What do nurse managers and clinical directors actually do?

Specialties Management

Updated:   Published

On any given day, what are the responsibilities you have as nurse manager or clinical director? I think management sounds fascinating and the 30+ year career nurses in my unit say they see me in management or as a director down the road, so I thought I'd see what it's all about!

MBARNBSN said:
I don't delegate my job. I do my job. I am a middle manager and a charge nurse. What tasks have I written that can delegate? I call doctors and page them myself. I pass my own meds. I talk directly to whomever.... I also perform my own teachings, audits,... huddles... attend meetings... trainings.. etc. myself. Are you talking about when I ask other departments to take care of things? Yes, I delegate the task of Engineering to Engineering and Housekeeping to Housekeeping... However, I perform my own follow ups because *I* am questioned as to why something is not done and not someone else.

I also supervise my direct reports myself. I evaluate them myself. I take care of their needs and help them to grow, myself. I discipline them myself. I do not have others to delegate to because again I am a middle manager + a charge nurse so I also run my shift myself. Maybe once I am off the floor and further up the food chain, then what you wrote will be true?

I agree. So many places operate so differently. It sounds like you are in what was called an assistant manager at my current job or an assistant unit director or a team leader or a supervisor... every place has a different title for levels of management. Some have a more "team management" approach where the manager/director may have a large number of FTE and several assistant managers. Some have managers with lower FTEs but little support from assistants. And some unfortunately have manager with a large number of FTEs and little support. It's all relative...

1 Votes
Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
jrt4 said:
I agree. So many places operate so differently. It sounds like you are in what was called an assistant manager at my current job or an assistant unit director or a team leader or a supervisor... every place has a different title for levels of management. Some have a more "team management" approach where the manager/director may have a large number of FTE and several assistant managers. Some have managers with lower FTEs but little support from assistants. And some unfortunately have manager with a large number of FTEs and little support. It's all relative...

I'm curious, in your facility, how many FTEs before a manager is given a supervisor?

I'm also curious what is the typical ratio of FTEs to staff. I have about 34 FTEs and 60 staff members. That ratio seems really high to me (meaning, a lot of staff for the number of FTEs I have), particularly at annual evaluation time.

1 Votes
jrt4 said:
Man... where do you work? It sounds like I need to get a job there as a manager. My 50+ hour work weeks busting my butt certainly do not compare to your experience at any of the hospitals I have worked at. Walk a mile in the managers shoes and it may not be so "cushy" as you think...either that or you have a really crappy manager.

Me too! Where can I sign up for that job. There is a reason why there are so many open nurse manager jobs and/or nurse managers don't last long. It appears to be a cushy job. I think the biggest thing I had to get used to was the mounds of paperwork. It's not a job for someone that wants to do 8-4, leave on time and/or feel like they are getting everything done. But it can be rewarding if you remember what it was like to be on staff.

1 Votes
klone said:
I'm curious, in your facility, how many FTEs before a manager is given a supervisor?

I'm also curious what is the typical ratio of FTEs to staff. I have about 34 FTEs and 60 staff members. That ratio seems really high to me (meaning, a lot of staff for the number of FTEs I have), particularly at annual evaluation time.

I don't know the average but based on my past experience its usually around 50 people 30FTE you would have an assistant nurse manager. I have 1 assistant nurse manager that I always seem to have to put into staffing just because of how we do productivity. I have around 80 staff across 4 departments. It's too much. At my previous job I had about the same amount of staff but had a full time assistant nurse manager. We were much more effective. Ho hum.

1 Votes
Specializes in L&D.
klone said:
Typical day:

Do it all again the next day, with individual variations.

?

You sound like an awesome manager and make mine look like _____. Many of the things you do she delegates to the charge nurses and staff nurses. The only thing mine seems to do is tinker with our schedule.

1 Votes
Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
RN_10 said:
You sound like an awesome manager and make mine look like _____. Many of the things you do she delegates to the charge nurses and staff nurses. The only thing mine seems to do is tinker with our schedule.

Thank you! Luckily, I have a nurse that does the unit's schedule. I bribe her regularly with candy because I would be seriously lost if she decided she didn't want to do it anymore!

1 Votes
Specializes in Management.
poopylala said:
On any given day, what are the responsibigies you have as nurse manager or clinical director? I think management sounds fascinating and the 30+ year career nurses in my unit say they see me in management or as a director down the road, so I thought I'd see what it's all about!

We just had to do an exercise where we attributed time for each and everything we do as managers. It came out to 72 hours a week not counting interviews and special meetings. I guess I know why I am so tired all the time :D

1 Votes
Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
txredapple79 said:
We just had to do an exercise where we attributed time for each and everything we do as managers. It came out to 72 hours a week not counting interviews and special meetings. I guess I know why I am so tired all the time :D

Yeah, I average 55 hours a week. I figured it out, and I make less than about 1/3 of the nurses whom I lead.

1 Votes

What a joke this thread is. Lazy management slave drivers talking about how tired they are and how stressful their job is. Give me a break. Try working the floor 8-12 hours a day 40+ hours a week. Where I work, the ADON and unit manager quit because they had to work the floor. Our morbidly obese DON was visibly distressed when she had to take a turn and remarked to me "I don't know how you guys do this every night". It is hellishly gratifying to see manage parasites and slave drivers fall apart when they actually have to do some work. They can't do the same work they are always threatening and intimidating us to do....do this, do that, I will write you up, disciplinary action up to and including termination, etc etc. One would have guessed that they broke their legs or had their fingers amputated when they are asked to push a cart up and down the floor. Truth be told. they are all lazy, sadistic do nothings who refuse to work the floor or dread it and that is why they quit when they are forced to.

1 Votes
Specializes in PeriOp, ICU, PICU, NICU.
Truth_be-told said:
What a joke this thread is. Lazy management slave drivers talking about how tired they are and how stressful their job is. Give me a break. Try working the floor 8-12 hours a day 40+ hours a week. Where I work, the ADON and unit manager quit because they had to work the floor. Our morbidly obese DON was visibly distressed when she had to take a turn and remarked to me "I don't know how you guys do this every night". It is hellishly gratifying to see manage parasites and slave drivers fall apart when they actually have to do some work. They can't do the same work they are always threatening and intimidating us to do....do this, do that, I will write you up, disciplinary action up to and including termination, etc etc. One would have guessed that they broke their legs or had their fingers amputated when they are asked to push a cart up and down the floor. Truth be told. they are all lazy, sadistic do nothings who refuse to work the floor or dread it and that is why they quit when they are forced to.

A lot of these managers came from the floor and did their time. Went on to further their education and go into management. Not all managers are lazy slave drivers. I have worked with some that aren't and some that are quite the opposite. Like in every walk of life, you will find good and bad. I am thankful there are some willing to go into management because I know that is something I would never want to do myself.

Don't be so hateful. Not everyone is as you portray them and some are worse. Truth be told.

1 Votes
Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

What a little ray of sunshine you are!

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klone - you seem FANTASTIC! I am currently an entry level supervisor that just received a promotion to Nurse Manager. I strive to help my staff out AS MUCH AS I can because I know what it's like to feel like you're drowning and have no one to help, or even to offer! Great job and I bet your employees LOVE you!

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