| Bruce Matthews lifted and fed patients as an | | | | roulette. If a patient's blood volume dropped, |
| orderly, and completed stints on as many | | | | Matthews had to decide which of three methods |
| specialty floors as he could as a beginning nurse. | | | | to use to increase it. |
| He made life-or-death decisions monitoring surgery | | | | "If you make a wrong judgment, it could be |
| patients during grueling 12-hour shifts as an | | | | deadly, " Matthews said. But he thrived because |
| open-heart recovery nurse. | | | | he liked thinking through a process on his feet. |
| Now, as director in charge of nursing | | | | Matthews then completed a stint in the cardiac |
| administrative support at a hospital in Winter | | | | catheter lab, a decidedly less thrilling job. On a lark, |
| Haven, Florida, Matthews benefits from the rare | | | | he applied for a critical care supervisor's job at |
| privilege of having an insider's edge on the job. | | | | the same hospital where he got his start. |
| Main Course | | | | He got the job, moving from patient care to |
| In a way, Matthews' job represents the flip side | | | | management, overseeing nearly 80 beds and |
| of his previous nursing positions. Instead of seeing | | | | subbing during the 3-11 p.m. shift when the nursing |
| patients, he assesses how many nurses are | | | | staff ran thin. He learned the financial ropes by |
| needed on a particular floor. He converts staffing | | | | tapping good mentors and reading on his own. His |
| provided by registered nurses (RNs), licensed | | | | pride shines even now as he describes how he |
| practical nurses (LPNs) and certified nursing | | | | persuaded higher-ups to include "flex pay'' in the |
| assistants (CNAs) into numbers or full-time | | | | budget, which covered recruiting incentives for |
| equivalents (FTEs). | | | | nurses during a shortage. |
| "I'm kind of like a budget analyst, " said Matthews, | | | | Bigger, Better Rewards |
| 43. | | | | After completing Army reserve duty during |
| Not Just the Job Description | | | | Operation Desert Shield in the early 1990s, |
| But his job is more than a numbers game, since | | | | Matthews took on a bigger assignment: managing |
| nurses have different competencies, and needs | | | | nursing support services for the entire hospital |
| vary from floor to floor. Matthews, who reports | | | | and affiliated facilities. |
| to the vice president of nursing and the hospital's | | | | The duties were similar to his previous job. There |
| CEO, accounts for that when he assigns staff. He | | | | was just more of everything -- more nurses, |
| must defend those decisions to higher-ups who've | | | | more beds (in excess of 500), more money to |
| never walked in a nurse's shoes. It gets more | | | | account for. He still works long hours, and when |
| complicated, since Matthews continually evaluates | | | | the Joint Commission on Accreditation of |
| how effectively nurses perform against his own | | | | Healthcare Organization makes its rounds, perhaps |
| and conventionally accepted standards. | | | | he feels a tad more pressure than usual. |
| Besides assigned duties, Matthews pitches in on | | | | Matthews considers himself a staff nurse " |
| other projects. For instance, he helped the hospital | | | | advocate " but acknowledges that he walks a |
| convert to a new computer system that made it | | | | tightrope sometimes to keep the clinical and |
| easier for nurses to order tests and supplies. | | | | administrative sides of the business happy. He |
| Getting There | | | | doesn't always succeed. |
| This orderly-turned-administrator advanced his | | | | "I like to be able to say, 'Yes, I can,' " Matthews |
| career by knowing what makes himself tick, | | | | said. He hit it off in health care because he |
| excelling on the job and seizing opportunities that | | | | enjoyed helping people. That remains the core of |
| taught him something new. By the time Matthews | | | | what he does today. |
| finished military service, working as an Air Force | | | | Advice for Aspiring Health Care Workers |
| medic with an open-heart specialist, he knew | | | | For nurses interested in moving into management, |
| enough to breeze through an associate's level | | | | Matthews offers his advice: |
| nursing program. He earned his license and started | | | | Don't pigeonhole yourself: Get as much experience |
| working as a nurse in a Winter Haven, Florida, | | | | as you can in every part of healthcare; that will |
| hospital, rotating through different floors | | | | make you more marketable. |
| voluntarily. | | | | Become familiar with tools of the trade: Even |
| Life or Death | | | | before he completed a bachelor's degree, |
| Later at Lakeland Regional, Matthews achieved | | | | Matthews oiled his skills in math, including basic |
| the best of both worlds as an open-heart | | | | algebra. Read journals that cover the job you |
| recovery nurse. Following a surgeon's protocols, | | | | want. |
| Matthews spent 12 hours monitoring patients | | | | Know what you know well: Matthews said his |
| hooked up to complex machines. As he describes | | | | insider's edge in nursing helped him to articulate |
| it, the job was about as intense as Russian | | | | needs to higher-ups. |