Advice for new ward managers

We often forget that nursing is as much about good management as good care giving.

Set your ground rules concerning what you can be flexible about and what you cannot

Whether that is managing yourself on a shift so that all your patients receive good care or being a ward sister responsible for care given by their team 24 hours a day, we are all taught to manage caseloads of patients, on a ward or in the community, from day one.

You just have to build on that premise - it is not just about going on a formal “management” course.

If you are a good care giver and you care about people, you’ll be a good manager because you’ll care about staff and naturally nurture them to be the best and provide the best care.

Nurses are good at following their gut instincts, and will deal with situations working out what naturally feels fair.

Leaders must practise what they preach. If I ask my team to do anything new, such as implement team nursing, or the mundane, such as cleaning the sluice, I always roll my sleeves up and do it myself too to show it is possible.

Set your ground rules concerning what you can be flexible about and what you cannot.

I am a great believer in pushing the boundaries and testing new ideas but, if there are safety rules, stick to them as they are there for a reason.

Support your staff if they can demonstrate a good reason for a course of action, even if it was done in an unorthodox way.

However, I remember an important turning point in my relationship with a number of staff who cut corners in doing a drug round. I observed an unattended drug trolley early one morning and removed it.

They were shocked when they saw it was gone - and saw quickly why that rule was there.

Their objective was to save time - which is laudable - but they compromised safety. Show your staff the impact of ignoring rules, rather than just reading out a dry list of regulations without context.

Lots of people don’t want to manage staff because it is seen to be really stressful if there are performance issues to manage.

Never shy away from managing staff performance. No one can improve if you don’t share your expectations and observations.

It is always better to spend time up front supporting and developing staff, through appraisals, objective setting and personal development plans than managing disciplinaries or other consequences of poor performance. Learn from the experience and expertise of your line manager and HR.

Caroline Alexander is director of quality and clinical governance for NHS East London and the City, and visiting professor at City University. She has been a nurse for nearly 25 years and was a Florence Nightingale leadership scholar in 2007

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