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Nursing Management and Leadership

Nursing Unit Management

Ward Organization

Expectations of Unit staff (nurses and secretaries)

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Geography

  • Nurses’ station
  • Pts. Rms.
  • Medication Room
  • Clean Supply Room
  • Dirty or Utility Room
  • Treatment Room
  • Conference Room
  • Report room

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  • Kitchen
  • Linen Room
  • Patient Waiting Room
  • Visitor Waiting Room
  • Employee Lounge

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Management of Nursing Unit Supplies and Equipment

  • Why is this important?
  • Proper management improves safety and quality of care.
    • E.g. Batteries burnt out on emergency equipment - serious
  • First impressions count – image of professionalism and competence.

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Managing the Nursing Unit Supplies

  • Stock only the supplies needed.
    • Over-stocking can result in waste, (outdated)
    • Under-stocking can waste both time and energy.
  • Keep a standard supply list
    • To determine amt. of supplies needed, compare amt. left on shelf with amt. on list, and order the difference.
    • Maintain a supply needs list on the unit bulletin board, and instruct staff to list supplies that are low.
    • Use the list as a reference when ordering.
  • Store supplies conveniently, with frequently used items in most accessible area.

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Management of Equipment

  • Check all standard equipment for working order at beginning of shift,
    • Flashlights, ophthalmoscopes, otoscopes
  • Return all equipment to proper storage.
  • Maintain computer terminals.
    • Printer ink (dispose properly), paper.
  • Pneumatic tube systems, post directions
  • Imprinter device, letters clear, file correctly and immediately after use.

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Nursing Unit Reference Materials

  • Drug guides, hospital formulary, policy/procedure manuals, nursing texts.
  • May need a unit log book to sign out books on a busy unit.
  • Keep policy manuals up to date, insert revised materials, discard outdated.
  • Keep doctor’s roster current.

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General Nursing Unit Equipment

  • Furniture, electrical fixtures, bathroom equipment
  • Be aware of replacement lists (“minor capital”).
  • If repair is frequent, ask about replacement.
  • Make rounds 1-2X a wk. on unit equipment, practice preventive maintenance.
  • Request repair from maintenance department.
  • If immediate, notify maintenance by pager/telephone.

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Nursing Unit Emergency Equipment

  • Check it daily, and immediately after every use to restore ASAP.
  • Practice using the equipment before an emergency happens.
  • Where are the fire extinguishers, how do you operate them?
  • Know emergency codes.
  • Know procedure for hazardous spill.

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Visitors

  • Immediately stop what you are doing when a visitor approaches the nursing station.
  • Communicate pertinent information, respond to their questions/requests or complaints.
  • Refer any questions that you can’t answer to someone who can. Another nurse or doctor.
  • Don’t say “I don’t know,” or “I’m not allowed to give out that information.”

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Steps to follow when a visitor complains

  • Listen carefully. Usually hostility is not aimed at you.
  • Ask pertinent objective questions, and gather as many facts as possible. Be caring!!
  • Say “I understand what you are telling me, or “I understand how you feel.” Not “That is not my job, or “I wasn’t here yesterday.”
  • Acknowledge their anger.
  • Inform appropriate person eg. manager, attending nurse and doctor.
  • Document.

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Organization of the Nurses’ Station

  • Take time to stand back and observe the nurses’ station.
  • Is it cluttered? Disorganized? Noisy?
  • Restore all items to their original places.

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Time Management

  • Plan for rush periods. Busy in a.m. during Dr. Rounds.
  • Schedule routine tasks such as transcribing and phone calls between urgent duties.
  • Cluster activities - deliver specimens to lab on way to lunch, or check charts needing forms while filing reports.
  • Complete one task before beginning another.
  • Avoid unnecessary conversation
  • Don’t perform tasks assigned to other staff
  • Take the breaks assigned to you.

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Stress Management Techniques

  • Effective time management. Ask for help when needed.
  • Don’t take frustrations of others personally.
  • Say “No” tactfully when you don’t have time for more.
  • Keep your sense of humor
  • Take your scheduled breaks

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