Greetings,

I been approached by my old director to be a Unit Manager at a HCA facility in Houston, TX. My question how is it working as a nurse manager for HCA, how much is the pay, and if it was a great job to have? Right now, I work PRN as a Tele nurse and I work full time as a clinical liaison.

Also, if you have worked as a Nurse manager in Houston, TX at other facilities, tell about your experience. I am interested in being a Nurse Manager, I just want to make sure it is the right decision at this time and opportunity.

I cannot provide specifics on salary, but you should not accept anything that is not in the mid 80k range for this position. More important than salary is -- will they provide you with training and support for your new position? Management requires an entirely new skill set. Without adequate preparation, you will be set up for failure. Also, ask about 'pay at risk' bonus schemes... this can (theoretically) add to your salary, but not if the goals are unreachable.

You may also want to delve into some details about the current status of the department. If it's a train wreck, you deserve the truth. What are the HPPD (hours per patient day) for the department? Where are they at, budget-wise? What is the turnover history? How many nurse vacancies? How much time does it take to fill a vacancy? What is the tenure of the current staff? Any significant quality issues? HCAHPS status? What is the level of education support - is there a unit-based educator?

You'll also want to know the specific expectations for the role, as this can vary significantly from one organization to another. Are there any subordinate leader positions such as permanent charge nurses? How many direct reports? What is the performance evaluation process? (this can be a fearsome task, particularly if they all have to be done at the same time each year) How are unscheduled staff absences (call in, no-show, etc) managed ..... are you expected to work if coverage cannot be found? What are the department staff meeting requirements? What scheduled reports are required? How are budget variances handled? If you are expected to do an in-depth variance analysis & develop an action plan each month, this could be a game-changer.... particularly if you are dealing with an unrealistic budget.

We need more savvy & effective nurse leaders. Don't be afraid to make the leap -- but do it with your eyes wide open.