Nursing Admin/Management positions in the HSE.

sunnyjim

I'm not trolling, even if it seems like I am.

The nurses career path can go from being out on the ward, to ending up doing nursing admin/management positions. Apparently these ranks don't go out on the floor, even though they are still technically nurses - a mate of mine recounted how during the strikes last time, these nurses were forced to treat patients.

How do the nurses here feel about these positions? Are they just more admin positions created by the HSE? Or a necessary representation of the nurses within the system?

JuliusCaesar

well, there's always going to be a hierarchy in any job. staff nurse, senior staff nurse, ward manager (ward sister), ADON (asst direcotr of nursing), DON (Director of Nursing) etc etc. These nursing postitions will be supported by admin staff/secretaries. Because believe it or not, being in charge of about 2000 nurses in a hospital will generate a lot of admin. There's shift rotations, annual leave, maternity leave....there are questions about pay, responsibilities, ethics. ADoNs and above don't deal directly with patients but mya provide supervision for the nurses who do. They will also deal with inter-professional disputes.

Nursing promotion can go a number of ways. The traditional way was either into nursing management or education. Now there is the clinical specialism route too, which is designed to have nurses with a lot of clinical expertise stay in direct patient care.

You want all nurses to stay on the wards forever?

sunnyjim

I'm honestly just curious JC. A few mates are nurses, they don't seem to know what nurses in these positions do.

RobFowl

This is a problem in nursing. As you go up the grades the jobs become more admin/management and less patient contact. The advent of nurse practitionerss and prescribers will help but there also needs to be a rethink on the whole structure. IMO a nurse manager with an admin/secretary would be far more cost efficient than a nurse manager and assistant nurse manager

missannik

RobFowl wrote: »

IMO a nurse manager with an admin/secretary would be far more cost efficient than a nurse manager and assistant nurse manager

As an Australian about to embark on working in Ireland, I don't understand the above comment. In Australia an Assistant Nurse Manager runs the ward, they are the team leader for the shift. Is it different in Ireland?

sunnyjim wrote: »

How do the nurses here feel about these positions? Are they just more admin positions created by the HSE? Or a necessary representation of the nurses within the system?

Management roles within nursing is necessary. Whilst they don't have patient contact they are far better in tune with patient needs then those in sole management roles that just focus on number-crunching. Nurse Managers run the wards on many levels- they co-ordinate patient services, perform quality projects, monitor staffing levels in line with patient numbers, etc. I must agree that ward nurses generally don't know what the roles above them do, I for one didn't get a grasp of it until I moved up the ladder somewhat.

sunnyjim

With all due respect, you're commenting on the australian system.

they co-ordinate patient services, perform quality projects, monitor staffing levels in line with patient numbers,

All admin duties. How would having a nurse do this job while 'keeping in touch with the patients needs'. Once you are admin, you're admin; you number crunch, you run QA projects, you deal with leave and HR.

The HSE needs cost efficiency, as RobFowl says. Would the Nurse manager and assistant nurse manager be counted as nurses working on the floor - or are they extra positions created with extra nurses taken on to fill their now-vacant positions?

tinner777

sunnyjim wrote: »

With all due respect, you're commenting on the australian system.



All admin duties. How would having a nurse do this job while 'keeping in touch with the patients needs'. Once you are admin, you're admin; you number crunch, you run QA projects, you deal with leave and HR.

The HSE needs cost efficiency, as RobFowl says. Would the Nurse manager and assistant nurse manager be counted as nurses working on the floor - or are they extra positions created with extra nurses taken on to fill their now-vacant positions?

I'm a ward manager and count of one of five looking after 23 in patients. Above me there are only two rungs of management, assistant director of nursing then director of nursing. Hse needs pruning ok but you'll find little chance in nursing, well i can only talk for cork. Btw your mates not working in nursing? Tell them those people asking the questions in interviews would have been nursing management

sunnyjim

5 ward managers for 23 patients? Is that 5 over individual shifts, or 5 on-the-whole?

tinner777

sunnyjim wrote: »

5 ward managers for 23 patients? Is that 5 over individual shifts, or 5 on-the-whole?

no mate, five nurses, so one ward manager and four staff nurses.

To be totally clear the day shift is covered by five nursing staff, me and four other staff nurses. I work 7 long days in 14. The other 7 days are covered by another ward manager and four staff nurses. At night the manager looks after 46 people with five staff nurses.

missannik

^ ^ ^ That’s a good ratio.

sunnyjim wrote: »

With all due respect, you're commenting on the australian system.

True, but you asked...

sunnyjim wrote: »

Are they just more admin positions created by the HSE?

Nursing management roles exist outside of the HSE, so this isn't just unique to your system.

sunnyjim wrote: »

All admin duties. How would having a nurse do this job while 'keeping in touch with the patients needs'. Once you are admin, you're admin; you number crunch, you run QA projects, you deal with leave and HR.

We number crunch with patients needs in mind- we consider staff skill mix, patient acuity, QA projects that affect patient’s needs, leave considerations with staff mix in mind. Any monkey can say that you need 5 nurses for 20 patients bottom-line, but they would not consider that Mr Jones has dementia and wanders and therefore needs to be specialled 24/24 or that a patient will be returning to the ward after surgery at 8pm, so maybe a night nurse can start earlier or have a short shift start at 8pm. That’s why you need experienced nursing staff in management roles, they know the demands of the wards. An accountant will just focus on the numbers and not the fact that it is a person behind that number.

tinner777 wrote: »

Above me there are only two rungs of management, assistant director of nursing then director of nursing.

Thank you for clarifying.
Now Rob Fowl’s comment makes more sense, assuming that he is referring to Assistant Director’s of Nursing. An issue with removing the ADON is that then pushes more workload onto the Nurse Unit Managers, as the secretaries cannot complete all the tasks that the ADONs usually complete. Sorry to bring up Australia yet again... A lot of small Private Hospital facilities amalgamate the roles of DON and General Manager, in an endeavour to cut costs- could this be a more suitable means for the HSE to reduce hospital costs? Or is this already the case?

missannik

After reading http://www.boards.ie/vbulletin/showthread.php?t=2055444436 I get the feeling that I'm in for quite a culture shock. So apologies to all who rolled their eyes at my previous comments... ignorance is bliss.