First Management Position

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Specializes in Critical Care.

Hello everyone! I will soon be transitioning into a new role on a new unit within my hospital as a "Nursing Unit Supervisor." From reading other people's posts, I believe it is similar to the role of an assistant nurse manager. For example, I will function as a permanent charge nurse, but I will be taking patients, delegating admissions and discharges, scheduling, doing performance reviews, etc. I will be one of four NUSs, and I will be working on night shift. I will be leaving the bedside as a critical care nurse to work on an adult medicine floor.

What advice or suggestions do you have for making such a transition from critical care to med/surg? I think it will be hard for me to not be able to put in a lot of orders based on protocol and standing orders (EKGs, ABGs, labs, etc. for critical situations). Also, nurses on medical floors do not take patients on pressors, BiPAP, etc. They are not allowed to insert PIVs or do sterile central line dressing changes.

I am still a relatively new nurse with only 2 years experience (in critical care). Do you think I will encounter older and more experienced nurses not willing to listen to my advice or suggestions? I get along very well with older and experienced nurses in my current setting, but do you think respect will be an issue when I assume this role as NUS?

Do you think my experience as a NUS on a medical floor will help me to return as a NUS in critical care if I continue working PRN in the ICU? In the long term, I would like to advance in the ranks of management.

How do you manage taking patients and being available as a resource to patients, families, staff, and physicians... as well as performing supervisor responsibilities?

Do you have any other advice such as how to become a respected member of this new team? Do you think it would be appropriate to ask the staff nurses to come to me first before calling the rapid response nurse as I have critical care experience?

Thank you all for your feedback!! This is a huge transition for me in a lot of ways, and I will freely admit what I do not know.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.

Hi, I am posting because I see no one has done so yet. In any case, I have no real advice to give since I am very wet behind the ears right now too. However, I want you to know that you are not alone especially on nights.

First, I think the transition should not be too bad from ICU to the floors. As an older and wiser nurse once told me, nursing is nursing no matter the setting. As for gaining the respect of any nurse, you must respect yourself and your nursing abilities first. So, although it is OK to be scared (a little), it is not OK to show nervousness or anxiety because it will kill your credibility. Specifically, older and experienced nurses respect confidence as well as the wisdom to be humble enough to defer to more experience when needed. If you can do that, I doubt you will have trouble with the older more experienced nurses as much as you suspect.

As for acting as a charge nurse, I do not take patients on my shifts. I have too many beds in my department and too many things to do at night to care directly for individual patients. That was made clear to me since the beginning and I have no plans to deviate from that. With that said, I know of entry-level nurse managers who take patients often, usually the day shifters, because someone else is around to help with other duties and responsibilities of the floor such as the department manager. Plus, I have read posts of some on here that work NOC shifts and take patients. Hopefully someone else will be able to respond to this thread and provide you with the supports you need soon.

By the way, congrats, good luck, and welcome to the other side! :)

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Specializes in Critical Care.
Hi, I am posting because I see no one has done so yet. In any case, I have no real advice to give since I am very wet behind the ears right now too. However, I want you to know that you are not alone especially on nights.

First, I think the transition should not be too bad from ICU to the floors. As an older and wiser nurse once told me, nursing is nursing no matter the setting. As for gaining the respect of any nurse, you must respect yourself and your nursing abilities first. So, although it is OK to be scared (a little), it is not OK to show nervousness or anxiety because it will kill your credibility. Specifically, older and experienced nurses respect confidence as well as the wisdom to be humble enough to defer to more experience when needed. If you can do that, I doubt you will have trouble with the older more experienced nurses as much as you suspect.

As for acting as a charge nurse, I do not take patients on my shifts. I have too many beds in my department and too many things to do at night to care directly for individual patients. That was made clear to me since the beginning and I have no plans to deviate from that. With that said, I know of entry-level nurse managers who take patients often, usually the day shifters, because someone else is around to help with other duties and responsibilities of the floor such as the department manager. Plus, I have read posts of some on here that work NOC shifts and take patients. Hopefully someone else will be able to respond to this thread and provide you with the supports you need soon.

By the way, congrats, good luck, and welcome to the other side! :)

Thank you so much for your response, MBARNBSN! I have read some of your other posts in this forum, and I truly appreciate your feedback. I am excited about this opportunity, and your words of advice and encouragement will definitely be taken into consideration and practice!

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I believe that being a nurse manager is a privilege and challenge at the same time. Your Critical Care experience is a great asset. You can learn a lot in two years.

As a more seasoned nurse (aka "older" nurse ;-) ) I would also like to say that I personally appreciate the insights that newbies can share. Communication is key. Have a presence... which you WILL in a charge nurse role. As a new RN in 1995, I thought so highly of our charge nurses. She worked very closely with the nurse manager and they were really the greatest team of leadership I've had in my career was on that Oncology unit. In my 20 years I have been blessed with true Mentoring leadership and also bummed/disappointed to have experienced very poor leadership. I believe we do learn from both types.

Your post *sounds" like you have enthusiasm and passion. There is always a lot to learn.

I also think you can be firm w/o being a jerk. Accountability is so important but it's important to require it from the get-go and by setting the best positive example you can. "You get what you tolerate".... whether from administration, fellow nurses or the docs.

Know that there will undoubtedly be challenges. There will also be blessings/joys along the way.

I personally am an avid book reader to learn more about leadership. "The Essential Drucker".... "Crucial Conversations".... "The Leadership Challenge".... read a biography of an inspiring leader in history. You do not HAVE to read everything "leadership" - that is just how my brain works. Soak up as much as I can from good resources. Listen to your co-workers. We cannot make everything perfect, but we can try to make it the best possible. We can also lead by positive example.

Best wishes to you!!!

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Specializes in Critical Care.

Thank you so much. I will definitely follow your advice. I especially like your point about requiring accountability from the very beginning. I will also check your book recommendations out. Thank you again, SummerIsMyFave2.

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Specializes in Intensive Care Unit.

Wow, I just posted this exact same question! I have not accepted the job yet, though. CLTNURSE13, are you happy with the choice you made? Like you, I have reservations about the transition and possibly losing some of my ICU skills.

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Specializes in Critical Care.
Wow, I just posted this exact same question! I have not accepted the job yet, though. CLTNURSE13, are you happy with the choice you made? Like you, I have reservations about the transition and possibly losing some of my ICU skills.

Hi KBICU, my last day in my ICU was Saturday, and I start my new position on Monday. So I will let you know how it goes! I'm excited regardless and think it will be a good transition.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
Hi KBICU, my last day in my ICU was Saturday, and I start my new position on Monday. So I will let you know how it goes! I'm excited regardless and think it will be a good transition.

YEAH, OP!! Allow yourself time to learn and grow in your new positon. In other words, do not beat yourself up. A lot of stuff will be thrown at you and there will be a lot of personalities to navigate, but be confident that your best is good enough! :) Oh, and have fun!!!! :)

-New Manager, who is still happy with the decision to move into management, despite it being a really tough job!!!! :)

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