Head Nurse

diane227, LPN, RN · Nov 12, 2009

It depends on many factors. And you should not be promoted to management just because of the length of time you have been at a certain job. Being a manager requires a certain set of skills that differ greatly from nursing. Being a leader and having the ability to motivate people and having the ability to get people to go along with you on the path where you want to take your department is not an easy skill to learn. People don't go just because you say so.

First of all you need to decide on your area of interest (ICU, ED, MED SURG, etc). Once you have done this, you need to work to obtain all the appropriate credentials for that area. For example you would want to get your ACLS (for any area). If you were in the ED you would want to be CEN certified and have TNCC and PALS. You might want to be an ACLS or TNCC instructor. This demonstrates initiative. You should volunteer for service on committees and offer to do any special projects that are required. If you want to be promoted, you have to get out there and get noticed. This is much more difficult if you work on an off shift.

If the opportunity arises, you should train to be charge nurse or relief charge nurse. If you think management is what you really want, start taking some management courses, especially in communication skills. Because learning how to promote team work, problem solve, and communicate in an appropriate manner is key to success. There are several excellent management books that I can recommend if you will send me a private email.

You have to understand that when you are the manager it is not a popularity contest. On any given day people are not going to like how you do things. They won't like or understand your decisions. But you have several responsibilities. You have to be available, fair, willing to go to bat for your staff, know how to communicate bad news in a way that makes it sound like a great idea. You have to know how to resolve conflict between people and how to deal with people who are chronically unhappy and whining. You have to remember that it is at 24/7 job and you are going to have to come in in the middle of the night if needed. You have to know when to address a problem or let it ride. You have to know how to do a budget, how to calculate how many man hours you use each day/ month/ year based on patient visits or patient days depending on what kind of unit your running. You have to know how to budget for capital equipment. You have to keep up with your patient satisfaction scores and figure out ways to get your scores up when they are not good (your reimbursement is tied to your scores). You have to know how to do payroll, how to delegate, how to conduct disciplinary action in a way that is motivating for the employee to promote the change that you want to see. And you have to help your employees be the best that they can be. You have to leave friendships outside the hospital because at work, everyone is equal and must be treated the same. You have to be able to terminate your friend if needed.

Let me tell you that being a nurse manager or a director is one of the best jobs you will ever have but it is WORK. Your hours are never your own. You will be a salaried employee and you will put in many more hours than you get paid for. The highest paid nurse in your department will probably make more than you do. But if you are motivated and you want to learn how to do it well you can become a wonderful leader. I loved management. Those years were some of the best years of my career. But I got tired of having to respond to an emergency at 3 am, going to meetings, trying to get people to do what they needed to do. I got to the point where all I wanted to do was worry about myself and no one else.

If you are making it your goal, get started. It is never too early to start taking some courses and reading a few books.

classicdame, MSN, EdD · Nov 13, 2009

agree with above post 100%

My friend was a staff nurse 18 mos before accepting an interim nurse manager job. They later hired her to the position and now she is Director over several hundred staff members. Turned out she is a great administrator who just happens to be a nurse.

MBAnursearizona · Nov 13, 2009

That's great news! I already have my MBA and strong business acumen, but am now working on getting clinical experience. Thanks for a realistice description of what this job is all about!