Published Jul 25, 2009
i am in need of some serious advice. i am currently employed as a clinical manager in a medicare-certified home health agency. we have seen a great deal of sudden, steady, increased census over the last several months with no sign of "letting up." i consider myself well-versed in medicare cop's, oasis, pps, practice standards, etc., and understand the business end of things. i am being asked more and more, though, to compromise and implement what i believe to be "in the gray areas," ...at the very least. i am seeing our outcomes decline, our surveys suffer, and more complaining by once happy staff. i have been trying tirelessly to make my bosses (new & plural!) understand the clinical necessities in order to make an agency successful, compliant, and, most importantly, provide our patients with the best care we can deliver. they however, are not clinically trained, and it has become a constant battle to make them understand the rationale for what is needed. the shoestring has been stretched to its breaking point, as well as some of my staff! this is taking it's toll on my mental and physical well-being. i guess i am asking advice on whether it is all worth it. would i be chopping off my nose to spite my own face if i were to say "see ya," and move out of management, or get out of home health altogether? from what i am hearing and reading, the nursing market is looking pretty dismal right now. i am so frustrated and disenchanted that i don't even know where else my skills could take me, and i have been a nurse for almost 16 years! any thoughts or advice would be greatly appreciated! thanks
I would show them the data that shows the decline in your quality and satisfaction of patients and staff as it relates to your increased workload. You could also look for some literature that supports your views to share with your new bosses.
I am in a similar situation. I am in a director level position working for an ambulatory surgery center affiliated with a teaching institution. Our financials are controlled by a business manager who does not understand that I need more than two people for each OR room. We need extra staff to cover breaks and lunches, to cover for call outs, run for supplies in an emergency ,etc. With 8 ORs, I often start the day with 16 people (two to a room- you guessed- it barely enough to run the unit). The main hospital affiliated with us has 30 ORs and is short 20 OR nurses. They would rather close OR rooms, postponing surgeries than hire travelers. My fear is that they will run off the nurses that are busting their butts. They won't listen, and I am getting to the point that if I am going to be doing patient care, then I would rather reduce my work schedule from 50 hrs a week to 36, work my 3 twelves and have a life!!! I will take a pretty good pay cut to do so, but my stress level will diminish and my husband might actually not get his head bit off by me on a daily basis. I am about to tell them to take a hike.
I was the Nurse Manager of the ER I work in for 3 years.... when I got to the point I could not take anymore I stepped back to staff and am very happy with my decsion....... good luck
SuesquatchRN, BSN, RN
I would certainly not leave without another position, but I have to say, if it didn't mean taking a med cart again (SNF), I would give up the big $1.50 an hour more I get for managing a unit.
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