New Unit Manager

Specialties Geriatric

Published

Hello!

I was recently promoted to interim unit manager. I feel overwhelmed and frustrated by the lack of organization and accountability throughout the unit. The staff are for the most part good at their jobs, but there are many systems, or lack thereof, which make it difficult for them to complete all of their paperwork. Since starting, I reworked the shower days and skin checks to actually coincide, instituted a new system for aides reporting changes or skin issues, and have started audits of many aspects of the unit. The pneumovac audit was horrendous, the ppd audit was mortifying, etc.

People are generally on board with my changes, and the only issues I've had with staff involve the fact that I've only been a nurse for 8 months yet I WAs the one promoted. My response to that is generally 'Did you apply?', then they get the 'Oh, well I guess I shoulda done that' look.

My main concern is trying to get all this finished by the time state roles around so we can pass our survey. I feel like by the time I get one thing fixed, five other things have gone wrong. It's this constant battle to keep my head above water.

Any advice for a new unit manager would be greatly appreciated. I'd love to hear from both unit managers and cart nurses so I know what is expected of me, as well as the best ways to help my staff. We have a lot of trouble keeping nurses, partially because we regularly work short. But that's because we can't seem to keep nurses. The nurses who have been there for a while are burnt out, and the new nurses are frequently scared off within a couple of weeks.

I suppose I'm just looking for ways to get organized quickly, and for systems to put in place to make the nurses and aides lives easier at work. I look forward to hearing what everyone has to say!

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I was actually in the same boat about 5 months ago, and then the next I know I'm now the ADON. :nailbiting:Just take your time. Don't try to fix everything overnight. I spent a lot of time at home in the beginning typing up schedules, spreadsheets, and creating plans to organize the unit. I also made late night and weekend visits just to catch up on work. Just focus on the important things and support your nurses and nurse aids. You may have to start the process of accountability with the staff that are not showing up to work. This can be hard, since the status quo has been to accept working short. Then little by little you can address each system and make changes as needed. Focus on your infections, care plans, warfarin therapy residents (PT/INR), incidents, diabetics, and grievances. Make sure you check all your new orders and that they are transcribed correctly (state will tag the heck out of you for this one). Audit your admissions and discharges for the same reason. Audit your nurses charting and MARS for holes and errors. This is just a starter. You will do fine.

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Hey there! I've been a new UM for a little more than a year now. I have TONS of advice and experience for you. If you are interested, send me an email and I can share some systems that really, really helped my unit. We were nominated for most improved in patient care this year at our yearly conference after the changes that were made out of 130 centers in 11 states, if that tells you anything :)

Meghann

[email protected]

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Specializes in LTC,Hospice/palliative care,acute care.

It sounds like organizational skills are sorely needed-that will go a long way towards increasing retention.I can't beleive skin checks were not ordered to coincide with the bath. I can imagine a busy floor nurse thinking "aint' nobody got time for that" because fixing it involves d/c'ing and entering a ton of orders (however I always did my body checks first thing in the morning while the resident was still in bed-they did not sit naked and wet on the shower chair while I stopped my med pass to run to the shower room to do it and I did not have to get on my knees on the wet floor to look at the wazoo) Good Luck-sounds like you are doing a great job so far.

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You seemed to have a lot of work handed to you, and it sounds like you're doing great. If you have a good attitude where employees feel comfortable explaining precisely why they didnt do things right,(ran out of time, wasnt properly educated, whatever confusion) it may shed light directly onto what is kinking the system, and employees will likely feel motivated to try and help you since they had a chance to feel understood without potential negative consequences.

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Ha! Aint nobody got time for that! My thoughts exactly.

It sounds like organizational skills are sorely needed-that will go a long way towards increasing retention.I can't beleive skin checks were not ordered to coincide with the bath. I can imagine a busy floor nurse thinking "aint' nobody got time for that" because fixing it involves d/c'ing and entering a ton of orders (however I always did my body checks first thing in the morning while the resident was still in bed-they did not sit naked and wet on the shower chair while I stopped my med pass to run to the shower room to do it and I did not have to get on my knees on the wet floor to look at the wazoo) Good Luck-sounds like you are doing a great job so far.
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