Unit Manager vs Charge Nurse roles

[HealinghandsRN]

Hello All,

Today is one month I am employed at a sub-acute unit hired as a unit manager. My backround in Nursing is acute care. I love what I am learning however trying to get this unit to succeed and do have supportive management and this is the first time their sub acute census is high, we are full. just a 31 bed unit. They have gone thru 5 managers in 5 years and now they have a new don and she is very supportive of me and knows that things have to change on the unit. However, I would like to know what u do in other facilities as far as charge nurse and unit manager positions......What is the difference, I have my own idea in the difference and the girls on the floor are stuck in their old ways. How is the desk handled? how is report given? and of course the role of the unit manager and charge nurse? Thank you for any input u can give........And any other resources that may be helpful to me I really appreciate. ie.....state deficiencies what they look for when the state comes in.....Thanks so much.:balloons:

[HealinghandsRN]

SS sets up meetings anyday....but, the one thing I see for starters is one nurse comes in at seven thirty and she is still late and the other comes in between seven and seven fifteen...so right there we are almost an hour behind. and the night shift nurse is sitting there waiting for them all to come in to give report. How did the girls give report to the next shift....for example at my place the charge gives charge report because we have the running report sheet for all shifts and the med nurses give their nurses report to me it is all a waste of time, I haven't figured a way but it just seems like one report should be given and all there or the charge nurse listen to the med nurses reports.....I am not sure which might work better but...and the one who works seven thirty to three thirty, I believe she is detrimental to the unit...she is a good nurse but, too busy butting her neck in everyone elses to do her job in a timely manner.....if they came in on time they would be at the desk earlier to help with the admissions, discharges, consults, orders and the phone that never stops ringing....Thanks so much and any input will help me a great deal. :pumpiron:I can do this....just need some consultation with other nurses who were or are in my shoes.

[CoffeeRTC, BSN, RN]

This was our set up. 11-7 and 3-11 had a house super. Each floor had one 11-7 nurse. Each floor had two nurses on 7-3 and 3-11. Each floor had a unit manager. I would get report from the house super and give report when I left. (It was very brief) The med nurses showed up on time and got report on time from the off going shifts I would also sit in on this report. CNAs started 1/2 hr earlier so they would do rounds with the other shift...they were also included in verbal report when they could.

The other shift must show up on time. Period.

The written report sheet would be copied at the end of the day and sent to all the IDT departments. Thay way they knew what was going on.

[Nursenan0]

I am a Unit manager in our facility for our skilled unit. We also had 3 girls leave the job in less than 3 years time. When I took the position I asked for total control of my unit. I choose who works it and when, I do my own discipline following company guidelines. We have no charge nurse. I work flex hours. Sometimes another shift will need something specific or I will want to be involved with something hapening on another shift. We have an MDS nurse and a restorative nurse. The lpns give report to each other and I look at their "cheat sheets" and ask questions as I go thru the day. My nurses do an excellent job of keeping on top of everything including our STNAs. If they need me they come and get me,call me at home or leave me a note. I take care of our Utilization review meetings for skilling, work with the Drs on changes that need to be made, do routine skin rounds and attend QA meetings skin meeting, morning meetings, admission meetings. Do QA reports all incident reports and investigations, all letters to families about skilling days and discharge planning. The families come to me with complaints and praise. My staff also come to me for complaints, things they would like to see changed and ideas they have. I help on the floor as the STNAs need and as my nurses need. Sometimes I work 8 hours sometimes 10- 12. I get paid hourly. I do have the families that like to call and yell also. When I know Mrs Jones is going to complain.....I call the family first, before she can and tell them what is happening. ( Your mother is complaining her light is not being answered timely but she isnt using her light...do you have any suggestions???) This seems to help. I work with social services to resolve the bigger issues....family problems, room mate problems.... I have a charge nurse who handles the entire building on second and third shifts, if she doesnt get put on the floor because of a call off. Hope this helps you some.

[HealinghandsRN]

Thank you for your reply.......very helpful input....How many nurses on each shift? who does the admissions and discharges? do you have a secretary? How long have you been doing this?? Thanks.

[Nursenan0]

We have 3 nurses on the floor each shift for a 98 bed facility. Only 1 nurse on my unit of 24 with 2 STNAs. No secretary. We al pitch in for admissions and discharges. I have been doing this for 6 months.

[CapeCodMermaid, RN]

I was the nurse manager at 3 different facilities...same kind of unit. 40 bed short term rehab/ sub acute. The first place had me, 2 nurses to do meds and treatments and 6 aides. It was privately owned. I did all the admission orders, care plans, MDSs, family meetings,family concerns, discharges, a lot of patient teaching, dealing with the not so nice doctors. I was salaried and never worked just 40 hours. We went down to one nurse on 3-11 and I couldn't leave her there with all the orders.

At the next place, the acuity was higher so there was me and 3 nurses and 4-5 aides. I was hourly there and rarely got out on time. We had 2-3 admits and discharges a day and there were more than a few days we had 4 admits! Mostly the nurses would call the docs themselves....their patients...their labs...

At the other place there were 32 patients....me and 2 med nurses a charge nurse who did admissions and orders and 5 aides. Not true sub acute...mostly ortho...stuck up rich people ortho. They did the meds and treatments but never called the docs. They would write down their concerns in a book and I would have to call the docs. That lasted a week and I changed it to teach them how to deal with doctors. Even with all that help it was chaos because the nurses didn't want to do anything but pass meds and do treatments.

At all three facilities, we had shift to shift report. The best way I've found is to tape report. That way the 11-7 people get out on time and if you're called to the floor for an emergency or to the phone, everyone else doesn't have to wait for you to get back.

It's not an easy job.

You need to make it your own.

[HealinghandsRN]

Thanks Capecodmermaid

Is there anyone that would like to share with me their nursing assistants assignment sheets? Thanks.:pumpiron:With alot of effort, I can do this!!