management style – JRM Nurse Consultants

When a nurse is working in corporate America, changes are bound to be evident, from what the nurse was used to at the hospital. When nurses take on the this role, they have higher skill sets in the business world than in the clinical world since they do not practice and they may not feel confident providing care. The role of a nurse manager in the clinical setting when she is managing the business aspect can be very confusing for nurses. This is because their training is that of a nurse and possibly they received their MBA to manage an office, however when put in a clinical situation, due to less involvement clinically, they lose their clinical awareness.

In some places, there are many nurse managers that are in this manager role and there is very little clinical involvement. The clinical they may get to do as a manager is when they go out in the field quarterly with staff or when they do chart audits. Some nurses maintain their clinical skills because they choose to be more involved in their staff’s patients, looking at their diagnosis and medications right along with the staff to be able to keep up with what is changing medically. Some managers are quite content with the non-nursing role.

This makes it very difficult at times dealing with a manager that is a transactional leader. Transactional leadership is a style of management when the leader promotes compliance from their staff through rewards and punishments. it is an antiquated method of management, where mostly punishments are used. After awhile the leader loses their staff due the rigidity of management. A transactional leader will not allow the status quo to change and when a nurse brings up evidenced based nursing approaches to help the staff, they may be quickly dismissed as this is not part of what a manager does. Some managers are told constantly that they are a manager and have to think like one, not like a nurse that is doing clinical. It sounds like a power struggle of the titles.

Marchionni, C., & Ritchie, J. (2007, January 25). Organizational Factors that Support the Implementation of a Nursing Best Practice Guideline. Journal of Nursing Management, 16(), 266-274. http://dx.doi.org/10.1111/j.1365-2834.2007.00775.x

Rubenfeld, M. G., & Schaeffer, B. (2014). Critical Thinking Tactics for Nursing Achieving the IOM Competencies (3rd ed.). [P2BS-11]. Retrieved from http://online.vitalsource.com/books/9781284059571

Rosie Moore, RN BSN, LNC

In some managed care organizations, there are several factors that inhibit critical thinking skills to be utilized. Some of these factors are contract led and others are management style. Long term care programs are mandated by the state to follow a certain protocol on managing their cases for the members that are seen. The care part for the member is not an issue, however the reports and assessments that are required to be filled out, keep the case manager from adequately spending appropriate time with the member. If there is one item not completely filled out, the assessment will be returned by the state. The assessment is at times sent back late from the state, forcing the case manager to redo the entire assessment that can easily take two hours. This in turn causes a high turnover of staff because the demands on their time as salaried employees working 12 plus hours and 6-7 days per week are not what they want to do.

These company cultures do not lend themselves for new implementations for a better way to manage the staff and their time. The industry has seen some of the staff say that they have PTO (it should be paid time off) but at times they are still checking emails and phone messages for fear of getting behind, so one has to ask themselves are they on paid time off or pretend time off? One manager cannot implement changes in the entire company, but with their own team they can apply evidence based nursing and critical thinking skills to make a difference internally.

Some ideas that a manager can work on with their team can be, discussing best practices for different aspects of the job. It seems that all team members and managers have to address emails, projects and reports, these will always interrupt the flow of the day. The team however, can control when they see their patients, make phone calls and when notes are entered in the system. When a manager is preparing to discuss the best practices, some things to consider can be based on the issues that the staff come up with ahead of time during the week or audits on their files. This can help the morale of the staff as well as their performance, decreasing the amount of turnover. (Marchionni & Ritchie, 2007)

In conclusion, every manager has their own style of managing. The best style of management is always going to be one that empowers employees to do their job based on examples and positive reinforcement. If all the employee ever hears is what they did wrong and never a word of praise, the employee will not strive after a while to grow and better themselves.

” A word aptly spoken is like apples of gold in settings of silver.” Proverbs 25:11

Written by Rosie Moore, RN, BSN , LNC

Years of experience in Work Comp, Case Management, Disease Management, Utilization Review and Prior Authorization.

Tag Archives: management style

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