• What are the responsibilities of someone in your position (e.g., VP, CNO, Director, or Manager) in the development of the annual budget?
Nurse Manager

Having business acumen is fundamental to becoming a Chief Nursing Officer (CNO). In some healthcare institutions CNOs are charged with overseeing large aspects of the annual budget of that facility. It is the responsibility of the nurse manager to design the organization’s budget and set goals for the center they represent or at least their nursing unit (Rundio & Sigma Theta Tau International, 2016). This is usually done in close collaboration with finance department. After the development of the budget and after it has been updated, it is then forwarded to the administrative unit and thereafter to the directors for approval. The fiscal year begins following the approval of the budget process (Rundio & Sigma Theta Tau International, 2016). The hospital must deliver the planned programs and services. It must be noted that the budgeting process is dynamic and ongoing. It is important to collect feedback in the budget management process.

The workflow in budget development entails the following stages: Collection of relevant data, service planning, activities planning, plan implementation, budget monitoring, executing corrective measures whenever required to (Rundio, 2016). One of the critical roles of the nurse manager in the chosen organization is to collect relevant information. Ultimately the department in charge of finances collects that information although it has to be in close cooperation with nurse managers. This way it becomes possible to create functional budgets. The information collected by the Nurse Manager includes:

Services provided by the institution: It is the nurse manager who collects this data. The Nurse Manager understands best the kind of services that are currently on offer and the services that will be needed in future. For instance the nurse manager might want to have the bed capacity in the hospital wards increased on a nursing unit that is underutilized. Often the nurse manager will be aware of a new pediatrician or neurosurgeon who is scheduled to come in and that this might increase the volumes in the facility. With this understanding the Nurse Manager will request for increased bed capacity.

Patient Mix: This is in regard to care complexity. The greater the care complexity the more reimbursement needed through budgeting. Each nursing facility and hospital evaluates its general patient mix index. This patient mix is generated for the entire organization by finance department. If the patient index is high then the reimbursement required will also be high.

The Nurse Manager is also responsible for providing information about the care standards, planning service changes with respect to prevailing needs, planning for resource utilization changes, and patient day hours.

• What financial aspect for which you are responsible has the most impact on the care of patients?

Patient care planning has the largest impact on the patients. As the Nurse Manager it is very...…and providing relevant data to the finance department for consideration. You will be least prepared for need analysis and cost estimation. The moment you assume that responsibility it becomes clear that patient care quality is primarily in your hands. The biggest challenge is making sure that every financial or budgeting decision made has a direct impact in enhancing patient care and alleviating emergency situations in the hospital. Predicting need and rolling out a financial plan beforehand to meet that need is definitely a momentous challenge.

• What would be your recommendation(s) to a new nurse administrator regarding financial management skills?

Any nurse administrator must be willing to learn and enhance their financial management skills. They must be able to foresee need and roll out a budgetary plan beforehand. For this reason every new nurse administrator must acquaint themselves with patient care and facility needs upon assuming that position. Each working day must be dedicated to identifying need and planning for financial solutions prior to the particular time that the solution is needed. The nurse administrator must also learn the skill of negotiating with the finance department and the facility administration. This requires certainty with the needs. Moreover, the nurse must also be careful not to be wasteful with finances (Yong, Saunders, Olsen & Institute of Medicine (U.S.), 2010). Every need must be judged as necessary and fundamental for the general good of the facility and the patients being served.

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