Like being charge, what does this mean for my career?

[Joe NightingMale, MSN, RN]

I've been on the med-surg floor about a year and a half, while that's OK I really like being charge better:

I like not having to answer call lights all the time (usually only have 1 low-acuity patient as charge) and being interrupted while I'm doing some other task.

I like doing things that involve planning and creativity, like doing the assignment or managing the staffing

I like the independence of going around helping other nurses.

I've been thinking about what this might mean for the future. One obvious suggestion is case manager, though the other obvious suggestion, unit manager, is something I'd like to avoid. I wondering, though, if there are possibilities that I've missed.

Thanks

[GHGoonette, BSN, RN]

I must say, unit manager is what sprang to mind; what don't you like about it? I know it's a pain having to do all that admin, but the best unit manager I know mucks in with her nurses; she is a guide and mentor in her department. And let's face it, such UMs are in pretty short supply.

You don't see yourself as in education or clinical instruction? Sounds to me like the "creativity and planning" bit would fit in pretty well with that ambition...

[Joe NightingMale, MSN, RN]

Education (and I'm assuming clinical instruction) is another possibility I'm open to, along with research.

I have strong reservations about the UM role for primarily two reasons:

1. Having to settle disputes between nurses. I really don't want to deal with the sometimes incredible level of hostility that one sees on the floor.

2. Having conflicting pressures from the nurses and the administration. Like when the administration demands one thing but the nurses either can't or won't do it, or have different priorities. You end up with the kind of insane stress my uncle had as a foreman for Ford Motors, dealing with conflicting demands from the workers and the administrators.

[llg, PhD, RN]

I was a really good Charge Nurse early in my career, too. I liked it and was good at it -- significantly better at it than many of the nurses with more experience.

When I originally went for my MSN, I majored in Nursing Administration, thinking that would be a good fit. But after only a couple of classes, I discovered that I was not really interested in many of the aspects of management roles -- such as budgets, assuring adequate supplies, being responsible for staff coverage 24/7, etc.

I switched my major and prepared for roles that combined CNS and Staff Development functions -- sort of like a CNL role (that didn't exist yet). I liked being the clinical leader, evaluating the care given in the department and helping the nurses give the best care possible. Sometimes that involves creating a new program, writing new policies, etc. and sometimes it involves doing staff education. It's something a little different each day of the week -- but the constant focus is that of helping the staff nurses deliver great care. That feels good.

Maybe you would like a role something along those lines.

[GHGoonette, BSN, RN]

I think that's a brilliant suggestion-the best of both worlds-and the closest to an exact fit if I read Joe's post correctly.

Strong managers can keep those interpersonal stresses under control, but have to be pretty ruthless sometimes. As for those clashes between policymakers and staff, they can get very bloody indeed, and intensely frustrating when the UM disagrees with admin.

In small hospitals where there's less paperwork for the UMs and a good team spirit between the staff members, as well as an admin that leaves the nursing managers to attend to nursing-related matters, running a department is a pleasure. But these are becoming few and far between, as the corporates ingest more and more of the little guys.

[Joe NightingMale, MSN, RN]

I switched my major and prepared for roles that combined CNS and Staff Development functions -- sort of like a CNL role (that didn't exist yet). I liked being the clinical leader, evaluating the care given in the department and helping the nurses give the best care possible. Sometimes that involves creating a new program, writing new policies, etc. and sometimes it involves doing staff education. It's something a little different each day of the week -- but the constant focus is that of helping the staff nurses deliver great care. That feels good.

Maybe you would like a role something along those lines.

Staff development is another possibility, kind of related to education (which I've also considered).

That would be a pretty good role, the one you describe. I like serving as a resource and solving problems, not bossing people around and hearing endless complaints and whining (which was how my last shift as charge went).

One of the things that makes me nervous about the educator role is how some of them seem entirely superfluous.

But that gives me something to think about. I've already considered the obvious choice of case management, but this is also a distinct possibility.

[GHGoonette, BSN, RN]

If I recall the various roles of my clinical instructors in the academic hospital where I trained, the job desciption would read:

Develpoment and implementation of in-service training programmes.

Integration of students into the clinical setting.

Preparation of students for clinical (practical) tests and examinations.

Evaluation of students in the clinical setting.

Development and organization of learning resources.

Probably much more, but this gives an outline of the kind of career I think might appeal to you. It would certainly exercise your leadership and creativity without having to put up with the day-to-day whining and conflicts associated with most management positions. Clinical instructors are so important in larger hospitals, in order to keep existing staff up to date with new developments and their skills honed, and orientation and training of new staff members.