RN Acute Care Department Manager

Job Summary: The Acute Care Nurse Manager provides clinical, operational, and administrative leadership for the Acute Care and Swing Bed services. The Manager is responsible for ensuring safe, high-quality, patient-centered care; effective staffing and resource utilization; staff development; regulatory compliance; and the ongoing development and success of the Swing Bed program.

This position is a working clinical leadership role. The Manager is expected to provide direct nursing support on the Acute Care/Swing Bed unit when staffing needs, patient acuity, census, or operational circumstances require additional coverage. Direct patient care responsibilities will be balanced with management duties and will not replace the Manager's responsibility for department leadership and oversight.

The Manager serves as a key leader in developing a strong rural inpatient and transitional-care service that supports patients locally and reduces avoidable transfers when clinically appropriate.

ESSENTIAL FUNCTIONS

1. Medical-Surgical Unit Management

• Provide daily clinical and operational leadership for the Medical-Surgical unit.
• Ensure safe, effective, and compassionate patient care.
• Monitor patient census, acuity, staffing needs, admissions, discharges, and transfers.
• Establish staffing assignments based on patient needs, staff competency, and available resources.
• Ensure appropriate RN, LPN/LVN, CNA, and other support-staff utilization.
• Maintain a safe and organized patient-care environment.
• Serve as a clinical resource for nurses and support staff.
• Promote evidence-based nursing practice and adherence to hospital policies.
• Address patient-care concerns promptly and appropriately.
• Participate in interdisciplinary rounds and care coordination.

2. Direct Patient Care and Staffing Support

The Manager will maintain clinical competency and provide direct patient care when needed to support safe staffing and continuity of care.

Responsibilities may include:

• Assuming an RN patient assignment when staffing needs require.
• Providing Supervisor nurse coverage when necessary.
• Assisting with admissions, transfers, and discharges.
• Supporting the unit during periods of increased census or patient acuity.
• Assisting with medication administration, assessments, treatments, care planning, and patient education within scope of practice.
• Responding to unexpected staffing shortages and urgent operational needs.
• Supporting staff during high-acuity or complex patient situations.
• Working collaboratively with the nursing supervisor/administrator-on-call regarding staffing and patient-care needs.
• Participating in the hospital's staffing escalation process.

The Manager is not expected to routinely function as a full-time staff nurse; however, flexibility to work the unit when necessary is an essential component of the position.

3. Swing Bed Program Leadership

The Manager is responsible for the clinical and operational development of the Swing Bed program.

Responsibilities include:

• Develop and maintain standardized Swing Bed admission and care processes.
• Identify appropriate patients for Swing Bed services in collaboration with providers and Case Management.
• Coordinate admissions from acute-care settings.
• Establish effective referral and intake workflows.
• Coordinate interdisciplinary Swing Bed care planning.
• Ensure appropriate nursing assessments and individualized plans of care.
• Monitor patient progress toward functional and clinical goals.
• Coordinate rehabilitation, therapy, dietary, pharmacy, social services, and other interdisciplinary services.
• Ensure discharge planning begins at admission.
• Coordinate transition of patients to home, home health, outpatient services, or other appropriate settings.
• Monitor Swing Bed census, referrals, admissions, discharges, length of stay, and patient outcomes.
• Identify opportunities to increase appropriate Swing Bed utilization.
• Develop relationships with referral sources and community healthcare partners.
• Participate in marketing and community education regarding Swing Bed services as appropriate.
• Collaborate with Finance, Case Management, Revenue Cycle, Quality, and Administration regarding program performance.

4. Staffing and Workforce Management

• Develop staffing plans based on census, acuity, skill mix, and patient needs.
• Manage staffing shortages and unexpected call-outs.
• Utilize available staff resources appropriately.
• Coordinate agency, per diem, float, or other supplemental staffing when needed.
• Promote cross-training between other hospital units when appropriate.
• Monitor overtime and staffing expenses.
• Participate in recruitment and retention activities.
• Interview and assist with selection of nursing personnel.
• Provide orientation and onboarding support.
• Conduct staff performance evaluations.
• Address performance and attendance issues according to organizational policy.
• Promote a culture of accountability, teamwork, and professional nursing practice.

5. Staff Education and Competency

• Identify educational needs based on patient population, quality data, and regulatory requirements.
• Develop and maintain competencies for Med/Surg and Swing Bed nursing.
• Provide or coordinate education related to:
  • Fall prevention
  • Skin and wound care
  • Medication safety
  • Infection prevention
  • Emergency response
  • Patient deterioration
  • Chronic disease management
  • Rehabilitation and functional recovery
  • Discharge planning
  • Swing Bed requirements
• Ensure required annual education and competencies are completed.
• Mentor new nurses and support professional development.

6. Quality and Patient Safety

• Monitor quality indicators for Med/Surg and Swing Bed services.
• Track and address:
  • Falls
  • Pressure injuries
  • Medication events
  • Hospital-acquired infections
  • Readmissions
  • Transfers to higher levels of care
  • Patient complaints
  • Patient experience
  • Other department-specific quality indicators
• Participate in quality-improvement projects.
• Develop corrective action plans when indicated.
• Promote a culture of safety and just culture principles.
• Report significant events according to organizational policy.

7. Regulatory and Compliance

• Maintain compliance with applicable federal and state regulations, hospital policies, and accreditation requirements.
• Maintain readiness for regulatory surveys.
• Ensure accurate and timely clinical documentation.
• Monitor nursing documentation and Swing Bed documentation for completeness.
• Maintain appropriate policies and procedures.
• Ensure staff maintain required licenses, certifications, competencies, and education.

8. Financial and Resource Management

• Participate in department budgeting.
• Monitor staffing expenses, overtime, supplies, and productivity.
• Identify opportunities to improve efficiency and reduce unnecessary costs.
• Support appropriate utilization of hospital resources.
• Monitor Swing Bed utilization and financial performance in collaboration with hospital leadership.
• Balance financial stewardship with patient safety and quality of care.

9. Interdisciplinary Collaboration

Collaborate effectively with:

• Physicians and advanced practice providers
• Chief Nursing Officer/Nursing leadership
• Case Management
• Rehabilitation/Therapy
• Pharmacy
• Dietary
• Respiratory Therapy
• Laboratory and Imaging
• Social Services
• Quality and Infection Prevention
• Health Information Management
• Finance and Revenue Cycle
• Community healthcare partners

10. Patient and Family Experience

• Promote respectful, compassionate, patient-centered care.
• Respond to patient and family concerns.
• Ensure patients understand their plan of care and discharge plan.
• Encourage patient participation in functional and recovery goals.
• Promote continuity of care throughout the patient's hospitalization and Swing Bed stay.