QAPI Coordinator

amoLucia · Mar 6, 2020

JMHO but NO NO NO! You seem to have a full plate. Very full; in fact maybe too full to do justice to them all.

I am particularly concerned with that 'substituting for floor nurse' stuff. That would be the killer for me. You'd still held responsible for all those other obligations. And that would be the killer for you.

You talk about training. Do you have a separate Staff Devel Coord? Records must be kept.

Nsg employee evaluations?

Employee health (like Hep B for ALL staff)? Workman's comp issues. Pt flu/pneumo compliance?

Safety - I'm familiar with Maint being resp for much of the building at, particularly MSDS & fire drill/evac and Bug Control.

It's one thing to be just the official 'Keeper of the Records" but that's only a mini-mini part.

When you say 'new admits', are you talking review & screening for 'Pt Recruitment? Because of the needed knowledge of insurance and care qualifications, that is quite detailed. That was always the Admissions Coordinator (who, by the way, got bonuses for getting new admits in a tight market). Sometimes, the MDS/RNAC covered some areas.

But 'assistance with admissions" says 'floor nurse' to me. Again that's the one thing I worried about when one person has to wear so many hats. And that would be you regardless of whatever due-time task you may be doing. No 3-11 or 11-7 house RN/Super avail? Guess who?

It's NOT that you couldn't be able to do any of those roles (you've prob have those skills, most esp if you have significant experience), but not all of them in one big fat title. Tasks could be delegated and you could coordinate/assemble those like you say in audits, audits, audits'.

Another issue - will you resp for nsg on-call and/or weekend Admin of the Day??? All dept heads usually are resp for AOD duty?

Sounds like a lot of what you're speaking is 'Assist DON' title. Unless you have a STRONG DON with supportive others, you've got your hands full. I hope your salary is commensurate.

And the final thing for you to angst about - when are you due for State Survey? Make sure the last Plan of Correction is being followed for remediation.

JMHO, but I think you've got too much (based only on what you've posted here and what I remember).

Good luck

amoLucia · Mar 7, 2020

Two more things came to mind. Firstly, are you salary or hourly???

Hourly (time clock punch-in) will document your overtime. But salary is a flat fee for which you SHOULD get some consideration for the all the excess time you'll likely spend. Some places promise 'compensatory (comp) time. Yeah - just try to use it! And will you have weekend/holiday AOD (administrator of the day)n duty? One is AOD (usually half-day Saturday and half-day Sunday) so there should be one full day off. Again, try to use it.

If you try to flex your time, you may well face resistance.

And secondly, how deep into care conferences and care planning? I'm hoping you have someone for MDS/RNAC or else some of that may be fall to you.

I'm trying to be realistic in all that I saw over the years. I don't assume that situations have improved very much over the years.

I hope your facility has a successful, responsible, cooperative and professional team approach.

Again, good luck to you.

** One thing - what are PIPs?

JEM1974, RN · Mar 7, 2020

Most everything you mentioned above, I am responsible for. We do not have a staff development coordinator in the facility anymore. I think a lot of those tasks are being handed off to me. I am responsible for emplyees drug screening, influenza vaccines, Hep B, TB, and patientsi nfluenza and pneumonia compliance. With safety the maintenance team and do fire and alarm checks and drills, I monitor Compliance of it. As far as new admits I help do new admitting orders, apts, advance directives, order clarification, address issues iin the transmission of orders. Currently I am on call every 5th week and one day during the week. I am also responsible for a continuous survey readiness process that we have. That is intended to keep us survey ready all year...hopefully. I am not responsible for care conferences and we do have a MDS coordinator.

* P.I.P is performance improvement process. When an area of concern is identified based on data and priority, we have a PIP meeting to try and brainstorm new processes for improvement. We then initiate those process changes and monitor for effectiveness.

caliotter3 · Mar 7, 2020

Too much for one person, period. Even two people equally sharing responsibilities as a well-oiled team, might find it difficult to cover all bases. And they should have an on-call nurse(s) available for covering the floor.

CharleeFoxtrot, BSN, RN · Mar 7, 2020

2 hours ago, caliotter3 said:
...And they should have an on-call nurse(s) available for covering the floor.

Ahh that's the rub! LTC bosses often count on unit managers (unofficially of course) as the go to people when there is a hole in the schedule. That was part of being "on call" someone calls off and you can't cover it guess what? You're stuck. Place where I used to work would make the Utilization Review nurse be on call and take shifts, what a disaster that was.

Jedrnurse, BSN, RN · Mar 7, 2020

Formulate an exit plan. They are going to run you into the ground and, as soon as something inevitably gets "dinged" by regulators/inspectors, hang you out to dry as a bonus.

JEM1974, RN · Mar 7, 2020

Yes, this is something I am worried about. There is a lot on my plate. There are several tasks that were not part of my job description that have been handed off to me. When I mention the abundance of responsibilities I am told that I need to figure out how to organize my time. I am a very organized and diligent person. So this is insulting to me. It is comforting to me that others see this as an overload of tasks as well. Thank you.

Jedrnurse, BSN, RN · Mar 7, 2020

3 hours ago, JEM1974 said:
Yes, this is something I am worried about. There is a lot on my plate. There are several tasks that were not part of my job description that have been handed off to me. When I mention the abundance of responsibilities I am told that I need to figure out how to organize my time. I am a very organized and diligent person. So this is insulting to me. It is comforting to me that others see this as an overload of tasks as well. Thank you.

If it were me (knowing that I'd be leaving soon), I'd say, "Since you're in effect renegotiating the job, let's begin by renegotiating the salary." Then they'd say "no" to which I'd reply "no" to the added duties.

I'd be fired, but it would be a satisfying way to leave...

amoLucia · Mar 7, 2020

Jednrurse - VERY satisfying approach.

I'm soooo glad I wasn't the only one who thought too much. So unless there's some great big compelling reason to stay, OP might really need to consider exiting.

There are some ways to lighten OP's Herculean load. A great idea is to consider delegating some of those tasks to others (like UMs & shift supervisors, even other dept heads). But a supportive Admin would have to be on board and accountability for delegated staff is absol nec.

OP WILL BE DINGED BIG TIME eventually. I know - been there, been dinged. Just too much.

OP - could some of your compliance tools be workable/tweaked for others to complete? That might be the best alternative I could see. At least to start. Run it past your nsg admin- maybe?

Again, lots of good luck.

*PS - I kinda' figured the PIP was something Qual Assur SOMETHING Improvement.

JEM1974, RN · Mar 10, 2020

I'm definitely becoming a dumping person for new tasks that keep coming up. I've been told I should be able to do everything in 12 hours, so why is it taking so long? Seriously? I even had someone complain that I wasnt helping them enough, when more than half of my work time is helping other NM, instead of doing my job. Its frustrating. Other NM act like I was hired to be their assistant and quality control, infection control, safety management, emergency and disaster prep, admit assist, recruiting, taking on call, helping fill schedule isn't time consuming at all.

Sorry for the rant.

amoLucia · Mar 10, 2020

? You deserve a hug!