North Shore University Hospital Work Values

Daily Duties at North Shore University Hospital:

The Oncology Unit itself has 38 beds; 30 RNs, 30 PCAs, and three secretaries.This Unit is part of the Surgery/ Oncology Service which contains 8 Units in total. Assistant Nurse Managers are the performing Managers on their shifts. There are two Assistant Managers on the Oncology Unit and one daytime Manager. Daytime Mangers are responsible for their Unit only, unless they are covering one other Unit for vacations. The evening Assistant Manager is one of three or four Assistant Managers who each cover up to two Units each. The night Assistant Managers are one of two and each will cover 5 Units. In covering 5 Units per night, the Assistant Manager is responsible to respond to the needs of 110 patients, 38 RNs, 20 PCAs, and 3 secretaries. The Night Shift Assistant Nurse Manager is hired to share the Administrative functions of the Unit including: Daily patient rounding to minimize escalating issues (patient/ family concerns, staff concerns or issues that may later evolve into a complaint from a patient/ family) 10 monthly Chart Audits, Blood Bank & Phlebotomy Monthly Audits (10 each, 9 mos out of the year) Daily Patient Care Hour entry, Daily Briefing on home Unit & episodic huddles on covering Units to convey information; Home Unit:Training Updates regarding Computerized documentation, Medication alert updates, In house policies/ mandatory topic Inservices. Specific responsibilities for home Unit & those covered include: Incident Reports, Fall Report & Documentation, & RRT response, and bedside assistance as needed for an Expiration (usually in the form of family comfort/ support person, entertaining questions from how the departed passed, how they appear, what happens next, time frames, etc and accommodating various religious and cultural beliefs/ traditions as well as visitation post mortem. The two night Assistant Managers alternate the responsibility of staffing nightly. On weekend coverage when the shift is 12hrs, the night Assistant Manager has the staffing responsibility for all 8 Units for both the night and the morning schedules. On weekdays, the staffing requirement is for the morning shift alone. Staffing is a tedious task as employees may call out up to 2 hours before the start of their shift and no overtime is permitted. It is very challenging to initiate phone calls at 5AM for 7AM coverage seeking out per diem employees or those who might want to switch days around to accommodate a need. Often times the need arises not for RNs but for PCAs as the unknown factor of 1:1 coverage is unable to predict 100%. A 1:1 requirement may reflect either the potential for the patient to harm themselves, harm others, or escape from the Hospital. These needs can be predicted from the Units if the issues arise during their stay, and 1;1 coverage can be planned for in advance. The unknown arises from the needs assess in the ER with new admissions that are then transferred to the units. Coverage must be obtained immediately and the hospital shares PCA staff so there is a constant bantering of staff swapping and break coverage. Again, the degree of difficulty of this challenge magnifies at night as there are less staff on hand, less Administrative bodies to seek out staff and the per diems we are calling are asleep at home so phone response is less than optimal. A typical evening for the night shift may begin with family members wanting to have clarifications regarding treatments, pending discharge plans, medications, changes in the patient's status, roommate issues or staffing issues- sometimes these same concerns were already discussed with their doctors or nurses- but the family wants to get another angle or just the satisfaction of hearing the same plan reiterated by three different caregivers. If the conversation is in a complaint format, the Assistant Nurse Manager must complete required documentation including all those remotely involved and copied to Managers, Department Director, and Quality Assurance Director. When covering 5 Units, this "damage control" can be a three hour plus adventure. Issues such as pain medications, status changes, and family concerns can resurface throughout the night as patients and families historically have increased anxiety as the night fall comes noting less staff on the unit and at times audible restlessness by others on the unit who are unwilling to sleep. The complexity of the Unit increases staff stress. Oncology Units are exceptional; the severity and complex issues surrounding the patient's stay is compounded by the concern about the dying process. Half of our Units we serve contain Oncology clients. Emotional toil on the staff is palpable. When a staff member breaks down, immediate attention is required to prevent not only a chain reaction, but more importantly to reinforce the support in order to perpetuate the strength of that staff member on the team. Again, as is typical with any night shift crew, because there is less visible support in the building they are more dependent on their Assistant Nurse Managers to endorse their capabilities. Staff briefing sessions are required to relay the daily happenings of the Unit. Usually, these are performed in one seating on the early shifts. At night, the process usually is repeated twice as staff may be tending to patients or on breaks. The morning hustle includes giving report to each Unit covered as well as the home Unit.

What they like about North Shore University Hospital:

The social vibrance of a hiring firm is very important to you. Your ability to make and maintain friendships there is a critical part of your decision. You would likely be dissatisfied with a workplace that is quiet, cold, or otherwise not particularly social. When you investigate a new hiring company, ask recruiters, managers, and potential co-workers about the social life and opportunities there. This is especially important when you are relocating; moving dramatically alters your social sphere both inside and outside the workplace.

Tags

Hospital Unit Management, Long Term Care 15yr tenure, Longevity , Unit Motivator, Inservice Education, MDS Coordinator, Care Plan Chair, Dedication, BSRN, MBA in Health Services Management

Skills

Presentation, Ecommerce Strategy and digital marketing channels optimization - SEO, SEM, email, affiliates - for high-profile accounts., Technology Solutions, Software Implementation, Requirements Analysis & Specification

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