Calling All Nurse Managers/Clinical Directors

yupyup5 · Jul 23, 2005

I have been a nursing director since 1993, before that I worked as a DON in a hospital based skilled nursing facility. From 1993-2001 I worked in the south suburbs of Chicago as a 350 bed hospital. Currently I work in Wisconsin at a 100 bed hospital. There I manage and provide leadership for 130 employees (entirely too many). I have three units, medical, surgical and inpatient rehabilitation. I also manage the staffing office and the house supervisors.

I have been blessed with the good fortune of great leadership to mentor me. I have been given automony in managing these departments. Our staff turnover is down, patient satisfaction is improved and we have active and quite busy unit based shared leadership committees. My suggestion to new managers and directors is get as much education as you can, preferably an advanced degree in nursing and most important "listen" to your staff. Take their issues and concerns to heart and include them in initiatives you take on. Thank you for allowing me to share.... :rolleyes:

USFguy · Jul 25, 2005

I have been a nursing director since 1993, before that I worked as a DON in a hospital based skilled nursing facility. From 1993-2001 I worked in the south suburbs of Chicago as a 350 bed hospital. Currently I work in Wisconsin at a 100 bed hospital. There I manage and provide leadership for 130 employees (entirely too many). I have three units, medical, surgical and inpatient rehabilitation. I also manage the staffing office and the house supervisors.
I have been blessed with the good fortune of great leadership to mentor me. I have been given automony in managing these departments. Our staff turnover is down, patient satisfaction is improved and we have active and quite busy unit based shared leadership committees. My suggestion to new managers and directors is get as much education as you can, preferably an advanced degree in nursing and most important "listen" to your staff. Take their issues and concerns to heart and include them in initiatives you take on. Thank you for allowing me to share....

I'm a BSN student at USF and have plans to become a critical care nurse. My program allows me to go directly from the BSN in to a MSN in Healthcare Systems Leadership for one more year (this is done by taking a few of my graduate courses my senior year). I eventually want to be a patient care director. Should I go on to get a post-master's in acute care nurse practitioner (being in line with my interest in critical care patients) for another year later on or should I be fine with the MSN? If I do the extra year for the NP post-master's certificate and later on get the DNP degree, since all APNs need one by 2015, I would have achieved one of the highest levels of nursing education (along with PhDs in nursing, DNSc degrees, Post-doctoral fellowships, etc.) I wouldn't mind taking on the new NP role while performing as a CCRN aswell (I love ICU nursing too much to leave it entirely behind) but I question myself because my ultimate goal is in management and administration. I would always attempt to practice clinically on the side part-time to keep my skills, but I feel that adding the NP title to this complicates matters. I would relish the additional training and education but feel I would be wasting it since it wouldn't be put to much use. I would just want the additional training for personal enrichment and probably could come in handy when moving up into higher levels of management (DON, Hospital Executive Board, etc.) What do you think?

yupyup5 · Jul 25, 2005

I'm a BSN student at USF and have plans to become a critical care nurse. My program allows me to go directly from the BSN in to a MSN in Healthcare Systems Leadership for one more year (this is done by taking a few of my graduate courses my senior year). I eventually want to be a patient care director. Should I go on to get a post-master's in acute care nurse practitioner (being in line with my interest in critical care patients) for another year later on or should I be fine with the MSN? If I do the extra year for the NP post-master's certificate and later on get the DNP degree, since all APNs need one by 2015, I would have achieved one of the highest levels of nursing education (along with PhDs in nursing, DNSc degrees, Post-doctoral fellowships, etc.) I wouldn't mind taking on the new NP role while performing as a CCRN aswell (I love ICU nursing too much to leave it entirely behind) but I question myself because my ultimate goal is in management and administration. I would always attempt to practice clinically on the side part-time to keep my skills, but I feel that adding the NP title to this complicates matters. I would relish the additional training and education but feel I would be wasting it since it wouldn't be put to much use. I would just want the additional training for personal enrichment and probably could come in handy when moving up into higher levels of management (DON, Hospital Executive Board, etc.) What do you think?

I believe strongly that nurses who are interested in beginning graduate studies should practice clinically for at least 5 years. This is based on personal experience, observations and discusssion with other graduate students. I think you should practice in ICU as a staff RN. Working as an NP will change your focus. Then after about 5 years, work on your MSN focusing on administration if possible. I realize many schools have stopped offering Master of Science in Nursing with a focus on nursing administration. That is the best way to go if you plan on working in nursing administration in the future. Best of luck in your endeavors.....

witnurse · Jul 26, 2005

I have been in nursing management for about 9 years. I was a staff nurse on various types of Critical Care Units. The most exciting was Cardiothoracic Surgical ICU. That also morphed into my first management position as Assistant Head Nurse.

My husband moved us to a very rural area 9 years ago. I was ready for a change from Critical care and took a job as a staff nurse in an LTC facility on the locked Alzheimer's Unit. I was there 2 months and a Manager position opened up on that floor and included another 32 patients who were complete care. I liked the paperwork at first(MDS) and building the care plans and seeing my patients get stronger or at least more comfortable. I had a deficiency free unit for all 3 years I held the position.

The call of acute care was strong though and I took a job at the local hospital and became their SCU Resource Nurse/manager. 2 years ago a position in Administration became available. This position includes membership on the Hospital Management Team as well as on the Nursing Leadership Team. I oversee 5 separate areas. Infection Control/Employee Health-Workers Compensation/Education-Hospital Wide/Survey Coordinator/Emergency Preparedness Rep at the local and state level. I recently became an ACLS Instructor and a certified Homeland Security Instructor for First Receiver's in a Decontamination Incident due to Biohazard/Terrorism.

It is an exciting, demanding SALARIED position. The pay is OK but not great. The staff nurses just received a 34%raise in order for us to recruit and retain RN's to decrease our High number of travellers. I recived a 2% raise as did the rest of the hospital.

I am excited about this forum and hope to "pick your brains" about many topics in the future.

Eeyore

chunnice · Aug 7, 2005

Hi,

I have recently been promoted to the Nurse Manager in my facility. I was a charge Nurse for six years here. My biggest problem is making the transition from fellow nurse to Supervisor. My DON is very supportive and that helps. I'm so happy I found this forum.

Laura

nurs010 · Sep 2, 2005

I have appreciated seeing all the posts from around the country. It appears to me that nursing leadership is in a crisis as much as anyone else. I am tired I admit, but still loving what I am doing. I am interested to know if there is a standard out there for how much is too much...and just because your good at your job doesn't mean you can do it on a bigger scale. Kudo's to all nurse managers...keep up the great work.

flothenurse · Oct 6, 2005

Hello! I am not a "mananger" but took my first job as a nursing supervisor. I am BSN and will be completing my MBA/ Health Care management Degree in May. I needed some supervisory skills and this "promotion" seemed to fit. I will have 14 memebers of the nursing staff reporting to me some are LPN's and a few are MA's. I am not in it for a popularity contest, but really would like to connect with my staff and earn their trust. I know, decisions can be hard, but I have always seemed to be the person who's job it is to help others acheive greatness. Anyone know what I mean? I loved being a floor nurse, but I worried so much about not doing something right or missing something that it would affect me outside work. I enjoy helping those that do great nursing, do what they do best. I see my self as the nurses step ladder to great care.

cicinurse · Oct 26, 2005

Hello, I am needing guidance from those of you that have been managers for awhile. I will start with some background info on my situation. I am currently the Interim Director of Surgery at a rural hospital. I had applied for the position about 4 months ago when the previous Director stepped down. I had been the charge nurse in the OR for the past year prior to my current position. The previous Director pretty much decided to step down and then convinced me into taking over the department. Although, I had not been involved in the budgeting as well as other upper management decisions, I am a fast learner and with minimal guidance I have managed to struggle through. I am hourly still but have been taking administrative call for the Department for the last 4 months with no compensation. I had hoped to gain this position but Director was recently hired from outside the organization. My problem is 1)no one in HR or adminstration has informed me of what my role is now,as the new Director does not begin for 3 weeks 2)I am concerned about continuing to take adminstrative call without compensation. As I am disappointed that I did not get the position I am continuing to run the OR as I feel my staff and Department depend on me and there is no other leadership. What to do? :confused: thanks

mshooha · Nov 3, 2005

Greetings All,

I am a nurse manager of a rural ER along with the Outpatient clinic. I started as a floor nurse and was able to develop this position as well as my department. The ER is thriving and we have actually contributed to overhead for the last 2 years!! I am very proud of my department and have the best nurses in the world working with me. I have been in management for 3 years. I have learned alot, but boy I sure have alot to learn!!!! I have a great role model with my CNO, she has been an excellent mentor.

nurselulu · Nov 28, 2005

How delightful to find a forum for Nurse Managers & Directors. I started out in 1993 as an ADON in a LTC facility 19 months out of graduating as an Associates Degree RN. The DON I worked for was most interested in 'eating her young' & in my not succeeding. I managed to survive a year of "training" with her and moved to my first position as a DON of a brand new 95 bed rural LTC facility.

It was very exciting to open a new facility in which we started out with 5 patients and 10 years later we had admitted almost 600 patients over the years. Believe me, it was the most intense highs and lows I've ever experienced and such a learning experience!

The most important lesson I can pass on, especially to those of you just starting out is this - NEVER lose your sense of humor:coollook: It will carry you through the most frustrating of times. My most frustrating time was during a state survey on day 3 when things get very testy and intense and I had an administrator that made me responsible for every department in the building from the front door to the back - I hadn't had a break all day and could NOT get a moment away from the administrator so I took a Bathroom break - would you believe she stuck a note under the door while I was in the bathroom to ask me about something?? I was so upset & mad:angryfire I stomped out of the bathroom to my office and immediately typed out my resignation. Luckily I took a moment to cool down and did not give it to her, but boy was it tempting. There were many more rewarding times - I just love the elderly and enjoyed every minute of it in the long run -

Now I have a new challenge as Director of a Home Health Agency. We do PDN and specialize in vent patients and also do skilled nursing in the home. At present I am trying to get our office certified to do Medicare & Medicaid as well. If anyone has any tips for this area, I would be more than grateful.

Till Later...... Nurselulu:nurse:

kat911 · Dec 11, 2005

I am a Hospital Supervisor in a 500 bed Teaching Hospital. My career spans 27 years and I have had many different clinical and management roles over the years. I like where I am now. Dealing with staffing issues and every other "problem" that comes up while I am on duty can be a real challenge. I'd like to hear about some of the Recruitment and Retention successes other managers have had, I am currently chairing the R&R committee.

Kristej · Jan 2, 2006

Awesome, love the ability to share thoughts and ideas with other managers, thanks for the opportuntity.

I am new to nurse management, I have been an RN for 11 years from floor nurse to speciality area, charge nurse and now nurse manager. This is a big challenge for me. I started in the department when it was only me and another agency nurse, built it up to 6 nurses, transfered to another job and in three weeks the department was in trouble, no one would step up and take charge. After 5 months, I came back to be the nurse manager and have had a huge challenge of trying to get everything back in order and had a big physcian turn over in the process. We are a new hospital and still need alot of protocols and policies to be implemented. I am looking for any ideas to help make this easier and run more efficiently. Lots of patients, very little space to work with.