A nurse in the United States is positioned as a doctor’s partner, which is logical: a nurse is constantly in contact with the patient, meets all their needs, responds promptly to the deterioration of their physiological and psychological well-being, and builds relationships with relatives of patients. The nurse’s primary responsibility is to identify all the relevant information concerning the patient’s health condition and prior medical history to provide this information to a clinician and secure a proper treatment plan. A strict division of duties exists not only between nurses and doctors but also within the healthcare hierarchy that develops in the practice setting depending on the level of competence of the staff. The nurse manager is responsible for managing the nursing department; usually, they report to the service director. They are fundamentally accountable for recruitment and day-to-day operations of the unit—for example, the division of liabilities.
The Features and Difficulties of Working as a Nurse Manager
Being a Leader
Leaders are members of the group capable of making responsible decisions in critical situations. They are authoritative people who play a central role in organizing joint activities and regulating relationships in various ranks. A nurse manager should be able to lead subordinates. Since leadership is inherent in group activities, and nurses are united in a group structure, management and leadership in medical activities are conditioned by each other (Gardner et al., 2019). If a nurse manager is a leaders, they will be able to competently organize the actions of their subordinates and provide patients with high-quality care and assistance.
Educating and Motivating the Staff
Besides carrying the responsibility of a leader who organizes and manages the nurses’ workflow, nurse managers are also perceived as role models in academic preparation and dedication to work. Thus, according to Bianchi et al. (2018), nurse managers play a significant role in promoting and implementing evidence-based practice in the workplace. Indeed, while required to have solid academic knowledge and the ability to work with scholarly evidence, managers are also expected to educate nurses on how to use scholarly evidence in clinical practice. Furthermore, the nurse managers play an exceptional role in motivating and inspiring the staff. According to Keogh et al. (2019), there exists a threatening tendency of staff shortage due to work overload and a discouraging environment. The COVID-19 pandemic contributed significantly to this tendency, making the correlation between the amount of work and average pay more negative. Hence, the nurse managers are to secure a beneficial working environment where nurses’ work is regarded as valued, and the communication with superiors is meaningful and non-derogatory.
The Problem of Planning
Due to a large number of responsibilities, the nurse manager faces a large amount of work. Therefore, there is a need to properly plan the workflow and distribute functions among subordinates (Warshawsky & Cramer, 2019). Planning helps the managers correctly determine the goals and objectives of the upcoming work. However, the primary purpose of nurse managers’ planning addressed the need to establish a properly functioning workflow with a beneficial outcome for most employees. Hence, budget allocation and shift schedule preparation are the primary responsibilities of a manager. In order to complete planning with minimum dissatisfaction rate and maximum efficiency in patient care, nurse managers are to constantly communicate with the team on their concerns and possible contributions to the workflow. In such a way, nurse managers are capable of maintaining efficiency and preventing staff shortages and low team morale.
Control may be defined as a system of procedures aimed at increasing the team’s efficiency and detecting obstacles in the workflow at an early stage. In human resources, control can be achieved by analyzing the professional and business knowledge necessary to perform essential job duties. That is why to get the results of such control; it is required to organize feedback to increase the motivation of subordinates for practical work. One of the beneficial ways to secure the nursing performance is for the nurse manager to conduct a self-evaluation session for the staff, followed by a feedback session. Indeed, according to Rasheed et al. (2018), self-awareness plays a crucial role in nurses’ education and cooperation with patients. Hence, by introducing regular self-evaluation sessions, the nurse manager can control the employees’ progress and encourage them to practice and evolve into professionals without constant supervision and superiors’ control.
Medical Workers Staff Reduction
The Main Problem
Registered nurses, supervising assistants, and nursing assistants, perform an impressive range of functions: assess the condition and symptoms of the patients, keep a patient’s medical history, provide medicines, cooperate with other medical specialists, and consult with doctors to create an individual treatment plan. In the United States, healthcare workers face layoffs, reduced salaries, and significant work overload due to a lack of federal healthcare support. As a result, exhaustion and lack of financial incentives affect the nurses’ job satisfaction and quality. Many states in the U.S. have stopped private medical procedures during the pandemic to curb the spread of the coronavirus. Instead, the focus has shifted toward providing urgent health care that requires more talent and less financial support. As a result, fatigue and extremely high-stress levels have led to lower occupational satisfaction and turnover (Savitsky et al., 2021). Hence, it becomes evident that in such a context, the primary role of the nurse manager is to boost the employees’ morale by securing meaningful communication and allocating professional duties.
A Personnel Crisis
Besides, one of the principal obstacles in nursing is the lack of workers. Since nurses comprise the most comprehensive group of health care providers, this personnel deficit puts many clinics and hospitals at risk of a staff crisis. That is why they need more nurses, and the sooner, the better. The situation is also settling to nursing supervisors, who are also now massively retiring (Phillips et al., 2017). Therefore, it is crucial to improve working conditions and provide students with a more affordable education choice.
The Evidenced-Based Practice System Implementation
The Evidenced-Based Practice (EBP) system is a strategy for integrating production and personnel, finance, and asset management to optimize the organization’s resources. The medical EBP system creates an integrated online database, which receives information in real-time (Shuman et al., 2018). At the same time, the costs of automating processes are reduced since the system keeps records of patients, drug stocks, and their purchases. EBP platform providers offer installation on the client’s equipment (local connection) with a cloud service. In the first case, one or more databases are created, and the organization owns them on the local network. In the second case, the applications are in a split mode in a shared database. So, each medical organization is allocated a separate area isolated from others. The “second type” of application aims to reduce the cost of maintaining the application by combining costs. Cloud applications quickly adapt to the needs of medical organizations using special expansion channels. At the same time, the software code does not change. If the vendor releases an updated solution version, the platform automatically combines it with the existing version.
The Problem Resolution
The Need for the Distribution of Responsibilities
In addition, with a wide scale of manageability, a nurse manager is busy solving various operational tasks at the loss of strategic ones. Overload is accompanied by the loss of personal contact between the manager and the staff; as a result, control over subordinates becomes more complicated, and the quality of employees’ professional training decreases, negatively affecting the team’s psychological climate and the results of their work. Thus, under such working conditions, requests to the nurse managers increase dramatically and sometimes go beyond their physical capabilities. Proper distribution of responsibilities requires high managerial skills and theoretical training for nurse managers.
Moreover, the nurse manager should know how to delegate authority. Delegation of authority is not a shift of affairs, not a search for free hands but a search for a candidate, a specialist who can cope with the task and share responsibility with you. If the nurse manager assigns too many of their duties to others, employees get the impression that they are not doing anything. The manager should remember that delegation is not “dumping responsibility” on an employee and not distributing responsibilities. The primary responsibility lies with the nurse manager, both for themself and the employee, so it is imperative to choose the right candidate to perform the task. And the job of motivation is to set goals and objectives so that people want to do what is necessary and how it is required. An employee who strives for success and development will work more efficiently, and employees with a creative approach will do their job better.
The Research on Delegation of Authority
Joint management at the unit level was considered to solve the above problems and the nurse manager’s work difficulties. It is a management process in which decision-making authority is delegated to the nursing staff at the unit level (Sullivan et al., 2017). Ten nurse managers were interviewed on the peculiarities of their work. The data was collected using content analysis and unique comparison methods. The participants’ quotes were grouped to define sub-topics and then into four global topics to describe joint management at the unit level (Fawsett, 2017). The result of the study was that collaborative management would significantly facilitate and expand the work of nurses. The judgments show the necessity for nursing managers to promote and appreciate staff cooperation in mutual management at the system level.
The main problems faced by the nurse manager are the heavy workload in various areas of the healthcare setting, the lack of working time for them to perform all functional duties at the proper level, and the tasks assigned to the medical organization as part of the modernization of healthcare. Therefore, to cope with such a list of responsibilities, the nurse manager should learn to delegate their duties to their subordinate employees and encourage and recognize staff participation in joint management. An important of the problems described above is the reduction of the staff of medical staff for various reasons. Therefore, the paper provides an example of implementing the EBP system, which will help solve this problem.
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Keogh, T. J., Robinson, J. C., & Parnell, J. M. (2019). Assessing behavioral styles among nurse managers: Implications for leading effective teams. Hospital Topics, 97(1), 32-38.
Phillips, T., Evans, J. L., Tooley, S., & Shirey, M. R. (2018). Nurse manager succession planning: A cost-benefit analysis. Journal of Nursing Management, 26(2), 238-243.
Rasheed, S. P., Younas, A., & Sundus, A. (2019). Self‐awareness in nursing: A scoping review. Journal of Clinical Nursing, 28(5-6), 762-774.
Savitsky, B., Radomislensky, I., & Hendel, T. (2021). Nurses’ occupational satisfaction during Covid-19 pandemic. Applied Nursing Research, 59, 151416.
Shuman, C. J., Ploutz-Snyder, R. J., & Titler, M. G. (2018). Development and testing of the nurse manager EBP competency scale. Western Journal of Nursing Research, 40(2), 175–190.
Sullivan, S. C., Norris, M. R., Brown, L. M., & Scott, K. J. (2017). Nurse manager perspective of staff participation in unit-level shared governance. Journal of Nursing Management, 25(8), 624–631.
Warshawsky, N., & Cramer, E. (2019). Describing nurse manager role preparation and competency: Findings From a national study. The Journal of Nursing Administration, 49(5), 249-255.