Unit Manager vs Charge Nurse roles

Katnip, RN · Jan 18, 2008

I don't have a lot of answers for you since I'm a new unit manager. But one thing, people tend to be resistant to any change, even good change.

I'd prioritize the changes you want to make then introduce them one at a time to the staff. Let them adjust to each change before adding another one. Yes, it takes time but I think everyone will benefit from a slower approach.

As far as the difference between charge and manager, a charge is in charge of the basic running of a unit for a particular shift. The manager is in charge of the bigger picture and of all shifts and the administrative duties that entails.

HealinghandsRN · Jan 18, 2008

Thanks for your reply.....have you always been in a LTC facility? I was hired for a unit manager position as I had said.....and previously the unit manager WAS the charge nurse at the desk......This is the first time there census is this high and it is absolutely CRAZY....no secretary neither...so in the past the charge nurse who was at the desk by herself was responsible for the unit, all family meetings, care conference day, Utilization review and every other meeting dept heads go to....and the desk would be empty cuz the girls that do meds and treatments think that is all they are responsible for......I told them I was hired as a unit manager and we ALL have to help at the desk. (of course not so harsh, but just trying to make a long story short) The DON told me today this is the first time EVER that they had a unit manager and a charge nurse on the unit...and she said of course that is prob one of the reasons in the past the unit was not successful....please tell me how it works at your facility...and report at the beginning and end of your shift....thanks.:balloons:

Katnip, RN · Jan 18, 2008

I don't work in LTC. I work in psych. But our report is verbal. We only have 8 hours shifts. Day shift is supposed to be in at 0700 and in theory that's when report is supposed to start, then the med nurse does the med count afterwards while charge sets up the assignment sheets. Same with all our other shifts.

As the new manager, since our unit is small, only 14 when full, I'll actually be charge and do admin duties throughout the day. We're lucky because we've got a good crew and most of the fulltime people really know what they're doing and that will free me up for the payroll, scheduling, interviewing and stuff.

delta32 · Jan 18, 2008

HI!

I was going thru what you are going thru except its a 40 bed rehab unit with constant discharges and admissions. I am given all sorts of responsability and absoultly no authority to do anything. I can write people up but that is it. I find that with out punishment for behaviors thier actions will not change.

The rehab unit that i have taken over the for the past 4 years the longest a NM has worked their was a year and all the rest have lasted 6 months. I hate it their with a passion and I am sick of manipulative patients and their families. I am tired of getting remmed at because "Ms. Jones was on the call bell for 4 hours" I think not. her room in right in front of my office. they only thing i get told is make the aides work faster and harder. they are!!!! they actually made me go around with a sheet of paper for them to sign saying that call bells will be answered in a timely manner.

I am so out of there!

good luck to you!

Jamie

sara62 · Jan 18, 2008

the charge nurse and manager need to be a team and unfortunately it's rare that would ever happen. It's worth a shot.

Good Luck

CoffeeRTC, BSN, RN · Jan 18, 2008

I'm gonna say that every facility is different.

For the most part, a Unit manager is like a mini DON. When I was one, I was accountable for all shifts. What I did varied. Mostly make sure staffing was okay (we had a staffing coordinator), deal with the docs and the orders, deal with the families, MDS, Careplanning, Meetings with other departments, staff evaluations. Each shift had 2 lps that did the meds, treatments and assessments. There was also a house super for the off shifts, but I would be called on occasion for problems.

I'm also thinking that what a UM and CN does will be different depending on what other persons you have in your facility. Do you have a MDS Coordinator? What about a resorative person? Some facilies will have the UM do this for each unit. Is there a house super for each shift?

As far as report...its is normally nurse to nurse. I would always sit in during report and listen. Some facilities that have the shirt overlap the CNAs would sit in or do walking rounds with the othe shifts. We also have a written report sheet that is passed on...that sheet is also given to other departments.

HealinghandsRN · Jan 19, 2008

Would u please tell me some of the roles of your job as a unit manager and the roles of the charge nurse? Thanks.

HealinghandsRN · Jan 19, 2008

Thank you Michelle126 for your reply.... we have a restorative person, a mds coordinator...and the roles u described is what I do so it sounds like the facilities were run similar....Who was at the desk all day though, did u have a charge nurse and what were her roles? admissions and discharges? How were consults handled? and were u as a unit manager salary or hourly and what kind of hours did u work...I am salary and of course I know that as a unit manager u don't get out on time but my set hours were 7-3 and the earliest I ever left this week was 425pm a couple of times I was there till 615. I do the exact roles as u said but the desk is chaos and all the girls expect me to stay and help with the desk till they are done. I am being pulled in every direction but being new to the sub acute unit, i need to know how it is done other places so I know where to draw the line.

CoffeeRTC, BSN, RN · Jan 20, 2008

I was salaried and kinda made my own hrs. 8-4ish and of course later. (this facility was very very flexable, somedays I didn't even get in my 8hrs due to hyperemesis with my first pregnancy....they were just happy to have a unit manager). I mostly did the admissions, MDS, Careplanning, attended meetings with families, IDT, restorative for my floor, answered phones, dealt with docs and did the orders. There was no charge nurse per se, put one of the LPNs ran things for so long before I came, she kinda kept that roll.

What type of things are they pulling you for? What can you delegate?

HealinghandsRN · Jan 20, 2008

ok let me ask u this....how about the call out to the docs on labs and did u have a call board....and what was passed on to the three to eleven shift? and let me ask u this not to get personal but what is the average salary rate for that type of position?:pumpiron: it seems like our labs and any other orders we may be requesting from docs are called out about 2 now when the docs call back and it is 230 and now I have a slew of orders to write and carry thru to the mars and I am there at seven am when can I draw the line and pass off things and what can i pass off to the next shift? What was your next shift responsible for?and also, SS schedules family meetings at three oclock....now I know as I said earlier as manager u won;'t prob get out on time but I am putting in tooo many hours and I think it is simply cuz I am not sure what is appropriate to pass off to the next shift....

CoffeeRTC, BSN, RN · Jan 20, 2008

First off...those 3pm meetings need to change. Why are they at that time? When do the other dept heads leave or maybe you can work 8-4 on those days?

As far as the labs...anyway you can get those back sooner or do they come over on the printer? I would start to make the calls, get the orders and write them and work on as many as I can. If you need to leave them for the next shift to take off...then you need to do that. First I would see if things can be juggled around a bit.

In most places that I've worked..3-11 might be judged as being less busy but for the most part is was just as bad or even worse than days. Most of the admissions would come in then, you would get calls back from the docs, less staff than days etc....

So that is why I'm saying to see if you can change things on days.

As far as pay...it is so varried from area to area. I don't do that anymore, but work PRN and make a ton more money than I would if I would be scheduled FT. I'd day it might be a few bucks more than staff nurse??