Every nursing unit has a nurse manager. Managers handle the administrative aspect of running a hospital unit and are privy to significantly more of the healthcare structure limitations than staff nurses. Leadership styles vary throughout management. Some are not conducive to a healthy nurse-management relationship while others can allow nurses to thrive. Staff nurses cannot control the actions of management, but there are ways to approach management with your concerns that can lead to more positive interactions regardless of their leadership style.
1. Build Trust
Managers are not always with you to see your critical thinking skills and strong teamwork mentality. Between meetings they might round on the unit, but they look at time sheets, attendance, satisfaction scores, disciplinary issues, and compliance with core measures.
Trust and respect work both ways, but the best way to earn it is to give it. Show up on time, follow procedures, and take pride in your role as a nurse. The character you already have with your co-workers and patients will be present to leadership through the structural lens of quality metrics.
2. Provide Facts
Whether it is a policy change, existing policy, or staffing issue, don’t just say, “It’s not safe.” Those three words are powerful, but alone have no power. The WHY it’s not safe has power. Upper management crunches a lot of data to make decisions and if they are not provided with tangible negative data, they will assume nothing is wrong.
Give details, MRN, times, orders, and describe scenarios using OBJECTIVE language. They do not know what they are not told. By giving your manager specific, objective ammunition to address nursing concerns it has a fighting chance to sway upper management to make changes.
3. Speak Up Anyway
When a leader is intimidating or non-responsive, speak up anyway. Be professional and objective while communicating. Don’t put them on the spot at the nurses station where everyone can overhear, but stop by their office and ask when you can come back to have a conversation.
If you have safety concerns and your leader does not listen, try again. If they still will not listen, continue moving up the chain of command.
Become the Leader You Want
Working under difficult management can wear you down. When nurses aren’t given the support they need it leads to lower staff satisfaction and higher burnout and turnover rates. If you have leadership skills and a desire to see healthier nurse-management relationships, become that better leader.
It’s not- “If you can’t beat them, join them.” But rather- Join them to beat them. Use their language of spreadsheet data to prove that your responsive and supportive approach to leadership has better outcomes. That, upper management cannot refute.
When given information in a manner they can understand and utilize for staff benefit, it can break down a seemingly frosty barrier and allow for further dialogue and change. A response might take longer than staff think it should, but it takes time to gather more data and make meetings with upper management. Much like when patients that get upset that nurses are busy, but don’t see the behind-the-scenes work are doing; there are hoops management has to go through to address nursing concerns, which takes time and sometimes gets denied by upper management.
But never stop advocating for a better and safer work environment.