North Shore University Hospital Work Values

Daily Duties at North Shore University Hospital:

Being on the Night shift as a Transfer Center RN involves working as a team of two RN's. One is the Transfer Center RN, and one is the Bed Management RN. Because there are only two RN's on duty, the Transfer Center also takes a service because it is impossible to cover the entire house (approx. 950 beds). The pulse of the Bed Management chaos is determined primarily by the activity in the Emergency Department. Other factors to the puzzle: Transfer Admissions, Emergency procedures required during the night on in house patients requiring not only OR (Operation Room)/IR (Interventional Radiology: biggest hit at night-includes Xray, CAT scan, MRI), also happenings on the Units- changes in patient's status, or local traumas. The Transfer Center RN has a specific task of manning the Transfer Center phone line. This entity is a means of generous income for the Hospital as it presents cases for admission that are current in other ER settings- either within the NSLIJ entity of 15 hospitals or anywhere in the world. The ER Attending must present the case in triage format to the Transfer Center RN who first must decipher what type of service is the first priority: a patient with pancreatic cancer who comes in vomiting blood and is now unresponsive may take first priority as a Neuro case, then a GI case, both would precede the underlying cancer diagnosis (an Oncology case) THe RN would notify the Attending on call that night at any hour and present the case, with the original MD on hold. Sometimes, it is a combination case and the Attending may request the RN to call in a consult with the Attending of another service so they can evaluate together to decide if the patient will be accepted and under which service they will initiate the transfer- so another MD is placed into the conference call. As the decision lends to an admission, the RN must link in our ER Attending to hear the case, and then have the EMS on the same line so they can be arranging pick up during the conversation. As predicted, speed and accuracy is a must as these calls are often life/death scenarios- espcically the complex trauma cases where a car accident may involve Ortho as well as Neuro intervention and then age is factored in - Peds cases/ adult- all requiring additional Attendings to be brought in on the call. Never mind it is 3AM, the Transfer Center RN is also a phone diplomat/entertainer- these doctors are names on a roster we are given and we rarely have ever seen these individuals so we must develop strong phone savvy relationships. Not to mention, any Transfer Center phone interaction is 100% tape recorded to assure the Director and involved parties that all is handled as accurately as possible. The Bed Management RN has the responsibility of clearing the bed board of any patients admitted from the ER and presently holding for bed placement. Diagnoses must be matched to specific Units prepared to cater to specific needs; isolation issues must be matched with roommates or provided a private room as available, priority has to be given to a patient being received from the Transfer RN for placement, in house shuffles due to changes in status, VIP and private pay clientes utilize one specific Unit where careful parameters are met and anyone can request a room if available which will cost at least $1000/night stay. This continuum of movement and unpredictability of traffic flow has to be conveyed to the Units timely so the staff can prepare themselves as best they can for the unpredictable flow of patients. Assignments may have to be shuffled, PCAs may need to flex to other Units, the night time Assistant Managers need to be on the phones and Units to smooth over the complexities. Facilitating the effectiveness in traffic flow and care in the Emergency Department is where the Nursing Supervisors are instrumental. Along with Environmental issues of the Hospital plant as an entity and the synchronization of the ancillary departments: Housekeeping, Laundry, Dietary, and Engineering also fall under their jurisdiction. The position is a stressful one beyond explanation; the benefits to this department is once you have survived, you know the building and all the specialties & their locations; you know the Managers, Supervisors and floor Secretaries by name so you can phone smooth a lot of interactions if you are 100% pleasant all the time, when you go home in the morning- your work is done. There is no carry over into the next day- the job description actually fits the job and all Administrative duties are carried out because there is no short cut and all times are recorded (time patient was admitted from ER to the time you found a bed to the time they got to that bed) so you are 100% accountable. Many stomach aches, but no surprises. This job is not considered Management on paper, but it is 100% Management. I cannot minimize how instrumental my phone pleasantries were in achieving swift results- from the sleeping Attending, to the new RN who was getting an Admission to her service that she was anxious about. It is all Management. And now as a Unit Assistant Manager, I am on the receiving end- I can meet all the phone voices and when I need info from Bed Management, I know how to work it- besides, I polished my relationships with them as well.

What they like about North Shore University Hospital:

Working in an organization that is technologically advanced, creative, and innovative is critical in your assessment of hiring companies. Less important to you are stability of the organization, the length of time an organization has been in business, and the business' plans for the future. You prefer a fast-moving company that will take risks to achieve its goals and objectives. The length of time the company has been in business is irrelevant. Maintaining status quo is unnecessary. You thrive on change, uncertainty and the upside of potential business risks, especially those associated with innovation. Stability for the long haul is not nearly as important as is working in an atmosphere that is charged with a sense of urgency and constant change.

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

These are some of the questions we asked our climbers about their experiences with North Shore University Hospital: