1. Brigham, Lynette Eckes MSN, CGRN

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What makes anyone choose to manage? Ask any nurse manager why he or she opted to supervise the work of others, and you will hear a litany of reasons. Many claim that they like to oversee and direct, others comment on their need to mentor, while others confess they enjoy being in charge and control. Overall, there are as many reasons as there are managers. In today's stress-filled healthcare environment, management is more important than ever, because effective managers are essential to the success of any organization.


Today's nurse administrator needs to continually update his or her management skill set to better understand and oversee the 21st-century workplace. The literature is filled with, "how to" suggestions, and management gurus tout their latest strategies to ensure best practice. Even the most proficient nurse manager, however, faced with the day-to-day workplace milieu, entertains thoughts of a career change. The manager-worker relationship paradigm is undergoing tremendous change and exerting strain, at a time when the need for cooperation and cohesion is paramount. Our healthcare arena is fraught with mounting challenges as it copes with an aging workforce, heightened patient acuities, and technological advances coupled with diminishing resources. Despite these forces, most healthcare professionals continue to strive for excellence. No wonder, we often find ourselves at odds with each other.


Management is often accused of looking only at numbers, whereas staff members are convinced they do all the work. Managers are perplexed when they do not get the response they anticipated from a collaborative effort to institute an identified improvement plan. Instead of acceptance, managers are met with resistance and negative feedback from staff accusing management of asking them to take on extra work at a time when they are already feeling overwhelmed and underappreciated. These disparate perspectives set the tone for an adversarial relationship that is both destructive and counterproductive. The impact of these differences is even more important now because the complexities of the healthcare arena require a united front if we hope to overcome the daunting challenges we face. How do we get back to a place that fosters collegiality, collaboration, and a team spirit to better promote a healthy, productive workplace environment?


Unfortunately, there is no simple way to accomplish this. The cornerstone of any successful working relationship is based on open communication, honesty, mutual respect, consistency, and a sense of fair play from both sides. Sounds easy, but in reality, doing so requires considerable time, sustained effort, and a willingness to work together. Nurse leaders help create and manage the environments in which nurses practice. Therefore, they must maintain an open dialogue and use active listening skills in dealing with day-to-day staff issues and concerns; however, management alone cannot address or correct ongoing problems without staff members also accepting their role in reaching accord. Management is responsible for setting the organizational structure, policies, and staffing, but employees must also bring their best practices, integrity, and work ethic to the table. Neither side can accomplish shared goals unilaterally.


Achieving success requires a combination of effective leadership qualities, staff buy-in, collaboration, ongoing communication, and long-term commitment. The hardest part may be agreeing to take on this challenge together. Perhaps then, we can improve the workplace environment for the entire healthcare team and improve job satisfaction without compromising our mutual need for excellence.


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