A career as a nurse manager is tough. Juggling budgets, addressing institutional finance goals, maintaining staffing, building a schedule and learning how to influence patient outcome (while being one level removed from direct patient care) can feel like overwhelming challenges.Pam DeCampli, RN: “Usually managers feel so overwhelmed because they have 20 tasks or 20 projects coming at them all at the same time. Deciding the priority is the first step that I usually take with them.”
Pamela DeCampli, RN, MSN, NEA-BC of Kirby Bates Associates, coaches nurse managers as they hone their skills in a daunting role. She spends an average of six months with an individual manager, providing support and education through weekly or biweekly communication. She also acts as a confidential sounding board. I spoke with Pamela about the challenges nurse managers face and she doled out tips for making their jobs more, well, manageable.
What is the biggest challenge faced by nurse managers now?
What they’re up against day to day is really about putting together the pieces, organizing their time and perspective and understanding the financial picture. Because that’s the real challenge for managers right now, particularly in light of value-based purchasing, which means that you don’t want a patient readmitted within 30 days of discharge or you don’t want skin integrity issues, etc. If you do have a patient readmitted within 30 days of discharge, you don’t get paid for that. And they call that value-based purchasing, which is really a misnomer. It’s not the intent of what the title lends itself to.
What can institutions do to set their nurse managers up for success?
Stay on track with the nurse manager during their first year to two years. Make sure that there’s that communication from either their superior or if it’s delegated to somebody in organization development; that they have meetings, maybe quarterly, that are just dedicated to “OK, this is not about operations or expectations, this is about HOW are you doing. How are you feeling about the progress that you’re making in your role? What do you feel competent and comfortable with and what is it that you still think you need assistance with?” And they’ve got to give feedback and say, “This is what I’ve observed. I think you still need some assistance with XYZ. How can I help you with that and are you feeling the same?” It’s validation.
Are you a nurse manager who feels overwhelmed? Some practical tips from DeCampli
- Get support: It’s really important for you to develop a relationship at work where you can get support at a peer level. And that you identify with somebody who you feel comfortable with, who you would say is your friend at work, that you could go to if you had one of those situations that you didn’t feel comfortable asking a superior or you didn’t want your subordinates to know that you didn’t know the answer when you should because you’re their leader.
- Circle back: Sometimes you think everything is running OK, but you need to do a spot check every once in a while to really validate that it is, indeed. We start programs or we implement change and then we forget to circle back just to do a “touch base,” to see whether we actually did affect the outcome or get the results that we wanted.
- Try the parking lot theory: You have to figure out what you have control over. Park the task or project that you’re working on in the “quadrant where you have control.” And park what you have no control over in another area of the parking lot. Because if you don’t have control over it, chances are you’re not going to affect a change or the outcome. So why are you spinning your wheels on it?
- Choose priorities: Usually managers feel so overwhelmed because they have 20 tasks or 20 projects coming at them all at the same time. Deciding the priority is the first step that I usually take with them. “So out of these 20 things, what are the priorities, and you can focus on no more than two or three.” And sometimes they don’t know. They’ve got to drill down, “OK, who is the owner of this task or project? Is it you, is it your boss, is it your peer, is it the healthcare system? And how are you a part of that? And then what are the pieces that you need to deliver?” Sometimes we need to distill it down to those little pieces and then build the picture around those issues or topics or tasks.
JOIN THE DISCUSSION: What is your biggest challenge as a nurse manager?