1. Grant, Susan Mitchell DNP, RN, NEA-BC, FAAN


Nurse managers have played an instrumental and essential role in the successful delivery of patient care for decades. Often described as the "hardest job in healthcare," the importance of the nurse manager role is never more apparent during a crisis such as a national nursing shortage or a global pandemic. However, the nurse manager role and its contributions have gone unrecognized. The DAISY Nurse Leader Award is one way healthcare leaders can elevate and recognize nurse manager's contributions.


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Many years ago, I began my career as a new graduate nurse in a medical ICU. I was enthusiastic and curious but was also unsure, anxious about encountering a situation that I could not manage and afraid I would make a mistake that would result in the harm or death of a patient. The practice environment in the medical ICU was thriving, unit standards of practice were high, and expert nurses took pride in teaching and sharing their knowledge. Patients and families were at the center of patient care. My nurse manager, Marcia Burnett, RN, was a wonderful leader whom nurses looked up to and served as a role model for all of us. I remember one morning when our end-of-shift report focused on a newly admitted 40-year-old male bilateral-amputee patient, with a large and infected sacral pressure injury. He was admitted directly from home where conditions were inhabitable. He was angry and abusive to staff, and no one volunteered to care for him for fear of his aggressive behavior. As the discussion in report ensued, I noticed Marcia repeatedly entering the man's room and pulling his curtain for privacy. After a time, Marcia opened the patient curtain. Marcia had bathed, washed his hair, and gotten the patient up in a chair. After painstakingly combing his long, knotted, and tangled hair, knot by knot, she finished by shaving his face. Marcia then brought the patient his breakfast, and I watched in wonder as he quietly ate and conversed with her. I realized Marcia was building trust and creating a therapeutic environment. By meeting the patient "where he was," Marcia established a human connection and initiated his healing. She demonstrated compassion and patience and provided extraordinary care to a suffering human being. I will never forget Marcia's role modeling that morning and how her behavior as a leader left an indelible mark on me as a new nurse and continues to impact my practice to this day. Marcia exemplified compassionate leadership.

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Several years later, I progressed to my first nurse manager role. During orientation, the nurse educator continuously referred to the nurse manager as the "linchpin" of the hospital. She described the nurse manager's role as critical to the organization and the patient care unit's success, and the "chief retention officer" and "chief executive officer" of their respective units. I recall thinking that her description of the role was a lot of responsibility, and I was energized by the opportunity to make a difference in my organization, for patients and for nurses. Throughout orientation, I found myself thinking about Marcia Burnett. As a nurse manager and leader, Marcia created a practice environment that exuded compassion, excellence, and patient-centeredness. I knew that because I had Marcia as my nurse manager, I could get through anything. As a new nurse, I relied heavily on her as my lifeline. Because of Marcia, I was willing to consider becoming a nurse manager and taking on a position with such significant responsibility.


Longitudinal Study on Nurse Managers and the Impact of COVID-19

Across the nation, nurse managers like Marcia profoundly influence patient care and provide the foundation for organizational success. Their leadership and courage are evidenced in their management of the COVID-19 pandemic. Nurse managers served as the linchpin and lifeline in their organizations on staffing, managing supply shortages, developing new standards of care, and creatively addressing surges in patient volume and acuity. Including previous descriptors, the nurse manager has served as the "chief" of emotional support, grit, and perseverance during these unparalleled times. Their efforts are extraordinary and far too often go unseen and unrecognized. Unfortunately, the stress on nurse leaders has led to burnout, exhaustion, and some of the highest turnover rates in recent history. Last August, as part 3 of a yearlong longitudinal study conducted by the American Organization for Nursing Leadership (AONL) on the impact of COVID-19 on nursing leadership, 36% of nurse managers reported they "are not emotionally healthy, and nearly 17% are considering leaving the profession."1(pp6,7) When surveyed, nurse managers were asked for solutions to improve their work satisfaction and well-being; their suggestions were not new or surprising. Their number one request is for work-life balance, a desire for flex scheduling, and reducing the number of direct reports in their span of control. Respondents proposed broader and more public recognition of nurses' contributions and the work of nurse managers.1 These are compelling data and an instructive signal for healthcare executives to recognize and preserve one of the most valuable roles in healthcare.


In an effort to bring national awareness of the significant contributions of nurse managers and their need for support, the DAISY Foundation and AONL have partnered in launching a national call for meaningful recognition of nurse managers, a review by healthcare executives of the AONL nurse leader survey data, and engagement of nurse managers in the redesign of their roles in healthcare organizations.


DAISY Nurse Leader Award

One way organizations may acknowledge and celebrate the meaningful contributions of nurse managers is through the DAISY Nurse Leader Award. This award was specifically developed to acknowledge nurse leaders who create thriving environments for compassionate care and practice. Although 5000 organizations recognize clinical nurses through the DAISY Award, only 400 honor their nurse managers with the DAISY Nurse Leader Award. Given the current environment, meaningful recognition of these extraordinary leaders may be a significant and powerful step in reducing burnout and boosting compassion satisfaction.2 Nurse managers are the linchpin of healthcare, and through meaningful recognition, organizations can pay tribute to the role of nurse managers, honor their organizational contributions, and ultimately highlight the impact that their leadership has on their nurses and on patient care.



Thanks to Dr Deb Zimmerman, DNP, RN, NEA-BC, FAAN, CEO of the DAISY Foundation for her contributions to this article.




1. American Organization for Nursing Leadership & Joslin Marketing. AONL COVID-19 longitudinal study. August 2021 report: nurse leaders' top challenges, emotional health, and areas of needed support, July 2020 to August 2021 2021;1-12. Available at: Accessed January 18, 2022. [Context Link]


2. Barnes B, Barnes M, Pabico C. Meaningful recognition: an imperative for nurse manager well-being. Nurs Manage. 2021;52(10):6-9. [Context Link]