Naomi, a novice staff nurse, calls her administrative supervisor, Madelyn, for assistance with Selma Rice, an 84-year-old patient  who has pulled out her I.V. line and wants to leave against medical advice (AMA). When Madelyn arrives on the nursing unit, she shows Naomi how to access the hospital policy and reviews the AMA procedure with her. After discussing Mrs. Rice’s situation, Madelyn and Naomi go to her room to explore whether anything more could be done to assist her. Madelyn discovers the patient wants to attend mass in memory of her husband and their 60th wedding anniversary. She contacts the hospital priest and asks him to meet with the patient. With this intervention, Mrs. Rice consents to stay in the hospital.

Madelyn encourages Naomi to provide a phone update to the patient’s son. Finally, Madelyn and Naomi collaborate to arrange an interdisciplinary meeting with the patient, her son, her physician, and her case manager to review plans for the rest of her hospital stay and discharge.

Looking for a professional challenge? Administrative supervisor may be the role for you. Every day, nurses like Naomi seek the assistance of administrative supervisors to help solve a wide range of problems.

Giving nurses whatever assistance they need to provide safe, effective patient care is an important part of this role. For instance, a supervisor may be asked to review and check a chest tube setup with a new nurse, explain hospital policy on administering I.V. metoprolol on a medical-surgical unit, or help a staff nurse obtain 3,000 mL of sterile normal saline solution for a patient’s continuous bladder irrigation.

In most acute-care hospitals, administrative supervisors are the on-site nurse leaders who work off-shifts, such as evening, night, and weekend shifts.

Qualifications

Each hospital establishes its own requirements for the administrative supervisor position. Generally, a candidate must have a current active nursing license and a bachelor of science in nursing degree; a master’s degree is preferable. Of course, you’ll need relevant clinical nursing experience as well, along with charge nurse or management experience. Administrative supervisors typically respond to all emergencies, such as cardiac arrests, so critical care experience is particularly helpful. Executive nurse board certification from the American Nurses Credentialing Center also is valuable.

Responsibilities

An administrative supervisor is the visible on-site nursing and administrative leader, with responsibility for the entire hospital during the weekend, evening, or night shift. Responsibilities vary but typically include responding to emergencies, addressing patient and family concerns, staffing, and supporting the nursing staff. Some administrative supervisors still perform some of the functions described in historical publications, such as rounding on nursing units, making urgent decisions, and releasing bodies to funeral homes. (See Historical perspective.)

Most nurses with critical-care experience adapt easily to responding to patient emergencies, such as cardiac arrests, strokes, and rapid response situations. In such emergencies, the supervisor ensures the patient is receiving the necessary care and assists as needed with documenting care, talking with family members, or  finding a transfer bed for the patient. Supervisors also respond to general hospital emergencies, such as smoke and fire situations, a broken water pipe resulting in flooding, or a bomb threat.

Ensuring appropriate staffing for the current shift and the next one can be challenging. As patients are admitted, the administrativesupervisor must make sure appropriate staff are on hand to provide care. For the next shift, the supervisor reviews the scheduled staff and makes adjustments based on the unit census and patient acuity.

Empirical research on the administrative supervisor role is just beginning. In a recent pilot qualitative study, Weaver and Lindgren interviewed administrative supervisors and found that they oversee and do everything needed to keep the hospital running, with responsibilities for staffing and patient flow, crisis management, and managerial support for the staff.

Are you interested?

For nurses who aspire to be leaders, administrative supervisor can be an exciting and rewarding position. Instead of being assigned to care for patients, the supervisor’s assignment is to care for staff nurses. This means being available and making rounds on all nursing units to answer questions, solve problems, assist with patientcare issues, and mentor novice night nurses to help them become experienced charge nurses. And sometimes, the supervisor’s role is simply to comfort and reassure a nurse, even letting her cry on her shoulder.

Susan Heidenwolf Weaver is an education specialist at Saint Clare’s Health System in Denville, New Jersey.

Selected references

Clare M. Handbook for the Night Supervisor in the Small Hospital. St. Louis, MO: Catholic Hospital Association; 1965.

Pfefferkorn B. A new deal for the patient at night. Am J Nurs. 1932;32(11):1179-87.

Weaver SH, Lindgren T. Administrative supervisors: a qualitative exploration of their perceived role. Nurs Adm Q. 2016;40(2):164-72.