Q I find it difficult to stay in touch with the night staff because my family responsibilities preclude me from spending time on the off-shift. Do you have suggestions for how I can stay connected?
Your question is a difficult one. Unfortunately, our acute care inpatient environments are 24/7 operations, and all staff members on all shifts need to have a relationship with their unit leaders. Employees want a manager who cares about and values them, recognizes and rewards a job well done, and allows them to make an optimal contribution with the opportunity for growth and development. Most want to get to know their unit leaders and expect their unit leaders to know them. The good news? There are creative ways to develop and maintain your relationships with off-shift staff. Here are a few suggestions:
* If possible, begin your shift early to touch base with the night shift; on alternate days, stay late to communicate with your evening team. Although long shifts can be tiring, if they're balanced with vacation days and time away from the unit, you can maintain your energy while working longer shifts with regularity.
* Hold unit-based retreats once a year for strategic planning and to encourage team building. Consider partnering with a similar unit whose staff can provide coverage for retreat days, while your unit nurses do the same for them at another time. Structuring the retreat in two repeated full-day segments works best to reduce the number of staff members off your unit at one time. A unit strategic planning process supports participative management, facilitates discussion of workplace goals, allows the entire team to align around a set of shared goals and objectives, and helps staff members get to know each other both professionally and personally.
* Arrange for at least one annual unit party as a time for team members to celebrate together and recognize accomplishments.
* Hire and delegate to strong, shift-specific assistant nurse managers to provide frontline supervision for your off-shift staff.
* During annual evaluations, make sure you're present on the off-shifts to perform an evaluation for and have a meaningful conversation with each and every staff member.
* Make plans to round one day every other month on the off-shifts, which requires only six off-shifts a year. If these shifts are scheduled ahead of time, you should be able to plan coverage.
If you use some of these techniques to stay in touch with your staff, you should be able to find balance between your home obligations and the requirements of your role as manager. If not, you may want to find a management job in a clinic or diagnostic area that doesn't operate 24/7.
Q What does rounding with purpose mean, and what guidelines should I adhere to when I perform rounds?
The Studer Group, probably more than any other consulting team, influenced the concept of "rounding with reason" or "rounding with purpose." Rounding with purpose moves the rounding experience from a superficial social connection between leaders and frontline staff to a meaningful dialogue that can contribute to both staff recognition and deliberate problem solving. In general, these rounds ask three questions:
* What's going well?
* Who should be recognized for good work?
* What needs improvement?
Often when leaders do rounds all they hear are complaints and concerns. This not only becomes discouraging for leadership staff, but also keeps the frontline team focused on the negative. Rounding with purpose forces teams to think first about what's going well. A discussion about what's working well naturally leads to a discussion about recognition: Who's contributing to what's going well? Beginning with questions about what's going well and who should be recognized allows staff to be aware of what should be supported and reinforced, while formally recognizing high performers.
It's only after we focus on what's working that questions about what needs improvement can be asked. This last rounding question is asked purposefully with an ear for problem resolution and in an attempt for staff and leadership to jointly own the resolution process. Through this approach, staff and leadership work together to create improvements, rather than problem solving being left to leadership alone.