Week 4 Oct 12-16

I met with my preceptor on Tuesday October 13 for 8 hours. My clinical objectives for this day were to learn what the requirements are for the units budget and how the manager adheres to these guidelines. Outside of budgeting for my family, I have never had to deal with maintaining a budget in an official capacity. What is the budget? What items are a part of the budget? How do you decide what items to use/buy and what items will need to wait. Today was an excellent day to address these issues. I learned from my preceptor that her budget consists mainly of employee wages and supplies for the unit. Each department the my preceptor manages has allotted hours established to keep her within the budget. Everyday, she reviews the previous day's hours clocked by employees to determine if she is within that budget and where she needs improvement. By using a computer system that interacts with their Kronons pay system, she is able to "plug" the numbers in and print her results immediately. She wants to stay at a 100% or above on her percentages. On this particular day, she is above 100% on all but one area. But, after reviewing the hours, we discovered that an employee had clocked in and worked under the wrong unit. After transferring those hours to the correct unit, all of our numbers matched. It was really interesting to learn how to operate this system. It really saves time and energy, which is always a plus. The budget for supplies is a tricky subject. The entire unit is allotted $500 per day for supplies. This includes office supplies and any other things ordered from central supply that these nurses use daily. On this day, we had to reorder the monitors for the newborn alarm system. Each alarm is approximately $150 dollars. These are reusable. But, the bands that secure them to the infant's legs are not. They are $50 a piece! So, my preceptor showed me how she has to "shift" her purchases around to different days so that she does not break her daily budget. It is a stressful process. I noticed that this process took more of our time than anything else. My preceptor agreed. She informed me that most her her time spent on budgeting deals with ordering supplies. I asked about items that cost more than her daily budget. In these instances, she has to submit a proposal to the CNO addressing what she wants to purchase, why it is needed, and three bids on how much the item costs. She told me that it took her two months to get a new trancutaneous bili monitor for the nursery because it cost $4,000. Overall, I felt that this was a productive week. I did not realize how much time and energy is required for just the budgeting portion of a manger's job. Even with the assistance of the computer system, it still takes a large amount of time.
Just a little note... My preceptor was awarded Nurseweek's Excellence in Mentoring award on Friday, October 9th!! She is now up to receive their national award for Excellence in Mentoring!