I figured out what my unit manager job really means.

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I am the cover your butt person. I am the one to care plan for the unmanageable. The elopers who are better tahn Houdini, the behaviors that can't be changed, for NYS that actively wants to tag you for harm where none was done.

I'm also the MDS person. I followed someone who didn't document so he did nothing to trigger RAPS, which raise reimbursements, which we need. I find out that if I accurately complete it to note bahaviors and a ton get triggered we get investigated for everything we've done to correct it.

Meanwhile, in the past week and a half I have had to work the floor every day. Every single day. Please tell me when I am supposed to actually look at anything to investigate the hustory and do this stuff accurately?

Now, I know some of this is being brand new, lots of vacation time being taken over the holidays, but how am I supposed to do it nall?

Help!

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Specializes in LTC, Hospice, Case Management.

Sue, sorry for your situation. Unfortunately many times this is the world of management. The world that many do not understand and love to critize. I feel your pain, been there myself. More often than not, you do make it thru these rough patches. It just gets difficult to see the light at the end of the tunnel. Good luck and Merry Christmas. I enjoy reading your posts. You seem to be handling yourself very well in your new position.

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Specializes in trauma, ortho, burns, plastic surgery.

SUE JUST DO IT....... if you can, lol! Or the other option is to reserve an UHAUL place in my UHAUL, lol :D

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Specializes in ICU, CV-Thoracic Sx, Internal Medicine.

Sorry to hear about the tough situation. Unfortunately I've been there myself. In retrospect things seem much easier to me now than they did when I was actually in those situations.

Best advice I can give you is to prioritize. Ask yourself the tough questions:

1. Where is the unit now?

a. Where is it heading in this direction?

b. Where do we want to be, when, and how do we get there?

2. Develop a plan with your director and all other stakeholders (physicians, nurses, ancillary staff, etc.).

3. Stay the course you set, ad lib as necessary. ;)

Sometimes things always seem like your just putting out fires instead of making progress. However, if you start by setting measurable goals and set dates to evaluate your progress you will find more meaning in your position.

Best of luck to you.

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Specializes in jack of all trades.

I understand your frustration. I recently left a position for these very reasons. As the DON, I was working the floor everyday 6 day week 12hr days because they couldnt keep RN's in our dialysis unit. I was expected to leave pts unattended by a licensed person while tending to paperwork, cms documentation, scheduling, labs, med changes, careplans, etc. If I didnt leave the floor then I had to do after hours or my one and only day off lol. I kept hearing "it will get better" and it never did. It' ultimately my fault as I allowed the abuse to continue too long till I suffered major burnout and resigned. Funny thing is my replacement is now enduring the same plight! It's one thing to be now and then but if you are finding it's a daily routine you may find they will depend on you to fill that floor space on a daily basis. Dont let it continue for too long as I did. Good luck to you as I feel your pain on this one.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

This is the reason why I will not ever accept a managerial position in a nursing home or long term care facility. I am not going to willingly be responsible for what others do (or don't do).

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Sorry I feel your pain. Try becoming the director of the same type of place. Trying to make sure the unit managers are doing everything. My unit managers were not as efficient as you it seems as I was the one chasing people to document. Being the permanent MMQ Queen (it is the equivalent to the MDS but but it is for the skilled care pts admitted under medicare in MA ) Dealing with the survey team for past deficiencies (those that occurred in the last survey when you were not the director), and DPH visits regularly for that houdini who keeps falling and breaking something. Being on call 24/7 working 100hr/week and regularly replacing the "sick unit manager or nurses and even an aide on occassion" because the corporation won't pay for agency nurses or OT why should they when they got salaried people they can abuse and the unit manager who is responsible for her floor 24/7 and has to replace sick outs as well if you cannot do it first. (I LOVE HCA FACILITIES ... NOTTTTTT)

Needless to say I lasted 2 years. I am happy to be a working stiff in an acute care facility as a staff nurse. Management ain't what it was cut out to be.Good luck unfortunately I can't say it will get better, you will just get better at putting up with everything thrown at you :cry:

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Sorry to hear about the tough situation. Unfortunately I've been there myself. In retrospect things seem much easier to me now than they did when I was actually in those situations.

Best advice I can give you is to prioritize. Ask yourself the tough questions:

1. Where is the unit now?

a. Where is it heading in this direction?

b. Where do we want to be, when, and how do we get there?

2. Develop a plan with your director and all other stakeholders (physicians, nurses, ancillary staff, etc.).

3. Stay the course you set, ad lib as necessary. ;)

Sometimes things always seem like your just putting out fires instead of making progress. However, if you start by setting measurable goals and set dates to evaluate your progress you will find more meaning in your position.

Best of luck to you.

Thank you for the good advice.

I am not salaried, thank goodness, and the constant shortness of nurses lately really is because my charge and others have a a lot of vacation coming and took it! The rats! ;) She's excellent, and I rely on her very heavily.

Where the unit is now is, "Oh, he's always been that way" with no easy trail in place to allow me to trigger a RAP. I'm going to have to go digging. Care plans that are, um, cavalier at best. And designed to drive the actual care rather than survive survey.

Well, I'm gonna go take my shower then once more into the breech, dear friends.

Thanks, all, for the words of encouragement.

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Specializes in Psych, M/S, Ortho, Float..

Sue,

I have been down that road too. Not enough staff willing to do the MDS assessments or even chart properly. I finally quit as no one else was helping me get them done. I was the only charge nurse that was there full-time so I was expected to do the most. Our designated MDS position was unfilled but the pressure was on to get them all up to date. I did all that I could, but it still wasn't enough.

I'm hoping that all of your co-workers will help out once they are back from vacation.

MDS was supposed to make it easier to get the required funding, but in my experience, it has been a nightmare.

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Specializes in Legal, Ortho, Rehab.

In my opinion, MDS is a full-time job, unit manager is a full-time job, and floor nurse is a full-time job. It shouldn't be a "hybrid job". I honestly don't know what to say...hopefully you can make lemonade with these lemons...Good luck!

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nytseshade, we have a f/t MDS corrdinator. I do the quarterlies on Medicaid only. Really not too onerous. And I am not a floor nurse, but we have been really short the past two weeks.

We'll see. In this environment and location, what it should be is trumped by what it is and that I'm employed.

:)

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Specializes in LTC, rehab, medical review.

I cannot help you there, as I am a new nurse myself, but my UM has the same problems. The poor thing has to manage the unit AND work the floor a few days a week!

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