Calling All Nurse Managers/Clinical Directors

[RNPATL]

hi everyone.... this thread is dedicated as an introductory thread for all the nurse managers and clinical directors out there. no matter what area of nursing you are working in, we want to get to know you. please take a moment to post a message and tell us a little about yourself and your career as a nurse manager/clinical director or director of nursing. if you are a nurse that has an interest in management related issues ... feel free to tell us who you are.

nursing management can be and often is a very lonely position to hold. no matter how popular you are with the staff, you are still the manager (boss) and are subject to criticism. it can be and often is very disheartening as well as frustrating. not to mention the call, and the amount of hours we work. in an effort to get us off to a great start .... please tell us about a management experience that was your most challenging and one that was your most rewarding. please remember confidentiality - so keep your post pretty non-specific, if possible.

it is my hope that this forum can be a support system to nurse managers and clinical directors. please feel free to use it that way!

i am looking forward to meeting everyone (virtually) and having some really powerful, educational and wonderful discussions here. i will post my introduction after a while ... i am very interested in meeting you all first.

thank you - patrick (rnpatl).

[Ginger35]

Wow!

I'm very impressed just reading the last couple pages of this thread! An interim CNO position is very impressive and it sounds like you may well be on your way to becoming the permanent CNO.

I can see that my situation relates to this thread well.....where to begin.....

My background is ER mostly. I have accepted a Med-surg management position in a rural hospital (28 bed unit). At this point, I have been there for about 2 months. Of course, I have not been there long enough to form an opinion in regards to liking the position or disliking it. Even after recently completing a master's degree(MBA), this is an overwhelming experience.

My biggest challenge is staffing and then scheduling. Constantly, it is in a state of change to drive anyone to pulling their hair out and I only have 27 FTE's.

I'm not even sure that I have completed most of the things I have in my own orientation packet - let alone going over all of the staff's. That is what this week-end is for - figuring out what there is still left for me to do to become familiar with.

I think my biggest challenge in the near future is to make sure that my floor is up to snuff - especially when state board makes their rounds this fall. I will be reading over all of the regs here starting this weekend along with completing CEU's required in Ohio, and coming up with a core schedule for staff (they use to do it from scratch every 6 weeks) - self scheduling - that didn't seem to work out well...

Okay, well - enough of my "rant" sort of speak. I'm not really complaining, just trying to figure things out.

If there is anyone willing to mentor a new manager online - I would definitely be interested.

[SisterKate]

Hi Patrick, good to see a post for that most maligned of nurses - the boss!

I have been a manager for about 7 years and this year, after much acting executive experience, made the move to Nurse Director. What I have noticed is that most junior staff don't seem to realise that I have a boss too. Senior staff are subject to very stringent controls, not least being the budget - not that I worry too much about that actually. If I have to go over budget now and again to maintain safety, so be it ( I work in Mental Health these days - used to work in general, then managed both in prisons, now gravitated to specialise in MH).I find that I am attracted to jobs where there needs to be a lot of change. I really enjoy improving clinical standards and making a difference for my patients. I guess change management is my forte, although it has taken me many years to realise it. I am very passionate about nursing and I think sometimes I must look manic I get so excited describing plans to improve care. The passion never leaves. But I must - out to collect a daughter ... like a manager, a mother's work is never done!

sisterkate.

[Saifudin]

I received notification of this thread in my in box and I didn't read the first installment, however, perhaps I can get a bit of advice from some of you.

I am a DON in a 300 bed mental health/addiction facility in Saudi Arabia. How I got here is another story but I was offered ADON in 1995 and in 1996 promoted to DON. I am an adult NP-C and currently working on a masters in health care administration.

Unlike all of you who are managers, I did not move up through the nursing management chain. I left general nursing in 1981 for NP school and had only worked as an RN for 3 years. After that it was NP ER then primary care practice till overseas work. I spent 2 years in Bangladesh doing relief work then Saudi.

Frank, I really like the leadership role. All of my staff are from the Middle East or Asia and most, except for 4 Filipinos are something akin to an LPN but most hardly make that grade. So, my challenge has been and continues to be developing the underdeveloped in a system that is trying to raise the standard but in bits and pieces. After getting over comparing america to the middle east and learning about my own arrogance, I have come to learn that success must sometimes be measured in millimeters and even a gain of millimeter is a gain and must be celebrated.

I have learned a great deal about leadership and listening with both ears, making decisions in measured fashion and try very hard not to let anger take over. I have had to back-pedal more than once and swallow my pride ( a very healthy thing to do) in order to correct my mistakes. One of the things I believe I have been very successful at is not changing my beliefs on certain issues pertaining to care and practice, especially in a system that integrity and ethics is not well understood nor considered very important. The sad part is this is antithetical to Islam and most staff are Muslims. Again, another story.

Now, I'm planning to return to the States. I have a wealth of experience spanning 30 plus years but I'm not sure exactly how I will fit in once back, but I believe that sound leadership is universal and caring for people crosses are political, religious and social boundries so I feel confident I will make it. Can I get into nursing management? Hmmm, good question..maybe some of you can offer your advice

Cheers

[luvRNs, BSN, MSN, RN]

Have had the priviledge to be in many different positions during my nursing career, including manager of multiple nursing units ( CVCU's CCU's, ICU's, telemetries) and director positions in two hospitals. As director in an academic hospital my span of control encompassed 350 FTE's,and included ED, urgent care, air ambulance, 4 critical care units, med-surg areas, cath lab, and endoscopy. In my next facility got to build and open a new critical care tower.

My passions are budget ( saved millions in both hospitals), and quality ( decreased CA BSI's and VAP rates to zero). I am recently retired, but my passion for nursing has not decreased, and I am really enjoying interacting with others on this website, both sharing my experience and learning from others! Nursing really IS continuous lifelong learning.....

[emilysmom,RN]

I am not sure if I fit here or not. I just accepted a job as a assistant director of residential services. I have to take and pass personal care home administration course. I have worked in LTC and home health.

[MizChelleRN]

Hi everyone! I accepted a new role as a clinical manager in an outpatient dialysis clinic. Rural area, 13 chairs, about 45-50 clients. I've been in direct patient care since 1995 and this is my first foray into management. I'm part of a pretty great team with lots of support. Glad to join you.

[khmrn]

Hi All. I became a RN in 2001; worked med-surg the first year, hemodialysis the next 2, and dermatology for 6. I became a full-time wife/mommy/student in 2010 and recently graduated with my MSN and passed the Clinical Nurse Leader certification. I have 2 interviews this week and am getting a bit nervous! Tomorrow is a very prestigious CCRC that has called me to interview for their DON/Clinical Mentor, and Thursday is a LTCF that is interviewing for the ADON position. Although I have worked with many elders in my career, and absolutely loved (most) of them, I have never worked in LTC, nor held a director's position, and have been out of the workforce for 5 years. I am starting to question my own capabilities! Any pointers would be greatly appreciated.

[NurseLatteDNP, MSN, DNP, RN]

Hi,

my background is nurse education. I have been a director of a 48 FTE orthopedic unit and joint camp at an acute rural hospital. I am about to make a transition into managing an inpatient oncology center that includes research facilities within. I am looking forward to the change. I plan to get my OCN certification after I obtain my DNP in 2017.

[MShaffer]

I just joined allnurses although I have been a nurse for over 5 years. I took the position of clinical director for a pediatric home health agency. I oversee two offices one in IL and one in MO. My biggest challenge is finding nurses to care for my ped private duty patients. Compensation is set because of the rate of reimbursement from the states. Any one have any suggestions for recruiting?

[pa_rn2012]

I'm brand new to being a clinical director, just started the end of June. I am having issues figuring out the administrative ends of things in PA for a stand alone ASC. I know I need to set up different login's and accounts to do reporting but I'm not sure exactly what to do. Can anyone help me? So far, I know about the state board and PSRS but I haven't been able to contact them yet and I'm honestly not even sure who to contact or how. I'm assuming I'll have to do something with CMS for medicare possibly and the DOH. Again, I have no idea who to contact or how to set up all of this. The last clinical director just left me high and dry with absolutely no direction on how to transfer anything from her to myself. Any help would be greatly appreciated because I'm trying to do this all by myself. Thank you in advance!

[Lauren Ridolph]

Hello Everyone,

I've been a nurse for since 1996. Mostly ICU and about 3 years of operations supervisor for my hospital back in California. Since then I have worked as a legal nurse consultant and did very well with that. Recently I took the LSAT's and was going to apply to law schools but decided to wait and felt it just wasn't the right time yet. So I turned to applying for positions that would give me more of a leadership role in nursing because I have an itch for a challenge and to make a difference and be influential. I just accepted a new position as Resident Care Director of a beautiful residential assisted living facility. As I've been talking to my regional director, one of the things she said would make me successful at my job is to make sure I keep my staff accountable and yet still be supportive. I brought this up to one of my ICU peers that I used to work with and who is now the manager of my old ICU.  She agrees and said even more so you must keep your staff accountable while you are coming in brand new. Can any of you give me some good tips/advice on how to navigate this in my new role? 

[kyhoward1989]

Hi all, I have been a nurse manager for 4 months.  Prior to this, I had been traveling for a few years.  My specialty is in critical care, more specifically CCU and post-surgical TCV.  My last assignment was close to home, which was perfect for me.  I had a few months left in my contract when I was approached by the director of cardiac care regarding taking this position.  I had no formal management experience; however, I've always been comfortable with leadership.  I humbly accepted the position.

I currently manage a cardiac surgery IMU/stepdown that has 67 employees that report directly to me.  It's been an interesting job so far, but I've loved every second of it.  Building the relationship and being the manager that I always aspired to be.  My unit went vacant for nearly 2 years prior to me, only having an interim manager, who did an excellent job keeping the unit afloat.  It's been a difficult transition for everyone, including myself.  We've rolled out so many quality improvement plans since I've stepped foot on this unit, and we continue to move forward.