Quote from trixie
Just wondering if all acute care facilities have nursing supervisors for all 3 shifts, or just 2nd and 3rd shift when the nurse managers aren't there? We have about a 200 bed facility and currently have nursing supervisors all three shifts. However, it may be in the plans to go to a supervisor only on 2nd and 3rd shifts. I'd like to hear what others are doing or have done and how it has worked out for them.
I worked at a large pediatric facility where there were nursing supervisors on the 7p - 7a shift. This was always a troubled system, however due to the small size of the facility, the problems were managed. The facility added several new units . At this point, the cracks began to show. Issues regarding staffing and patient placement began to cause excessive waits in the ER and recovery room, nurse staffing was poorly managed with certain unit charges not revealing when the beds were emptied or scheduling changes that resulted in more or less nurses. Unit managers were involved in day to day managemement meetings etc.. that staffing issues were not addressed in a timely manner. I would highly recommend 24 hr nursing supervisor. Someone needs to be in place who "can manage the needs of the house" who has the time and ability to follow up on staffing and patient placement issues. In the two facilities where I worked in this role, each went to 24 hr nursing supervisor to resolve those issues. It would be staep backward to change the system. I think that your institution is not aware of the problems that will result. Here is a short list of problems:
1) Managers (and or charge) would refuse patients when they had beds availiable because "this was not their type of patient" therefore physicians were angry to find their patient waiting on a bed when there were beds availiable. - Nursing supervisor made and enforced decisions on patient placement
2) Frequently staff would not remove patients from the census (computer) and available beds were not being used - nursing supervisors "walked" the house and talked with charge and knew which patients were leaving and when as well as getting social work involoved when discharged families occupied rooms because there was "no ride" - Nursing supervisors facilitate the flow of patients and reduce patient wait times
3) Often staffing was not regularly update - Nursing supervisors knew through their "rounds" what staff was availble, they ensured that all units
were fairly staffed
4) Charge nurse would state they could not take patients because of staffing - Nursing supervisors reviewed patient acuity and staffing and decided if moving a patient to another unit was appropiate or not
I think it will be a comedy of inefficiency and mismanagement to depend entirely on each unit manager to work with the other unit managers on these issues.