New Job as RN Unit Manager

suebird3 · May 23, 2006

Welcome to the LTC Forum! I can tell you we need more people like you in the LTC trade. I wish you luck!

Suebird

bonesrn · May 24, 2006

LOTs and LOTS of paperwork....

MrsStraty · May 24, 2006

Yes I heard about the paperowrk thing.....and guess what I LOVE paperwork, I know I'm an oddball! I have worked LTC throughout my whole life, much of it as a CNA, and I left the acute setting to return to my roots, geriatrics. I absolutely LOVE geriatrics. I can't even begin to tell you the reasoning, it is just something my heart desires, to see that our elderly get the care that they deserve. After all, we wouldn't be here without them and second of all people need to understand that when we are in the LTC facility, we are in the resident's HOME, they are there, most of them until they die. Anyhows I feel a rant coming on, so I'll just go and clean my house now.....

MrsStraty

bonesrn · May 24, 2006

Lord knows we need people like you in LTC. I didn't mean to sound negative with the above post..I guess I am a bit jaded as I took on the day supervisor/ADON job in Jan and I really miss being out on the unit. I try to get out their everyday and do something clinical but most days I spend at meetings, doing staffing planners etc. It doesn't help that the company is very micromanaged so getting things changed is a long, drawn out process...I came into the job thinking that I would be able to make changes, improvements for both staff and patients...and well, it hasn't really been that easy.

I wish you luck and hope that you enjoy your new position!

MrsStraty · May 24, 2006

That is exactly how I am coming into the job, thinking I can make changes, we will see. I am truely excited and I can't wait to start on Tuesday. I hated the acute care setting and I am just so thrilled to go back to LTC, that is where I belong! Although it was hard to find a staff RN position, every place I interviewed for suggested RN Unit Manager to me and I thought why not? If they feel I am ready then I must be. I'll keep you all posted on how I do!

MrsStraty

CapeCodMermaid, RN · May 25, 2006

MrsStraty-

I hate to burst your bubble, but most places are SO desperate for someone who will agree to be a nurse manager they don't care if you have enough experience. No offense...you might be a great nurse, but being the nurse manager is a hard thing to do. Good luck. I hope it's what you want.

PS to those other managers....I'm the ADNS and I do make a difference clinically...micro managed or not if you have the knowledge and aren't afraid to speak up, you can make a difference. I've only been at my job for 3 weeks and already have gotten 6 residents on the Alzheimer's unit scheduled pain medication which has significantly decreased their behaviors. Just because you're management doesn't mean you give up being a NURSE!

NRSNFL · May 25, 2006

MrsStraty-
I hate to burst your bubble, but most places are SO desperate for someone who will agree to be a nurse manager they don't care if you have enough experience. No offense...you might be a great nurse, but being the nurse manager is a hard thing to do. Good luck. I hope it's what you want.
PS to those other managers....I'm the ADNS and I do make a difference clinically...micro managed or not if you have the knowledge and aren't afraid to speak up, you can make a difference. I've only been at my job for 3 weeks and already have gotten 6 residents on the Alzheimer's unit scheduled pain medication which has significantly decreased their behaviors. Just because you're management doesn't mean you give up being a NURSE!

Mermaid

That was rude and mean. MsStray, you keep that positive attitude, I have no doubt you got the job because you're qualified....probably BECAUSE you have a fabulous attitude and perspective.

NRSNFL

CapeCodMermaid, RN · May 26, 2006

Mermaid
That was rude and mean. MsStray, you keep that positive attitude, I have no doubt you got the job because you're qualified....probably BECAUSE you have a fabulous attitude and perspective.
NRSNFL

Zowie----wasn't trying to be rude or mean and sorry if you took it that way. I was trying to inject a dose of reality. LTC is NOT for sissies and I have seen more than one poor nurse leave in tears because the facility hired her out of their need...not hers. If we are truly here to help eachother out and give different perspectives on our chosen area of practice, we must be able to be truthful about the job market and employers.

MrsStraty · May 26, 2006

I have worked LTC almost my whole career, which began when I was 18 and I am now 35! I know ALL about LTC and their troubles and how desperate they are, but I also KNOW that LTC facilities need people like myself who actually care about their residents and respect them and I want others to follow my attitude and if I can make a difference that way, then I am happy.

MrsStraty

ERP1 · May 27, 2006

I can relate to what you've shared... I started as a RN Manager in a LTC facility just two months ago... I don't mind the paperwork but the attitudes are what is difficult to deal with... You have to be able to assert yourself

AND put the administration accountable for what needs to happen as well.

In the past, nothing has been done to deal with multiple call ins/tardiness and attitudes... there are new adminstrators and RN managers now and we have our work cut out for us....

The aged individual deserves to have quality, dignity and safety from all perspectives...With all the hassles.. I am still happy to be there and to promote these values!

Enjoy and take care of yourself in the process!

Daytonite, BSN, RN · May 27, 2006

advice i was given was to (1) establish for yourself some kind of organized calendar so you know your deadlines for things (2) never let the people you supervise know when you are going to be checking up on them and never make rounds by the same route--vary it and (3) no matter how strongly you sympathize with the staff you supervise, remember that you also have a boss you have to report to and that your job performance is important to your continued employment--don't expect the people you supervise to understand this.

you will be the one who makes sure that all the policies and procedures are being followed by the staff. if you are the one to check over time cards before they go to payroll there will be a certain day and time they have to be turned in. you definitely don't want to miss that day and time! you are probably going to be responsible for making sure the monthly mars and tars get checked and put out on the first of each month. this is a big responsibility. i learned from the pharmacy how to make corrections so the next month's print outs had the changes i wanted on them that would be carried over month after month thus eliminating a lot of unnecessary handwriting. a lot of med errors occur because orders get missed and not carried over to the next month. new admission charts are also a big source of transcription errors and should be audited very closely in the first days after admission. if you have medicare patients take the care to learn about skilled charting and just what makes the patient "skilled". the mds nurse should be able to help with this. i made rounds once a week where i wrote down a list of things that maintenace needed to fix or that housekeeping wasn't cleaning.

one of the things that i was able to do was first find out exactly what the pharmacy's computer service was able to do. it was more than just printing out the monthly mars and tars. the pharmacy also supplies consultation services as part of their service to the facility, so don't be afraid to call them about anything to do with meds, the med carts or the printed order sheets. i found that they were able to print out all kinds of information that came out of the database of doctor's orders. we were able to generate lists of dnr patients and other things. so, i was able to make sure each patient's orders had all the necessary orders that were required. because i liked working on computers and being creative i was able to create customized fax forms for the nurses to use in notifying doctors of falls, lab work and other things. i also was able to develop some one page nursing care plans for common things like falls, skin tears, n&v that could just be whipped out of a paper file and very simply customized for a patient. i was able to organize the med and treatment carts. being in charge gives you the freedom to do these kinds of things. i organized aide assignments and their worksheets.

the biggest shock for me was learning to deal with the people problems. since you've worked in ltc for awhile i'm sure you are aware that some shady characters sometimes show up to work in these places. i strongly recommend that you take one of the 8 hour seminar courses in supervision for the first time supervisor and/or how to deal with difficult people. i've taken them both a couple of times. i learned new things from each course. i also got several little handbooks on how to deal with difficult employees. the hardest are the insubordinate employees. after that come the ones who do their job, but have bad attitudes and nasty behavior. you don't have to permit that kind of behavior and there are ways to handle them, but you will most likely need to take the initiative to learn on your own. in some cases, i found a number of dons who knew even less than i about dealing with some of these problems. i would start with reading the rules of the facility and knowing them as well as the disciplinary policy. understand that documentation is necessary to fire anyone. instead of incident reports a simple writing in the form of a memo works quite well for both praise and discipline. i would also read up on manipulation and learn how to recognize it as some will do their darndest to suck up to you with an ulterior motive in mind. above all, be fair and don't play favorites.

good luck!