crb613 11,897 Views
Joined: Feb 7, '04;
Posts: 1,715 (11% Liked)
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I would not recommend a position as a home health supervisor without some serious home health experience. There is the common misconception that it is an "easy job," I assure you that it is not. Ditto long-term care.
If you haven't been offered a chance at the charge nurse role after three years, I would suggest that you ask your nurse manager why that is, then request it. Most places have a training program for charge nurses that teach you what to expect and how to meet the requirements of the role. Start there before you start looking at supervising positions that you are not experienced with.
Honestly, if you want to get into management, you must first excel in your field and that takes paying your dues. I hate to see anyone in a management position just because of a degree without having the requisite experience and knowledge base.
Nurse managers manage budgets, manage staffing schedules, manage issues, etc.
When they try to manage professional staff they run into problems.
Professionals engaged in their work typically prefer leadership to management. They prefer to be engaged in problem solving and process improvement and don't appreciate someone telling them how to do their jobs.
Teams are built on trust and accountability. There has to be room for honest discussion of issues so that the evidence can be examined and considered in relationship to the work and flow of the department. When staff have a department manager who will respect their needs and their opinions, whom they trust, they can be very creative and can come up with some very creative and innovative solutions to problems.
Good department managers engage their staff, empower them to problem solve, and lead them through implementing process improvement whenever that is an option. When that is the standard in the department the staff are much more accepting of the things which MUST be dictated to them, over which the manager has no control.
Good department managers understand how to develop and support teams and team members.
I've seen the first wave of management getting pressure for low scores, not getting raises and so they are coming down on us.
Realistically, how do you raise satisfaction scores? Especially in this environment? I could be the best nurse, with the best doctor and people are still not going to be happy. I guess our pts just weren't filling them out, or giving false addresses so they don't get them anyways.. Or the few that did return them were angry.
So many people think you should just get whisked in, have all your tests back in 30 minutes or less, catered meal and a diagnosis and complete resolve if symptoms/pain before they leave. When you lack a magic wand, people are angry.
Awful. Confusing, redundant, and glitchy are just a few words to describe it.
I despise Meditech. It is totally unintuitive and clunky. Everything takes so much longer because I'm trying to figure out where/how to do things. I can't wait until it's gone.
I hate meditech I think the system is outdated and hard to navigate
Out hospital system is so focused on pt satisfaction scores that I really don't think they care about narcotic abuse, lying about anything, visiting 4 ER's in 1 day ect ect.
Not giving them all they want leads to poor scores/lower reimbursement
I would have looked at her with my nicest smile, turn and make direct eye contact...."Hello 'Doctor'....We've done several things 'doctor' but the patient remains in the present rhythm AND rate, what do you suggest next...would you like for me to get you the chart so you may review the meds already given?" and add if not at the patient bedside "Hey Joe (ED doc) the hospitalist is here and would like you to review the patients treatment so far"
"Hello 'doctor'...we've done several"...and list of time and dosages of meds and patient response..."the patient remains asymptomatic and in the present rhythm what would you like to give next...would you like for me to get the chart so you may review what has already been given?"....and add if not at the patient bedside "Hey Joe (ED doc) the hospitalist is here and would like to review this patients treatment thus far"
And give her my FULL attention for her next response....
Don't beat yourself up. We are just mere human folk. It is normal when you have been doing everything you are supposed to and then the above happens. Like you said hindsight and all. I am notorious for having the perfect response in my car on the way home: ).
Why would you WANT to? I certainly don't. I have enough to do.
When the newbie says "I know," more than five times a shift during orientation. And then does it wrong anyway.
When they say "I'm ready to take my own trauma," and they've seen only one.
When they look confused, but don't ask questions, or say they don't need help.
It's the Exasperated Room, or Everyone's Retarded.
And by retarded I mean Snookie, or Tom Cruise jumping on Oprah's couch. Nobody have a cow.
Some trauma bays stock a few units of O- blood in the bay in order to facilitate getting blood hung and transfusing rapidly in the case of a huge bleed. Blood can also be run through a rapid transfuser such as a Level I. Make sure the person in charge of it knows how to properly operate it unless you want to see what happens to a unit of O- at high pressure. XD
Yep, if it is an emergency and pt is actively bleeding out or coding, I just give blood wide open to gravity. The risk of a transfusion reaction is not as important compared to the need to get blood in fast.
Yes, you run the blood in as fast as possible. I've had more than 1 unit of blood running in with pressure bags at the same time in patients that are bleeding out (AAAs, GI bleeds, ruptured ectopics, traumas, etc.) If the pt is coding or just at the point, it's more important to get some circulating volume and get them more stable than to worry about a reaction.
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