Nurse Managers and Assistant Nurse Managers in U.S. health systems have many things demanding their attention each day. And that is during “normal” times! The 2020-2021 pandemic created more challenges for managers in care delivery organizations. Nurse Managers were tasked with securing medical equipment, turning units into COVID-19 care areas, short staffing, and providing emotional support for nurses who were seeing traumatic events daily.
This was an event that no one could have prepared for, but now looking back, how can we put plan and prepare to put Nurse Managers in the best position to succeed?
Encourage Constructive Relationships with other Leaders
Make sure Nurse Directors have a relationship with your Nurse Managers that is based on mutual respect and accountability. Provide constructive performance feedback, which helps the manager grow and develop. Avoid micromanaging the manager though, as this could be interpreted as a lack of trust. In a constructive Director-Manager relationship, there is clear communication on expectations, a trust on judgment on operational decisions, and a mentor relationship being built.
Do your Nurse Manager have collegial physician relationships? Nurse Managers and physicians partner to achieve quality patient outcomes. Talk with your managers about this and see if they have a physician partner who looks out for them, and wants to help them to improve patient outcomes in the manager role.
Encourage Nurse Managers to be Transparent about Rocky Times
Nurses do not expect their managers to have all the answers to problems, but they do want the truth. If there is transparency about instability, and a manager acknowledges that the team is going through rocky times, it can be a building block for trust. It can also help solve the issues. When staff members have all the information on a topic, they may devise reasonable suggestions or alternatives to solve or improve a problem. Through transparency, nurse teams can mature more quickly. A lack of transparency however can have long-term detrimental effects and lead to less trust, or even turnover.
Teach Nurse Managers to Think about Retention of their Team
At Catalyst Learning, one of the biggest issues we’re hearing from our customers and advisors is that short staffing of nurses is everywhere. We keep hearing that many nurses on teams are very young and inexperienced. Besides just natural cyclical employment, the pandemic pushed some early retirements of Boomer nurses, and a lot of experience has left the building. Unfortunately, there is little we can do about this.
For your Nurse Managers to be successful, they need an experienced team. So make sure they are thinking about retention, especially of younger nurses who may shuffle out quickly. Encourage managers to offer role clarity when nurses first start and communicate on critical issues. Teach managers to offer recognition to make their team feel valued, intervene when disengaged nurses become disruptive, and offer opportunities for growth for high-performing young nurses. If your Nurse Manager plans on how to keep nurses engaged in the role and in the job, it will pay off.
Promote Stress Management and Nurse Resiliency from the Top-Down
It’s obvious that fatigue sets in during stressful times, and nurse burnout happens even during “normal” times. Nurse resiliency is vital to our public health community, but how can we prepare Nurse Managers to help staff, and deal with it themselves? Our systems can promote resiliency from the top-down by encouraging nurses to take emotional breaks, like music, hobbies, exercise, or personal spiritual events. You can encourage Nurse Managers to huddle with their teams and teach nurses to recognize what they can and cannot control, and that other nurse teams are scared too. And you can encourage nurses to pursue emotional support and connectedness to peers, have work teams find a buddy who they can reach out to when workload is intense, and promote Employee Assistance Programs that your health system has for associate support.
Collaborate to Create a Great, Thriving Environment
OK, a Nurse Manager’s role is hard, the word “Fun” may not make sense. But you can help create an environment that focuses on positive attributes of the role. For example, encourage your Nurse Manager to recognize excellence in nursing practice when she sees it in her unit. That will be beneficial to her and the team. Also check on your managers to gauge if they have a manageable workload, adequate resources, and accessible professional development to equip these leaders with necessary knowledge and tools.
Are you creating a culture of meaning and excellence for your managers? Do they feel like their role is just churning out work, or do they see how their work is evident throughout the entire health organization? When constructing your leaders’ priorities, show them how these priorities are aligned with the organization’s mission. Show your manager how her work supports the standards and expectations of excellence your organization has, and that her work helps maintain a reputation for excellence. Assure there is an alignment of goals and desired outcomes in performance evaluations to assist the manager in getting the work done through others.
“The Journal of Nursing Administration” October 2017 issue, entitled “Magnet Supplement The Role of the Nurse Manager: Pivotal to Nursing Excellence” – articles written by Jeffrey N. Doucette DNP/RN/CENP; , Nora Warshawsky, PhD/RN; Sharon Lake, PhD/RN; Arica Brandford, MSN/JD/RN; Mary Kay Rayens, PhD; Donna Sullivan Havents, PhD/RN/FAAN
“A Phenomenological Study of Nurse Managers’ and Assistant Nurse Managers’ Experiences during the COVID-19 Pandemic in the U.S.” Wiley Online Library, Jane H. White PhD, RN, PMHCNS-BC, FAAN, March 10 2021
“Behind every RN is a nurse manager: 4 tips for these leaders during the pandemic,” Beckers Healthcare, Mackenzie Bean, June 11 2020
“Exploring nursing managers’ perceptions of nursing workforce management during the outbreak of COVID-19: a content analysis study,” BMC Nursing, Sarieh Poortaghi, Mehraban Shahmari, Akram Ghobadi, January 29 2021
“Nursing leadership during COVID-19 Enhancing patient, family and workforce experience,” Patient Experience Journal (PXJ), Anne Aquilia (Yale New Haven Health), Karen Grimley (UCLA Health), Barbara Jacobs (Anne Arundel Medical Center), Maryellen Kosturko (Yale New Haven Health), Jerry Mansfield (Mount Carmel Health System, Trinity Health)
“6 Healthcare leaders share the most difficult aspect of their job,” Kelly Gooch, Beckers Hospital Review
“How to Build – and lead- resilient health care teams during COVID-19,” Katherine J. Igoe, Harvard School of Public Health, September 20, 2020
Another resource was Rose O. Sherman, who offered guidance letting us know of issues managers are facing. (July 2021)
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