The number of nursing managers today is one to shake the entire medical profession to its roots. Their numbers have increased over the years, and they are about to make effects in the medical field to further enhance their own progress and the progress of the medical profession at the same time. The 300,000 strong nursing directors epitomize the largest section of the healthcare management workforce. This shows that they are dominant in the medical sector in terms of numbers, as this can also be seen when one is in the hospital. The number of nurses is always more than that of doctors. But besides having these numbers, they have been overlooked in their potential to positively affect the clinical results and strategic goals, by the healthcare organization for years. Not only is this demeaning, but it is also not right in any way. These nurses are equally as important as every other medical personnel present in any medical facility.
The vice president of patient services at the Cincinnati Children’s hospital Medical Center, Cheryl Hoying, RN, Ph.D., NEA-BC, FACHE, FAAN, says that things are changing. She also stated that if things are not changing, then change must be instilled for nursing directors. This is to ensure that the nurses can tender their take on any medical consensus debated on, to ensure effective performance and convenience. She added that if things are not appearing to change, then everyone should be rest assured that it would definitely change in the future. It was obvious that the nursing managers were poorly treated and underappreciated. The nursing managers worked under stressful conditions, and received no support to ease them of the stress they faced at work and ensure they were able to perform effectively.
She urged the CNOs to ask themselves questions such as “what are the supports that nurse managers need to be resilient in that role?” Questions like this spur the entire nursing field to think deep on how the nursing managers work extra hard, just in order to receive the support they need. This was asked in order for them to portray more seriousness and get effective results from properly communicating their needs.
To receive the support stated in question, many have given their suggestions on how to effectively getthe support of the leaders, both individually and collectively as a whole unit.
She concluded that the following reasons are to be considered in order to properly and effectively show support:
Making Management Manageable
One thing the nursing field lacked was the adequate number of nursing managers, if there was any. The nursing directors faced a lot of stress handling the unit. This affected them in several ways and caused them to work extra hard. Hoying stated that the leaders should evaluate the expectations they might place on the nurse managers in this area. She stated that she discovered a trend that troubled her about the nursing directors in her organization, about seven years back. In her words, “What I am seeing was all the directors getting out of here at 7 or 8 o’clock at night and not being able to get home in a timely manner.” This indicated that the nursing directors were overworked and received no assistance in any way to relieve them of the strenuous duties they had to carry out on the daily basis.
This pushed her to approach the CEO to get something done about it. She laid her complaint about how the nursing directors had to work overtime to get their job done, stating how stressful their job was and how they received no support in any form. She got the attention of the CEO and was able to successfully change the order of the way the working conditions were for nursing directors. The case was to add nurse managers to support the nurse directors. This would make sure the managers, as well as other nurses, are assisted and managed properly for effective performance. A new order was implemented by the organization that a ratio of one manager to twenty-five FTE was to be in place. This depended on the number of employees present in the unit. The number of employees had a proportion ratio to the number of managers they would receive. Therefore, a unit of 50 staffs would have one nurse director and one nurse manager. In a unit of about 75 staffs, there would be one nurse director and two nurse managers.
Working with the given ratio, it would be easier to work with all the staff and carry out all the educational stuff that is required with the staff, and the other way round too. This gives the nursing director some breathing space, in order to carry out the activities he is required to with ease and with speed. It also gives room for the nurse manager to also be successful, and carry the full responsibilities of the role. Having huge amounts of direct reports would not be an uncommon situation for the nurse managers, and this is something they should be able to handle properly and effectively. On the other hand, the leadership is considering if the practice is going to favor the nurse managers or is in their best interest. This because the number of people each manager is responsible for might be a deal breaker. In a scenario where a nurse manager is responsible for about a hundred people, and receives a report to do an evaluation on each of the people he or she is responsible for might be problematic, how does one start to do individual evaluations on a hundred people?
The only solution for any nurse manager is to have a good and realistic foundation with each of the people he is responsible for, even before he is educated on it.
Development of Leadership
One major benefit of the ratio is that it allows room for development of leadership skills, for both the nursing directors and nursing managers.
Hoying said, “That was really the foundational piece, making sure that we built in the opportunity for that director to go to different things and to attend sessions and help mentor and grow that nursing group that is coming up in the ranks.”
Another advantage of this ratio method is that it gives room for a strong clinician to get promoted to management position without any previous training. She said of the manager/director structure that “this way they are learning budgets, they are learning HR issues, they are learning how to mentor others. They are learning as they go and they have twenty-five employees that they are helping along.” Provision of this type of support is not only of benefit to the nurse managers, but goes a long way of benefiting the staff nurses, patients and the organization.
She said, “It is our job as leadership to make sure we have got the right resources so that they are successful and they are going to enjoy their role. Because when that role turns over that affects everyone in the unit.”
This is to emphasize that the role is a delicate one and must be handled in the most proper and efficient way possible to ensure that the people being responsible for are not negatively affected.