New 11-7 shift supervisor position

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Specializes in adult psych, LTC/SNF, child psych.

I currently work in a 135 bed sub-acute rehab/nursing home. I've been a staff nurse here for 4 months. I've been a nurse for 4 years, although psych was my previous specialty. I'm doing really well on 7-3 - I'm innovative, do a ton of creative problem solving, streamline my work, keep everything stocked, and try my best to keep both med carts under control. I'm also very interested in doing QA and education. Today, I was asked by the DON if I would be interested in taking a M-F 11-7 shift supervisor. She said she'd include some QA and staff development duties. Right now, we don't have a nursing supervisor on nights, so I'd be filling a currently unmet need. My DON has said that she'd like me to work with the 3-11 shift supervisor for a week or so before starting on my own. Do you think this is enough time to get a good picture of job duties and expectations?

I'm going to be meeting with the Administrator and the DON on Thursday to discuss the position and negotiate the salary. I am really excited about the idea of never working weekends. I'm married with no kids and DH will actually be starting an evening position soon so we should be able to make things work to see each other during the daylight. I'm aware that I'll probably have to pick up a cart if there is a call-out, do assessments before sending someone out, and helping with admissions. Are there any red flags I should look for when meeting with administration?

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I think you should go for it, especially if you'll be getting paid more. You have a decent amount of experience including knowing the policies and procedures etc of the facility.

The DON obviously thinks you can do it.

Just make sure you get time to learn the new role before you start on your own.

Good luck

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Specializes in retired LTC.

Important ---- Ask if you'll be responsible for any weekend ON-CALL. Almost all places require their management team to share weekend on-call. Just so you're not surprised!!!

Good luck!

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It's a trick at my LTC facility. Whenever we get a "11-7 RN supervisor" she always gets stuck on a med cart. ALWAYS

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Are there many meds on the 11-7 shift though?

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At my LTC, I have to start at 4:15am and then I usually finish at 6:30am or 6:45am. It takes a long time because people are asleep and you have to wake them up first to give them their meds. In addition to regular pills, you have to give residents with G-tubes pill thru their tube and then some residents have an Isosource bolus to give. Of course, many people have a blood sugar ordered for 6am in the morning. IV antibiotics are also ordered for 6am. You can always count on the pharmacy to show up with a great huge shipment of pills and narcotics at 6:15am. If someone is going to fall on your shift they always seem to fall around 6am too.

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^^ My life. They don't even bother having another nurse for the med cart, it's just my job all-in-one.

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@Bringonthenight I think it really depends on your facility and how they structure their med times. At my facility, this is one of the (few) great things about 11-7 - Out of 21 pts, I have one midnight med, then everyone else gets meds at 6 am, and for everyone it's either Synthroid or Prilosec (or Zantac for the tubes). Lots of fingersticks, though...

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Specializes in retired LTC.
At my LTC, I have to start at 4:15am and then I usually finish at 6:30am or 6:45am. It takes a long time because people are asleep and you have to wake them up first to give them their meds. In addition to regular pills, you have to give residents with G-tubes pill thru their tube and then some residents have an Isosource bolus to give. Of course, many people have a blood sugar ordered for 6am in the morning. IV antibiotics are also ordered for 6am. You can always count on the pharmacy to show up with a great huge shipment of pills and narcotics at 6:15am. If someone is going to fall on your shift they always seem to fall around 6am too.
Oh, didn't you forget about having to pull the vanco peak & troughs too (and whatever else labs via the PICCs)?

In all honesty, I have worked places where I have pushed the cart only occ, but then in other places, I was the 'working' supervisor all the time. Depending on other variables, it may or may not be difficult for OP.

I am curious as to why NOW do they need an 11-7 super when they haven't had one before? If OP has to cover the floor often, her ability to do all those QA & inservices will take a backseat, esp if she's on a rehab unit.

I hope she's not going to get bamboozeled.

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I am a new grad supervisor on nights & i do not pass meds unless down an LPN; I run the house and if any situations arise I take care of them (deaths, calling docs, pharmacy, labs etc) and dealing with employee conflicts. Med pass at night isnt bad though!

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I just resigned my position as a Night Supervisor for a small nursing home (rated 5 stars! by the Medicare/Medicaide site!) after a "Bait & Switch" was pulled on me. When I was hired, I was told I would be Supervisor for the entire facility, which consisted of Side A and Side B, each with 55-60 residents. Each side has 4 halls-orange, yellow, blue, and green. This facility is a mix of long term and short term residents. So, for the first 6 weeks, I loved my new job! My responsibilities including talking with family, responding/handling any unusual situation (a fall, a new skin tear, etc), making the decision to send a resident out to the ER, communicating with the doctors, Director, DON, and unit managers, assisting the nurses and CNAs with care off residents, especially when using the Hoyer or stand lift. I assessed any new admission or post hospital resident, took off orders/verified the orders, inserted foley or G tubes, and more. I helped with the Med Pass and stocked the med carts, ran the glucose monitor controls for 4 accucheck monitors, received, processed and put away deliveries from the pharmacy tech, including narcotics, that are delivered every 2 hours around the clock and wrote a nurses note on every resident who was a new admission, post hospital, anyone on hospice, any resident taking an antibiotic, tube feeding residents, any resident who has had a fall or has new symptoms of illness, anyone who has a new skin wounds....

Then, one evening when I arrived at my usual time at 6:45 pm, I was told that "a CNA called out so you need to take a cart." I said "ok, but who will be the supervisor?" The 3p-7p supervisor laughed and said "YOU are!" (being both a supervisor and a med nurse) I was a little surprised but since I was new, I did not want to complain. Also, the way the other nurse informed me that I was to be supervisor and to take a cart implied that this was going to be very simple and easy-no worries. However, there was so much work to do that it was ridiculous. I had no time for a break, which wasn't too bad, but I honestly did not even have time to use the bathroom. There were tube feedings to flush and re-start with newly primed bags and tubing, patient equipment (foley, nebulizers, and O2 cannulas with humidifiers, triangular containers, leg bags) that had to be replaced and dated once a week on the weekends....the humidifiers were not pre-filled, so all had to be hand filled...

You get the idea...I was still doing the 6 am med pass at 7:15 am, so I stopped to give report to the day shift nurses (2 nurses-each was assigned to have 2 of my 4 carts). The unit managers arrived (one for side A and the other for side B). I gave them report and handed each unit manager The Supervisor Reportr-updated with my notes from 7p-7a- for all 115 residents. " I did not finish up my notes and finish "clicking off" treatments and ancillary orders until almost 9:30 am. As I was driving home, I remember thinking, "that was rough, but oh well. At least I don't have to do that every shift."

Guess what? It turned out that THIS WAS THE ACTUAL SHIFT. So EVERY 7p-7a shift, I was supervisor for the entire house, the only RN. I always had to take 4 med carts....I was told that absolutely I could not start any 6 am meds even one minute prior to 5 am, and could not finish up the 6 am med pass even one minute past 7 am. Everything I did was time stamped. I then decided to do the tube feedings and accuchecks before 5 am, since the time for these tasks said 11-7 shift. Some of the residents took as many as 14 pills at 6 am. I had to remember which residents preferred to swallow their meds whole with water, and which ones wanted them crushed in applesauce or yogurt. Or which residents could swallow the pills whole but only with Gatorade, not water. I made a list to help remember which residents took their meds whole versus which required the meds to be crushed-I also noted the preferred juice, and yogurt/pudding/applesauce preferences.

I just resigned because I made 3 med errors in 8 weeks...the first med error was this: I had two residents in the same room; both were prescribed Tramadol 50 mg po prn pain. While I was taking a pill from each cardboard blister pack, the phone rang (it was another CNA calling out sick) and the pharmacy tech had arrived at my cart to have me sign off the huge bag of medications he was delivering. As soon as the meds are delivered, I had to stop everything and lock up the narcotics in one of the 8 carts; I then had to put away each of the individual blister packs into the correct med cart (one of the 8 med carts). So, somehow, I took 2 tablets from one of the blister packs. I gave each resident a tablet. But this was considered a med error because I should have taken one tablet from each resident's personal blister pack instead of taking two tablets from one blister pack. Yes, I know this but I was a little distracted. Then I gave a resident who was ordered both oxycontin 5 mg and oxycodone 5 mg the wrong one at 6 am-even though both were ordered for her. I don't even remember the third error, but these med errors all resulted in a formal write up and a discussion with the unit managers and the DON, plus they had me take an on-line course called "How to Avoid Med Errors."

I am really upset about this experience. Is this typical of a small nursing home facility-to have a supervisor take a med cart as part of his/her job?!!

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Specializes in retired LTC.

"and other duties as assigned". This phrase just about covers it all. Check your job description.

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