What is an "RN supervisor"???

[RNdynamic]

This might seem like a really base question, but what precisely is an "RN supervisor" in the setting of a nursing home/SNF? Two people I know were hired as brand new graduates from nursing school as "RN supervisors" in a nursing home. Does that mean they are like actual supervisors, like the kind of nursing supervisor you see making rounds in a hospital? Or is the role somewhat different in LTC? It's hard to picture new grads being "supervisors" if they have no experience in nursing, much less supervising nursing.

[Kooky Korky, BSN, RN]

As a Weekend Relief RN Supervisor, I did staffing. That was often not easy. I addressed and tried to solve any problems or complaints from patients and families, made sure staff had supplies, linens, pudding and jello, spoons, med cups, etc. and went to the distant supply area, kitchen, or Laundry to get them when needed.

I relieved for breaks and lunches sometimes, helped with treatments - these were things I wasn't required to do but I wanted to be sure my people got their breaks and that all treatments were done.

You could probably help with any admissions.

You might have to handle disciplinary matters. I had a couple of staff shouting at each other and making threats that their husbands/brothers/boyfriends would come to the facility and "Kick your butt". I got Security involved when I was not able to quell the storm. Calling Police is frowned upon as an embarrassment to the facility, but put safety first. You might not have a Security Guard.

You make rounds on each area every hour or so, just being seen by staff is good and maybe you can lend a hand or head off a problem.

You can help with feeding, toileting, whatever needs doing. I loved visiting with the residents and getting to know the visitors. I read the charts to learn their histories and got report on any problems (like fevers, falls, coughs, allergic reactions, new skin tears, no BM for > 2 days, rashes, etc.)

I often called docs so Charge Nurses didn't have to take time out from passing meds, charting, and doing all that they had to do. I got new orders and went to the Weekend/Night/Stat Pharmacy Box for the new meds ordered or, if they weren't available in The Box, I faxed the new order to the Pharmacy so they would get it over to us ASAP.

I gave Report to the oncoming Sup, did the little bit of paperwork required.

For instance - suppose a resident falls. First comes the assessment to find any injuries and determine if it's safe to move the person. Without X ray eyes, this can be frightening. Then there's calling 911 if you find that necessary or getting the person up if you determine that's safe.

Treating wounds and taking pictures of them must be done. Always get full set of VS. Temp and O2 sat, too. Think: Jury.

Doc and family or guardian must be notified. Might be the Public Administrator of your county if person is ward of court (see their chart face sheet)

Documenting in chart

Incident Report (This will go to DON, Risk Manager, and Administrator Monday morning)

Normally, the Charge Nurse will do all of this - CNA can do the VS - but there's no rule saying you can't help.

As Sup, you will report this fall to next shift Sup so she/he can take a look at the person and check VS are stable. IF pt had to go to hospital (hip fracture, needed stitches, etc.), I notified the on-call Administrator right after we got the pt cared for.

You will determine when residents need protection from bad weather - high winds can break windows so pts are moved away from them into an enclosed hallway, for instance. If too difficult to move, blankets go over the windows.

You might have to deal with a fire, explosion, visitor injury, lost resident, mechanical issues, plumbing issues, and so on. You have to determine when the problem can wait til Monday vs. when to call in your mechanic, plumber, whoever (the issue is overtime pay and no one in your facility will be happy to authorize it. So if you or staff can't plunge the clogged toilet, the residents can probably use a different toilet for the weekend.

You will likely be expected to notify the Admin on call for any big issues - like the first 4 I mentioned. If the mechanical issue is the building's air conditioning or heat is out and weather is extreme, if residents (not staff) might suffer from the heat or cold, you will want to get the problem fixed ASAP and OT pay will likely be authorized for this.

As in any setting - when calling docs or Admin, have the facts. " It's now 88 degrees on Hall A and 89 on Hall B and 7 families have stated that it is unbearably hot. The families are Smith, Jones, etc."

There is likely a Log Book where you will note any events that are out of the ordinary. Keep your own log, too, as Incident Reports and Log Books have a way of disappearing when someone wants to keep their contents from prying eyes - like someone who's suing the facility. Do not tell ANYONE about your private Log. I guess you can keep it in your locker. I advise against taking home anything with pts' names. HIPAA

Make sure your Nursing insurance covers you for supervising.

Try to work at least a couple of shifts as a staff nurse before Suping. You will feel much better about it.

God bless and best wishes, hope this helps. Let us know.

[suzw]

Korky, I want you for our sup! Im

guessing that's like an RCM (resident care manager). Our RCMs don't get nearly as involved as you do. One of them simply tells me what I need to do (when I'm already drowning) instead of helping me do it. The other never knows what to do either because she is even newer than I am (but experienced in LTC).

[lumbarpain, ADN, RN]

I have worked in one facility for over 2 years..I am an RN but only work part time 3 days a week...due to high turnover in my place

many nurses and CNAS leave...so....being I am the Last Mohican...does this make me a supervisor because

everyone comes to me being I have been there longer? I never got a job description to say I was..yet..I take the job and grin

and bear it. ..Most times I am right on a lot of things..but get no credit..my ideas to make things easier are taken

for granted. my ideas come back to me 2 days later after I said something would be a good idea..but..I don't get a pat on the

back...its a thankless job most times and very distressing, depressing and disappointing...this is just my opinion

after doing LTC for over 20 years..

They use and abuse , that's what I have found out.

[lifelearningrn, BSN, RN]

At one of the larger (maybe largest) LTC corps in the states, all RNs are "RN Supervisors". It doesn't matter how much experience you have, that is the title. Your role isn't any different from any other nurse working the floor. This title is basically a CYA for the company that there is an RN in the building along with LPNs and CNAs.

The job was no different than the LVNs on the floor... unless something out of the scope of an LPN came up, in which you (or another RN) would handle that situation.

The "supervisors" were the ADON and DON.

[downsouthlaff, LPN]

I'm an LPN in LTC and the facility that I am employed the DON is the only RN in the building Monday-Friday and we have a LPN/ADON present also. The RN Supervisor comes into play on weekends because of CMS 8 hours of RN care let day reg. There was a time at the facility I work at where "Weekend RN Supervisor and Weekend LPN tx nurse existed. Now it's the Weekend RN TX Nurse. In an effort to cut cost. They basically do there txs do a few body audits, get report on hospitalized residents and head home. The LPNs continue to run the floor as charge nurses as on weekdays.