Management Progression Assistance

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Hello! I have been an RN for 11 years. I have spent the past 7 years working full-time as a nursing professor. I have my BSN and MSN (nursing education) and I am finishing up my EdD in healthcare leadership. My long-term career goal is a Chief Nursing Officer or Chief Nurse Executive. I have not worked as a bedside RN for the past few years outside of contingent in the Summer (off work as a professor), but I do take students to the hospital for clinical, teach in the skills lab, and teach in the classroom. I also work as a contingent clinical educator for a local health system. I'm also involved in committee leadership, mentoring, and research. Given my upcoming graduation, I decided to look into jobs to transition into a leadership role within the hospital setting. Basically, they do not consider my doctorate degree as any experience or leg up nor do they consider my academic leadership experience as relevant. I have been told by all recruiters that I would need to start at the beginning -- go back to a bedside nurse, then charge nurse, then assistant nurse manager, then nurse manager, then director, etc etc etc.... Any advice here? I'd really like to not go back to a bedside nurse. I love not working nights/evenings/weekends/holidays all the time. I have a lot of leadership experience in academia and I will have a doctorate in healthcare leadership soon. Send help! Any ideas of what I can do here? 

Specializes in Education, Skills & Simulation, Med/Surg, Pharm.
7 hours ago, Jedrnurse said:

I don't think that chats are a substitute for rolling up your sleeves and taking a shift, though it would be better than what some managers/administrators currently do. I stand by my original concept- if you're a licensed nurse and supervise those who provide care, you should have to "do it" yourself every so often.

How often? Is it safe to have management (especially over multiple units) jump in and take a full patient load when they may not be doing that actual job very often? Would it be a safer / better alternative to have them take shifts as a resource person to help out on the unit? I am sure that person would be kept very busy as units are always short staffed. 

2 hours ago, SmilingBluEyes said:

Are you willing to relocate to get this kind of position? It really may come down to that.

I'd strongly prefer not to. We have 3 major health systems in the big city where I live. I work for a state academic medical center now and have a pension... the kind where I'm set for life if I retire from here and lose it all if I leave. 

Specializes in Education, Skills & Simulation, Med/Surg, Pharm.
2 hours ago, SmilingBluEyes said:

You may like this but in reality, CNOs often DO have to come in nights/weekends when the stuff is hitting the fan. It does not sound as if you are willing to do what it takes to me. JMHO. Good luck anyhow.

I fully understand it will happen. I'm not opposed to it across the board. I'd just prefer evenings/nights/weekends to not be my standard working hours. My FIL is c-suite for a local health system and I've had several dinners over the years with their CNO. I am well aware of what the hours entail. 

Specializes in Education, Skills & Simulation, Med/Surg, Pharm.
53 minutes ago, JKL33 said:

I don't think it's so much that they want to make you struggle up through the ranks as it is that your leadership experience has a different enough focus that you quite possibly don't have the actual experience for the role you seek. I say this speaking very generally and with the caveat that some people have managed to gain wider experiences than what simple past role titles might suggest.

I don't see why re-starting in a staff bedside role is necessary, but unit manager, unit director and of course service line director are certainly relevant. I think you are being a little naïve in the way you are describing the interchangeability of different leadership areas. For example leading/teaching/guiding 5-10 pre-licensure students seems equivalent to barely getting one's feet wet in general leadership. The same with being a leader amongst your colleagues who are also teaching students. Frankly the staff charge nurse role seems more relevant than some of these.

You need to look at this realistically. I mean this to just be straightforward/real talk, not harsh....but some of what you are saying sounds like a young adult whose only job has been watching 2 kids all Summer then describing that as experience running a business, experience being a lifeguard, experience running a taxi fleet and experience being a 'personal chef'....YKWIM? Yes, the things you have done are important and there's no doubt you have learned a lot being a boots-on-the-ground leader in your various roles. I just don't think it is probably the same as all that goes into executive decision-making and producing results and directing the entire nursing service line. Etc.

I could be wrong. But best to think it through now so you can get on a realistic track to your goal. Best of luck!

 

I take 8 students at a time to the hospital (total of 32 in a week). I lead a classroom of 170 students or so. In the lab setting, I teach 80 students a week. I lead college-wide committees. In the summers, when I work as a clinical educator, I am in charge of the onboarding of all med/surg nurses, often rotating around hospitals and units to check in with management, preceptors, and the new hire nurses. I usually manage about 40 nurses or so at a time. I work collaboratively with the preceptor and unit manager and ultimately write a report that goes to the person in charge of new hire nurse education for the whole health system (I do med/surg specifically). Sure, will I have to learn the ins and outs of how that unit and the hospital run? Yep. But that's way easier to teach someone than how to be a good leader and a good manager. And unfortunately, from my experiences and the experiences of many others... they promote those with the knowledge of the unit and the hospital but aren't good leaders. The latter is much harder to teach. 

Specializes in CMSRN, hospice.

Do you run charge in your per diem job during the Summer? Are there any leadership opportunities available on that unit or within that hospital that you could assume to gain this particular experience?

I completely understand not wanting to go back to nights, weekends, and holidays on a permanent basis, not to mention staying over from scratch. That's why I would recommend trying to move up in the ranks within your current per diem work, if possible, and maybe click a little time as an assistant manager or clinical unit coordinator. Some of these positions would likely be available on days as well s nights, and may not even require any holidays. That will allow you to demonstrate and develop your managerial and leadership skills while also showing off your competence at the bedside, both of which will be necessary to eventually do the work you want.

Speaking from a bedside nurse's perspective, I do think I would be a little wary of leadership that hasn't spent much time at the bedside, or even doing management at the unit level, recently. I hear your point that there are transferable skills from your work in education that will apply to more senior management, but there are enough key differences that this would be a worthwhile effort. I know I would really appreciate a manager who made it a point to seek out this experience and really build on it for a couple of years.

Specializes in Education, Skills & Simulation, Med/Surg, Pharm.
1 hour ago, NightNerd said:

Do you run charge in your per diem job during the Summer? Are there any leadership opportunities available on that unit or within that hospital that you could assume to gain this particular experience?

I completely understand not wanting to go back to nights, weekends, and holidays on a permanent basis, not to mention staying over from scratch. That's why I would recommend trying to move up in the ranks within your current per diem work, if possible, and maybe click a little time as an assistant manager or clinical unit coordinator. Some of these positions would likely be available on days as well s nights, and may not even require any holidays. That will allow you to demonstrate and develop your managerial and leadership skills while also showing off your competence at the bedside, both of which will be necessary to eventually do the work you want.

Speaking from a bedside nurse's perspective, I do think I would be a little wary of leadership that hasn't spent much time at the bedside, or even doing management at the unit level, recently. I hear your point that there are transferable skills from your work in education that will apply to more senior management, but there are enough key differences that this would be a worthwhile effort. I know I would really appreciate a manager who made it a point to seek out this experience and really build on it for a couple of years.

I don't work at the bedside, so no charge nurse opportunities. I am in charge of the orientation and training of new hire nurses on the med/surg units. The position that would be above me is the person that is in charge of new hire nurse orientation for the whole hospital (I take the med/surg units only) but that position is full-time and I applied and was not considered due to a lack of leadership experience. The person they hired was a unit nurse manager previously. 

I am at the bedside all the time... I'm just teaching nursing students while I am doing it. So I am not solely in charge of their care although we do 90% of the care. I realize it's not the same. But I am not absent from the bedside and completely unaware of what goes on there. I just know management and leadership can be very disconnected and just... awful. I hear it all the time. I want to be different. Like I mentioned earlier in an earlier reply.... You can teach someone the ins and outs of a specific unit or hospital. You cannot teach someone to be a great leader. Often, people from the units are promoted into leadership positions with great knowledge of how the unit works, but they aren't good leaders. I have leadership skills and leadership experience. I am willing to take the time to learn the staff and their unit(s). I just wish someone would give me the chance, but I cannot even snag an interview to make my case. I keep getting a ton of HR interviews and they *love* me and they plead the case on my behalf but the hiring manager never wants to proceed. 

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I just thought of something. A lot of senior admin positions want you to have an MBA. Have you looked into that? A doctorate in Education is NOTHING to sneeze at and I am impressed at  your educational progression in 11 years, but EVERY one I know who advanced to such positions possessed MBAs.

Specializes in CMSRN, hospice.
1 hour ago, HOPEforRNs said:

I don't work at the bedside, so no charge nurse opportunities. I am in charge of the orientation and training of new hire nurses on the med/surg units. The position that would be above me is the person that is in charge of new hire nurse orientation for the whole hospital (I take the med/surg units only) but that position is full-time and I applied and was not considered due to a lack of leadership experience. The person they hired was a unit nurse manager previously. 

I am at the bedside all the time... I'm just teaching nursing students while I am doing it. So I am not solely in charge of their care although we do 90% of the care. I realize it's not the same. But I am not absent from the bedside and completely unaware of what goes on there. I just know management and leadership can be very disconnected and just... awful. I hear it all the time. I want to be different. Like I mentioned earlier in an earlier reply.... You can teach someone the ins and outs of a specific unit or hospital. You cannot teach someone to be a great leader. Often, people from the units are promoted into leadership positions with great knowledge of how the unit works, but they aren't good leaders. I have leadership skills and leadership experience. I am willing to take the time to learn the staff and their unit(s). I just wish someone would give me the chance, but I cannot even snag an interview to make my case. I keep getting a ton of HR interviews and they *love* me and they plead the case on my behalf but the hiring manager never wants to proceed. 

Gotcha. I couldn't tell from your original post if the contingent Summer position was direct bedside care.

Specializes in oncology.
8 hours ago, JKL33 said:

For example leading/teaching/guiding 5-10 pre-licensure students seems equivalent to barely getting one's feet wet in general leadership. The same with being a leader amongst your colleagues who are also teaching students. Frankly the staff charge nurse role seems more relevant than some of these.

You need to look at this realistically. I mean this to just be straightforward/real talk, not harsh....but some of what you are saying sounds like a young adult whose only job has been watching 2 kids all Summer then describing that as experience running a business, experience being a lifeguard, experience running a taxi fleet and experience being a 'personal chef'.

In the early 80's I tried to breakout from teaching into a leadership role in home health. I had worked home health during graduate school. I found a huge disconnect with what administrators thought I had done from what I had really done. I believe they thought the teacher role was easy. I said jump and students jumped. They never realized I was dealing with students who couldn't come to class because of domestic violence, no gas money or no childcare. They never understood that there is budgeting of supplies for lab and figuring out the best use of the students time. Patient safety, medication delivery etc all go with the territory. Reports and more reports and making sure the program follows the college policies and the accreditation policies. Meeting with other departments that insist their subject course should be required when there is a finite number of credits allowed. Developing sound policies and follow through on those policies. Standards etc.  What about when a student files a discrimination suit or a grievance?

 They will never make a TV show about a nurse teaching a group of students but actually there is a good British mystery involving a murder of a student nurse during a skills lab: https://en.wikipedia.org/wiki/Shroud_for_a_Nightingale

Much better than that Cherry Ames crap

Specializes in Education, Skills & Simulation, Med/Surg, Pharm.
6 hours ago, londonflo said:

In the early 80's I tried to breakout from teaching into a leadership role in home health. I had worked home health during graduate school. I found a huge disconnect with what administrators thought I had done from what I had really done. I believe they thought the teacher role was easy. I said jump and students jumped. They never realized I was dealing with students who couldn't come to class because of domestic violence, no gas money or no childcare. They never understood that there is budgeting of supplies for lab and figuring out the best use of the students time. Patient safety, medication delivery etc all go with the territory. Reports and more reports and making sure the program follows the college policies and the accreditation policies. Meeting with other departments that insist their subject course should be required when there is a finite number of credits allowed. Developing sound policies and follow through on those policies. Standards etc.  What about when a student files a discrimination suit or a grievance?

 They will never make a TV show about a nurse teaching a group of students but actually there is a good British mystery involving a murder of a student nurse during a skills lab: https://en.wikipedia.org/wiki/Shroud_for_a_Nightingale

Much better than that Cherry Ames crap

Yes! I am also always dealing with last-minute call-offs, scheduling make-up times, no-shows, students struggling, tutoring, remediation, conflicts amongst students, student crisis... I also have 10 different clinical instructors in one of my courses I have to manage. I have to schedule them while looking at their preferences and clinical/lab/sim availability and try to balance the schedule. I also always have to deal with faculty calling off and rushing to find coverage so students do not miss lab/sim/clinical. Clinical faculty are supposed to deal with the students directly when issues arise but I always end up having to step in as well. I do so much conflict resolution! 

Specializes in oncology.
9 hours ago, HOPEforRNs said:

I always end up having to step in as well. I do so much conflict resolution! 

No one understands the faculty  job until they have to manage large groups (student nurses) into clinical units, deflecting (and complying with)  hospital politics and poor staffing, troublesome staff, and poor  patient practices. 

I did join a faculty where the school was mandated to increase the faculty educational level. Most of the faculty working to acquire the MSN chose "Leadership" as their functional role. No hospital administrator is going to assign a portion of their responsibilities to a graduate student, whereas in the educational arm of studies YOU are assigned to provide clinical observation, classroom education etc. 

 

 

 

 

My sense has been that hospital administration does not view academic management experience the same as hospital management. At least as far as nursing is concerned. In some ways, even though it doesn’t always seem like it, they are two different worlds. Healthcare is a business, and nursing education is in a small corner of that business. Managing a facility day in and day out and being responsible for it 24/7 is hospital management. Academic management of clinical groups is not dissimilar, but is looked at as a micro sphere of hospital management and definitely not the same. It seems to be an unspoken “rule”  that working only in academia is viewed by some administrators as a good retirement gig after earning your stripes in the career ( at least as viewed by the hospital). I’m not saying I agree with these perspectives per se, but it is the reality of the current landscape that I can see. That is why there are in some hospital contexts overqualified nurses from an academic perspective doing certain roles that they might feel they are under qualified for… The academic possibilities and the workforce realities do not always meet for nurses.
 All that to say, if you really want a hospital upper management job, I think you would have to follow the recruiters suggestions and go back to square one. 
 If you don’t want to do that, you should stay in academia where the bulk of your experience seems to be. All the best!

Specializes in Med-Surg/Tele/ER/Urgent Care.
On 7/10/2021 at 10:32 AM, HOPEforRNs said:

I fully understand it will happen. I'm not opposed to it across the board. I'd just prefer evenings/nights/weekends to not be my standard working hours. My FIL is c-suite for a local health system and I've had several dinners over the years with their CNO. I am well aware of what the hours entail. 

What is “c-suite “?

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