Calling All Nurse Managers/Clinical Directors

Mili · Jun 21, 2005

I have been in nursing management since 1999. At present, I am Director of Patient Care for a 15 bed Cardiac Step-down and a 33 bed general medical unit. I am directly responsible for 48 FTE's--which translates to 65 employees.

My greatest challenge: When I became the Director for my current unit, the unit was in a great amount of turmoil. The previous Director had walked off the job--no notice, he just didn't come back. The nurse manager--who had not gotten along with the director--had just transferred to another department. The amount we were spending on agency nurses was astronomical--1/4 of the RN positions were vacant. Needless to say, I had my work cut out for me. That was three years ago. Now, my unit is extremely stable. All of my RN positions are filled and we have not used agency help for 18 months.

I guess you could say that my greatest challenge also became my greatest reward. I wouldn't change what I do for anything.

Monica RN,BSN · Jun 26, 2005

Hello There.

I have a new position as a DON for a 120 bed LTC facility. I love nursing management and have been an RN for 16 years. I like these boards and find there is a lot to learn and conribute by searching them. Thanks for allowing me to introduce myself.

RNPATL, DNP, RN · Jun 27, 2005

I have been in nursing management since 1999. At present, I am Director of Patient Care for a 15 bed Cardiac Step-down and a 33 bed general medical unit. I am directly responsible for 48 FTE's--which translates to 65 employees.
My greatest challenge: When I became the Director for my current unit, the unit was in a great amount of turmoil. The previous Director had walked off the job--no notice, he just didn't come back. The nurse manager--who had not gotten along with the director--had just transferred to another department. The amount we were spending on agency nurses was astronomical--1/4 of the RN positions were vacant. Needless to say, I had my work cut out for me. That was three years ago. Now, my unit is extremely stable. All of my RN positions are filled and we have not used agency help for 18 months.
I guess you could say that my greatest challenge also became my greatest reward. I wouldn't change what I do for anything.

Wow - you should be very proud of the fact that you have been able to stablize the unit and fill your positions. In this day and age, that is a very big accomplishment.

If you have the time, please take a moment to share some of your ideas with us about how you were able to manage the turnmoil and turn around a unit that was failing.

Nice to have you on the management forum with us!

RNPATL, DNP, RN · Jun 27, 2005

Hello There.
I have a new position as a DON for a 120 bed LTC facility. I love nursing management and have been an RN for 16 years. I like these boards and find there is a lot to learn and conribute by searching them. Thanks for allowing me to introduce myself.

First - congratulations on your new position (I think) .... being a Director of Nursing for a long term care facility can be and often is a very big challenge. Sounds like you are very excited about it and I am sure you will do great.

Please visit the management forum often and let us know how you are doing. This is also a great place to post questions or get good ideas for retention programs or other management related questions you might have.

Good luck with your new role!

Justanurse1 · Jul 15, 2005

i have been in some form of nursing management since 1997. my role has progressively moved up and i am now vp of clinical services in a small rural hospital. every day brings new challenges and opportunities. one accomplishment in my current position that i am really proud of is bringing my nursing budget from $1.4 million dollars in agency to less than $300,000 last year. it is a wonderful feeling to see our own staff growing and becoming part of "our hospital" as opposed to watching the money go to nursing agency. i just hope we can retain them now. i just came across this forum and am looking forward to interesting discussions here.

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).

RNPATL, DNP, RN · Jul 15, 2005

I have been in some form of nursing management since 1997. My role has progressively moved up and I am now VP of Clinical Services in a small rural hospital. Every day brings new challenges and opportunities. One accomplishment in my current position that I am really proud of is bringing my nursing budget from $1.4 million dollars in agency to less than $300,000 last year. It is a wonderful feeling to see our own staff growing and becoming part of "our hospital" as opposed to watching the money go to nursing agency. I just hope we can retain them now. I just came across this forum and am looking forward to interesting discussions here.

Welcome to the Nurse Management Forum. I see that this was your first post as a new member to allnurses. We are pleased that you are here and hope you find our forum a nice place to share and visit.

Congratulations on bringing your agency cost down. Sometimes nurses do not undestand that when a hospital uses agency, it impacts their ability to provide better benefits and wages.

It is nice to have you with us and I hope you enjoy the forum.

Justanurse1 · Jul 16, 2005

Thank you. I think this is a wonderful way to communicate with other nurses around the country. I would like to pose a question regarding nurse patient ratios. Is there a standard ratio for an average med-surg unit?

Welcome to the Nurse Management Forum. I see that this was your first post as a new member to allnurses. We are pleased that you are here and hope you find our forum a nice place to share and visit.
Congratulations on bringing your agency cost down. Sometimes nurses do not undestand that when a hospital uses agency, it impacts their ability to provide better benefits and wages.
It is nice to have you with us and I hope you enjoy the forum.

RNPATL, DNP, RN · Jul 16, 2005

Thank you. I think this is a wonderful way to communicate with other nurses around the country. I would like to pose a question regarding nurse patient ratios. Is there a standard ratio for an average med-surg unit?

I think if you conduct a general thread search, you might find a great deal of information about nurse to patient ratios.

For my med-surg unit, we try to keep the day shift at 1:5-6. Most times we are successful. I do have a freestanding charge nurse on the day shift and she/he takes patients if the nurses have reached their max load of 6 patients. This has been an excellent structure for the unit. Our unit is very busy and we see a lot of patient volume! At night, our nurse to patient ratio is 1:7-8. Of course, on the day shift, we generally have CNA's and they take approx. 10 patients each. On a given day, we might have 35 patients, which equals 3 or more CNA's, plus a secreatary (maybe even 2 if our surgical volume is high). On the night shift, we have a CNA ratio of 1:16 and we also have a secretary.

Justanurse1 · Jul 16, 2005

I think if you conduct a general thread search, you might find a great deal of information about nurse to patient ratios.
For my med-surg unit, we try to keep the day shift at 1:5-6. Most times we are successful. I do have a freestanding charge nurse on the day shift and she/he takes patients if the nurses have reached their max load of 6 patients. This has been an excellent structure for the unit. Our unit is very busy and we see a lot of patient volume! At night, our nurse to patient ratio is 1:7-8. Of course, on the day shift, we generally have CNA's and they take approx. 10 patients each. On a given day, we might have 35 patients, which equals 3 or more CNA's, plus a secreatary (maybe even 2 if our surgical volume is high). On the night shift, we have a CNA ratio of 1:16 and we also have a secretary.

Thanks

nurs010 · Jul 23, 2005

Its great to hear that there is success out there. I am a manager (titled Care Delivery Supervisor) and I over see 7 specialty clinics. I have approximatly 110 staff as I oversee the nursing and secretarial float pools. We are extreamly busy and just startetd taking several of our clincs live on an electronic medical record. My frustration is endless it seems. I love my job and get along well with most of the staff, but it seems that trying to accomplish what needs to be done is just not a possibility. How do others get through...

Any advice for a manger who just want success?

Ellica · Jul 23, 2005

I have been a nurse manager for two years now. I managed the staffing office, the float pool nurses, a small group of transporters and unit secretaries. I enjoy the diversity of my role and the challenges that go with it. It is overwhelming due to the numbers of employees that report to me, roughly 100, give or take a few on any given day. I have an open door policy and try to speak to all employees working everyday. This however, has begun to wear me down.

I don't believe I can change the way I do my job, I need to change my job. Just recently we have lost several nurse managers and at every opportunity I have been asked to move to a department. I enjoy the employees I oversee, but I think I need to downsize. Currently their is a department in need of a manger with a 30 bed capacity, 2 specialty areas, and less than 50 employees total. This is my challenge, I am comfortable where I am, I know the role, but am beginning to burn out or down.

I must admit that I do like change. This would be all new I have not worked in either of these particular types of nursing. In addition to my job I am also enrolled in school to complete my BSN. I am not sure if I can do it all, but the decrease in responsibility would be welcomed. However, the learning curve, as well as, going to school makes me question if I could really do this?