Who’s the Boss?

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Your former colleagues now report to you. Your new peers are your former superiors. You’re spending less time at the bedside and more time in management meetings. The excitement of a promotion and all of the new opportunities-personal, professional and financial-that come with it, can be quickly tempered by the realities of new expectations and new challenges.

Debra Yergen is the author of Creating Job Security Resource Guide (Yergen & Co., 2008). The skills for being a great nurse and those for being a great manager are quite well aligned, notes Yergen. According to Yergen, individuals hoping to become truly great nurses should:

1) Be flexible and able to adapt. “Things change constantly in health care, from the patient’s condition to the natural evolution of medicine,” said Yergen. “Nurses need to adapt to these changes.”

2) Yearn to learn. “Every day, new therapies, modalities and technologies are introduced and health care specialists need to have personalities that embrace opportunities to improve the patient’s experience and prognosis.”

3) Embrace research and new developments. “To ensure patients receive the best care available, nurses, doctors and medical specialists need to be open to implementing new treatments.”

4) Love people. “Patients who are sick, aren’t always kind to hospital staff,” admitted Yergen. “It is important to give excellent, empathetic, non-judgmental medical care, no matter who the patient is or what the circumstances may be.”

5) Value teamwork. “Sometimes the best help comes from another source-you have to care enough to say, ‘If I can’t help you, I’ll find someone who can’.”

Yet, while many of these qualities translate into a supervisory role, others don’t. “For instance, someone who is compassionate, empathetic and completely non-judgmental may have a difficult time enforcing hospital policies or reprimanding someone who is continually late,” she says. “Sometimes ‘loving people’ can translate into making excuses for bad decisions and supervisors who do that can end up putting their facilities at risk.”

It is critical for nurses who wish to move into supervisory roles to be able to demonstrate that they have the “capacity to compartmentalize people and issues and segregate long-time personal relationships,” said Yergen. “When we’re at work, I’m your boss-when we’re outside of work, I’m still the friend I’ve been for 20 years.”

What to Expect

Lillee Gelinas, RN, MSN, FAAN, is vice president and CNO at VHA Inc., the national health care alliance. Gelinas agrees that the skills sets for clinical and management nurses are very similar and revolve primarily around “people skills.” Succeeding in a management role, she related, “requires being collaborative, building effective teams, being politically savvy and being able to migrate across the different issues in the organization.”

Critically, she noted, nurses transitioning into supervisory roles need to be comfortable dealing with paradox. “As a manager you may have to confront some conflicting situations,” said Gelinas. “What’s best for the organization might not be best for the unit that you’re managing-learning to deal with paradox is extremely important.”

Heather Fleming, RN, a new house supervisor at Aurora St. Luke’s Medical Center in Milwaukee, agrees and noted that, for her, one of the biggest challenges in transitioning to a supervisory role is a shift in perspective from focusing on the needs of a specific unit, for example, to taking a much higher-level, organization-wide, point-of-view. “When you transition into a role like this, it gives you a greater perspective,” said Fleming, who assumed her new role in November. “It’s a mind shift-you have to work more inter-departmentally.”

Fleming says that the ability to ask good questions-and then really listen to the answers is critical, in nursing and in a supervisory role. Those in supervisory roles will inevitably need to make tough decisions, Fleming said. It’s important that those decisions are based on facts. “You need to be well-informed. You need to hear all sides of an issue. Sometimes people jump to conclusions or can only give you part of a story-you need to dig to get all of the information you need to serve everybody the best you can,” she advised.

To this end, she recommends getting to know who the best sources of information are. “Know your resources-make copious notes about who you can call in what situations,” she suggested.

Certain requirements of a supervisory role present inevitable challenges – learning to delegate; learning to provide effective feedback (positive and constructive); learning to evaluate, hire, coach and develop others, etc.

Fleming says that she was fortunate to have been involved in two development opportunities through Aurora that provided her with valuable preparation to assume her new role. One-a leadership academy-was a 16-month program that provided classes on a variety of leadership skills, as well as the opportunity to interact with senior leaders. The other-a management fellowship program-provided an opportunity to be matched with a mentor for a year to learn about the realities of leadership from someone in the role.

But not all are so fortunate to have those opportunities so readily available to them. Still, even in organizations without such programs, there are opportunities to gain valuable knowledge.

Where to Look For Help

A good place to start that may not immediately come to mind is with your organization’s nurse recruiter. The person in that role is generally part of the human resource department and has a high level of awareness of the skills and competencies necessary to succeed in supervisory roles. “They’re frequently one of our best resources,” said Gelinas.

“It really is a matter of being a self-starter and not waiting for someone else,” said Gelinas. There are tough times for nurses, she admits, and they have become tough very quickly. “I’m unfortunately seeing an awful lot of nurses being laid off,” she noted, adding that the situation seems less grimfor those with four-year nursing degrees. In addition, she added, new Magnet standards emphasize the need for nurses at certain management levels to hold this degree.

To that point, she added that tough times can present an opportunity for nurses who need to further their educations. “Seize those opportunities that look like lemons and turn them into lemonade,” she suggested, noting that while the cost of training will obviously be a concern, that scholarships are available.

Spending development time strategically is also important, she noted. “If we spend a lot of time doing online courses or CEU types of activities that don’t count toward a B.S. in nursing if we don’t’ have one-wow!- that may not have been time well spent,” she pointed out.

Don’t be hesitant to call upon the advice and experience of others, Fleming stressed. She has learned to leverage the wisdom and experiences of those who have gone before her. “One of the biggest helps for me has been listening to my coworkers’ stories about different situations and how they’ve handled them. Just hearing about how they’ve problem-solved and the steps they’ve gone through has been a good learning experience,” she said.

Ultimately, the preparation, persistence and bumps along the way, are well worth it, said Fleming. “Every day will be different – every day will be a challenge – but in a good way.”

Lin Grensing-Pophal is a freelance writer and frequent contributor to ADVANCE.

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