Welcome to our new bimonthlyManager Matters column, featuring must-know topics for new nurse leaders across the healthcare continuum.
Nurse S had been a team leader in the ED for 6 years and was apprehensive about applying for a nurse manager opening, but felt she understood the needs of the department and staff better than outside applicants. When she was notified of the decision to promote her to manager, she was thrilled and couldn't wait to get started and change things to improve patient care. Then, reality set in. With no formal leadership training and a lack of a management orientation process, many of her efforts seemed futile and she started to wonder if she was really qualified for this role. The department had been through four managers in the last 5 years, and she didn't want to be a part of this legacy. Nurse S decided to hang on in hopes of finding a resource to educate and guide her through her new leadership role.
Follow the steps
Nurse manager turnover rates sit at an average of 8.3% nationwide, according to the American Organization of Nurse Executives.1 This results in many organizations tapping into clinically strong direct care nurses to fill these vacant leadership roles. The expectation typically revolves around a misperception that nurses with expert clinical skills are prepared to lead effectively.
It's standard practice to provide orientation for novice nurses and nurses who move from one specialty to another. Yet, new nurse managers transitioning from direct care nurses to nurse leaders are often left to fend for themselves in their new role. This type of transition is challenging and difficult at best, but even worse when a nurse isn't provided any foundational leadership knowledge or skills.
If you're a new manager who falls into this transition category—or if you have a nurse reporting to you who has shifted roles from direct care staff to leader—you can take steps to position yourself for success.
1. If your organization has a nurse manager orientation program, provide adequate time for participation. Remember, it's never too late to take advantage of this educational opportunity. If orientation isn't available, take advantage of a basic nurse leadership course at a national or regional conference; some nursing specialty organizations also offer programs for new managers, such as the Association of Critical-Care Nurses. In addition, many community colleges offer management certificate programs. The basic principles of leadership are the same regardless of the industry or service being provided, so reach out to whatever resource is available to you. It's essential that time is allotted for growth and development as a nurse leader, and this should be preplanned and communicated to others, such as your manager and staff members.
2. Subscribe to literature (online or hard copy) that provides ongoing knowledge, best practices, and problem-solving perspectives for resolving common leadership challenges. Explore both healthcare journals and nonhealthcare-related sources, such as the Harvard Business Review. As mentioned in step one, your intentions may be good as the “to read” pile grows; however, unless you also allocate time to read and review, the timely and relevant content can't serve to improve your skills as a leader.
3. Take advantage of manager/leadership automated e-mail quick tips that can help keep you on target with your goals. In addition, look for professional blogs and Really Simple Syndication, or RSS, feeds from a variety of professional and regulatory organizations. Sort these into topic folders on your computer for easy future access.
4. Review your job description with your manager to clarify any uncertainties you may have during the transition process. Communicate the specifics of your role directly with staff members through e-mail, meetings, and posting your job description for staff to review. This becomes a priority for those managers who were promoted from within the department. Clearly defining your new role is essential for your former peers to be able to grasp how your relationship with them is about to change.
5. Recognize that some staff members may not be supportive of your promotion. Identify these team members early on and meet with them to discuss your expectations. Provide a comparison of your roles using job descriptions as a reference for specific expectations. Set ground rules that clearly define expectations of all staff members and send a message that their support is needed to promote safe and efficient patient outcomes.
6. Develop key connections with a network of nurses in similar positions. You can do this through nursing specialty organizations or locally through a group within your own organization. If a network isn't already in place, consider initiating one through your education or human resource department.
7. Identify a seasoned nurse leader whom you see as successful in his or her role to be your mentor. This person doesn't have to be someone from your organization; seek potential mentors from state nursing associations or nursing specialty membership groups. Some specialty organizations offer mentoring opportunities. Don't discount nurses you may know who are in graduate school seeking projects to complete their program requirements.
Create an action plan
During the transition period, it isn't uncommon for new managers to set unrealistic expectations for themselves (and for staff members, as well). The energy and desire to get things done clouds the reality of what it takes for change to occur and, more important, what it takes to sustain the change. To assist you in developing an attainable to-do list, consider the following:
- Meet with your manager to discuss departmental and staff needs and develop a priority list from this conversation.
- Using your list of priorities, identify items that need to be researched or completed to be considered accomplished.
- Develop a timeline for each item while taking into consideration your other responsibilities.
- Consider items that are appropriate to delegate to staff.
Develop a priority chart that includes time goals to assist you in planning your daily needs. (See Table 1.) Within this chart, you can include the time needed for your leadership growth and development. Integrating these elements directly into your daily calendar creates a more realistic picture.
There will always be other projects on which you wish you could spend your time, but remember it's unrealistic to expect that you can fix everything, especially while you're working to meet the other ultifaceted requirements of your job.
Be sure to communicate your plan to your manager and staff members. Their perceptions of your performance are shaped by what they see and hear, so it's essential that you define your expectations. Engage staff members in moving the department forward by including them in developing their own priority lists of things they'd like to see accomplished or changed. This can be initiated at a staff meeting and continued through a survey process. Including staff members in this process demonstrates that you:
- respect their opinions
- care about what they think
- recognize the importance of including them in decisions
- acknowledge their departmental and nursing specialty expertise.
The path to success
New nurse managers require a solid knowledge base of effective leadership practices.1 What's the sure path to success? Create a plan of action that includes engaging staff, supporting education, sustaining ongoing role development, and allotting time for leadership mentoring.