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Nurse Managers Must Model Relationship Skills

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By Jennifer Thew, RN
Originally appeared in Health Leaders Media.

Few would argue that nursing's traditional pathway into management is a sure model for success—promote a strong clinician into a managerial role without much training in administrative skills and, violá, you are a manager.

Fortunately, more organizations are delivering the training and support nurse managers need to become successful managers with intentionally designed programs to help them develop skills in budgeting, cost-benefit analysis, and the economics of healthcare.

But, while building nurse managers' business acumen is essential, the importance of "softer" relationship skills for a manager's success should not be overlooked.

"I think [nurses] have to have good communication skills. I'd say that's probably right up there with clinical judgment," says Tina M. Marrelli, MSN, MA, RN, FAAN, author of The Nurse Manager's Survival Guide, president of the consulting firm Marrelli & Associates, Inc., and chief clinical officer for Innovative Caregiving Solutions, LLC, and

Marrelli shared her thoughts on the value of relationship-based leadership. Here are a few of her insights.

Connection Builds Teamwork

The secret to a well-oiled nursing unit is connection, Marrelli says, so nurse managers must build a culture that fosters togetherness. They can do this by making the unit's mission clear.

"We're all in this together, we like each other and, though we might have differences, we respect each other," she says. This is something nurse managers can model by encouraging staff to connect with each other on a personal level such as sharing breaks and common meals. 

"It's an opportunity to really know each other as people because once you get there, you all communicate, everybody's willing to cover for each other, and everybody thinks they're an equally competent nurse," she says.

Be Mindful of Staff Stress

In the current healthcare environment, there are many expectations—from patient satisfaction to preventing readmissions—being placed on both healthcare leaders and bedside staff. Being attuned to how these demands are affecting nurses is a positive attribute of a nurse manager, says Marrelli.

"When a manager knows enough to say to somebody, 'Are you OK?' usually, people will say what's going on," she says. "It really is all about relationships. Do we schedule time with team members when we know there's a problem going on or a concern? You know everybody's busy, but think about how 'more busy' you'd be if you have to go to HR to hire a new person.

"Their stress could be short staffing or an education gap if they are caring for [a type of] patient they don't usually care for on the unit," she says.

Marrelli also encourages managers to make staff meetings a safe place to bring up issues.

"Depending on the environment, sometimes they feel like they can't say [anything]," Marrelli points out. "So just saying, 'If anyone has anything they want to discuss,' " is a supportive gesture.

Take Action

Listening goes a long way, but if staff members share issues that are negatively affecting their work environment, nurse leaders should act to help resolve the problems.

For example, if nurses express inexperience in caring for a certain patient population, a nurse manager can find a way for them to increase their knowledge base.

"During an in-service, you can do some education and make it fun and engaging so people walk out of there with a skill set that they feel better about," Marrelli says.

She also emphasizes taking to heart the feedback that employees leaving the organization share.

"The problem we have sometimes is people are hired and they don't get that support," she says. "So, what does our onboarding look like? What does our orientation look like? Do we really want to hear why people leave?"

While the truth can be hard to hear, acting on the feedback can lead to positive results.

"We're going to keep hearing the reason people leave. It's time we think about how we can help retain [employees] and ways to make things better," Marrelli says.