What all do nurse managers do?

Long Term Care Columnist / Guide · Apr 18, 2008

It depends on the job.

I'm the DON for a 42-bed assisted living facility. Every now and then I have to cover shifts, and I do some wound care and a LOT of education. Yes, I do spend quite a bit of time behind a desk---developing care plans, preparing staff training materials, answering questions, delegating nursing tasks such as fingersticks and insulin injections, working with other care providers and basically serving in an assistant administrator capacity. But when there's an emergency, I run just like I did back in my med/surg days............and I have to admit, I still like that adrenalin rush!

llg, PhD, RN · Apr 18, 2008

It depends. The higher up the chain of command, the less likely it is that a manager would be involved in direct patient care. However, a lot of hospitals have positions on the lowest rungs of the management ladder that work part of the time at the bedside and part of time doing "office work" types of things.

In essence, you are unlikely to see a Vice President for Nursing Services at the bedside ... but you might see an Assistant Unit Manager at the bedside.

The above refers to a large institution. At a small institution, you'll see more managers at the beside simply because the areas they are responsible for is much smaller.

candiceena · Apr 18, 2008

Thanks guys. Do you know how quickly one can get into the management aspect of things? Can this be a specialty that you lean towards like NICU or pain care? Also, does it require a business degree to get into management?

petra · Apr 19, 2008

I am the house manager of a small facility. I do work on the floor along with management duties. They include chart audits, admissions, P R scheduling and all employee issues.

I love both, patient care and management. The only problem I have is separating the two and organization.

allnurses Guide · Apr 19, 2008

I am a nurse manager within a large surgical unit and I insist on at least 2 clinical days every week. But it does get difficult sometimes as if there are managerial issues then the clinical days can get tied up with non clinical stuff. I always make sure that one of my deputies has a business day on my clinical days to try to deflect some of this.

UM Review RN, ASN, RN · Apr 19, 2008

Sorry for my being naive, but are nurse managers similar to managers in other fields? Or are they also involved in direct patient care?

Most nurses have more respect for the nurse manager who was excellent clinically and worked at the bedside for a few years before moving on to management.

We (I have to include myself in the group) feel that someone who has worked at the bedside can advocate for the nurses better, having actually done the job and felt the pain.

Long Term Care Columnist / Guide · Apr 19, 2008

Angie O, you are spot on! And the good nurse manager REMEMBERS what it felt like and treats her staff better as a result.

I must admit, however, that sometimes it's gut-wrenching to be on the other side of the desk when it comes to employee discipline and termination. I hate having to write up staff members, and firing someone upsets me for days even when it's deserved. Of course, I try to be fairly selective in the hiring process so that I don't have to discipline or terminate someone very often........:)

allnurses Guide · Apr 19, 2008

Angie O, you are spot on! And the good nurse manager REMEMBERS what it felt like and treats her staff better as a result.
I must admit, however, that sometimes it's gut-wrenching to be on the other side of the desk when it comes to employee discipline and termination. I hate having to write up staff members, and firing someone upsets me for days even when it's deserved. Of course, I try to be fairly selective in the hiring process so that I don't have to discipline or terminate someone very often........:)

I've found this about hiring as well, I am really harsh now on shortlist and interview and if there are any doubts I just don't appoint. It is easier that was rather than having to go through the process of trying to get rid of staff that can't perform. The HR stuff is the hardest part of my job without a doubt.

RN1989 · Apr 27, 2008

Thanks guys. Do you know how quickly one can get into the management aspect of things? Can this be a specialty that you lean towards like NICU or pain care? Also, does it require a business degree to get into management?

No it does not require a business degree but in many places it does require a minimum of a BSN.

Yes it is a specialty and there are certifications for being a manager.

I don't believe that trying to get into a manager position quickly should be your goal. You are the head of the food chain for a particular department. Which means that you must be on top of your game and be a resource person for nearly all problems that arise whether they be patient care treatment problems or interpersonal staff relationship issues that require good leadership skills.

The staff will have no respect for someone that does not have experience to deal with the numerous crazy situations that occur on a daily basis.

You must be able to multitask and quickly switch gears from working on a schedule to saving a pt's life, to counseling a staff member to going to an admin meeting then back to the floor to work as unit secretary for a while then back to your office to work on the budget then back to the floor to pass water and help pt's to the bedpan.

You will generally have 24/7 responsibility for your department. People will call you with the absolute dumbest questions at 2 am and you have to think clearly, respond to their question, and try not to bite their head off for not talking to the charge nurse or house supervisor first.

It is a lot of work and heartache to be a good servant leader. Do not enter into it lightly and blindly.

Chaoticdreams33, MSN, RN · Apr 28, 2008

I just thought I would add a little comment. One day as a nursing assistant I was called to come in because they were short. So short in fact, that our Nurse Manager was working as an aide! Yes, I actually took report from my NM who was in a plastic apron just finishing cleaning someone up. Props to her:)