Six steps to ensure new nurse manager success

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Six steps to ensure new nurse manager success

After reading this article, you will be able to:

  • Discuss strategies to help nurse managers adjust to their new role

How are vacant nurse manager positions filled at your hospital? Too often, nurses are promoted to managers because they are excellent clinicians and communicators. Once in their new role, they suddenly have to deal with finance and budgeting, patient safety concerns, quality improvement projects, recalcitrant staff, and many other tough topics. And they are expected to achieve a blend of clinical and business management with little to no training.

“It’s not unusual for a person to be promoted into a management role because of their effective leadership in a clinical arena,” says Mary Ann Holt, partner, operations improvement at IMA Consulting. ”But not everyone with clinical expertise can transition to being an effective leader.”

Holt says organizations must set expectations for new nurse managers so they understand their role. Investing in training, coaching, and mentoring is vital. 

Holt’s advice is echoed by Shelley Cohen, RN, MSN, CEN, president of Health Resources Unlimited, an educator who often leads new nurse manager boot camps. Cohen recommends organizations follow six principles to help new managers adjust to their role:

1. Have realistic expectations. One of the biggest hurdles new nurse managers face are unrealistic expectations from the person they report to.

“They expect them to have no transition period,” says Cohen. “They haven’t even been oriented to the department and we expect them to go in there and start battling.” 

2. Allow time for orientation. For the first two weeks, new managers should spend time as a staff nurse observing and learning the unit, not in management tasks. 

“This will help them get a grip on how the department functions from a staff nurse’s eyes,” says Cohen. “It gives them a chance to get to know the staff, the demographics of the patients, and gets them to see in real time what the issues are and better understand them.”

3. Plan the first 30 days. “Give them a piece of paper with ‘here’s what I expect in the first 30 days of you on the job,’ ” says Cohen. Include the formal time for orientation on the unit and the most important issues nurse managers need to become familiar with and devote their time to. 

4. Manager support. New managers need support from their director in the form of uninterrupted time.

Directors should schedule three-minute meetings twice a week with new managers. “That means no texting and no e-mail while they are talking,” says Cohen.

Transition to once-a-week, hour-long meetings. After the first month, work out a schedule for how often and how long to meet. Cohen says these meetings are important. “Even if the new manager says ‘I don’t need to meet anymore,’ that’s not true,” she says. “This is a clue there’s a bigger problem. They need to force the meeting.”

5. Learning leadership principles. New managers who are promoted from within the organization must make a difficult transition from being “one of us” to “one of them.” All new nurse managers want to be liked by the staff, and one of the biggest challenges for the people they report to is to teach them that it’s not being liked by the staff that counts, but how effective they are in their role. 

“It takes time to teach this,” says Cohen, “but it is one of the biggest jobs of the person they report to.”

Both internal and external managers find the volume of work overwhelming when they do not receive training on how to deal with problems. 

“They just put Band-Aids on everything so they can get through the day,” says Cohen. “They need to be taught how to solve the problems so they permanently go away.”

Organizations should invest in sending them to fundamental leadership classes or find someone in-house who can teach the ABCs of leadership. 

6. Find a mentor. Being fresh to the role, coupled with a lack of trust from staff due to being new, can leave managers feeling like they are on their own. Find a mentor who can offer support and encouragement. The mentor may be another nurse manager in the organization or from a sister organization. 

Just because new managers have mentors doesn’t mean directors can relinquish this area of responsibility; mentoring nurse managers should be a vital part of their job. “My greatest mentor was the person I reported to,” says Cohen. “He felt that was part of his job and he took ownership of it. And that was the key to my success in leadership.” 

The key to success and retention of new nurse managers is the time and support put in at the beginning. Investing in these crucial managers will pay dividends in staff satisfaction and the competent management of units.


HealthLeaders Media, June 2010, HCPro, Inc.