Supervison
Posted by Kim on February 25th, 2007 / 
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In reading the posts about unions and management AND CNA’s, I got to thinking about WHO causes them (the CNA’s) the most aggravation. It’s not the Administrator. It’s the charge nurses and the DON. One leads to the other. While I think the DON has more management experience (in most cases) the nurses do not. They claim to, but I have yet too see any proof if this. I’ve been a CNA (LNA) for almost 17 years. I’ve worked in nursing homes, hospitals, assisted living, home health care and hospice. I’ve also worked in an MD office.
In this light, it would be great to see nursing homes get the charge nurses some training with real management skills.
Charge nurses are supervisors, whether they like it or not (for union related benefit.)
What is “Supervision”?
There are several interpretations of the term “supervision”, but typically supervision is the activity carried out by supervisors to oversee the productivity and progress of employees who report directly to the supervisors. For example, first-level supervisors supervise entry-level employees. Depending on the size of the organization, middle-managers supervise first-level supervisors, chief executives supervise middle-managers, etc. Supervision is a management activity and supervisors have a management role in the organization.What Do Supervisors Do?
Supervision of a group of employees often includes
1. Conducting basic management skills (decision making, problem solving, planning, delegation and meeting management)
2. Organizing their department and teams
3. Noticing the need for and designing new job roles in the group
4. Hiring new employees
5. Training new employees
6. Employee performance management (setting goals, observing and giving feedback, addressing performance issues, firing employees, etc.)
7. Conforming to personnel policies and other internal regulations
Out of the list above, charge nurses in nursing homes are not responsible for everything. They do organize their unit and the aides working on their shifts; they SHOULD notice the need for more staff; they usually do NOT hire but they DO oversee training;
they DO employee performance management with the exception of firing. Most charge nurses have a lot of say in evaluations.
And they make sure aides conform to (often outdated and silly) policy and internal regulations.
To be fair, charge nurses don’t have the time to adequately supervise. They pass meds, perform assessments of residents, respond to nursing needs and treatments, deal with doctors and families. WHEN they have time, they keep an eye on the aides. There is a say among CNA’s:
Behind every good charge nurse stands an excellent aide.
It’s true.
I think nurses should have extended training in these areas:
Setting Goals
When setting goals with employees, strive to design and describe them to be “SMARTER”. This acronym is described in this guide, in a subsection listed above, and stands for:
1. Specific
2. Measurable
3. Acceptable
4. Realistic
5. Timely
6. Extending capabilities
7. Rewarding
Supporting Employee Motivation
Clearing Up Common Myths About Employee Motivation The topic of motivating employees is extremely important to managers and supervisors. Despite the important of the topic, several myths persist — especially among new managers and supervisors. Before looking at what management can do to support the motivation of employees, it’s important first to clear up these common myths.
Observing and Giving Feedback
1. Clarity — Be clear about what you want to say.
2. Emphasize the positive — This isn’t being collusive in the person’s dilemma.
3. Be specific — Avoid general comments and clarify pronouns such as “it,” “that,” etc.
4. Focus on behavior rather than the person.
5. Refer to behavior that can be changed.
6. Be descriptive rather than evaluative.
7. Own the feedback — Use ‘I’ statements.
8. Generalizations — Notice “all,” “never,” “always,” etc., and ask to get more specificity — often these words are arbitrary limits on behavior.
Conducting Performance Appraisals/ReviewsYearly performance reviews are critical. Organization’s are hard pressed to find good reasons why they can’t dedicate an hour-long meeting at least once a year to ensure the mutual needs of the employee and organization are being met. Performance reviews help supervisors feel more honest in their relationships with their subordinates and feel better about themselves in their supervisoral roles. Subordinates are assured clear understanding of what’s expected from them, their own personal strengths and areas for development and a solid sense of their relationship with their supervisor. Avoiding performance issues ultimately decreases morale, decreases credibility of management, decreases the organization’s overall effectiveness and wastes more of management’s time.Addressing Performance Problems
1. Note that performance issues should always be based on behaviors that you see, not on characteristics of the employee’s personality2. Convey performance issues to employees when you see first see the issues!
Don’t wait until the performance review! Worse yet, don’t ignore the behaviors in case they “go away.”…
AND MUCH MORE!!
Just some ideas. For those who want and desire a fair and healthy workplace. Charge nurses have a lot on their plate; it is fair to expect them to be the supervisors who do all the above AS well as pass those meds, deal with the MD’s, tackle families and all the other things they typically do on an average day? Maybe, aides feel a sense of hopelessness because they know they are not being supported and well supervised?
February 26th, 2007 at 7:45 am
Sveral years ago at a nursing home I worked at they did things differently.
Every three months the nurse sat down with each aide. She went over things that are listed on the annual eval…those areas we are evaulated on like quality of work; team player attitude, attendance, in services, job know hows and the like. EVERY THREE months we all KNEW exaclty where we stood. These little meetings were called the quarterlies; the nurses would tell us anything we needed to work on and praise us on anything we had done that was worthy of praise- which was usually quite a lot of GOOD stuff. These mini evals didn’t count as an actual official eval, but they were very helpful to we the aides. When that yrly eval came there were no surprises. Things like attendance problems were nipped in the bud. Problems with difficult residents were addressed too…I had a HUGE personality conflict with a certain resident and it showed in my attitude and it was noticed by others. When the nurse mentioned it to me, we talked about it and she arranged for me to get some training with the medical issue this resident had that I was so uncomfotable with (colostomy)…I was a better aide for it.
Where I work now we’re lucky if we get an eval on time or even 6 months late. It’s a piece of paper with check boxxes and lines for siggies. It’s not very inspiring and certainly not a tool that can be used to learn from.
February 26th, 2007 at 9:20 am
Hey thats cool Cheryl. Bet it took the nurses a lot of time though to do this.. Cudos to that place!
Good staff are well managed staff. Not in the sense that they are micromanaged- no- but in the sense that they feel valued and important. It takes some skill to do all that. Too often we’re rushed in our day to day work. We don’t have time to say THANK YOU, or to ask about the sick kids and the ill Grandmas and those other problems we each have in the back of our minds…at work.
At my work we have Caught In The Act forms. Little pads with carbon copies x 3 that are solely to WRITE others up for the GOOD and above and beyond things we each do so often. We all write others up all the time too…I give them to my peers as much as to my nurses and bosses. It’s a nice way to recognize the good things. A copy goes to the DON, to the HR people. And each month a name is drawn (well, several names cause we’re a bigger place) and winners get a dinner out and a massage, free…for two.
And these CITA are included in the evals.
February 26th, 2007 at 9:27 am
Seems to me there is a need to have a person fill the void of supervisor. Nurses are TOO busy. It wouldn’t happen but it would be awesome if nursing homes could hire a person who does nothing but supervise. Need not be a nurse either; in fact I would suggest this role be filled by someone who is more resident focused, vs. nursing/medical focus.
February 27th, 2007 at 9:15 am
Not to many nursing homes are going to opt for a supervisor position, esp a non nurse. Although it’s a good idea for sure.
Cheryl what a good thing: Three month evals. Never heard of such a thing.
Here’s something to think about:
How about asking the aides for input when it comes time for the nurses evals???? How many places ask for THAT??? Are aides capable of rating a nurse? And if so, on what points????
February 27th, 2007 at 5:26 pm
Aides doing the nurses evals???????????????
HAHAHAHAH NOW that is funny Kim.
February 27th, 2007 at 6:51 pm
I know it’s funny but is it possible? I say it is. Ask your boss.
All they can say is NO.
February 28th, 2007 at 9:22 pm
The DON where I work just comes around and asks us for thoughts.
One way or the other…I work weekends (and OT once in awhile) so we don’t see her too much…the w/e nurse manager will ask us, on our own, if we have any concerns and input.
When something happens with a charge nurse- say, she YELLS at an aide- and we’re around to hear it- we let the DON know through email. Not everyone has work email though so a quick note will work as well. Just the facts…date, time, who, where…as an FYI for the DON. I guess these incidents get logged into some critical incident report log system they have attached to the eval program (on the computers). It goes both ways too- when a nurse does something reallllly good we report that as well.
March 1st, 2007 at 7:40 am
The ICU I worked in did peer evals. Sometimes we can be a better judge of what our peers are or are not doing. The manager gave the eval to the person but it was written by 2 peers who were anonymous and the manager added her comments as well
Mary
March 1st, 2007 at 3:57 pm
We used to get a random survey that went to random people about how the administrators and nurses were doing and we did not have to give our name, however the bad part about it was the administrators and nurses gave the surveys out personally so there for they got to choose whom would get to complain. Did not make any sense to me but if perhaps all the staff were given these surveys, well then, that would be something amazing. Seems they were trying to get on the right track they just did not think things through carefully enough.
Carmen
March 1st, 2007 at 7:51 pm
mary when I have filled out those about peers I have tried to be very fair. Cause I know what a good eval feels like, and a bad one must really SUCK. I try to be honest but not to overlook problem areas- this can be a tough seat to sit in. While we want others to know where they’re problems are, we don’t want to shoot down their morale to the point they hate coming to work.
March 1st, 2007 at 7:52 pm
Well that’s dumb Carmen, of the bosses to do that. Did they even realize this?
March 2nd, 2007 at 9:22 am
Like I said, it was as if they were trying but did not think things through carefully enough or the directors did not follow instructions properly if you know what I mean. Yeah I do not believe in peer evals. I think it is just a time for other aids to glorify themselves by pointing out what others do wrong in a ridicules manner. I personally would rather boost them up with the things they are doing right if I am there peer. If I were a supervisor then it would be a little different as far as giving gentle constructive criticism. But as far as giving evals as a peer I do not feel it is my place.
March 2nd, 2007 at 9:58 pm
LOL…it also places us in an awkward position at times too. I can imagine the nurse seeing the DON give us those feedback forms…and they would KNOW who gave it. NO THANKS. no forms.
Ask me and I might tell. But I won’t put it in writing. I WILL document problems though and I could care less if the nurse see’s that stuff…in fact, I usually give the nurse in question a copy of the problems and letter. Puts me in the hot seat for a little bit maybe…but it’s not like I haven’t gone to the nurse in person and talked about the issue (s).
March 5th, 2007 at 11:44 am
I like the idea of being able to evaluate peers and my nurses I feel us CNA could give valuable feed back on how the RNs are supervising us and how well they address issues that occur during the shift. As for my peers I feel it is essential to address the need for further training
March 5th, 2007 at 5:31 pm
I mentioned this to the nurses I worked with over the weekend. THEY said CNA\’s have no legal right to evaluate them- RN\’s- because they supervise US and our work. The nurses said if they got an eval with feedback from aides, they would quit. CNA\’s are not able to *assess* the work of a nurse nor are we educated to make judgements on their work.
I asked about the non nursing aspects. Like leading, managing, supervising, ability to be fair and honest; and about keeping morale up. They were all pretty quiet about this. Figures.
I would not evaluate a nurses\’ work; but I would their ability to be a decent manager. After all I am the one who is being managed.