Rarely does such a decision run counter to the wishes of any physician who takes a moment to understand the decision in context, but it can happen, and we are responsible for providing care smoothly throughout the institution. The most difficult decisions involve moving a patient laterally, say from one surgical unit to another. That's a decision that's usually driven by individual physicians. The role of the supervisor isn't to manage the house, it's to supervise the house, and that's a very critical distinction. We follow up on events and solve problems, then we hand off to the manager or others to provide a long-term solution.
Nurse managers work in a more focused way with their own staffs.
But our responsibility covers a broad spectrum. On the night shift, I'm sometimes the only manager that employees regularly are able to chat with. Dennis, you continue to work as a supervisor even though you are in a broader management role. It's a great opportunity to get out and talk with the staff and find out what's really going on - to really understand people's issues. By the way, I'm also responsible for critical care units, and that helps me to keep in touch as well.