No job in your hospital is quite as important as that of the nurse manager. They are ultimately responsible for keeping your patients safe and comfortable, and their families and visitors happy. They also ensure that the nurses they supervise are well-trained, highly motivated, and provide the best possible patient care. In addition, preparing and administering a departmental budget is also among the nurse manager’s responsibilities. Finally, nurse managers must interpret your organization’s mission and philosophy, and ensure that the nurses for whom they’re responsible reflect those ideals in their day-to-day actions.

But the establishment of a group of competent and effective nurse managers in your organization doesn’t happen by accident. It takes a commitment to an ongoing process for selecting, training, and motivating them. Let’s consider each of these efforts in more detail.

Choose the right nurses as nurse manager candidates

You should consider a number of attributes in your nurse manager candidates. Most important is the right attitude. Do you have a nurse who is especially helpful, kind, considerate, and more interested in getting the job done than other nurses on the team? Look for someone who sees nursing as a calling and not just a job. As we learned in our last newsletter, you just can’t teach attitude.

The next key trait to look for is dedication to the practice of nursing. It’s practically impossible to measure, but you know it when you see it. Some outward examples would be a staff nurse who decides to take classes to improve her skills at her own expense; or a nurse who volunteers her/his time at a homeless shelter, where medical expertise is always needed. If you observe a staff nurse with an especially strong level of commitment to patient care and dedication to the profession of nursing, chances are excellent that s/he will excel as a nurse manager.

One other key characteristic is leadership. Do any of your nurses take on more responsibility without being asked? Does s/he regularly provide guidance and direction to other nurses without coming across as bossy and controlling? When the going gets tough, how does this person respond? And last, do the other nurses like and respect this individual?

If your organization is fortunate to have a staff nurse with a great attitude, a love of nursing, and the qualities of a leader, you’ve found your next nurse manager trainee. I urge you to take a close look at your staff nurses with these attributes in mind. Promoting a person without these three key qualities might “fill the opening,” but you will not get the best nurse to manage team members effectively for the long term. Remember, today’s hiring mistake is tomorrow’s problem.

Provide the best training you can for your nurse manager trainees.

Presumably, the nurse(s) you identify for management are seasoned professionals with great education, skills, and backgrounds. Despite that, additional training and leadership development will likely be necessary to ensure the new nurse manager’s success. Many hospitals today, unfortunately, do not have the resources to provide adequate orientation and training inhouse; the smart ones look to outside organizations for help.

For example, The Institute for Johns Hopkins Nursing runs the innovative Nurse Manager Academy, designed to ensure that nurse managers have the skills and perspectives they need to be successful in their positions. The mission of the Institute is “to share the innovations in practice, science, and scholarship of Johns Hopkins Nursing with other healthcare professionals locally, nationally, and worldwide.”

I spoke with Jane Shivnan, MScN, RN, AOCN, Executive Director of the Academy. She explained that because the nurse manager has one of the hardest jobs in healthcare, it’s imperative to give them all the tools they need to be successful. “We teach basic business skills,” said Shivan. “Nurse managers need to know how to manage budgets and people. They also need to improve their communication, presentation, and negotiating skills.”

Known as the “Cadillac” of nurse manager training programs, Johns Hopkins provides a five-day course that leaves nurses feeling refreshed and recharged, ready to get back to work with new skills. They also have new colleagues, with whom they keep in touch by listserve, sharing ideas and best practices. The cost is (I think) very reasonable at $3,300, which includes tuition, meals, lodging, and even a massage.

The return on investment is excellent. One Midwest hospital sent all fifteen of their nurse managers to the Academy over the past few years. All are still at the hospital and two have moved up to director-level positions. Bermuda is so impressed with the program they send all of their nurses, while hospitals in China, Singapore, and the United Arab Emerits send as many as they can. Locally, Boston Children’s, Brigham and Women’s, and Mass General all have taken advantage of the Academy.

Let nurse managers know how they can grow professionally within your organization.

Three main retention drivers, according to the Retention Drivers Report, by Career Systems International, are exciting work and challenge; career growth, learning, and development; and working with great people and relationships. Let’s take a moment and focus on career growth, learning, and development. These are the real keys to retaining your nurse managers and discouraging burnout.

A career doesn’t always mean moving up. Offer your nurses multiple options, such as lateral moves, special projects, or growing in place. Ask your nurse managers what they would like to learn and how. Perhaps one wants to improve her financial skills by taking a class at a local community college, while another wishes to learn more about team-building at a weekend workshop. The fact that you ask and show an interest in their careers will greatly improve your chances at retaining these valuable individuals.

Summary: While we’ve seen many significant changes in my 30 years in hospital administration, one constant has been the need to develop and retain the best nurse managers possible. By making this a top priority at your organization, you will reap the benefits well into the future.