Management on Decline?

[MikeyJ]

I am currently only a nursing student -- scheduled to graduate May 2008. However, I was speaking to a few nurses that I know very well (both are in their mid 50's). One is a clinical director here in my current residence, and the other is a Chief Nursing Officer back in Michigan. Both were telling me that I should seriously consider going into management as a nurse. They told me that because I am male, it would actually be easier to get into a management position (I have no idea how much truth there is to that, but that is what they told me). Furthermore, the CNO was telling me that there is a massive shortage of CNO's around the country because lack of interest from staff nurses and other nurse management, and also lack of experience. She was telling me that CNO's usually start out at 100K for smaller hospitals, but their salary can rise well above the 200K mark for large 500+ bed hospitals.

My question being, why is there such a lack of interest in nurse management? I understand that there is probably a lot of headaches in management (as there is with management in any field). Furthermore, I would think that there would be a plentiful amount of nurse managers looking to get into a CNO position. I understand that they must work their tails off, but a salary that large would be a large incentive.

Any insight?

[NRSKarenRN, BSN, RN]

2 more things.

1. Back in the early to mid-1990's ... nurses had trouble getting government funding for nursing education. There was intense competition among the various segments of the nursing profession for the limited funding available.

The Nurse Practitioner groups won that war and the nursing administration programs were the big losers. All government funding for graduate level programs in Nursing Administration was terminated. Many Master's level programs shut down or dramatically reduced those programs -- thus dramatically reducing the pool of people educated at the graduate level in Nursing Administration and the amount of research being done in the field for many years to come.

By the way ... that move also created an over-supply of NP's in some areas and also contributed to today's nursing faculty shortage. Those of us graduating with PhD's in the 1990's could not even get interviews for faculty jobs unless we had NP certification as well. Many potential faculty members were turned away and had to find employment outside of academia. Now they wonder why we are not faculty members!

2. Look at the threads on this bulletin board. Most people blame their managers for everything they don't like about their jobs. Managers are bashed left and right on this board and in "real life" as well. That need for an exceptionally think skin makes the job unappealing to most young nurses as they plan their careers. People are more attracted to NP roles (less organizatinal/administrative hassles) and/or CRNA roles (more autonomy and money). Few younger nurses see the management positions with its 24-hour accountability and constant blame attractive. Nor do they see hospital staff development roless being attractive as they also involve a lot of organizational hassle and little positive support from the staff. Thus, we have a serious shortages of qualified applicants for such positions.

:yeahthat:

Same thing I've seen in my neck of the woods.

In 70's and 80's, I had many wonderful mentors when we had "Head nurses" responsible for single nursing unit. Downsizing hospital staff, management multiple units with 24/7 nursing, administrative and budget responsibility has distanced managers from daily positive interactions with their staff. Too often focus is on "damage control" and "patient satisfaction" with only administrative crumbs left for positive interaction with staff. Staff are unable to see times mangers gone to bat for staff behind lcosed doors or in interaction with physicians. How can any staff value this position or gleam nuances of howbest function in this role if managment not involved in day to day activities but stuck in office/meetings? Juggling my 20 staff to fill 12.5 FTE positions is a fine balancing act---yet alone managing staff for a 60 bed unit.

[anonymurse]

Too often focus is on "damage control" and "patient satisfaction" with only administrative crumbs left for positive interaction with staff.

Culture building is the prime management function. Once a culture is built, and yes the possibility has to be inherent in the larger organization, many things will take care of themselves. This is the concept of fire prevention practiced by all vs. putting out fires practiced by one or a handful. Now putting out fires is heroic, and many want to be heroes, so it takes a lot of self-denial, or just an understanding of what works, to build a great culture. Lots of trust. The amount of work involved is staggering, and it's truly a labor of love.

[llg, PhD, RN]

llg is so right! Management-bashing is the latest sport it seems. Besides, I'll be honest. When I went back for my MSN, my idea was to go into management. I worked as the night charge nurse and was expected to keep on top of everything and I do mean everything as well as take patients myself. Nope, that job was fraught with real danger. So...after getting my MSN, I did a post-MSN CNS certificate and guess what? I make more money than my mangement counterparts, am responsible only for my own decisions and like it better.

Management is not something I aspire to.

I, too, started my MSN as a Nursing Administration major -- but switched to the CNS track halfway through the program. I did officially graduate with a minor in administration, but I have never held a real management role. I have always optend for CNS and Staff Development positions because I don't want the 24-hour responsibility and I don't want the staff to blame me for everything that doesn't go their way.

[Kelly_the_Great]

Hi,

I just wanted to thank you all for offering your perspectives as nurses who have "been there."

I've just recently obtained my BSN and had wanted to pursue my MSN with a focus on leadership/administration, so that I could help facilitate positive work environments for the bedside nurse in order to provide for an increased quality of care to the patients.

However, being new to hospital nursing, I sure do see the negativity directed toward our nurse managers. I also see a lack of participation from the staff nurses. I mean, they gripe and complain in the med room yet offer nothing up in the way of concerns (let alone solutions) during staff meetings.

This along with administration's pressures placed upon the nurse manager I'm sure results in an almost impossible situation.

Do y'all think it's totally hopeless state of affairs?

[llg, PhD, RN]

Do y'all think it's totally hopeless state of affairs?

I'm never hopeless. There is always a part of me that continues to hope for the best. But it is pretty bleak right now for people in management positions. They are held accountable by upper-level administrators for the performance of their department, but not given the resources they need to do the job well. Then the staff blames them for everything that happens.

Few staff members show support for their leadership team, making it increasingly difficult to get them together to accomplish anything positive ... or to put your career on the line fighting on your ungrateful staff's behalf.

[mydesygn]

I have managed a small group of staff (6 staff, clerical/secretarial staff) and a unit (40 staff, majority nursing). By far, I would not manage a nursing unit again. However, it was not the staff that soured me on management. The issues I faced with the smaller group were not that different from than with the larger group (just amplified). What soured me on management was that unfortunately, I managed in a situation where I was required to work 1-2 shifts in staffing each week as well as having to co-manage staff with 2 other managers. Those 2 requirements amplified the level of job stress for me particularly co-managing.

I don't think managing is a hopeless cause -- I just believe that there are some hard and fast realities that all managers must develop the techniques and strategies to deal with. There are hard core complainers and hard core complainers are takers, you have to recognize them for what they are and stop spending all your energy and time on their needs -- I know that's easier said than done. But once you begin concentrating on the staff that doesn't live to stir the pot, you will earn their respect and loyalty. Don't get me wrong -- you can't ignore the hard-core complainers but you can stop enabling and supporting their behavior.

As a manager, you have to celebrate the small successes (even if you are the only one celebrating). When I first got my staff schedule out on time with the numbers balanced -- honey, I celebrated, even if I knew somebody was going to come to me the next day and want changes. The reason I celebrated is I had developed an efficient system and now my staff knew without a doubt that the schedule will always be complete on that date consistently without fail. I was doing my job.