Assistant Nurse Manager

Duties and Responsibilities

The Assistant Nurse Manager serves as the primary leader in the absence of the Nurse Manager and provides coverage for the Nurse Manager during meetings, vacations, and other periods of absence. The position is responsible for 24/7 unit accountability and is an exempt position requiring a minimum commitment of 40 hours per week.

The Assistant Nurse Manager also functions as a Registered Nurse and may provide direct patient care as needed based on patient acuity, staffing needs, department operations, and organizational requirements. For positions assigned to the Med/Surg, ICU, Swingbed and Joint Units, the Assistant Nurse Manager provides additional clinical and operational leadership related to emergency patient flow, triage, staffing, patient assignments, emergency protocols, and the coordination of care in a high-acuity environment.

• Coordinates the efforts of assigned staff and provides leadership in the delivery of patient care.
• Supervises clinical care provided by nursing and support staff and ensures appropriate delegation and follow-through.
• Serves as the primary leader in the absence of the Nurse Manager.
• Covers for the Nurse Manager when he/she attends meetings, is on vacation, or is otherwise unavailable.
• Serves as Administrator on Duty (AD) in rotation with Nurse Managers following appropriate training.
• Assists the Nurse Manager with the overall management and daily operations of the department.
• Assists with developing and implementing department goals, objectives, policies, and procedures.
• Assists with assessing and adjusting workflow to promote efficient operations and quality patient care.
• Promotes maximum appropriate use of staff resources and supports appropriate staffing patterns.
• Participates in staff scheduling and makes appropriate patient care assignments based on patient acuity, staff competency, and department needs.
• Ensures appropriate staffing coverage for patient care needs, including meals, breaks, admissions, discharges, procedures, and changes in patient volume.
• Conducts or participates in staff meetings and department huddles as appropriate.
• Participates in the applicant selection and interview process as requested.
• Assists with staff evaluations and provides feedback regarding performance and professional development.
• Assists in identifying staff educational needs and recommends appropriate educational opportunities.
• Assists with orientation, onboarding, and competency validation of new and existing employees.
• Assists with counseling employees regarding performance, conduct, attendance, and adherence to organizational standards.
• Collaborates with the Nurse Manager regarding formal corrective action and disciplinary processes.
• Demonstrates skill in supervising and supporting staff in the performance of their duties.
• Demonstrates flexibility and adaptability and may rotate to another shift or department when operational needs require.

Clinical Leadership and Patient Care

• Performs all duties of a Registered Nurse and provides direct patient care when needed.
• Assumes responsibility for the completeness and quality of nursing care provided by assigned staff.
• Assumes charge nurse, team leader, or direct patient care responsibilities as necessary.
• Demonstrates sound clinical judgment, critical thinking, and the ability to make timely decisions in complex situations.
• Prioritizes patient care based on acuity, safety, clinical needs, and available resources.
• Ensures patient care is provided in accordance with hospital policies, departmental standards, regulatory requirements, and National Patient Safety Goals.
• Demonstrates competency in clinical skills and knowledge appropriate to the assigned area of practice.
• Ensures appropriate assessment, reassessment, planning, implementation, and evaluation of patient care.
• Identifies changes in patient condition and ensures timely notification of the appropriate healthcare provider.
• Ensures physician orders are implemented promptly and appropriately.
• Promotes safe medication administration and compliance with medication safety policies.
• Ensures appropriate documentation of patient assessments, interventions, responses to treatment, and changes in condition.
• Promotes appropriate pain management, fall prevention, skin integrity, infection prevention, and other applicable patient safety initiatives.
• Ensures appropriate use of patient identification, specimen labeling, medication verification, and procedural safety practices.
• Supports safe management of IV therapy, vascular access, blood products, medications, monitoring equipment, and other clinical treatments within the scope of practice.
• Ensures appropriate patient preparation and recovery related to procedures, treatments, surgery, and transfers.
• Promotes patient and family education and involvement in the plan of care.
• Assists with discharge planning and ensures appropriate patient and family understanding of discharge instructions.
• Initiates consultation with other healthcare disciplines based on patient needs.
• Maintains awareness of patient, family, physician, and staff concerns and facilitates appropriate resolution.

Emergency Department-Specific Responsibilities

For positions assigned to the Emergency Department:

• Supports the Nurse Manager in the overall management and daily operations of the Emergency Department.
• Assists with coordinating patient flow from triage through discharge, admission, transfer, or other disposition.
• Demonstrates the ability to prioritize patients based on acuity and established triage criteria.
• Ensures triage documentation meets established department and regulatory requirements.
• Responds promptly to triage needs and assists with reassessment of patients awaiting treatment or an available treatment space.
• Monitors the waiting room and ensures patients awaiting care are reassessed according to department policy.
• Initiates or oversees approved emergency treatment protocols as appropriate.
• Makes appropriate patient care assignments based on acuity, staff competency, patient volume, and available resources.
• Coordinates staffing and workflow in response to changes in Emergency Department volume and patient acuity.
• Assists with maintaining appropriate coverage during periods of high patient volume or increased acuity.
• Supports timely coordination of care among physicians, nurses, ancillary departments, EMS, patients, and families.
• Ensures families are kept appropriately informed regarding patient status while maintaining patient confidentiality.
• Promotes staff competency in emergency clinical skills, equipment, protocols, and procedures.
• Assists with evaluation of staff competencies and development of improvement plans when indicated.
• Maintains competency in emergency equipment and procedures appropriate to the assigned department.
• Supports the safe care and monitoring of patients requiring high-acuity interventions, including cardiac monitoring, defibrillation, rapid volume administration, procedural sedation, and other emergency interventions within the scope of practice.
• Supports appropriate use of emergency department policies, protocols, and evidence-based practices.
• Promotes efficient patient throughput while maintaining patient safety and quality of care.

Quality Improvement and Risk Management

• Participates in ongoing unit Quality/Process Improvement and Continuous Quality Improvement activities.
• Assists with identifying quality concerns, patient safety issues, and opportunities for improvement.
• Coordinates or participates in quality improvement activities as directed by the Nurse Manager.
• Investigates incidents and assists in determining appropriate follow-up actions.
• Reports quality, safety, staffing, and operational concerns through the appropriate chain of command.
• Participates in audits, monitoring activities, quality studies, and performance improvement initiatives.
• Assists in developing and implementing corrective actions when opportunities for improvement are identified.
• Promotes compliance with National Patient Safety Goals and organizational safety standards.

Communication and Collaboration

• Acts as a liaison among physicians, patients, visitors, nurses, ancillary departments, and other members of the healthcare team.
• Communicates effectively and professionally with patients, families, physicians, leadership, peers, and support staff.
• Provides concise, pertinent hand-off communication at shift changes and during transfers of care.
• Ensures timely communication of significant changes in patient condition, staffing concerns, operational issues, and safety events.
• Encourages open communication and a positive work environment.
• Accepts feedback and seeks additional guidance when necessary.
• Promotes teamwork, collaboration, professionalism, and respectful workplace behaviors.

Infection Prevention and Safety

• Utilizes standard precautions and appropriate personal protective equipment in all aspects of work.
• Complies with hospital hand hygiene and infection prevention policies.
• Initiates appropriate isolation precautions based on patient condition and organizational policy.
• Maintains knowledge of multidrug-resistant organisms and appropriate infection prevention measures.
• Reports staff noncompliance with infection prevention practices through the appropriate chain of command.
• Complies with maximum barrier precautions and applicable policies for central line insertion and vascular access.
• Ensures appropriate sterile technique for applicable procedures.
• Promotes appropriate cleaning and disinfection of equipment between patients and/or staff use.
• Supports timely collection of cultures and administration of antibiotics when clinically indicated and consistent with organizational protocols and quality measures.

Documentation and Technology

• Conforms to departmental and organizational documentation standards.
• Ensures nursing documentation accurately reflects care provided, patient assessments, interventions, responses, restraints, pain management, seclusion, transfers, and other applicable clinical information.
• Utilizes the electronic medical record and other clinical technology in accordance with organizational policy.
• Complies with requirements regarding prohibited abbreviations and appropriate documentation standards.
• Repeats and verifies verbal and telephone orders and test results in accordance with policy.
• Maintains accurate and timely documentation of patient care and departmental activities.
• Utilizes computer systems and Microsoft Office applications as required for the position.

Education and Staff Development

• Assists with ongoing unit education and staff development.
• Participates in orientation of new employees.
• Assists with identifying staff competency and educational needs.
• Supports development and implementation of educational opportunities and competency plans.
• Participates in management workshops, in-services, and professional development activities as appropriate.
• Maintains current knowledge in areas of responsibility through continuing education, self-directed learning, and participation in educational programs.

The Assistant Nurse Manager must demonstrate competency in providing and/or supervising care for patients across the lifespan, based on age, developmental level, weight, clinical condition, and demonstrated needs.

Patient populations may include:

• Infants – newborn to 1 year
• Toddlers – 2 to 4 years
• Children – 5 to 9 years
• Adolescents – 10 to 18 years
• Adults – 19 to 69 years
• Geriatric patients – 70 years and older

Age-specific competency includes, as applicable:

• Assessing and interpreting patient data based on age and developmental level.
• Selecting equipment appropriate to the patient's age, size, and condition.
• Administering medications based on age, weight, clinical condition, and established medication safety standards.
• Recognizing age-specific physiological, developmental, behavioral, and psychosocial needs.
• Involving parents, guardians, family members, and/or significant others appropriately in care and education.
• Recognizing and reporting signs and symptoms of abuse or neglect.
• Providing privacy, dignity, and developmentally appropriate communication.
• Modifying patient education and communication according to developmental level and health literacy.
• Identifying age-specific safety risks and implementing appropriate interventions.
• Assessing nutritional status and initiating appropriate interventions.
• Recognizing and responding to age-specific changes in condition.

Knowledge, Skills, and Abilities

Must possess the following:

• Strong organizational and time-management skills.
• Effective leadership and delegation skills.
• Strong communication and interpersonal skills.
• Customer experience and service skills.
• Critical thinking and analytical skills.
• Ability to determine an appropriate course of action in complex situations.
• Ability to manage multiple and simultaneous responsibilities and prioritize work effectively.
• Ability to work independently, exercise sound judgment, and maintain a positive attitude.
• Ability to read and comprehend written instructions, policies, procedures, and regulatory requirements.
• Ability to follow verbal and written instructions.
• Excellent verbal and written communication skills.
• Appropriate grammar and spelling skills.
• Basic computer skills.
• Microsoft Office skills.
• Ability to maintain confidentiality of medical, financial, personnel, and legal information.
• Ability to complete assignments accurately and within established timeframes.
• Ability to function effectively in a fast-paced, high-acuity healthcare environment.

Other Essential Functions

Performs other duties as assigned or requested.

Professional Requirements

• Adheres to the hospital and departmental attendance and punctuality guidelines.
• Performs job responsibilities in alignment with the core values, mission, and vision of the organization.
• Maintains current licensure, certifications, competencies, and required education.
• Completes annual education and competency requirements.
• Maintains patient confidentiality at all times.
• Reports to work on time and as scheduled.
• Wears identification while on duty.
• Adheres to the organizational dress and appearance standards.
• Maintains all applicable regulatory requirements, including state, federal, and local regulations.
• Represents the organization in a positive and professional manner at all times.
• Complies with organizational policies and standards regarding ethical business practices.
• Participates in performance improvement and continuous quality improvement activities.
• Attends staff meetings, leadership meetings, in-services, and educational programs as required.
• Maintains professional boundaries and demonstrates respectful communication with patients, families, visitors, physicians, and coworkers.
• Maintains required clinical competencies for the assigned department.

Physical Requirements and Environmental Conditions

• Have near-normal hearing; able to hear alarms, telephones, normal speaking voices, and virtual/web-based communications.
• Have near-normal vision, corrected or uncorrected, including the ability to distinguish colors.
• Demonstrate good manual dexterity and eye-hand-foot coordination.
• Standing – continuously within the shift (67–100%).
• Walking – continuously within the shift (67–100%).
• Climbing – occasionally within the shift (1–33%).
• Bending/stooping – frequently within the shift (34–66%).
• Twisting at the waist – occasionally within the shift.
• Pushing/pulling – frequently within the shift (34–66%).
• Lifting/carrying 25+ pounds – occasionally within the shift (34–66%).
• Reaching above the shoulders – frequently within the shift (34–67%).
• Lifting/carrying up to 50 pounds with assistance – occasionally within the shift (1–33%).
• Ability to work in an environment with potential exposure to blood, body fluids, infectious materials, medications, chemicals, and other occupational hazards.
• Ability to respond promptly to clinical emergencies and other urgent patient care situations.