House Supervisors Fill Staffing and Safety Needs - Fort Worth

House supervisors at Cook Children’s Medical Centers work around the clock to ensure safety by overseeing where staff and patients are placed.

If a unit needs more nurses for the next shift, the house supervisor pulls from the nursing pool or a unit that has extra. House supervisors also keep tabs on severe weather, resources in short supply, medical alerts and building security.

It’s a role that requires leadership, problem-solving skills and constant communication. When needed, they fill in as administrators, patient advocates and even overnight makers of infant formula. From fire alarms and medical alerts to behavioral health emergencies, the house supervisors show up to give support that helps keep patients, visitors and employees safe.

“It’s not a routine job. It’s play-by-ear all day long,” said Gina Hernandez, MSN, RN, CPN, Director of Nursing Administration at Medical Center-Fort Worth. “At times, there can be non-stop action, and it can be from one end of the campus to the other. It requires a lot of flexibility and critical thinking.”

Connecting the Dots

The department of house supervisors falls under Gina’s position. Working as a house supervisor for many years taught her to view the separate units of the hospital as a cohesive whole. 

“I loved seeing the whole picture and touching everybody throughout the day,” she said. “Even now, I’m listening constantly to what’s going on. I like being that resource for whoever needs help.”

Cook Children’s Medical Center – Fort Worth has four full-time house supervisors, one halftime and four in a relief position. Six house supervisors and two in relief are at Cook Children’s Medical Center – Prosper. 

Crista Schronk, MSN, RN, CPN, Supervisor and Staffing Coordinator for Nursing Administration in Fort Worth, manages the house supervisors and in-patient bed placement. A house supervisor is on duty every hour of every day to make sure the hospital’s medical-surgical and intensive care units have the staff coverage they need for the next shift, Crista said. 

During daily staffing calls at 4:15 a.m. and 4:15 p.m., the house supervisor checks in with each charge nurse and tracks which units have just enough personnel, more than enough, or a shortfall, depending on patient census and acuity. The house supervisor can transfer staff from one unit to another or pull from the internal staffing pool to backfill a need.

A unit might find itself on the staffing “minus” side due to employees out sick, taking care of sick kids at home, or on maternity leave. Another unit might show a “plus” of extra employees scheduled for that same shift. It’s up to the house supervisor to make those pluses and minuses even out. Crista compared the 4:15 call to solving a Sudoku puzzle.  

“A lot of strategy goes on, and a ton of communication,” she said.

Seeing the Big Picture

House supervisors have a hand in the placement of nurses, advanced and patient care technicians, patient sitters and other staff. They also help generate a smooth flow of patients to prevent hospital backlogs.

House supervisor Toni Smith, BSN, RN, listed other duties that fall under the umbrella:

• Communicate with Occupational Health when an employee is injured

• Coordinate with funeral homes and with LifeGift for organ donation

• Monitor the weather and send weather alerts  

• Facilitate in case of an Omnicell discrepancy

• Be a resource for policy questions

• Precept and mentor students

“It’s a lot of plate spinning and juggling cats at the same time,” Crista said. “It really stretches your brain.”

Nicole Rauch, MSN, RN, CPN, works as a relief supervisor on the day shift. Nicole described the house supervisor as a point person and resource.

“Anybody in the hospital at any time can call us with questions. If we don’t have the answer, we will figure out who to ask,” she said. “Every day is different, but we are the central hub for almost everything that happens.”

Cook Children’s values – including kindness, collaboration and safety – come into play. House supervisors show compassion by advocating for families. They collaborate across departments by plugging in staff where they’re needed most. Priority on safety informs every decision.  

House supervisors occasionally have to give frustrating news to charge nurses: Either the unit’s patient load is increasing, or some of their staff are getting moved for that shift. But they want their Cook Children’s co-workers to know we’re all on the same team.   

“You can deliver that rough news but also let people know how much you appreciate their hard work,” Crista said. 

Nicole added: "We appreciate their flexibility and working with us and trusting us to know what we’re doing and why we’re doing it. We’re here to help any way that we can.”