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'Can you manage nurses if you don't actually nurse?'

  • Comments (5)

Years ago I worked with a nurse manager who was happy to tell her staff that their standards were too high. She rarely ventured onto the wards where standards of care were a problem. Wearing a suit and managing with extremely long arms from an office several floors away from her wards meant she rarely saw a patient let alone what was happening behind the curtains.

Can you manage nurses if you don’t actually nurse?

The recommendations of the Francis report suggest nurse managers need to be more clinically involved. But we have created a system that undermines the value of clinical care. Career progression with higher status and salaries takes our most able nurses away from the bedside. This creates barriers between clinical nurses and nurses who don’t nurse. Nurses commenting on this website appear to have little regard for their managers because in their eyes they lack clinical credibility.

Perhaps, on this issue, we can learn something from medicine. Doctors place great value on clinical skill and expertise. Doctors in management positions practise medicine and also go to meetings. Medical directors look after patients. So when they talk about medical issues they are informed by first-hand experience, who can argue with that?

Sadly, walking wards and spending time with staff once a month or even once a week does not equate with being a clinical expert.

It would be great if nurse managers carried a clinical caseload but how would it work in practice? I am interested to hear your views.

  • Comments (5)

Readers' comments (5)

  • Being a nurse and a manager has different skill sets.
    Managing means being able to manage people.

    How many managers trained as nurses?
    How many nurses trained as managers?

    How would the manager who has trained at uni, got a degree in management cope with a patient?

    To be a good nurse/manager you need be good at both things and that's probably hard as managers and nurses train for completly different set of skills but it is possible.

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  • Skills and expertise have to be developed in both, and interlinked. A highly experienced + trained nurse does not instantly become a competent manager, likewise an experienced manager from another area would need time to develop nursing skills.
    Competent managers are able to utilise resources at hand to deliver a service that is required. Limitations are usually driven top down. Expert managers are able to provide enough resources to those who need it to deliver the required service by acquiring, negotiating and balancing resources and their limitations. If limitations are preventing safe service delivery, they can make a business case for them and also to inform clients/patients of these limitations so to give them a good understanding of the situation. Great managers can see tiny details as well as the broader perspective, and are readily accessible and approachable. They can also empathise from another person's perspective.
    Managers may not also necessarily be good leaders and same applies the other way round.

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  • Anonymous

    PDave Angel | 26-Mar-2013 12:44 pm

    MSc Healthcare Management, RN - no job!

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  • Anonymous

    I will like to see nurse managers first be nurses, then if they like, take on the necessary training required to become managers. Very important though, is that all nurse managers should carry a clinical caseload and keep their feet firmly on the ground.
    This is not impossible, by dividing their working time into the two areas and keeping the two separate to ensure 100% of their time in any area is not diluted with distractions from the other area.
    In fact if all the nurse managers use this model of work, while in the week one manager is being clinical another can be non clinical.
    The true Nurse Manager will relish this model.

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  • Ellen Watters

    Nurses diversify in many ways throughout their career. And it may be that until you have been a nurse for quite some time (years) that you don't know which area you would like to specialise in or what your particular skills and strengths are, be it management, oncology, or other related area, some nurse leave to become paramedics or lecturers for instance.

    I think that managing nurses is quite a unique skill to have and you need to have some insight into what they do on a day to day basis in a wide range of areas and circumstances.

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