1. Murray, Kathleen RN, CNA, MSN

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Q How many staff members is it reasonable for a department nurse manger to lead?

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The number of staff members reporting directly to a manager is often referred to as her span of control. It's important to understand that span of control refers only to direct reports, rather than the entire staff within a department. For example, a nursing director may technically have oversight for 250 employees, but her span of control would only include the managers who report directly to her. Healthcare organizations recognize the importance of establishing the optimal span of control for their managers in order to achieve successful outcomes.


The first step is to complete an assessment to evaluate the comparison of responsibilities required for all managers within the division, the complexity of the unit(s), the manager's years of experience, support resources for the manager, and her level of interpersonal skills with direct reports. After this is completed, recommendations regarding the optimal number of staff members who report directly to the nurse manager can be established. Additionally, the organization will need to monitor certain metrics, such as nurses' job satisfaction, patient satisfaction, and turnover, on an ongoing basis to monitor the effectiveness and efficiency of departmental operations.