Developing Nurse Managers: Targeting Leadership Capabilities to Improve Clinical & Business Outcomes

Nurse engagement and retention is a key driver of patient experience. Nurse managers play a key role in improving engagement, retention and overall effectiveness of the clinical workforce, directly impacting healthcare outcomes. For this reason alone, it’s clear to see the importance of developing nurse managers and their leadership capabilities. The key question every healthcare system faces is the following: With the fast pace of the workplace, emergencies, high spans of control and constant change impacting the workplace and the heavy demands put on all caregivers, how can hospitals, clinics and health systems provide the necessary development? Let’s take a look.

Why Developing Nurse Managers is Critical

Unlike many of the key players of a healthcare system, nurse managers in all specialties of care are in a unique position of both patient contact and the daily business of caregiving. Nurse managers must supervise and deploy the nursing staff in a manner that achieves positive outcomes for patients while also meeting the goals of the business. They must make budgetary and personnel decisions, establish work schedules, manage a large staff of nurses, partner with physicians and administration, complete mandatory education to maintain licensure, adapt to the daily demands and oversee patient care. 

A nurse manager’s leadership capabilities affect many areas of both the business and patient outcomes. One study found that 75 percent of nurses view their nurse managers as a critical voice for both staff and patients. A review of the turnover rates of new nurses aimed to gauge the intentions and attitudes of new nurses regarding their work and how their nurse managers impacted their environment, behavior, and career decisions. Poor management was cited as one of the top reasons for newly-licensed RNs to leave their first job, and supervisors were named by many as the primary reason their job was difficult or impossible to do.

Along with protecting retention among the entire nursing staff, developing the nurse manager’s skills will also help boost the experience, engagement, safety and retention rate among nurse managers as they find more success and satisfaction in their positions rather than frustration and potential failures. In other words, effective leaders create more satisfying workplaces with better outcomes across the board. Plus, hospitals can lose more than $8 million annually to nursing turnover. The need for developing the leadership capabilities of nurse managers is clear. 

Developing Leadership Capabilities for Nurse Managers

An editorial in the Journal of Nursing Management examined several papers published on the subject of developing management and leadership capabilities within the National Health Service in the U.K. While the financial structure of that healthcare system is different from those in the United States, the fundamental needs are still the same: provide quality outcomes for patients while keeping costs in check. The editorial identified the process of converting tacit knowledge into explicit knowledge as the most important ingredient in developing nurse managers. Much of the body of nursing knowledge is acquired through experience and related to action, while leadership capabilities require both tacit knowledge gained through action and concrete skills.

The editorial describes several methods nurses used to gain both more skills and experiential knowledge. These included activities such as web-based learning, preceptorship programs, adapting the culture of the workplace with an external facilitator, and structured leadership and management interventions focusing on information management. One of the conclusions found in one of the examined papers found that the most effective forms of development are those directly connected to experience in the workplace. In other words, the “belief that leaders are born and not made has finally been eclipsed by the importance of job experience.”

Facilitating Development Effectively

The best nurse managers engage with their teams to achieve exceptional performance standards. They have the tools to inspire others and are an important catalyst for change and continuous improvement within an organization. Creating a workplace environment that champions these abilities while providing pathways to acquire these skills and put them to use will provide the best organizational outcomes as the very nature of nursing education relies heavily on on-the-job experience, mentorship and building knowledge through actions. 

Leadership development programs that provide formal leadership training and structured fellowships are another piece of the puzzle and have been shown to be particularly effective for leaders who are new to their roles or to the organization. Additionally, development experiences that offer coaching, adaptive learning practices and on-demand learning have proved to be effective for nurse managers. This approach allows the learning experience to be personalized and adapted to the scheduling demands of nurse managers.

Large organizations with the necessary resources can also provide individualized onboarding and ongoing educational opportunities for nurse managers based on their specific needs. These can be particularly helpful when combined with networking opportunities with others in leadership positions. As the nurse manager’s needs evolve over time, having access to a network of leaders and educational resources can help sustain their growth.

Development Activities Work

To be effective leaders, nurse managers must have a balanced understanding of the practice of nursing along with the practical needs of the organization. Clinical knowledge is continually being developed across all levels of nursing, but only those organizations that balance clinical experience with leadership development will enjoy the benefits of the strongest nurse managers. Development activities for nurse managers have been proven to work in many scenarios, especially when the focus of development is individualized.

Ongoing management and leadership development will improve the overall performance of the organization while providing competitive advantages as well as increased retention rates and job satisfaction across the entire nursing staff. Several studies and surveys have found that the most common complaint among nurse managers is a continually growing workload with decreasing levels of support and work-life balance. By reinvigorating the position of nurse manager with better access to educational tools and mentors, and transforming the work environment to one where growth and development is the norm and “trial by fire” is eliminated, the entire organization – and all the individuals that make it successful – can enjoy greater satisfaction and better outcomes across the board.