New unit manager who is not a nurse

  1. Hello my friends, I need input on this one. I have been holding the OR together for 6 months without benefit of any management experience whatsoever. Believe me, it has been rough. The hospital finally hired a manager who starts next week. However, and here is the rub, he is not a nurse. His OR experience is scrub tech. What are the implications here? I have met this man and am impressed with him, he is coming from an Indiana hospital where he has been managing an OR much like ours. He has a Master's in administration. He has told me I would continue as charge nurse, but I have yet to hear that from administration.

    How can I be managed by a manager who is not a nurse? The RN's I circulate with are all agency nurses; I have been stringent in overseeing their work, especially in light of the fact that our hospital is in deep trouble and is now a State Monitored Institution. I am over my head in my present job as manager and have been awaiting the day that a new manager would arrive. I am eager to get away from the phones and the desk and back into the rooms. But I have grave concerns about the implications here.
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  2. 14 Comments

  3. by   armyrn
    Administration is not nursing, so why should one have to be a nurse to manage an O.R.? I think it's more important for him to be an experinced and strong manager than to be a nurse. He has O.R. experience, you said, as well as management experience. Would you rather have a great leader who happens not to be a nurse, or a poor manager who dumps their workload on you and takes all the credit but hey, they've got that "R.N." behind their name? I say give the guy a chance!
  4. by   armyrn
    In case you are wondering, yes, I have been getting absolutely HAMMERED by my O.R. head nurse lately!
  5. by   live4today
    Originally posted by VictoriaG
    Hello my friends, I need input on this one. I have been holding the OR together for 6 months without benefit of any management experience whatsoever. Believe me, it has been rough. The hospital finally hired a manager who starts next week. However, and here is the rub, he is not a nurse. His OR experience is scrub tech. What are the implications here? I have met this man and am impressed with him, he is coming from an Indiana hospital where he has been managing an OR much like ours. He has a Master's in administration. He has told me I would continue as charge nurse, but I have yet to hear that from administration.

    How can I be managed by a manager who is not a nurse? The RN's I circulate with are all agency nurses; I have been stringent in overseeing their work, especially in light of the fact that our hospital is in deep trouble and is now a State Monitored Institution. I am over my head in my present job as manager and have been awaiting the day that a new manager would arrive. I am eager to get away from the phones and the desk and back into the rooms. But I have grave concerns about the implications here.

    So much for getting one's BSN to be eligible to become a Nurse Manager, huh?
  6. by   VictoriaG
    Perhaps I did not make my point clear. I am the only staff RN on the surgerical unit. I am in a small rural hospital that does 130 surgeries a month. The other 2 RN's walked out, and the agency nurses we are getting do not do PACU so an outpatient nurse and I are the only nurses in the hospital who do recovery. All Hell breaks lose after emergency cases when I am not on call, as there is usually no one avaiable to recover, and Anesthesia or an overworked ICU nurse has to do it. I would just feel more comfortable if the new manager had a license to back me up.
  7. by   Teshiee
    I agree. Management and nursing are two different ships. Manager need to manage and let the nurses do nursing! He may be the one to turn things around.
  8. by   Teshiee
    Just because a manager is a nurse doesn't mean that he or she will back you up. I have worked in units that the manager could care less if they are understaffed they are not coming in to help. Fortunately that is not too often but it does occur.
  9. by   NRSKarenRN
    Contact the state health department to see what rules they have. THAT is the group to say if this is permissable or not. Since you are so small. I share your concerns re a non-nurse OR MAnager.

    Also find out AORN's position:
    http://www.aorn.org/

    Chapter links:
    http://www.aorn.org/chapters/chpinfo.htm
  10. by   Jolie
    I agree with Karen that it may be prudent to check with the state to determine whether it is permissible to have a non-RN in this position, and what implications that will have for you.

    Many states do not permit non-RN's to have charge positions in hospital units. Since his job is at least one step up from that of charge nurse, I'm not sure how such a restriction would affect him. Will he have 24 hour accountability for the unit? By virtue of his training and experience, is he qualified to accept any clinical assignment which may be necessary in an emergency or period of short staffing? Is he qualified to circulate in an emergency? Will he be responsible for setting Policy and Procedure? By law (and hospital policy) can he sign off on P&P, or is that strictly a nursing function?

    So long as his lack of an RN license does not hamper his ability to carry out his managerial duties, and any staff duties that may become necessary, I would not have a problem working with him. But I would steadfastly refuse to accept any additional responsibilities that his training and education do not permit him to do.
  11. by   NRSKarenRN
    Travelin JCAHO site for homecare info and found this:

    JCAHO:
    http://www.jcaho.org/
    Go to site and click on standards on left bar---look at 2001 standards.
    Scroll to Standards and Intents for Sedation and Anesthesia Care
    for info applicable to you.

    Also see :Leadership

    Planning and Design of Services
    LD.1.3.2 The design of patient care to be provided is appropriate to the scope and level of care required by the patients served and standards of practice.
    LD.1.3.4 Care is available in a timely manner to meet patient needs.
    LD.1.9 The leaders are responsible for making initial appointments and reappointments, and granting or curtailing the delineated clinical privileges of licensed independent practitioners.

    Directing Services
    LD.2.1 The leaders are responsible for developing, implementing, and maintaining policies and procedures that guide and support the provision of care.
    LD.2.2 The leaders are responsible for providing an adequate number of qualified, competent staff.
    LD.2.3 The leaders are responsible for determining the qualifications and competence of patient care staff who are not licensed independent practitioners.
    LD.2.5 The leaders are responsible for determining space and other resources required for services.
    LD.2.7 The organization complies with all applicable law and regulation.

    Improving Performance
    LD.4 The leaders set expectations, develop plans, manage processes, and set priorities to measure, assess, and improve the quality of governance, management, clinical and patient care services, and support activities.
    LD.4.3.1.1 The leaders appropriately communicate information from cross-organization performance improvement activities.
    LD.4.3.2 Leaders ensure that the processes for identifying and managing sentinel events are defined and implemented.

    Check bottom of site:
    If you do not find the answer to your question, you can call the Department of Standards at 630-792-5900 or submit your question using our online form.

    Looking at the standards, how can you have a non-nurse supervising RN's? Think they would get more bang for their buck by having an RN supervisor who would also be availabe for cases too.
  12. by   Maula, RN
    With the shortage that we are experiencing, I am not surprised that your hospital has looked outside of nursing for the management position. But for you this may spell disaster. You are alone, no back-up and no one to cover you. Also can his Surgical Tech license make him accountable or are you accountable since you are the only regularly scheduled RN.


    I sure wouldn't want to be in your shoes!
  13. by   Jenny P
    As usual, NrsKaren, you have hit the nail on the head here. The problem that VictoriaG has, though, is the (probable) fact that her hospital ISN'T JCAHO affiliated. Remember, this is the hospital that had the administrator "investing" hospital funds, the uncaring BOD, mold growing in the central supply area, the broken sterilizer, and the pitted, dull surgery instruments.

    VictoriaG, I tried to pull up your Michigan Nurse Practice Act because it MAY have something in it about who can supervise RNs; but I couldn't get through to the right page. Check that out and also your State Dept. of Health (who's number you've probably memorized by now, LOL!). You say that he is coming from a hospital in Indiana where he held the same position; is it possible that he may have some contingency plans already in the works?

    I would definitely set up an appointment with him ASAP and voice your concerns about PACU, hiring new RNs for the surgery team, and his duties and obligations towards the whole OR staff. If he can tell you some of his ideas and what he sees as problems; give him a chance to see what he comes up with (if it proves to be legal in Michigan for non-nurses to manage nurses). How he reacts to your concerns may also tell you what type of manager he is.

    VictoriaG, I again salute you. If this hospital survives; it will be because of all of your hard work, determination, and dedication to this patient population.
    Last edit by Jenny P on Apr 18, '02
  14. by   texastwin
    Check with your State Board of Nursing as in TX only another RN or MD can clinically supervise an RN. TX State Board of Nursing told me that ANYONE can supervise you when it comes to attendance, time cards, etc. But, clinically, they must be an RN or an MD to supervise an RN. Just how much clinical duties will this guy have?? Actually, I think I'd be looking for a more stable work environment myself!

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