1. Hader, Richard RN, CNA, CHE, CPHQ, PhD, FAAN, Editor-in-Chief

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Exceeding quality standards, balancing tight budgets, dealing with human resource issues, growing the business, and providing service excellence are all responsibilities of a nurse leader. If you feel that the expectations of the nurse manager role are insurmountable and believe that you couldn't possibly achieve success on your own, you're right. A single individual can't achieve success without first developing an aligned infrastructure of human and material resources coupled with effective organizational systems.

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As a leader, you need to acquire the right supplies and equipment and recruit and retain the talent necessary to get the job done, while concurrently developing a system that's organized, information rich, effective, and efficient to sustain and improve quality. All ofthis sounds overwhelming, but if you spend the time developing a management and staff team to help you achieve your objectives, it can be easily accomplished and you can have a lot of fun doing it.


The daily operational issues of managing a department can leave very little time to strategize a methodology to accomplish organizational objectives. As difficult as it might be to find the time to plan, it's essential to visualize your area of responsibility from 30,000 feet. By visualizing the big picture, it'll give you a broader perspective regarding problems and barriers while simultaneously stimulating ideas that'll help to resolve them.


Knowing what you want to achieve will provide a vision that'll inspire others to succeed. Blindly managing daily activities will achieve minimal results and won't cultivate an environment that motivates others to attain key objectives. Moving above and beyond the ordinary is only possible if you build a strong team.


The key to building an infrastructure is surrounding yourself with talented, motivated, and intelligent individuals who aspire to hold your position. These team leaders are typically highly motivated, volunteer to take on difficult assignments, and seek opportunities to emphasize their strengths. It's most likely not necessary for you to go outside of your organization to find this type of talent. Carefully observe your staff for effective organizational and communication skills, commitment to the goals of the organization, and the ability to generate creativity and innovation. Seize the inspiring leader's motivation by encouraging her professional development, coaching her progress, and supporting her when she makes decisions.


Delegating responsibility to others will allow you to spend more time focusing on directing and coordinating the process rather than being saddled with the responsibility of monitoring each detail. An effective leader will develop a system to periodically check on progress rather than micromanaging trivial matters. Establish a level of trust with your staff members so that they can engage and find ownership in the process.


A crucial component necessary to building an effective infrastructure is to develop a system in which you can easily retrieve data that's necessary for you to make appropriate decisions. Determine the key data elements that are important to your objectives and establish a method to review these metrics at periodic intervals. By auditing the data, you'll be able to quickly intervene and minimize the chance of deteriorating performance.


Holding yourself and others accountable for being organized and disciplined are essential to a sustainable infrastructure. Being consistent in your approach, establishing high standards, and employing positive coaching methods will provide support and encouragement for your team to succeed.


Richard Hader