Suppose your manager (or her manager) came onto your unit right now. Could you answer these questions:
1. Are there any patient safety issues on the unit?
2. Where are we vs. budget this week?
3. How are supplies? Are we within budget? Are any supplies at risk of being expired? Are par levels appropriate? Are supplies organized and accounted for?
4. Have you completed performance evaluations for all of your staff on the unit?
5. What is happening during the afternoon and night shifts?
6. Which patients are ready for discharge, and which are having issues that will lead to a longer-than-anticipated stay?
7. What beds will be available today, and approximately at what time?
8. Is every nurse on the unit safe, competent, loyal, committed, and proud of the results on the unit?
9. How have you interacted with the medical staff today? Are there any issues, complaints, or suggestions from the medical staff we should be considering?
10. Are there any issues with staff that could lead to grievances or that are causing a competent nurse to be a “flight risk”?
These are only some of the details that the effective nurse manager attends to every shift, every day — while also thinking about longer term issues of improving performance on the unit. The best nurse managers are proactive in anticipating problems and resolving them, ideally in a way that inspires confidence from her own manager and frees her manager to focus on other pressing issues.
The nurse manager’s role is a challenging and crucial one, especially because of the myriad issues and details that she must track and handle. This is a position that requires 100% accountability and responsibility, even for things not always within one’s control.
