Ask the nursing expert

Q: I am struggling with a unit manager who resists being responsible for the care of her residents other than on the day shift. Any suggestions?

A: Ask yourself if you believe that she is a valuable member of your nursing leadership team. My first thought is to review her job description with her, focusing on accountability of her unit.

Assuming there are supervisors on the off shifts, she still needs to be accessible for any questions regarding the plan of care for her residents. Stress that she is not expected to sit by the phone awaiting phone calls but that her management position requires more involvement than her shift-to-shift charge nurses.

Explain that this is not only an expectation that you have but that it is also an industry standard. If she still waivers in her commitment, suggest that she step down and resume a charge nurse role or another position as available.

Q:I am having some issues with nursing leadership and the scheduling of time off at holiday time. How should I handle this?

A: This is a sore spot for many directors of nursing. I request that my managers, assistant DON and supervisors submit, in advance, their requested time off for the holidays, no matter how minor the holiday.

I may be a bit old-fashioned, but I believe there needs to be a strong nursing leadership presence in the facility on holidays due to the number of visitors who want to interact with a clinician who knows their family member well.

Illness, changes in condition, and admissions do not pay attention to holidays. The last thing a DON wants to hear on a Monday morning or after a holiday is “things sure are different in this building on weekends or holidays” or “no one here was able to answer questions that I had about my father.”

Please send your rnursing-related questions to Anne Marie Barnett at [email protected].