Latest Comments by stephva1008

stephva1008 2,299 Views

Joined: Mar 25, '09; Posts: 104 (27% Liked) ; Likes: 46

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    This is probably too broad a question for a forum ae don't know your textbook, syllabus, etc. I would recommend studying your material. I'm sure you will do fine if you study! Good luck! Study and go in with confidence.

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    Crucial conversations.

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    The BSN classes include more theory and research as well as leadership and ethics classes. I don't think any class with "toughen you up" although I would highly recommend "Crucial Conversations" training. I dp think practice makes perfect. You need to practice now. Do you have the ability to delegate to CNA's? I would definitely work on your organization skills if that's an issue. I would sit down with your unit manager and talk about your goals. What does she see as your strengths and the areas you need to improve? Tell her your ten year goals and see if she can help propel you forward. Succession planning is a hot topic now with leaders and many nurses absolutely do NOT want to be in management...the fact that you are interested is a good sign.

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    All good questions. If you just graduated with your BSN, sitting down and setting up some milestones for the next ten years is important. I assume you are not an RN to BSN and that you have no nursing experience? If so, you need at least 2 years nursing experience as a floor RN. Then I would start training for charge nurse positions, or assistant unit managers, house supervisors, etc. Learn as much as you can. If you want a hospital administrator position, like a director or CNO, you have to work your way up the ranks. This almost always involves a unit manager position to start. If you do that for 4-5 years, and have a handle about how it is run 1 unit, start applying for director jobs and manage multiple units for at least 4-5 years. Then I would apply for CNO positions. In the meanwhile, I would get your MSN or MHA (masters of health administration). I think the MBA is less important these days for nurses (this is my opinion). Employers want to see that you can manage a large number of FTE's, stay under budget, have a healthy operating margin, and maintain your quality metrics. You will need a master's in nursing though. Some magnet facilities are requiring that a masters degree for unit managers as entry level and I wouldn't be surprised if that trend increases.

    I'm sure managerial director roles exist in medical staffing agencies but I imagine you would have to work up through the ranks there as well. I'm not as familiar with those organizations.

    Good luck in your journey! The world is your oyster!

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    Quote from smuface
    Hello, I am a new grad RN and have been working in a Neuro IMC for the past 6 months. I applied for a dual degree program - MSN Health Services Leadership and Management / MBA. I'm pretty confident that I will get in and I will be finding out if I was accepted within the next 2 weeks. ...but, I'm now a little unsure about where I can go with this degree choice. I would love to hear from other people who have an MSN/MBA and what they do/did. Thanks
    You could be a unit manager or director in a hoapital. If you have long term care experience you can be a director of nursing in a nursing home. In my opinion, the MBA is becoming less important in leadership positions than the MSN but it will help you with making budgets, etc.

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    Feel free to email me the questions if you still have a need. Stephanie at steph.va.1008@gmail.com

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    Feel free to email me the questions if you still have a need. Stephanie at steph.va.1008@gmail.com

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    I think you do more hands on direct nursing care than most managers. I don't necessarily think that is a bad thing. When talking about your resume, emphasize metrics/outcomes. Maintained operating margin of 8-10%, managed 20 FTE's, Lean Six Sigma PI project saved the unit x number of dollars, Press Ganey scores in top decile for ___# of years, core measures.... With a smaller unit/hospital, you will wear more hats. If you go to a larger hospital, you probably won't be expected to work the floor, most of the managers at my hospital do only in a crisis situation. My duties involve: staffing unit, schedule, maintaining productivity numbers, managing/disciplining staff, recruitment/hiring, service recovery, tracking metrics/core measures, education (we don't have a unit educator either), serving as a magnet team leader, human rights advocate, research council chair, and various other hospital committees. So, just remember to focus on outcomes and numbers if you're working on a resume and emphasize what you've learned and how you've contributed to the bottom line and to quality patient care. You can be a great manager in a small hospital as well as a large one. Keep us posted!

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    I work probably 50 hours/week when you count in time taking work home. I'm glad I did it, and I have no regrets. But that's me. I will say that, financially, you will have to work your way up to a salary that would compare to CRNA. A few years as unit manager with proven results, then director, VP, etc. This takes awhile in my experience. CRNA school is tough but once you're done, you're done, and you will have any job you want waiting for you with a good salary.

    It all depends on what you like to do ultimately. Keep us posted.

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    SummerGarden likes this.

    Until you have an offer letter in hand, I wouldn't give notice for your current job. I would wait the 7-10 days, then call back. Get them to email you the offer letter as an attachment, then put in notice. Most jobs you only need 28 days notice and the VA moves slow, so you should have plenty of time.

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    NRSKarenRN likes this.

    It's tough to go through for sure. It's better to lay off some people than continue the further downward spiral for sure. What I would look at is your census. Is it bimodal? Can you staff by the census trends? For example, our unit census drops significantly during the summer. When we had to cut FTE's we converted a few staff to 9 month employees who have the summer off. It works great for folks with children home from school and we call less staff off in our low summer census months. Be creative. I would also encourage you to contact other like units that are in your compare group for staffing benchmarks. Call them and see how they staff. I've learned a ton by networking with colleagues from around the state and nation. Good luck - it's not a fun position for sure. Keep us posted!

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    They may ask you about managing FTE's...do you send folks home when you're overstaffed? Talk about a time where you had to discipline a subordinate. Licensing issues...what did you learn going through the last JCAHO inspection or CMS or whatever....How do you manage risk, how do you track quality indicators and who you benchmark against? Why do you think you are qualified to be a DON?

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    Daisy Doodle and cfaith like this.

    I have a weekly email huddle that has about 10 points of interest. I send it out every Friday afternoon and it contains all the info I get throughout the week but condensed into one email and more relevant for the staff. We also have a display monitor in the staff breakroom that runs a powerpoint continuously. I can change that easily to put up slides on staff birthdays, updates to retirement policy, benefits, reminders about unit policy, get togethers, blood drives in the hospital, etc. Easy to change. I also have staff meetings every other month and charge nurse meetings every other month (opposite months). We have education at every staff meeting where the staff themselves take turns presenting on a topic and we have a pre and post test using the Turning Point "clicker" software. The every other month face to face meetings combined with the weekly email "huddles" and the display monitors in the staff break room seem to have hit "the sweet spot" with regards to sharing data.

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    I wouldn't say any track is detrimental to moving up the ladder. Even OB isn't just OB. It's L&D, postpartum, newborn nursery and, in some hospitals, women and children are under the same director.

    To move up the ladder you need to have outcomes. To start your management journey, sign up to be a shift manager or house supervisor after hours, then a unit manager, then director, then CNO. But you need to have outcomes and make your productivity and budget targets from a UM on up.

    Then there are other nonclinical departments like performance improvement, risk management, etc. I wouldn't imagine a CNO coming from a nonclinical area. A CNO needs to understand the average staff nurse and unit's struggles. But I'm sure it's been done before, lol.

    Welcome to the journey!

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    Altra likes this.

    No, management was not something I ever considered, though I was an officer in the Navy Nurse corps, lol. When my current position became available and was offered to me, I turned it down initially! But my boss was persistent and I yielded eventually (my big thing was I wanted to continue grad school).

    I'm so glad I took the job, though there are "those days." My kids are both in school and I'm a single mom so the M-F day shift schedule was what clinched the decision for me. I screwed up royally my first year, that's where experience helps. I love being able to have the kind of influence you are describing.

    I did read some books but they didn't help me that much. The book that had the most impact on me is "Crucial Conversations." Highly recommend that one.

    Good luck in your decision-making process. Feel free to PM me anytime for questions, or, if you take a management job, to vent, lol.


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