Job Title: Registered Nurse, Clinical Manager
Type of Company: I work for a large university-based acute care hospital.
Education: diploma, RN, Hospital of St. Raphael's School of Nursing BSN, Sacred Heart University (Jewett City, CT)
Previous Experience: I have been a nurse for 35 years. I have always worked in the same acute care hospital. I have worked on surgical floors most of my career. I was able to work per diem when my children were small and at that time I floated to different floors where needed. I have been on the same surgical floor for about 18 years. I have a certification in Wound, Ostomy and Continence Nursing. I took the clinical manager position on my unit about 2 years ago.
Job Tasks: There are two main components of my job. The first is as a supervisor for the nurses, nursing aides and clerical staff that work on my unit. I am responsible for keeping the unit staffed and running smoothly 24 hours a day. The number of patients can fluctuate and it can be challenging to have the right amount of staff to care them and still stay within budget. The majority of patient complaints come to me also and I have to figure out what exactly occurred, what can be done to ensure whatever happened does not happen again and to provide or arrange for service recovery if needed.
There are many Department of Public Health Guidelines that we are subject to and another part of my job is to update and or remind staff of these guidelines and audit their documentation and practice related to these guidelines. If there is a staff member who is consistently non-compliant, I am responsible for providing remediation or discipline.
The second part of my job is more clinical. If there is a staffing shortage, I can fill in and take care of patients. I also help to orient or educate new staff members to our unit. Taking care of patients includes a complete physical assessment: evaluating their vital signs (temperature, pulse, blood pressure, respiratory rate, oxygen saturation and pain level), assessing their neurological, cardiac, respiratory, vascular, skin status. Managing and inserting intravenous lines, wound care, dealing with psycho-social issues, patient education and interacting with the medical team, and other care giving staff are just a few of the many other aspects of this job. Another aspect of caring for patients is also caring for and supporting the patient's family. Providing educational support and expertise for staff is also part of my clinical role.
Best and Worst Parts of the Job: One of the best parts of my job is taking care of patients. I love the challenge of figuring out what each each patient or his family needs. Every patient and situation is different. Providing care and support through a difficult hospitalization is very rewarding. I like the "hands on" aspect of patient care and the critical thinking that is required to do this job well. For the most part patients and their families are appreciative and it is a wonderful feeling knowing that you have helped someone navigate through a complicated hospital course. Even if the outcome is not always the best, there is always something to be done to make the situation a little more bearable. It is also rewarding to see the competent and compassionate care provided by someone you have mentored. You are continually learning something new, whether it is a new piece of equipment, new medical development or something from a patient.
The worst part of my job is dealing with patient complaints or incidents that should not have happened. It really hurts to know a staff member had an inappropriate interaction with a patient or visitor or that there was an error that should not have occurred. Being in the hospital is stressful enough and families and patients are often at their wits' end and a little extra consideration of this fact goes a long way. I hate going to a patient or family member and having nothing but an apology to offer. It is also hard to confront a staff member who may have just been having a bad day or was stressed by so many demands and responded inappropriately.
Job Tips: If you are considering a career in nursing, go for your bachelor degree in nursing if at all possible. it is easier and lest costly at first to go to a two-year school but you really do not get the same education and I think a four-year degree will be required in the future. Adequate and correct documentation is a large part of this job and this is what I find lacking in the shorter programs, but you also need a good solid science and critical thinking background to succeed.
You have to be able to multitask. You will need to continually set and reset your priorities on any given day. On your best day you may be caring for four patients and they will all want something at the same time. On some days or shifts, you may have as many as 7 or 8 patients.
Be prepared to work off shifts, weekends and holidays especially if you plan on working in a hospital. When you start, you may not get a whole week's vacation in the summer. Many hospitals require you to work every other weekend.
Additional Thoughts: The nursing profession has changed so much over the last 35 years. It is continually evolving, most for the better. My biggest complaint is how the media portrays the nursing profession. It is so far from reality.
From a financial perspective, even with the current healthcare crisis, there will still be a need for nurses. Many RN's are baby boomers who are beginning to retire or are retiring now. If you want variety, I do not know of another profession that offers the ability to work in so many different settings.
Despite all my complaints over the years and the fact that there are many things I would change about my profession, the pros far outweigh the cons. I cannot imagine anything that would have been more fulfilling for me.
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