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A Dying Breed.

Posted Dec 23 2008 9:14pm

I n today’s healthcare work environment it is increasingly difficult to find nurse managers that are clinically competent to function in the areas that they are administratively responsible for. Many nurse managers have transcended the bedside functionality of nursing and gone on to fill their days with Joint Commission requirements, budgets, personnel evaluations, schedules, and a host of other administrative activities. Walking into just about any nurse manager’s office one will find a slew of files, folders, books and small post-it notes littered on any surface – horizontal and vertical.

Nurse Managers have by the very nature of their position twenty-four hour accountability for the department that they oversee. They are the main contact person for any other discipline or internal and external source for that clinical area. In essence they are the go to person. For someone to aspire to such a position of responsibility one must poses good communication skills, be well organized, resolve conflict appropriately, and show abilities to handle stressful situations. Why is it that so many managers become and are unable to function in a clinical capacity in their own departments?

The nurse managers of today live in an office that is dimly lit and often times segregated from the clinical area that they are responsible for. They are difficult people to reach. Staff members that work during the off shifts rarely have any contact with their managers unless it is done via e-mail, and that is when the manager decides or remembers to respond to the original staff member’s mail. When asked about clinical issues many nurse managers are unable to provide adequate feedback for complex clinical questions. Many nurse managers are not even familiar with the day to day processes of their own departments. And most nurse managers are not clinically competent to work in the areas that they govern. This fact is the most concerning.

Why is it that today’s managers are so incapable functioning in their own areas? Why don’t we see nurse managers regularly working in their own clinical area? How can they accurately assess and evaluate other staff members, identify processes that need improvement, and understand the issues in their own department when they are held to their desk chairs like a hunk of steal is to a magnet? Many a staff nurse has said to me “I’d like to see them come out here and do all this everyday”, a point well taken. It is time for nurse managers in all sizes of facilities to become more involved in the day to day operations of the areas that they are responsible for. Put down the clip board and mouse and step away from the desk. It is time to do a little trench time.


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