9 Ways to Transform the Nurse Manager Role – Lets Make It Fun Again!

The move from volume-based care models to outcomes-based care models has changed the role of the Nurse Manager. The role was always tough, but it is more challenging and complex than ever. Today’s Nurse Manager is required to be an expert in quality, staff engagement, patient experience, work culture, regulatory issues, physician relations, compliance and performance improvement. The role is hard to recruit for, and it is unlikely you’ll ever hear someone say “I cannot wait to do that someday; that Nurse Manager role looks like fun.” Managers are overworked, stressed, and generally overwhelmed. And they are one of the few leaders in healthcare that interface daily with every key stakeholder; so take care of them! Prioritize supporting, coaching and mentoring these individuals. Here are a few ways to transform the Nurse Manager, and try to make it fun.

1. Encourage Unconventional Ways (FUN) to Get Nurses/Staff Excited
Encourage your Nurse Manager to recognize excellence in nursing practice when she sees it in her unit. We’re not just talking about higher HCAHPS scores, actual real-deal fun! Sure managers attend lots of meetings, fill out forms, audits, and have to spend time at computers. But make sure the Nurse Managers main role is being the leader of the clinical practice of the unit. Put FUN right into their job description.

What if your manager spent just 15 minutes a day asking a nurse about a patient story to give recognition, or even advance inspiration? Encourage managers to find the great stuff the staff does and then take time to brag about it. Examples could be creating a Spirit Award or a Nurse-only meeting where they can discuss/laugh/or even sing about experiences. Bring in a karaoke machine, pizza, organize white elephant gifts, ugly team trophies, and get bedside nurses into department newsletters. The Nurse Manager sets the tone for the unit, so her actions will  resonate and encourage others.

2. Prepare your Charge Nurses to be Leaders
Trained and prepared Charge Nurses are very beneficial to Nurse Managers, who appreciate and value having a trained team to work with. Trained Charge Nurses know how to lead and delegate, solve smaller unit issues, and act as second set of eyes on busy, chaotic units. They can be on the alert for any patient safety issues, and trained Charge Nurses lead to improved patient/staff satisfaction, reduced nurse turnover, improved quality, and improved strategic outcomes. When you have a team of prepared Charge Nurses, it’s not just tasks that get performed better, it is a culture change. Communication improves, inappropriate behavior is addressed, and Charge Nurses better understand their roles as educators.

NCharge®: “Nurses Learning to Lead” offers classes like Charge Nurse Fundamentals, Supervisory Skills for Positive Outcomes, and Critical Thinking Skills for Charge Nurses which will help prepare your Charge Nurses.

3. Effective Nurse Manager/Unit Staff Relationships and Priority on Staff Development
Encourage your Nurse Manager to partner with their front-line staff to achieve quality patient outcomes. Make sure they are ready to collaborate with front-line staff to develop solutions to the challenges the unit is facing, and have time to coach and receive front-line staff feedback on patient care issues. Ask staff what matters most to them? Do they find meaning in the work they are doing? Performance coaching and feedback to the staff is essential to building trust. If your Nurse Manager is over-worked or overwhelmed it is important to assess priorities and provide support for time off. The staff will reflect what they are seeing in their leaders.

4. Fair and Manageable Workload/Work-life Balance
Check on your Nurse Managers to gauge their life Zen! Check to see if they are equally satisfied with their work and non-work lives. See if there is a perception of even distribution of work among peers, and adjust if necessary. Keep the number of direct reports to the Nurse Manager role at a manageable number.

5. Adequate Budget/Resources
Make sure your leader has access to information, finances/financial knowledge, and IT that is available to perform work functions. Also make sure there are sufficient human resources and supplies to meet operational demands. Manager Inclusion in the budget development process is critical. Additional tools may be needed to teach the staff about how the decisions they make impact the overall success of the unit.

6. Culture of Meaning and Excellence
Discuss with your Nurse Manager how the organization’s mission and vision are evident throughout the entire hospital/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.

In your organization, do administrative leaders value the contribution of nurses and managers? In great organizations, nurses and managers have a voice in organizational policies, and feel empowered to act.

7. Learning Context
If you are a leader of Nurse Managers, create a blame-free environment with established lines of responsibility and accountability. Work with your managers to create an emphasis on proactively identifying system flaws and acting to fix them. When errors do occur, focus on identifying the system errors rather on identifying individuals to blame. One way to do this is to push nurse administration to encourage creativity and innovative solutions to problems. Give managers some flexibility to try new processes in patient care without fear of negative repercussions.

8. Constructive Relationships with other Leaders
Make sure Nurse Directors have a relationship with the Nurse Manager that is based on mutual respect and accountability. Make sure there is constructive performance feedback which helps the manager grow and develop. Do not micromanage 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 can be built.

Also be sure that your Nurse Manager has collegial physician relationships. Nurse Managers and physicians partner to achieve quality patient outcomes. Talk with your manager 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.

9. Socialization and Education
Make sure your Nurse Manager has had a proper orientation and is prepared. Find ongoing and accessible professional development to equip these leaders with the necessary knowledge and tools.

For a long time, hospitals have promoted the best clinicians into these roles with minimal “leadership” preparation. A good clinical nurse with leadership potential can go home on a Friday, come to work on Monday as the new Nurse Manager, and we expect that something has occurred to transform her into a leader during the weekend? Unfortunately, it doesn’t work that way.

So be intentional about how to cultivate, onboard and grow leaders in organizations! It is more important than just preparing your future leaders, it also has hospital implications – there may be no other role in the organization that is better suited to know the complexities, decision making, and impact of the decisions at the bedside than the Nurse Manager. Using some or all of these strategies will help road map a better future for today’s stressed-out Nurse Manager.

Article is a brief summary of “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