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Path to Management

More than ever, nurses have the opportunity to move beyond the clinical setting into leadership roles

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Desire and attitude. That's what Angeline "Missy" Pratt, MHA, RN, CNOR, assistant vice president of perioperative services at Georgia Health Sciences Medical Center, Augusta, GA, believes it takes to succeed as a nurse manager.

"It's one thing to see an opportunity, but it takes desire and a good attitude to step in and be successful," explained Pratt, who noted that today's nurses have much more options than they did when she finished training more than 45 years ago.

Because nurses can specialize in myriad areas, a nursing degree in this day in age can be a springboard into numerous careers, both inside and outside the hospital setting. Therefore, nurses should be on the lookout for opportunities and be prepared to take them, she said.

Climbing the Clinical Ladder

There seems to be growing interest in having nurses be more than just a support team on a hospital floor, believes Angela Groeteke, RN, CCM.

"Management opportunities are an excellent growth opportunity that benefit the nurses - and their healthcare organizations," she said.

In Groeteke's experience, nurses have an innate ability to do two things very well: analyze and assess conditions (health or otherwise), then communicate and collaborate.

"This mix is a natural ladder to a management role, and the executive suite," said the vice president of clinical operations at Eagle Hospital Physicians, which has headquarters in Dallas and Atlanta.

What makes nurses aspire to those roles? Perhaps they want to advance their careers beyond the clinical setting. Or, they may be in a place where they need change - and want to effect change, or just balance skillsets, said Groeteke, who provided case management support for a large multi-specialty physicians group prior to her current role. Before that, she served as a catastrophic case manager for a health insurance company.

Groeteke describes her career path as typical: a focus on being a top-quality registered nurse who emphasizes caring for people and making a difference within a clinical setting.

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"My career change deepens my level of experience - and my skills. I still get to work within a hospital and help nurses and related teams accomplish their goals, plus I've grown my business experience to understand a hospital's financial, operational and administrative issues," she said.

Pratt's path to management was a bit more circuitous.

"During the first 12 years in nursing, I was in management for 7 of those years - then left to explore other opportunities, because I didn't want to look back and think "I wish I had ..."" she recounted. Pratt worked in medical sales, then computers, and, later, network training. "That led me back to healthcare in 1991, where I was able to incorporate marketing, technology and nursing skills into various leadership roles, including my current position in perioperative services."

Pratt currently manages the perioperative service line, incorporating the skills she's learned in nursing and other management roles to improve the patient experience.

Key to Success

Groeteke said success boils down to "if you talk it, walk it."

"It requires leadership and living by example, communicating effectively and collaborating. It also requires an individual commitment to learn, listen, motivate and encourage others - and to be patient," she stated. "Success also requires a consistent commitment to honing your clinical skills, and to leap off the ledge - learn new skills that can advance your career."

She commented that one can't succeed without knowing their target. This requires setting goals and ongoing accountability.

Sandi McDermott, DNP, RN, NEA-BC, associate CNO at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford, Bedford, TX, believes the most important key to success is finding a strong mentor who is deeply passionate not only about nursing, but about people.

"As the facility ACNO, it is my responsibility and my passion to mentor nurse managers in their current roles as managers, to encourage and support them as they pursue educational growth, and to mentor staff nurses and students in nursing leadership," she said.

Clareen Wiencek, PhD, RN, ACHPN, ACNP, added two more keys to succeed in a management role: leadership and team.

"Leadership that does the right thing so staff members become bigger and more valuable. Team because, to be successful in a management role, someone has to have your back," explained the nurse manager/clinician at Thomas Palliative Care Unit Massey Cancer Center, Virginia Commonwealth University Health System, Richmond, VA.

Wiencek, who also serves as a director on the national board of directors of the American Association of Critical-Care Nurses (AACN), has practiced in a variety of acute and critical care nursing roles.

"I've followed an integrated path focusing on palliative care that has been driven by the American Association of Critical-Care Nurses' vision of healthcare driven by the needs of patients and families," she said, noting she's been able to do this because of the support she's received through AACN as her chosen professional organization.

Born vs. Made Leaders

The increasingly regulated environment of healthcare is today's most significant challenge, Wiencek observed.

"But it is offset a hundredfold when one experiences firsthand the growth and empowerment of nurses at the bedside," she acknowledged.

Pratt put the challenges of nurse management into perspective, saying a bad day is not the rest of one's life.

"Always remember, you can go home, sleep on it, then come back the next day with the attitude that it will be better," she said.

Sure some nurses are better able to handle the demands of nurse management, but why? McDermott believes some nurses are naturally drawn to and excel at leadership roles and responsibilities. On the other hand, many leaders are driven by the joy of learning and a passion for higher education, she said.

"There is no magical formula, and it often depends on the situation," Pratt responded. "Becoming successful in your leadership decisions is not always easy. You frequently deal with negative situations and you have to figure out how to turn that negative into a positive. I think the best leaders are those who are able to dialogue with their team - and include patients and families, too - and work together for solutions."

Groeteke noted born leaders have an innate vision of their destiny and direction, and drive themselves to leadership, while others see opportunities and make their way to leading initiatives, projects and people.

"Leaders are made when someone ahead of them reaches out with the generosity of help and support along the way. Leaders are born when they dare to stand up for what is right, even when they find themselves standing alone," Wiencek concluded. 

Beth Puliti is a frequent contributor to ADVANCE.




     

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