Nurse Manager Interview: Leadership and Role Development

Introduction

Nurse managers play a critical role in the nursing profession. They are often the primary point of interaction between nursing staff and patients, and they significantly impact patient outcomes. The role of the nurse manager is demanding: nurse managers carry leadership and management responsibilities that include ensuring adequate staffing, setting unit goals, managing budgets, hiring new staff, providing training, and evaluating staff performance. As the nature and form of healthcare continues to transform and grow, nurse managers will require more advanced knowledge and skills to remain effective in a dynamic workplace.

Nurse managers are also responsible for creating a healthy and successful work environment. As Moore et al. (2016) observe, nurse managers who foster a positive workplace have a significant impact on nurse morale and motivation — effectively meaning that nurses in such environments are more likely to be satisfied with their jobs. In essence, nurse managers are indispensable to the growth and development of healthcare enterprises.

It is important to note that many new nurse leaders envision themselves being more confident when working with others. Just like emotional intelligence, confidence is a learned trait. In basic terms, confidence involves knowing your role, staying focused, recognizing when you need help, believing in your staff, and understanding your limitations (Raso, 2017). Confident leaders are firm in their positions and do not second-guess themselves, though this does not mean they forgo consultation. The right measure of confidence ought to be grounded in experience and organization-wide input. By contrast, arrogance often has no basis beyond what the bearer perceives as correct. Confidence must therefore be carefully distinguished from arrogance when considering the role of nurse managers. Practice can build confidence — for instance, by taking leadership roles in volunteer settings — and people who actively seek opportunities to lead will develop greater confidence in their ability to do so (Northouse, 2018).

This paper synthesizes the results of an interview conducted with a nurse manager in an attempt to assess and evaluate role development in management and leadership responsibilities.

Nurse Description

One person I found to be both confident and a highly capable leader is my nurse manager. She graduated from Tel Aviv in 2001 in Israel and received her bachelor's degree in nursing. Immediately after graduating, she served as an army officer for three years, a role that required her to pass a wide range of assessments. During her first year she received training in managing people, and throughout her military service she developed a broad set of competencies. Her desire was to take an active role in management.

After leaving the army, she worked in Israel in a pediatric emergency room as a shift manager for five years. Her military background meant she needed no further training to step into that role. Concurrently, she also worked part-time in pediatric dialysis. She subsequently relocated to Massachusetts, where she has lived for the past fourteen years. She has worked at a pediatric office for ten years and has served as nurse manager for two of those years.

Before assuming her role as nurse manager, she was trained for several months by the retiring nurse manager, who even prepared a reference binder for her use. Once training concluded, her responsibilities broadened considerably. Her current duties include triaging phone calls — such as providing medical advice to parents regarding their children — interviewing and hiring new staff, running morning lab controls, monitoring vaccine refrigerator temperatures, ensuring that high-risk infants receive their synagis vaccine, and ordering vaccines. From my perspective, her responsibilities are extensive and include a substantial amount of paperwork.

During the interview, she indicated that her strengths include caring, delegation, commitment to her job, and strong communication skills. She described her leadership style as democratic. She gives nurses credit for their own work and collaborates closely with them — for example, praising nurses for handling phone triage well. When a nurse has difficulty with a call, she steps in to assist. She views all members of her staff as equals, offers suggestions rather than directives, and ensures that everyone's opinion is heard. She listens carefully to all staff members and promotes clear communication among the team. She is not only committed and friendly but also mindful of others' wellbeing, a strong motivator, and an advocate for group decision-making.

Role Analysis

The nurse leaders of today operate in an environment markedly different from that of two decades ago. While the core roles of nurse managers have not changed dramatically, today's healthcare environment demands a different set of competencies. These competencies include systems thinking, interpersonal effectiveness, and personal mastery (Marrelli, 2017), in addition to human resource management and financial management skills. Strong nurse leadership is critical to creating a work environment that is safe and healthy for both nurses and patients. Effective nurse leaders improve patient safety, support staff, and embody the qualities of achievers, experts, critical thinkers, and effective communicators.

Nurse managers need strong communication skills to handle difficult conversations with staff, patients, healthcare providers, and families. Expertise requires knowledge and skills gained through leadership development. Being an achiever means obtaining desired outcomes. Critical thinking in nurse managers demands knowledge, planning, and learning skills (Henriksen, 2016). Additional qualities that make a nurse manager effective include the ability to prioritize, a strong work ethic, honesty, loyalty, good judgment, and emotional intelligence (EI).

Effective leadership requires EI. Nurse managers can enhance their EI by improving their ability to recognize and understand emotions in themselves and others. EI has a positive impact on nurse-patient relationships, stress management, communication, compassion, and teamwork (Lancaster et al., 2015). Waterbury (2016) states that EI and self-awareness are important dimensions of being a good communicator. Self-awareness involves understanding one's own strengths, weaknesses, and feelings, while EI is defined as the ability to express and understand one's own emotions and those of others. Nurse managers with high EI and self-awareness are better able to understand the people around them (Waterbury, 2016).

Pipe et al. (2016) further assert that strong leaders are guided by what is meaningful and true to them. Good leaders coach, influence, and guide others. They must be self-aware and attuned to the strengths and weaknesses of those around them. Notably, in order to be a good leader, one must also know how to be a good follower (Pipe et al., 2016). While strong leadership skills are essential, it is equally important to acknowledge that even effective leaders have areas of weakness.

Conclusion

A nurse manager ought to ensure that a nursing unit is not only run efficiently but also functions as effectively as possible. As noted throughout this paper, the healthcare workplace continues to evolve — whether driven by technology, patient protection concerns, regulatory changes, or shifting illness trends. These changes stand to make the duties and responsibilities of nurse managers increasingly complex. For this reason, the importance of continuous competence development cannot be overstated.

In their diverse roles, nurse managers must ensure that their clinical environments function well, which requires building close working relationships with staff while simultaneously improving patient outcomes and sustaining staff motivation. The nurse manager discussed in this paper has effectively balanced staff concerns with patient care — producing a healthy working environment and a continuous improvement in the quality of services delivered. Going forward, she is well-positioned to continue playing an active role in strengthening the practice and driving results.

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