Assistant Nurse Manager Duties

[redskngolf]

Is anyone willing to give insight on how they delineate duties between the Nurse Manager (NM) and the Assistant Nurse Manager (ANM). I am a relatively new NM and I am looking to provide more structure to our leadership team. I have teased out pretty well what the roles/duties of the CNS and Nurse Educator are/will be, but am having a harder time with myself and the ANM. My first thoughts are to have the ANM function as a clinical nurse manager and have oversight of all clinical aspects of the department(s) (clinical performance, quality metrics etc.) with myself handling administrative duties (budget, scheduling, time and attendance etc.). Obviously I would still be ultimately responsible for all aspects of the units but thought this would help us to have clearly defined roles day to day. I would also still assist/jump in as needed and provide leadership and coaching/mentoring to her.

Thoughts?

[SummerGarden, BSN, MSN, RN]

Yes.... Actually my organization uses ANMs as front-line managers within the hospital setting. So ANMs are on the floors and run the shifts (If needed, ANMs also can cover breaks). Our administrative duties include the areas you listed (quality, work place safety, and risk performance metrics and we also sit on committees), the budget on a shift-to-shift basis (control over HPPD and the staffing mix), and we have direct reports so we also provide oversight over individual performances. However, we partner with the NM, Quality, Risk, etc. to get quality and risk numbers and we are responsible to implement corrective actions and provide oversight during our shifts.

With that said, another organization only used ANMs to assist with quality and performance measures and did not require them to be on the floors. The units did not perform well... So, those ANMs were considered unnecessary and their positions were eliminated across that organization within the hospital setting. Thus, the better use of an ANM may be the way my organization uses us. If you work in a different setting, then maybe they can spend most of their time in an office working to support the department?

Let us know what you come up with and how well it is working out for your department/organization. Good luck! ?

[klone, MSN, RN]

Actually, I think it would be more appropriate for the ANM to be responsible for schedule and attendance, and the NM to be responsible for things like quality and performance. The latter stuff is more "high level" stuff and less about the day to day operations. Think of the things that more involve TJC, CMS, and regulatory - those are the things that are more appropriate for the NM to handle.

[SummerGarden, BSN, MSN, RN]

16 hours ago, klone said:

Actually, I think it would be more appropriate for the ANM to be responsible for schedule and attendance, and the NM to be responsible for things like quality and performance. The latter stuff is more "high level" stuff and less about the day to day operations. Think of the things that more involve TJC, CMS, and regulatory - those are the things that are more appropriate for the NM to handle.

Klone, I think scheduling will depend if the organization or department is centralized or decentralized. My organization has a department that handles schedules. On the other hand, ANMs deal with attendance (that is part of performance and discipline).

As an aside, Klone, if my job only allowed me to deal with schedules and attendance, I would not accept the job because a non-manager can manage schedules. For instance, in one job as a case manager I made the schedules for my department to help my nurse manager. In another job as a charge nurse, the charge nurses were tasked to do the schedules. Thus, tasking ANMs with only low level duties and responsibilities will not attract and/or retain creative, effective, experienced ANMs.

In fact, all the ANMs I know, especially those of us who are master prepared, want some high-level responsibilities even though it is a challenge to perform our jobs. Partnering with the department manager with some high-level responsibilities makes us better at our jobs (we see and understand the bigger picture) and it helps us to grow professionally. Most importantly, a good nurse manager will share some of the high-level responsibilities with ANMs to allow for patients to be better cared for and the department to be fully supported.

[klone, MSN, RN]

I didn't mean to imply that schedules and attendance would be the ANM's only duties. My point was that typically, the ANM is tasked with the day to day operations of the unit (things like schedules, attendance, helping out with what's happening on the unit at the moment, making sure everyone's getting their breaks, answering questions and being a resource to staff), while NM's are usually tasked with the higher level, big picture stuff (budget, quality metrics, strategic initiatives, employee engagement, etc). That's how it's been at every place I've ever worked that had a manager and assistant manager.

[SummerGarden, BSN, MSN, RN]

22 hours ago, klone said:

I didn't mean to imply that schedules and attendance would be the ANM's only duties. My point was that typically, the ANM is tasked with the day to day operations of the unit (things like schedules, attendance, helping out with what's happening on the unit at the moment, making sure everyone's getting their breaks, answering questions and being a resource to staff), while NM's are usually tasked with the higher level, big picture stuff (budget, quality metrics, strategic initiatives, employee engagement, etc). That's how it's been at every place I've ever worked that had a manager and assistant manager.

OK, I think we are thinking along the same lines. However, not to say you are implying this, but I have worked in two types of environments where only the duties and responsibilities assigned to ANMs were as you describe above. However, my current environment is requiring me to perform at a higher-level and participate in higher-level activities along with my lower level ones. This environment attracted me and is retaining me. The other environments got old quick because after a while the job itself can become a grind (both physically and mentally). Thus, since you are a service director, you may wish to consider requiring your ANMs to share in more of the higher-level opportunities within a department. Or at least provide the opportunity to the ANMs who wish to grow. You may see really good outcomes to include retaining and growing internal talent.

[klone, MSN, RN]

Sadly, I have no ANMs. I wish I could off-load some of my responsibilities.

[NurseMal09, BSN]

Does anyone use ANM working 12 hr shifts?

[SummerGarden, BSN, MSN, RN]

18 hours ago, NurseMal09 said:

Does anyone use ANM working 12 hr shifts?

Yes. Some of the departments and facilities within my organization has ANMs who are scheduled for 12s. However, the only Staff RNs working 12s are ICU and NICU. So, those that work outside of those two environments have direct reports for two shifts. For example, an ANM covering 7a-7p on a Medical Surgical unit will have front-line staff as direct reports on both AM and PM shifts.

[RNCHN, BSN, RN]

On 3/12/2019 at 4:28 PM, SummerGarden said:

Yes.... Actually my organization uses ANMs as front-line managers within the hospital setting. So ANMs are on the floors and run the shifts (If needed, ANMs also can cover breaks). Our administrative duties include the areas you listed (quality, work place safety, and risk performance metrics and we also sit on committees), the budget on a shift-to-shift basis (control over HPPD and the staffing mix), and we have direct reports so we also provide oversight over individual performances. However, we partner with the NM, Quality, Risk, etc. to get quality and risk numbers and we are responsible to implement corrective actions and provide oversight during our shifts.

With that said, another organization only used ANMs to assist with quality and performance measures and did not require them to be on the floors. The units did not perform well... So, those ANMs were considered unnecessary and their positions were eliminated across that organization within the hospital setting. Thus, the better use of an ANM may be the way my organization uses us. If you work in a different setting, then maybe they can spend most of their time in an office working to support the department?

Let us know what you come up with and how well it is working out for your department/organization. Good luck! ?

I am a Clinical Nurse Manager and this how we are used. We run the floor, cover charge nurse breaks if absolutely necessary. I audit, observe, and validate practice, quality, and performance. I escalate any issues so NM and I can address as a team. The organization has placed as leads in reviewing policies, and magnet narratives. All CNMs know how to run unit in case the NM is out for extended period of time. My NM handles supplies, equipment, workplace safety, budget, interdisciplinary issues, and the TO. We have matrix reporting so I report to DON and my NM.