I am somewhat puzzled by the idea of people studying to become healthcare administrators with NO experience in the health care field whatsoever. Some have the goal of becoming a "clinical administrator" - how can you become a "clinical" admin if you are not a clinical person???
Currently I am sharing a graduate studies class with students who are mostly not nurses. It appears to me that they have the idea that their previous knowledge from education, science or such is enough to become an administrator in a hospital, clinic or other facility. If this is the new trend - it scares me!
I once worked as a clinical manager under a facility administrator who had NO healthcare or clinical experience. Her focus was clearly "numbers", no social skills, and no idea about the area she was supposed to manage. It was a bad experience all around. I left shortly after she started.
I understand that we need people in healthcare who are administrators but most successful admins in facilities and hospitals or clinics are nurses.
Maybe I am confused by the terminology here, but in my experience [sNF] the administrator is not managing the nurses at all. The administrator runs the business end and the DON manages the nursing end of things. Granted they work together, but they are two totally different jobs. In 20+ years I've never worked under an administrator that stuck their noses into the nursing side without DON involvement.
I am with you, RiskManager. In my experience, more and more administrative positions are being filled with nurses, but that historically has not been so. I think the essential thing here is putting people with the right perspective into positions of leadership, with some having clinical primary educations and others a more business oriented background. There is no perfect administrator mold in my opinion.
Great points. My son in law recently graduated from MBA school and is in a corporate leadership program with a major health care company. I am about to graduate with an MHA and I have 30+ years experience in the industry as an RN. Each of us will bring strengths to an organization--he with a better business focus and me with a better clinical understanding. The great thing is that we could end up working with different professionals who are like-minded about both clinical and business success going hand-in-hand, which I think they do. So does he, by the way!
How can you manage nurses if you don't have more than a superficial knowledge of what their job entails? The same way people without management skills (nurses without management education) can manage business entities, like hospital departments: by learning on the job. This is the way most nurses entered the higher positions in health care. They possessed qualities that would make for good administrators, as well as those that make good nurses. There are commonalities, but there are also very different skills for each profession, which is why today, a master's degree is all but required in most administrative positions. From what I see, nurses with MSNs qualify as readily as MHAs and MBAs, which makes perfect sense. Each person will take unique qualities to their positions.
How can you manage nurses if you don't have more than a superficial knowledge of what their job entails? The same way people without management skills (nurses without management education) can manage business entities, like hospital departments: by learning on the job. This is the way most nurses entered the higher positions in health care. They possessed qualities that would make for good administrators, as well as those that make good nurses. There are commonalities, but there are also very different skills for each profession, which is why today, a master's degree is all but required in most administrative positions. From what I see, nurses with MSNs qualify as readily as MHAs and MBAs, which makes perfect sense. Each person will take unique qualities to their positions.
Nursing is a highly regulated profession which requires much specialized knowledge and experience together with knowledge of the laws that pertain to nursing practice. To say that someone with a purely business background can just step in and manage nurses effectively without this knowledge is management ideology. Certainly someone with a business background can manage nurses and if you read on this thread and on this site you will find examples of how ineffective this has often been in practice. The same applies to other industries: a family member of mine once worked for a large corporation that provided a specialized service to customers - at one point in their career the powers that be decided to put MBAs' with no knowledge of the industry in charge of running the organization instead of experienced people with industry knowledge: the result was bad.
Just a few days ago I was looking at my niece's university business course curriculum which covered a broad area of business competencies, but while she is looking forward to finishing her studies and finding a good job she has no illusions that her business knowledge somehow makes her competent to manage professionals in specialized fields that she has no knowledge of, any more than I am persuaded that my nursing knowledge/training along with some business courses would make me competent to manage an accounting department. Your example of nurses going on to manage other hospital departments (which presumably require a manager with nursing knowledge/experience) is hardly comparable to someone with purely business training managing nurses.
Specializes in NICU, PICU, Transport, L&D, Hospice.
I wonder how the ancillary staff feel about nurses thinking they're the best administrators. I can imagine that the finance, legal and engineering depts might have a different opinion of a nurse being their best leader.
Now a director of nurses should be a nurse with working experience as well management training and experience.
Generally speaking, inpatient hospitals are designed for the delivery of nursing care in a controlled environment. They also offer physicians a controlled and consistent place to perform procedures that they cannot complete in the office or clinic setting.
It makes sense that nurses should be engaged in the executive management and oversight of the function of facilities which primarily exist for provision of nursing care. They do not exist as institutions of law or engineering.
How can you manage nurses if you don't have more than a superficial knowledge of what their job entails? The same way people without management skills (nurses without management education) can manage business entities, like hospital departments: by learning on the job. This is the way most nurses entered the higher positions in health care. They possessed qualities that would make for good administrators, as well as those that make good nurses. There are commonalities, but there are also very different skills for each profession, which is why today, a master's degree is all but required in most administrative positions. From what I see, nurses with MSNs qualify as readily as MHAs and MBAs, which makes perfect sense. Each person will take unique qualities to their positions.
For a while I had looked into MBA programs but in the end enrolled in a MSN program that focuses on quality and safety. I did a class on financing and policy, which gave me a really good insight into how healthcare is financed. Leadership classes are already part of the BSN curriculum but in graduate studies I looked at it from a different angle.
I did not enjoy being a manager. Supervisor was ok but manager was just the typical middle management that grinds you up.
In the hospital setting nurse managers are nurses who nowadays have a master's degree and some places have nurses in higher administration reflecting the way nurses are involved within a hospital.
They are paper shufflers and number crunchers, that is why. The ca state hospitals have psych techs as supervisors and nurse co-ordinators, supervising and auditing RN work! It is equivalent to a CNA supervising RNs. However the people you are referring to at least have a bachelors or masters degree and not just a high school diploma
They are paper shufflers and number crunchers, that is why. The ca state hospitals have psych techs as supervisors and nurse co-ordinators, supervising and auditing RN work! It is equivalent to a CNA supervising RNs. However the people you are referring to at least have a bachelors or masters degree and not just a high school diploma
Nursing is a highly regulated profession which requires much specialized knowledge and experience together with knowledge of the laws that pertain to nursing practice. To say that someone with a purely business background can just step in and manage nurses effectively without this knowledge is management ideology. Certainly someone with a business background can manage nurses and if you read on this thread and on this site you will find examples of how ineffective this has often been in practice. The same applies to other industries: a family member of mine once worked for a large corporation that provided a specialized service to customers - at one point in their career the powers that be decided to put MBAs' with no knowledge of the industry in charge of running the organization instead of experienced people with industry knowledge: the result was bad.
Just a few days ago I was looking at my niece's university business course curriculum which covered a broad area of business competencies, but while she is looking forward to finishing her studies and finding a good job she has no illusions that her business knowledge somehow makes her competent to manage professionals in specialized fields that she has no knowledge of, any more than I am persuaded that my nursing knowledge/training along with some business courses would make me competent to manage an accounting department. Your example of nurses going on to manage other hospital departments (which presumably require a manager with nursing knowledge/experience) is hardly comparable to someone with purely business training managing nurses.
While I'm sure your personal experiences are important, not everyone will have the same experiences with being managed by someone in or outside their field. I believe that in many cases, nurses MUST supervise nurses, so I am talking about Management, which would be a level above the nurse supervisor. Not everyone with the title RN must be managed by a nurse. There are ineffective RNs and effective business majors who can influence outcomes in practice every day. It isn't black and white in my opinion.
Maybe I am confused by the terminology here, but in my experience [sNF] the administrator is not managing the nurses at all. The administrator runs the business end and the DON manages the nursing end of things. Granted they work together, but they are two totally different jobs. In 20+ years I've never worked under an administrator that stuck their noses into the nursing side without DON involvement.
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Unless they are a micromanaging power hungry administrator who ties the hands of everyone!!!!!!! I worked for one who felt the need to stick her head into every clinical aspect of running the nursing unit.
For example, on meal breaks. "You are to take you assigned meal break at the assigned time. No variation allowed" If you have a person in the air on a lift, are you supposed to just leave???? Or tell them to wait to be toileted?
On toileting, "You are to toilet the resident when either scheduled or when needed" no variation THE RESIDENTS NEEDS MUST BE MET!
She insisted staffing on numbers and refused to took at acuity.
I could go on...she is gone now and the new adm gets it, she is not a micromanager. She will question what she does not understand but that is it. Once she gets a reasonable explanation, she is good with it.
This is absolutely my biggest pet peeve. Medicine is not about numbers. It is about people. If you have never done the job how can you be the administrator? This is the current trend in one of the big Dialysis Companies and it is a huge mistake. It is NOT all about the numbers, it is about giving good care to very sick people. Yes, you have to be financially prudent, but not at the cost of people. I have been a RN ADMIN for 15 years. I know the job and I understand how things work. I can step in as needed and I serve as a resource for the staff. I know how to make the numbers work, but I don't do it at the cost of my nurses nor my patients. No, I do not have a MBA from Stanford, but I do have almost 40 years of being a nurse.
kbrn2002, ADN, RN
3,969 Posts
Maybe I am confused by the terminology here, but in my experience [sNF] the administrator is not managing the nurses at all. The administrator runs the business end and the DON manages the nursing end of things. Granted they work together, but they are two totally different jobs. In 20+ years I've never worked under an administrator that stuck their noses into the nursing side without DON involvement.