How often do you get called?

caliotter3 · Mar 30, 2015

I thought the purpose of having a house supervisor or other supervisory personnel between the first line supervisor and the DON was to prevent this type of thing. When working in the facility, I never would have called the DON unless it was for something unusual, terribly important, and that I was certain she would need to know before the start of her own workday. If there was no house supervisor or the ADON failed to answer their phone, it still needed to be important before calling the boss. Only thing I can suggest is that you speak to your personnel verbally and then in writing, suggesting that they start showing more initiative in using their management problem-solving skills. Then address this on their performance evaluations if necessary.

CoffeeRTC, BSN, RN · Mar 30, 2015

I'm amazed by this too. I work in a really small LTC...50 beds. The last few DONs took a lot of the nurses responsibility away and wanted to micro manage everything. Horrible. As a part time worker that has been at the facility for a long time, I sort of ignored a lot of what was going on. I'm the nurse on duty and in charge of the facility and that is how I worked. If it was a reportable issue, then I called. We have a new DON and ADM and they are aware of these practices. Poor things, must be odd coming into a building that ran that way.

My suggestion (if I was back in charge again or in your shoes) is meet with your supervisors and unit managers and let them know what their responsibilities and role is when you are not in the building. Make sure they have the resources and background to deal with the issues on their own....empower them! Maybe do a few case studies/ role playing type of in services with them?

Are they newer employees? or newer nurses? maybe that is the issue.

Nascar nurse, ASN, RN · Apr 2, 2015

My first question to every call would be (in a very respectful tone) "Ok. What have you done about xyz"?

If they can easily come up with several things they've done then they probably do need additional guidance.

If there is a big long stupid quiet "doy....." after the question then my next question would be "What do you think you should do next"? Also in a very respectful tone. Once you guide them towards the right answers, I give a cheerful little "See, now next time you can handle that situation all on your own. Good for you". If they don't get it from there, you're going to have to do some teaching and maybe disciplinary action. Nurses need to be able to think for themselves...especially someone gettning paid supervisors pay.

LTCRN4LIFE · Apr 6, 2015

No, I don't deal with this......anymore. Go to HCPRO site and download "The Basics".......adapt it to your facility and needs. Hold a mandatory meeting and present it. Has done wonders for me. You will have to refer to it from time to time so staff know you took it seriously, but will save you even the annoying common sense calls and emails that you get when you are at work as well.

HehLPN, LPN · Apr 11, 2015

In our facility, after hours we have an on call manager, which is not always a nurse. We call or text them for anything we absolutely have to have and cannot do ourselves. If they need to contact our DNS or ED, then they will and will get back to us. If we have a call off, we, as charge nurses, deal with it and try to find someone to come in or rearrange staff to make it work. We have a list of phone numbers for nurses and CNAs in our schedule book. There really is no need to wake someone up in the middle of the night just to handle something that we can take care of. We also have a mandation policy. We have 1 nurse and 1 CNA mandated to stay in the event of a call off for each shift. It works well. We work on a point system and No Call No Shows are never ok For any reason unless you're unconscious, then you better bring a Dr note to return. We have an NP, as well as our medical director, that comes in a couple times a week each. There is no reason we would need to call the on call NP for narcs or other meds if we are keeping up with how many refills our current narcs have. We request hard scripts at the time they are there. If we get labs back late, as long as they are unremarkable, we wait until the day shift to have our regular NP look at them. If our computers go out, we have 3 ring binders for back up paper charting on each unit for nurses and CNAs. If an employee is whining like a child, they are free to go home. They will receive full points for the missed shift, and double the points if it is their weekend to work, on top of having to make that weekend shift up on their off weekend. We will then work on calling another staff member in to help cover the shift. As nurses, we also collaborate. If I can't figure something out, I will call a nurse on another unit for help, etc. The only thing we call/text our DNS for directly are choking incidents, falls, or 911 emergencies and that's just to notify him in case he needs to report it and so he is not blind sided in morning meeting. He never works the floor if we can help it. He has his own pile of work to do. I have only had one incident I had to call our DNS for. I had argued with a CNA who was refusing to work the floor our DNS scheduled her on. I had been telling her for 30 minutes that she needed to report to her scheduled unit, get report, and relieve the CNA on her hall. She kept telling me that if she had to work that unit then she was going home. I told her that was her decision but I couldn't guarantee she would have a job the next day. Unfortunately, I eventually had to call our DNS and tell him she was acting like a child and refusing to work where he scheduled her. He talked to her and told her to go where she was scheduled or go home. If she chose to go home, she didn't need to come back the next day because she would not have a job. Of course he was not happy about being woke up, and I wasn't happy I had to wake hime up. That CNA received a written warning write up when our DNS came in early just to speak with her the next morning. Hope some of this helps you and I hope you're getting enough sleep! (All of our floor nurses are titled "Charge Nurse" to take "charge" of the little things.)

Jessie71385 · Apr 29, 2015

I developed a list for our "Nurse Supervisor" (one floor, whichever the supervisor is that day). Call me for unexpected deaths, fire, elopement, fall with injury, and raging family. They do know to call if they have exhausted all efforts to find replacement for call in (doesn't happen very often). This is pretty much it. I will go numerous days without a phone call. When they do for something silly, I tell them "Thank you for the call, please make sure to use your list from here on out."