Susan McIlvinney is one of a small team of nursing resource managers at the Montreal Children’s Hospital. She and her colleagues Carmela Jumeras, Atif Abbas, Michelle Bayard and Barbara Cooke—all nurses with bedside experience—play a key role in ensuring that nurses have the tools and support to do their work. “We don’t manage the nursing teams—that’s the role of the nurse manager on each unit,” says Susan. “But we take care of anything and everything that the nurses need to provide the best patient care possible.”
A key factor that distinguishes this team is that they are rarely seen at the Children’s during the day from Monday to Friday. They work evenings, nights, weekends and stat holidays, rounding out the 24/7 requirements of caring for patients.
Susan has spent her career at the Children’s and has worked in her current role for 10 years. She says it’s a job that is constantly evolving. “It’s the unknown, the problem solving that I really like.” As anyone working on the units knows, patient needs don’t follow a strict schedule, and many hospital services are only available during regular hours. Susan and her colleagues work to remedy those situations. “It can be as simple as finding a necessary medication after the pharmacy is closed,” she says. “We keep inventory data from every unit so we can arrange to transfer meds if needed.”
From Monday to Friday, the nursing resource manager starts work at 3:15 in the afternoon. Susan describes how the shift rolls out. “I touch base with Cindy McCartney, who’s the Nurse Manager for Patient Flow, to find out the key issues for that day, and do the handover. Then I’m off to the afternoon bed huddle meeting in the Emergency Department,” she says. “The assistant head nurse from each inpatient unit also attends the meeting, and they bring info on possible patient discharges from their units.”
At 5:00 p.m., Susan starts rounds on all the units. “The face-to-face meetings with staff are really valuable because it gives us a chance to take the pulse of what’s happening and see first-hand what’s needed.” At the end of her shift at 11:15 p.m., Susan meets with whichever of her colleagues is scheduled for overnight. “We give really detailed handovers to each other, and go over all important details they need to know to take things through to the next morning.”
On weekends and stat holidays, the nursing resource managers work 12-hour shifts, so they attend the morning bed flow meeting and do morning rounds on the units as well as afternoons.
Responding to codes One of the key responsibilities for the nursing resource manager is to respond to all codes called at the Children’s. “No matter where I am or what I’m doing, when a code is called, I head straight there,” says Susan. “During a code, we make sure that the team involved has everything they need, which could be anything from extra people to an IV pump.” By being on the scene, they can evaluate the situation as it’s happening. “We’re the eyes and ears on the ground, so we also act as an information resource for anyone in the hospital who needs to be kept up to date.”
In the past couple of years, the nursing resource managers have been involved in two Code Orange events: one a simulation exercise, and the other the real thing. “Every unit in the hospital has a Code Orange staff fan-out list. One of our jobs is to coordinate and sign in all extra staff coming in to respond to the code. The simulation exercise was a really valuable planning experience for when the real thing happened,” she says.
Susan has many examples big and small of how the nursing resource manager supports staff in providing care. She recounts the story of a young boy who was given the green light to go home on a Saturday but was missing an essential piece of equipment that would allow him and his family to leave. “I tracked it down for the nursing team and as a result, the family headed home right after that,” she says. “It might seem like a small thing, but without it, they would have had to wait until Monday. It was really nice to help make that happen.
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Susan McIlvinney and Atif Abbas are part of the Children’s Nursing Resource Managers team. At the end of every shift, the managers do a handover where they review the key issues of that day.
Kelly Anne Goudreau, Assistant Head Nurse, B8, and Susan consult the Tableau de lit to review the latest information on patient admissions to the unit.