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Move up to the role of nurse manager – American Nurse

Today

Move up to the role of nurse manager 

March 2011 Vol. 6 No. 3

 Author: Pamela F. Cipriano, PhD, RN, FAAN, NEA-BC

NURSE MANAGERS at all levels work together to address emerging trends, adopt innovative ideas,

and work toward the shared goals of quality, efficiency, and excellence in practice. They guide and

lead frontline nurses while contributing to an organization’s success.

Some of the most rewarding experiences happen on the front lines. The nurse manager is

responsible for nursing practice and quality of care among frontline nurses or nurses in a single unit

or department—as well as overseeing all personnel and budget matters and creating an environment

that supports professional practice and employee engagement. Traditionally, head nurse  was the title

assigned to the frontline manager role. Today, nurse manager   or director   is more common.

Nurse managers straddle the worlds of staff and middle-upper management, ensuring a two-way flow

of communication. They translate and promote organizational goals to frontline staff and remove

barriers that could hinder their performance. Managers must keep pace with current advances in

care and technology as well as regulatory and legal requirements.

Command central

Most nurse managers play the role of command central—providing support, recognition, just-in-time

information, a calm hand and cool head in emergencies, and advocacy for patients, families, and

staff. They also have an opportunity to encourage personal development and professional growth

among staff. Above all, managers see the impact of the care their nurses provide and its effect on

patients and families. Managers set the stage and expectations for excellencein caring, optimizing quality, and a “just culture”—one that doesn’t hold practitioners accountable for 

system failures but that doesn’t tolerate reckless behavior. Nurse managers instill hope and

determination for teams to do their best work.

The larger the organization, the greater the need to ensure a unified approach to staying focused on

achieving goals and objectives. Directors or administrators responsible for more than one department

take a systematic approach with managers, providing clear expectations and direction so staff know

their roles and accountabilities.

Beyond nursing

Nurse managers may be responsible for personnel in other disciplines, not just nursing. In many

settings, teams consist of nurses, assistive personnel, social workers, therapists, technicians,

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teachers, fiscal and front-office staff, chaplains, pharmacists, and others who contribute to patient

care. Nurse managers also interact with ancillary staff who care for the environment, provide

nutritional services, maintain physical facilities, and support the nursing staff in care delivery. Nurse

managers have the skill and breadth of experience to manage

complex operations as well as diverse personnel.

Together with frontline managers and clinical leaders, nurse management teams help set the

organization’s direction and goals. These teams strive for consistent practices and accountability

across an organization. Together, the team sets goals to support the overall direction of the

organization, encourage and monitor performance at the unit or department level, and evaluate

results that build across the organization.

Nurse managers may choose to advance to a nurse executive role. The executive is responsible for 

practice, fiscal matters, strategic planning, advocacy for human resource issues, promoting

professional achievement, and assuring an environment that supports clinical excellence. Serving as

liaisons, nurse executives partner with multidisciplinary colleagues, set the vision, and serve in a

leadership capacity for the organization as a whole. They also act as external ambassadors and

establish collaborative relationships with the public, lawmakers, academic partners, and other nursing

groups.

Look for stepping stones

If you’re interested in becoming a nurse manager, look for ways to add supervisory responsibilities to

your role; these can be stepping stones to a management position. Specific education inmanagement helps prepare you to handle the legal, fiscal, planning, direction, and control functions.

For nurse executives, graduate education is a must in the view of the Joint Commission. For a top

nursing position in an accredited organization, you’ll need a master’s degree. (See How much do

nurse managers make?  by clicking on the PDF icon above.)

 As a nurse manager, you’ll serve in a highly rewarding multidimensional role, reaching patients,

families, staff, and professional colleagues. But you may have to make sacrifices; managing people

can be stressful and challenging. Dealing with staff recruitment and retention, resource competition,

and relationships always creates dynamic tension. But with greater attention now focused on

transforming nursing care and the profession for the future, this is an exciting time to consider a

career in management.

Selected references

Cathcart EB, Greenspan M, Quin M. The making of a nurse manager: the role of experiential learning

in leadership development. J Nurs Manag.  2010;18:440-447.

Espinoza D, Lopez-Saldana A, Stonestreet J. The pivotal role of the nurse manager in healthy

workplaces: implications for training and development. Crit Care Nurs Q. 2009;32(4):327-334.

Hader R. The compensation tumble. Nurs Manage. 2010;41(8):26-31.

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Kirby KK. Are your nurse managers ready for health care reform? Consider the 8 ‘Es.’ Nurs Econ.

2010;28(3):208-211.

Kleinman CS. Leadership roles, competencies, and education: how prepared are our nurse

managers? J Nurs Adm. 2003;33(9):451-455.

Perrotto A, Grossman MB. Ten ways to the top. Nurs Manage. 2010;41(4):28-32.

Pamela F. Cipriano is Editor-in-Chief of American Nurse Today and Nurse Scholar-in-

Residence at the Institute of Medicine in Washington, D.C.