1. Murray, Kathleen RN, cNA, MSN

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Q I'm currently a manager in an organization where the nurses are represented by a union. I find working in this environment difficult. Do you have any suggestions on how to deal with a union worker?


Always remember to be fair, dependable, and consistent in your approach to the employees and follow the contract standards. Become familiar with the union contract and obtain clarification for any questions you have. Also, seek out direction from your supervisor to arrange a meeting with the union representative. Use this opportunity to get to know each other. It's beneficial to both parties if you focus on creating a great work environment for the staff members providing patient care.


The need to remain current in management practice is vital to your success, which is why continuing education plays such an important role in your management development. Choose courses that'll provide training in your noted development areas.


One of the most valuable resources you can have is a good mentor. Seek out a manager in the organization who's adept at leading, who has the best outcomes, and who you think will make a good mentor. Ask the mentor to provide specific practical information regarding his or her own management experience in working with the union, important issues facing the organization's leadership team, and potential sources of his or her own frustration. This mentoring opportunity will help you broaden your leadership skills.

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Developing interpersonal relationships, communicating effectively, building a team, leading by example, and helping people grow within the ranks are all crucial to your development as a manager. By relying heavily on a positive attitude and a sincere approach to working with the union, you'll succeed in your managerial endeavors.


Q I have budgetary responsibilities, and I believe my organization is ready to apply for Magnet designation. How much should I allocate for the process?


To start, visit the American Nurses Credentialing Center (ANCC) Web site at to obtain the most current fee schedule for the Magnet Recognition Program. For the first year of your Magnet journey, you'll need to purchase the Magnet Recognition Program Application Manual. It contains the pertinent information needed for preparing the written documentation. The fee for the manual is $100. Most organizations order several of the manuals for distribution to the identified key stakeholders in the Magnet journey. Based on the size of your organization, you should budget between one and 10 manuals.


You'll need to complete the gap analysis and establish timelines. This'll take approximately 18 months to 2 years. It's during this time that your CNO will need to evaluate the budgeted funds available for participation in the National Database of Nursing Quality Indicators (NDNQI), continuing-education programs, national certification fees, tuition reimbursement, staff nurse committee attendance, conference attendance, nursing research, publications, and clinical ladders. The budgeted dollars needed will depend on the size of your RN workforce.


Next, you'll need to complete the application form indicating when your organization plans to submit its documentation for appraisal review. The fee for the application submission is based on the number of beds (hospitals between 101 and 949 beds would pay about $2,500).


Once you submit the document to the ANCC, two to five appraisers (the number depends on your organization's size) will review it. You'll need to budget approximately $1,000 per appraiser for the document review.


Finally, the on-site visit fee is based on the number of appraisers assigned to your facility. Plan on spending approximately $1,500 per appraiser/day. The fee for the entire process can range from about $10,000 for 100 or less beds to approximately $50,000 for hospitals with a bed capacity between 750 and 949.