I spent yet another twelve hours following the house supervisor at Timpanogos Hospital yesterday, and it was not nearly as busy as it was Saturday. My goals for the day included learning more about how to manage a schedule, how to positively interact with employees, how to manage conflict in order to be a more effective manager and/or leader, and learning more about the roles of house supervisor, and learning more about the role of nurse practictioner (which is what my mentor is studying to become).
My mentor carried a paper copy of the schedule with him throughout the shift, and he had to call many employees off and put many on call. He regularly went in to the computer system to make staffing updates, and we rounded on the units many times to interact with employees and to get current census information. He stated that he could collect the information over the phone, but talking to them in person adds a personal touch and creates rapport. The staff seemed genuinely happy to see him whenever we rounded. We answered some calls to obtain supplies from the central distribution area because only he had keys to the room. He did state that whenever staff calls him for supplies, he is careful to ask if they have checked other places before he must run around the hospital seeking them out. Otherwise, he would be playing fetch all day because the staff at one time had gotten in to the habit for calling him for supplies that would often be available on an adjoining unit that they had not bothered to check.
There was one incident of conflict. An RN in the nursery complained that lab staff was rude to her. The order for blood typing had, according to her, been entered in to the computer system. A lab staff member claimed that it was not in the system, and the nurse stated that the staff member was rude and unhelpful on the phone. The blood typing had been completed prior to our arrival, but the nurse stated that it took a while to get it done and the difficult situation was a waste of time and resources. The nurse was advised by my mentor to fill out an incident report regarding the situation. We then went to speak to the lab staff. The one staff member who had been reportedly rude was not there, but another lab staff member stated that the order had been entered very late in the shift, and the blood typing had been done when the order was received by them. She stated that the staff member had followed procedure. It appeared to be a problem with the computer systems not properly communicating with each other. When we finished talking to the staff member in the lab, my mentor stated that it is important in conflict situations to remain calm and neutral, and to listen to both sides. He stated that he didn't doubt that the lab staff member had been rude because she has a history of behaving in that manner. Nurses have a tendency to not fill out incidence reports, but the reports provide documentation of problems to administration. The documentation may help to reinforce future complaints from nurses of rude behavior from that particular staff member.
It appears to me that the role of house supervisor is all-inclusive. We rounded the units for census data and to see if they needed assistance. We collected supplies for units. My mentor temporarily fixed a door that would not seal with a wad of paper and some tape until engineering could get to it when they were able to come in. He told me that part of his responsibility was to make sure the place didn't fall apart over the weekend. In the emergency department, some of the nurses were discussing nipples on the fountain drink machine. I asked my mentor what was meant my this, and he took me to the machine. He told me that the apparatuses should be cleaned daily, but often they are done weekly if they are lucky. He took the nipple off one of the dispensers and showed me why. The dispenser nipple was coated in black gunk. It was disgusting. He said it didn't tend to get as bad with the Sprite dispenser, but he had seen it worse that that on the Sprite dispenser before. I don't think I will be drinking fountain soda drinks again! We then proceded to clean that portion of the machine, soak them for disinfection, and replace the nipples with previously disinfected ones.
Later in his office, we had a considerable amount of down time. He is attending school to become a nurse practictioner, and I asked him questions about the roles of a nurse practitioner. He stated that the most difficult part of becoming a nurse practitioner is learning to rely on yourself and get out of the habit of calling the physician for every problem. This is because you become the prescribing provider. He stated that the adjustment from registered nurse to nurse practitioner is a hard one to make. According to the nurse practitioners he has spoken to, that adjustment can take at least a year. A nurse practitioner can choose to work under a physician or open a private practice, but he stated that it is usually wise to work under a physician until that adjustment is made. He also stated that family nurse practitioners are reimbursed by medicare at 85% of what a physician gets. So these nurses get to do the exact same work as a physician and get less money for it. Go figure.
While I considered the day to be boring for the most part, I was still grateful for the opportunity to get some more clinical hours completed. I expressed gratitude to my mentor for allowing me the experience of following him, as I do at the end of every shift. My next shifts are scheduled for February 26 and 27. Only two more shifts to go!
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