come out and help for 2 hours 2x a day(only 4 hrs of your day) and problem solved.

txdon · Jun 10, 2011

My facility has 89 residents, 15-20 are skilled. Each nurse has a total of approx 22 residents. Most are LTC expect the 15-20 skilled residents. The unit managers are responsible for overseeing and "managing" the unit. When they spend most of the time assisting the nurse with her job they are not able to manage the unit, which has resulted in numerous deficiencies. Expired meds/insulins, incomplete incident reports, CNA's not changing residents, not following up with labs, putting in t.o's, maintaining/updating the matrix, weekly skin checks, attending IDT morning meeting with residnet updates r/t skin, wt loss, falls. As the ADON there is no way I could spend 4 hours of my day working the cart and get my work done. I am the Risk Safety Manager, Employee Health Nurse, Infection Control, and SDC. I also do all the new hire orientations and ongoing staff training and inservices. I spend atleast 12 hours a day with all my responsibilities plus work every weekend. Our facility has hired unit "Managers" because things were getting missed. We have alot of agency nurses who make tons of mistakes. We need to have oversight. Maybe it would make more sense not to have unit managers and add two additional nurses to the floor each shift. It would be more costly but maybe more efficient. Any thoughts?

Long Term Care Columnist / Guide · Jun 10, 2011

It's wonderful that the unit managers are willing to help out on the floor---certainly something we don't see every day!---but I know from experience that if they're working the floor, they're not getting their own work done.

IMHO, the best (and cheapest) staffing model is to use CMAs for the routine med passes and simple treatments so the charge nurses can deal with the tube feeds, diabetics, wound care, new orders, phone calls and so on. The unit managers can then tend to the MDS, care plans, staffing, audits and other administrative duties. :)

txdon · Jun 11, 2011

In my state CMA's aren't allowed to pass meds in our facility. Does anyone have any other staffing suggestions or ideas?

nursemel11 · Jun 18, 2011

I recently accepted the position of unit manager over the skilled and rehab units at my facility. There has never been an unit manager here before, so higher management doesn't really know what my duties should be.

When I first started, I focused on cleaning up the unit. Cleaning, stocking and organizing the med room, treatment cart, med carts and filing cabinets so that the nurses had everything that they needed at their fingertips. I now take off all MD orders, ensure that new admits have everything they need, make all appointments and transports, follow up on labs, coordinate with MD and monitor daily charting. I file incident reports and transfers as well.

This takes a lot of work off of the charge nurses. I do wish that I had a clear job description, but at this point, I'm just doing what needs to be done.

edhcinc · Jun 19, 2011

Hi.

Each facility needs to decide whether a unit manager position manages CLINICAL care on the unit or is a highly paid unit clerk.

Too many facilities put this person into the situation described by nursemel11.

What a waste of professional skills which our more complicated patients need!

The RN unit manager must function as a professional nurse--and should assess patients, work with the patient (and other IDT members) to plan his/her care, assure care is given, evaluate the outcome of care given with the patient, assure staff is trained, performing and supported, and assure clear and open communication amongst/between all unit staff.

Hire a unit clerk to schedule appointments/transport, stock supplies, etc. :idea:

Good luck!

sls73 · Jun 19, 2011

We are a 59 bed facility and on dayshift have 1 RN and 3 LPN's(1 does tx and 2 do meds) and on 3-11 we have 1 RN and 2 LPNs.

I hired a Nurse Manager a little over a year ago and decided to make them clinical. This position works 9 am to 6 pm so that they are there to help cover both shifts. Job responsibilities include over-seeing the weight program, skin program, and infection control program. She also makes sure that she covers the dining room at supper making sure that everyone is where they are to be (that seemed to be our weak area). Audits are completed on family notification of incidents, new orders, and Coumadin changes. She also works with the nursing assistants on toileting programs and making sure the documentation complete/timely. Oh and if there is a late afternoon admission or two- they are still there till 6 pm to help the staff.

I know there is probably more, but this is a snapshot.

achot chavi · Jun 20, 2011

IMHO, the best way to organize a unit is first to study what each staff member is doing every half hour of the day (I ask them to prepare for me a list) , then list each staff members responsibilities and plug it into half hour slots so that each staff knows what they need to do, and that they have the time to do it. Of course the schedule you give will be flexible but it will give a framework to the staff so they stay focused on their individual tasks. I have found that some staff are 'spoiled' and are constantly asking for help. If that happens I have to check out why.

You are about to make great changes and that requires strong leadership. You are going to have to believe in what you are doing and sell it to your unit managers who have developed bad habits- they cant differentiate between their responsibilities and their staffs responsibilities. Good Luck!!