Retaining nurse managers: Tips to orient, develop, and support

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Learning objective: After reading this article, you will be able to
1. identify strategies to support and develop nurse managers

Organizations devote much time and effort to retention at the staff level, but they have forgotten the importance of retaining middle managers. There is not adequate attention, nurturing, and support given to the very people who are relied on to retain the nurses who are recruited.

An organization's recruitment and retention goals need to include the leaders who oversee the nursing staff.

Nurse managers' challenges
An administrator may view nurse managers as leaders who should not need handholding to want to stay in their jobs, but it is important for them to put themselves in the shoes of today's nurse managers.

In many facilities, nurse managers face daily struggles to manage their workloads and support their limited staff. It must become a priority to support this vital group of employees and meet their professional and personal desires.

Promotion without training
Part of the challenge is that many nurse managers and leaders are hired based on their clinical skills, rather than their leadership capabilities. People cannot be expected to stay at and excel in positions
for which they have no skills or training.

On the other end of the spectrum are those managers with appropriate leadership experience who accept management positions. Many administrators are so relieved when they finally find such a person to fill an open position that they return to focusing solely on their own job responsibilities.

These new managers, administrators reason, have the qualifications for their roles, have performed them well elsewhere, and will hopefully ask for help or support if they need it.

Such misperceptions can result in new managers who are unhappy because they sense a lack of administrative support.

Imagine being a newly hired manager in a facility where you do not yet have a feel for processes, systems, or team. Your new staff will test you to see how you measure up, the medical staff may not cooperate, and you'd like to fit in with your peer group, but no formal introductions were made through your administrative leader. So now you feel isolated and unprepared.

Establish goals and expectations
Leadership development plays a vital role in the success and satisfaction of nurse leaders and will directly affect the retention of all leaders--not just the newly hired. Although retention efforts should focus on both new and seasoned managers, how you approach your retention efforts will at times be directed by the managers' length of employment within the organization.

Tips for developing nurse leaders
The following are tips for administrators to use to help develop nurse leaders:

  • Have senior administration allot specific time for retention efforts related to mid-level managers
  • Engage managers in discussion to gain input about their individual requirements as they relate to professional development and personal needs
  • Clarify and define what constitutes success in their role from both your perspective and theirs
  • Schedule ongoing formal and informal communication opportunities between the nurse manager and the person to whom they report

Orient the new manager
In working with nurse managers, be sure to consider the following important points:

  • Provide an accurate job description. Is there a written job description that clarifies the expectations of the job? The job description may have been written several years ago and may not reflect current issues. Review the job description with the manager annually.
  • Identify management and leadership skills. Develop a process to identify a new manager's basic knowledge of management and leadership skills. Include terminology related to fiscal issues and formulas to calculate staffing and budget needs. This assessment will provide a framework through which to develop goals and identify the supportive and educational needs of the manager.
  • Establish goals. Set goals that help managers assess their accomplishments and that allow you to track their progress as leaders.
  • Provide support from peers. Assign all new managers a mentor from their peer group. Consider having a hotline that managers can access to leave a message if they need resources or advice about an employee issue. The last thing you want is managers spending time trying to resolve something about which another manager can immediately direct them.
  • Offer support and perspective. Schedule regular one-on-one meetings. Make sure that you have reviewed the reasons why previous managers have left-even if you disagreed with their perceptions of the situation. This might offer valuable insight into how you can support new managers.

Most administrators consider leadership development to be simply providing education, resources, and tools for the manager. However, it also includes picking up clues about whether managers are so overwhelmed that they cannot function in their roles.

For retention efforts to be successful, there has to be a place for helping managers who feel that they are in over their heads. Be alert to some of the warning signs that indicate that a manager needs to be thrown a life preserver.

Don't assume that things will be better next week. Make the effort now to confront your concerns and get help and support for the manager. You may do so through your employee assistance program, by taking time off, or through a combination of administrative support and setting new, more realistic expectations.

Editor's note: The excerpt above is adapted from HCPro's book A Practical Guide to Recruitment & Retention: Skills for Nurse Managers. For more information, visit