Nurse manager making schedule

Transitioning from Staff Nurse to Nurse Manager

Rome wasn't built in a day; neither can a truly effective nurse manager by made in a day. Yet professional training for management-bound RNs is seldom comprised of more than a few disjointed days and/or weeklong development seminars. Such training is valuable but, by itself, inadequate. A systems-oriented management training approach, in which seminar-based education is just one of several developmental tools, ensures a smoother transition and produces more effective, more satisfied professionals who are more inclined to stay with the organization that helped their career growth.

No Easy Place to Be

In an industry whose expenditures are growing at two times the rate of inflation, nurse managers must master both clinical and business management skills to ensure staff retention. In terms of projected job growth, they're in the nation's fastest growing profession, which isn't surprising since it is predicted that the nation will face a nursing shortage of more than one million by 2016. Two forces new to their industry--globalism and consumerism--are rising simultaneously and converging rapidly. Simply stated, nurse managers work in a maelstrom and traditional preparation leaves them woefully unprepared.

Effective leaders in any industry must communicate with their staff, manage stress, make decisions and handle power wisely. Additionally, managers must acquire and cultivate skills such as financial and change management, cultural literacy and personnel development and evaluation. Neither traditional nursing training nor mainstream management training effectively prepares nurses to transition from staff to management. Non-nurse instructors struggle to help nurses contextually understand their new management responsibilities. Moreover, offsite courses can rob nurse managers of the chance to learn in their actual environments.

Developing Nurse Managers--Systematically

In some ways, the transition from staff to management mirrors the transition from student to staff. Both involve moving from a simulated, hypothetical work environment to an actual one and require new competencies. Both can lead to frustration, insecurity and heightened stress. Therefore, both require a systems-based developmental approach that includes education, hands-on experience and support. But that's where the similarity ends.

For transitioning nurse managers, an ideal systems-oriented development system comprises five components:

  1. Content: Instructor-led seminars are the one and only component of most training processes, in a systems-oriented approach, it's one of several. The most effective educational materials are comprehensive, peer-reviewed "core" content reflecting current and emerging clinical guidelines and standards, delivered via interactive classroom and Web-based learning resources scaled to organizations' specific staffing and technological resources.
  2. Practice: RNs entering the management world need real supervisory experience. Constant organizational change, increasing diversity and new technology promise to continue changing the nursing workplace. Now, more than ever, interpersonal skills are success factors for nurse managers. Developing them is a hands-on, face-to-face process that calls for a combination of cooperation, commitment and action.
  3. Preceptors: Like their clinical counterparts, management preceptors guide the transitioning nurse through practice-based and classroom-setting clinical training. Because they evaluate performance, a nurse's immediate supervisor or manager ideally serve as an effective management preceptor.
  4. Mentors: As seasoned managers themselves, nursing mentors provide support to transitioning nurses emotionally, while offering career development and guidance and helping them socially integrate into the hospital's nursing community and employee hierarchy.
  5. Support groups: More than 40 percent of U.S. nurses working in hospitals reported being dissatisfied with their jobs. Torn between the many, often competing needs of patients, staff and the administration, frontline nurse managers need support from the entire organization.

Measuring to Manage

While reports abound on the nurse manager's importance in retaining nursing staff, few have studied the importance of proper management development of nurse manager effectiveness and retention. However, since you can't manage what you can't measure, hospitals need empirical data to monitor the outcomes of systems-oriented development programs. To create it, they need robust, comprehensive evaluation systems that monitor managers' performance in real-time, while informing improvements to the programs employed in their development. Moreover, if an organization is going to invest resources--human and financial--in management development, outcomes are important to demonstrate return on investment.

Bottom line? Developing and retaining nurse managers in today's complex, dynamic healthcare environment is challenging. But with a systems-oriented management development approach that combines education, practice, mentoring, coaching and support, it is possible.

Charles Krozek, RN, MN, is President and Managing Director of Versant Advantage, Inc., a leading provider of integrated, evidence-based and Web-facilitated programs that assist hospitals and healthcare organizations with strategically stabilizing their RN workforce while optimizing financial performance.

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