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Tips for New Nurse Managers

Learn seven ways to make your transition into a new management role a smooth one.

When being promoted into new positions, only 24 percent of the respondents to a recent Institute for Corporate Productivity study rated their organizations as "good" in terms of helping making the transition from individual contributor to manager a smooth one.

There is no doubt the move from clinical practice and bedside nursing to management represents a significant change - and requires different skills. Here are seven tips for new managers that can help make the transition a smooth one.

1. Get to know - and establish relationships with - the key players
Patricia Frasca, RN, is clinical operations lead for Advanced ICU Care in St. Louis. "One thing that's important is to know who your go-to people are for advice," said Frasca -particularly HR resources. "You need to know who you can rely on to help mentor you."
Lisa Boesen, PHR, agrees. Boesen is principal of Talent Innovations Group Inc., in Houston, and has experience as an allied health clinical manager, HR management and organizational development."

In addition to getting to know and nurturing relationships with go-to people, Boesen advises new nurse managers to never hesitate to use these internal resources. New managers sometimes have a sense they need to know it all - they don't. "It's better to use their experience and talent as problem prevention, rather than problem management."

2. Set clear guidelines and expectations up front
Successful managers will have a vision for their units, said Boesen. How do you see your unit aligning with the business objectives of the hospital? "Set aside time at team meetings to collaborate with your team on a vision and steps to accomplish this vision," she suggested. Then work with the team to identify their areas of contribution and establish clear expectations. That is foundational work. Gaining commitment and agreement from your team to team objectives provides a framework for the evaluation of progress - and individual contributions.

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Tina Selvey, RN, is nurse manager of a cardiac ICU at Ball Memorial Hospital in Muncie, IN. She has been in this role for 2.5 years and has worked at Ball for 13. Selvey moved from a staff nurse role into a management role and said "that came with a lot of challenges because I was a peer to the people in my unit and then stepped in to be their leader." Her tip for others who find themselves in this position: "Hold people accountable - it can be really hard, but it's important."

Selvey pointed out that holding team members accountable to team and individual goals is critical. It can be tough, she said, particularly for those who come, as she did, from the ranks of those they now manage. But, she noted, "I've learned, in time, that holding people accountable actually gains you respect."
3. Know your staff
Management is all about communication and connections, noted Frasca, who stresses the importance of getting to know staff members well. "If you can relate to them on a personal level it really does help," she said.

In addition, said Boesen, managers need to have a clear understanding of the strengths, weaknesses and opportunities for each of their team members. "Assess your team objectively," she said. "Determine strengths and areas for improvement."

4. Accept ambiguity
The job of a manager is rarely the same from day to day and it lacks the sense of closure nurses may be comfortable with as bedside nurses.
"You do not have closure because nothing ever really ends," noted Frasca. "That's not a bad thing," she added, but says it is something that takes some getting used to. "It comes with time."

5. Watch your attitude
Managers truly set the tone for their staff, said Frasca, and need to maintain a positive, upbeat attitude. "Remain positive and show that you are a team player," she said. "Even if things are crashing around you, you need to maintain composure because you're the role model for your staff."

6. Get comfortable with policies, procedures - and the numbers
People skills are important, but managers also need to be comfortable with policies, procedures, facts, data - and numbers!
"You need to know the policies and procedures better than anybody because you need to be a resource person and you lose credibility if someone comes to you with questions and you don't have the answers," said Frasca. She acknowledged there will always be "gray areas," but added that, in those cases it's important to know, again, who the go-to people are.
"Probably the biggest challenge I had - and it was kind of unexpected - was the budget part of the job," said Selvey. "I'm a bedside nurse, not a businesswoman! It was pretty shocking to come in and realize I would be responsible for this multi-million dollar unit."

Training offered through Ball offered immensely here, she said
7. Take advantage of training/educational opportunities
Don't expect yourself to know it all - and don't hesitate to take advantage of the broad array of training opportunities available through your organization, associations, community - or online.
Those new to management or interested in moving into management, suggested Boesen, should "research the nursing leadership competencies from the American Organization of Nurse Excecutives or Nursing Leadership Institute.

Selvey is grateful for the educational and training opportunities offered at Ball and said these helped her immensely in moving into a management role. Selvey was able to participate in the Nurse Manager Academy, which involved interactions with department leaders, HR, finance, etc. "They helped to mentor us and gave us tips and guidelines on what was expected in our role to help us be successful,' she said.

Frasca also recommends taking advantage of as many management classes - and communication classes - as possible. "You're constantly talking with people and you need to be able to come across in a positive manner at all times,' she said.

Ultimately, said Frasca, remember managing is a team process. "A good manager knows she is only as good as the people who work for her," she said. "I've been blessed with having good people."

Lin Grensing-Pophal is a freelance writer in Chippewa Falls,  WI.

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General questions for fellow managers:
I have a nurse who changed the language on a ventilator. The change lasted for a few moments. No settings or numerical read-outs changed, nor did the ventilator alarm during this episode. The patient's mother noticed the change and complained. I have done service recovery with the mother, but what should I do with the nurse?
I have verbal warnings, written warnings, (DML) Decision making leave, or termination. OR should I coach the RN?
What do you think the appropriate measure should be.

Chris F,  RN,  UCMCJune 08, 2015
Cincinnati, OH

This is my first time to open this site and im glad and happy because what i read is very helpful since im a new head nurse in a satellite clinic of EHL group here in Dubai, UAE. Thank you for posting this article. I hope i will be updated through my email regarding this site.

Suzette Bongat,  Head Nurse,  EHLAugust 17, 2010
Dubai, UAE

I have been a nurse manager,a charge nurse, staff nurse and an informal leader. I have thru my BSN established myself administratively in the nursing field. I have worked as an independent nurse completing Health assessment,teaching CPR and skin care. I love all that aspects that being a nurse has to offer. I am currently applying for RN jobs on careerbuilders and have sent been on interviews where I am more qualified. I am willing to do any nursing job. What I find that emplifies being a good nurse manager is someone who has done the job of her peers that she is expecting others to do. I feel too much emphasis goes into with someone is certified versus experience. I enjoyed the article and thank you very much for writing it.

Carol Anaski-Figurski,  RN BSN,  TBDJuly 14, 2010
Oswego, IL


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