Need a Manager's Insights - Career Advice

  1. To be honest, I really don't know where life is taking me..... I am a RN with 12years experience encompassing:

    2 years experience in a small rural community hospital ER (currently working)
    3 years case management
    4-5 years ER/Trauma in a level II trauma center
    2 years telemetry / cardiac step down

    I want to grow into a management or directorship role in an ER: There are no growth opportunities within the organization that I currently work for - they have been downsizing.

    This is my educational background:

    Started out with an ADN,
    then progressed to a BSN
    will be graduating with an MBA this June with a healthcare specialization.

    However, competition for these positions is fierce where I live and I have never held a "management" position. One of two things either happens to me when I apply for a open position here in Northwest Ohio.

    1) They are promoted from within the organization or
    2) They have the management experience without the education

    I guess I felt the need to obtain the MBA because so many managerial nurses that I have worked with in the past have said that being thown into budgeting FTE's and departmental supplies & equipment & revenues without any real orientation or a business acumen is extremely stressful - then, trying to balance the people issues of conflict management, patient complaints,physician issues et al.

    Soooo, I decided to obtain the MBA so that I would have the education as it pertains to the finances, leadership plus continue being current with the clinical side.

    Now, my question is: How the heck to obtain the "management" experience when it appears that most of the facilities out there want someone with experience? How do you move up when there are seemingly no growth opportunities?

    I am even willing to relocate, but still having problems finding positions on Monster.

    I don't want to sound like I have "grandiose" thoughts of myself, but whoever I land a management position with will have someone that will have the business background / clinical expertise and represents nursing's voice in the organization...

    Does anyone have insights or suggestion to offer?

  2. Visit Ginger35 profile page

    About Ginger35

    Joined: Aug '05; Posts: 176; Likes: 13


  3. by   llg
    Not all positions are listed with Monster. I would contact a couple of head-hunter firm and let them know what you are looking for. You can usually find their advertisements in nursing journals.

    Many "first level" management positions are hired from within. So, if you know of a hospital that you would like to work at, you might want to take a job there as a staff nurse to get your foot in the door. If it's a financial possibility, you might want to work in float pool within that hospital ... or work for an agency that would expose you to multiple possible employers.

    The agency or travel nursing option might be good because you could take a series of 13 week contracts and get your foot in the door at several places. As they interview you and get to know you, there would be no problems telling them something like, "I'm doing travel nursing while I am looking for a management job." As they get to know you and see you as a competent nurse, they may know of a position that would be right for you. The key is to network and keep your skills current. Volunteer for special projects/committees, etc. Be the Charge Nurse or Shift Coordinator (or whatever) and get involved in activities that help run the unit. Highlight those things on your resume.

    It is rare to see people go from being a staff nurse directly to being a full time manager or director. Most people go through an in-between stage, during which they are still a staff nurse (or assistant manager, or shift coordinator, or something like that) with some enhanced responsibilities that give them a little experience in the management realm. How much of that type of stuff have you done?

    Keep in mind that you may have to take a job or two that is not your dream job in order to make that transition to management. It might be a med/surg unit or a unit in a hospital that is not the type in which you will want to stay more than a year or two. It might not even be a regular management position: it might be an assistant manager or a team coorinator or a project manager position or something like that.

    Anybody else have any suggestions?
    Last edit by llg on Mar 30, '07
  4. by   traumaRUs
    SIx Sigma is what our hospitals in central IL are all using for their "change agents." I know having a yellow belt or green belt is useful for the management-hopefuls too.

    Another thing you might consider a management position outside of the hospital as a first-run so to speak. That would give you exposure to management too as well as some experience.

    Another option, though not management is to get your APN. I actually started a combined MSN/MBA program but got too bogged down in the business courses and realized that wasn't what I wanted to spend my time on.

    Hope this helps.
  5. by   Ginger35
    llg & TraumaRU - Thank-you so much for your responses and feedback.

    It is so nice to post on here and get some insights. I know that having the masters in business will definitely help a lot. The MSN, I may have to wait a bit to pay off some loans - then go back unfortunately - unless something is negotiated in a contract about obtaining this.

    Please keep the ideas coming....
  6. by   JoycMarr
    As someone mentioned above, most levels of management in nursing have started out at the lowest level and worked their way up. For example, one might be an assistance manager (and still be working as staff nurse) or spend years as a charge nurse before progressing to managing a unit (which is an entry level manager). So even if you have a MBA I don't think you would be able to just immediately be hired in a Director or VP level. From what I've seen they really are looking for the years of experience and not so much the education in many cases. I'm not sure what advice to give you except you may have to apply for a entry level management position and if you 'prove' yourself it may be easier to transition within a year or so with the education you have. I personally chose a MSN over the MBA because I wanted to have choices. What I've found is it's made me able to market myself better. I never understood why everyone thinks that figuring FTEs and budgets is so hard when usually a computer program is doing the hard part (the math) for you....LOL.
  7. by   Ginger35
    Thank-you JoyceMarr,

    Here in the Indiana - Ohio area, I have seen the progression to management. Many who did not have the "mgt" experience but promoted from within. Though, I do see your point here in regards to management experience. I do not expect this to be a cake walk - that is for sure. I do plan on the entry level mgt for a start. Everyone has to start somewhere. At least the education will be behind me - for a little while anyways..
  8. by   neneRN
    I agree with the above posters re: try and get some lower/middle management experience as charge/supervisor and work your way up from there. Both of our current nurse managers started as staff nurses, progressed to charge, and then supervisor before becoming managers(one has >20 yrs exp in same dept and the other, 7 years in same dept.) But this process can take several years. I worked as a staff nurse for 3 years, charged for 2, and just started as supervisor this year and that's as far as I want to go into management. I think most units like to hire from within..I would pick an area you love and go this route.
  9. by   classicdame
    I would also consider an appointment with the graduate student's dean and even the dean(s) at the area nursing schools. They know about positions because they deal with various facilities. One of my instructors recommended I contact a facility about an opening that had not yet been advertised and I was hired shortly thereafter. Good luck.
  10. by   mommy2boysaz
    Ginger, I tried to PM you but your mailbox is full and it won't go through until you "make some space"!

    Let me know when you have room!
  11. by   desertrn
    <TABLE class=tborder id=post2202753 cellSpacing=0 cellPadding=6 width="100%" align=center border=0><TBODY><TR vAlign=top><TD class=alt1 id=td_post_2202753 style="BORDER-RIGHT: #ffffff 1px solid"><HR style="COLOR: #ffffff" SIZE=1> <!-- / icon and title --><!-- message -->I have been a nurse for 20 years.(Ten of those in the ED) My last 3 years in the ED was under a manager who bullied me on a daily basis. Wrote me up for ridiculous hear-say lies from a few of her new hire, incompetent, lazy, loud mouth friends.
    Now I have these bad marks on my otherwise spotless record. My manager was recently fired and my complaints along with the Dr.'s and several other nurse's was the catalyst.
    I was recently offered a position, which involved a promotion and raise with
    the same healthcare organization. When I called a few days later to check the status of my transfer I was told "Sorry the position isn't available".
    I've got a feeling that the person who offered the job took a look at my file and backed out. What can I possibly do to recover my reputation? Should I question this manager to be sure of my suspicions? I am more than qualified for the new job. And I know it is still available.
    <!-- / message --></TD></TR><TR><TD class=alt2 style="BORDER-RIGHT: #ffffff 1px solid; BORDER-TOP: #ffffff 0px solid; BORDER-LEFT: #ffffff 1px solid; BORDER-BOTTOM: #ffffff 1px solid"> </TD><TD class=alt1 style="BORDER-RIGHT: #ffffff 1px solid; BORDER-TOP: #ffffff 0px solid; BORDER-LEFT: #ffffff 0px solid; BORDER-BOTTOM: #ffffff 1px solid" align=right><!-- controls --></TD></TR></TBODY></TABLE>
  12. by   Ginger35

    I would think that you are entitled to view your file in HR. So, I think that is a good place to start. Anything that you feel is inappropriate, untrue & etc should be addressed and perhaps contested. I would definitely explain about how long you have been there and your stellar employment history prior to this nurse manager coming into the picture and how her write up has affected your growth within the organization. Point out this last issue you just explained to us. I would *think* this would prompt some sort of action.

  13. by   RSturchRN
    I have been a nurse for 12 years. During those 12 years all in surgery my roles included everything from staff RN to charge RN. Once I decided to take the leap of faith in management, I chose to change organizations. I was fortunate in the new organization in that I had a director that was willing to teach me about budget, leadership, ect... I currently hold a BSN and if I were to pursue my education it would be a MBA. I agree with the Six Sigma Leadership program. Obtaining the blackbelt and or green or yellow is most helpful. I believe going directly from staff to a director role could be overwhelming! While education is important, don't forget about the politics of a situation. Good Luck to You!
  14. by   Ginger35

    Thank-you for the feedback. Yes, going from a staff position to a directorship would be a big change for anyone. That is part of the reason I decided to "bridge" with the MBA.

    I know many hospitals are gearing more and more working toward quality initiatives. I believe that this is due to CMS outcomes and this being tied to reimbursement.

    Anyways, I have seen quite a bit of postings for jobs regarding the yellow, green, and black belt in Six Sigma. I had thought that these certifications were for those who come from a background in QM or TQM (I understand that everyone needs to be involved in quality).

    Anyways, my question: Are they expecting managers from all disciplines to obtain these certifications from your area? Just curious. How would one go about getting them?