On the Roles of Nurse Managers

Jayvee Eduardson A. Avisa, RN, RM

According to the American Organization of Nurse Executives, “the nurse manager is

responsible for creating safe, healthy environments that support the work of the health care team
and contribute to patient engagement. The role is influential in creating a professional
environment and fostering a culture where interdisciplinary team members are able to contribute
to optimal patient outcomes and grow professionally”. That being said, the nurse managers are,
and should be, skilled nurses that combine both clinical expertise and leadership. Nurse
Manager’s are the ones who supervise staff nurses in order to provide the optimum quality care
that is needed by the patients.

Being a nurse manager is no easy task. They have to be properly educated and skilled to
do their required task. Continuing Professional Education, I believe, is one of the pre-requisites
of becoming a nurse manager. It will prepare them to be that nurse manager fit for the institution.
Moreover, they should be properly trained in handling employees. Leadership style is also one
thing that Nurse Managers should consider. They should know what leadership style is effective
for a certain institution. Say for instance, Autocratic or Authoritarian Leadership is not always
effective because it makes it harder for staff nurses to voice out their opinions, complains, and
suggestions for the betterment of the organization because they might be too afraid of the nurse
manager. On the other hand, this may give nurse managers the respect that is needed from the
staff nurses. Such circumstances should be considered in choosing the best possible leadership
style the institution needs so that the staff nurses and nurse managers will have a harmonious
relationship to maintain order in the institution.

Human Resources Management in health care is very critical in providing effective and
efficient health care. Nurse Managers and Nurse Executives should develop policies to increase
efficiency and effectivity of health care. Effective policies are critical because it mandates staff
nurses of the proper things to do during certain situations. Moreover, policies are used for staff
nurses to prevent untoward harm and negligence in patient care. Furthermore, nurse managers, as
stated previously, act as leaders to staff nurses. In line with that, I believe that nurse managers
should be of good standing where staff nurses could look up to.

One of the roles of a Nurse Manager is to hire competent and skilled applicants fit for a
vacancy. This role is very crucial for the improvement of the institution. Why? Hiring a
candidate for a job is like providing the appropriate antibiotic for a specific bacterial disease. If
for instance you provided the wrong anti-bacterial, the disease will not go away; the person will
not be healed. However, if you provide the right anti-bacterial and instructed the patient to take it
properly, the disease will be gone and the person will feel better in no time. Just like in hiring for
a candidate for a specific job. If you hire the best candidate, it will be beneficial for the
organization. That candidate will help the organization to realize its vision and mission. That is
why it is very crucial for nurse managers to screen applicants properly as the result of the
screening process will affect the organization as well.
 In the Philippine setting, however, it is very hard for nurse managers to search and hire
for a staff nurse that suits the institutions’ qualifications. There is a scarcity of nurses and this
makes one of the roles of nurse managers even harder. As a result, nurse managers tend to hire
applicants who do not necessarily pass the qualifications set for a certain position. However, this
is one of the challenges of being a nurse manager – to think of ways for these newly hired staff
nurses to be trained and skilled as they go on with their journey in the institution. Nurse
Managers should consider ways to provide trainings, workshops, and seminars for the
advancement of these newly hired nurses which will be both beneficial for these nurses and for
the institution as well. Developing nursing care is essential not only for these newly graduated,
newly hired nurses but also for staff nurses in the institution because by doing so, they will have
the necessary skills and training to provide for the best quality nursing care they could possibly
give.

Another role or function of the nurse manager is nurse staffing. The nurse manager
should see to it that proper staffing is being utilized. Proper staffing means a better opportunity
to provide better health care. However, in the Philippines, where nurses are scarce, it is near
impossible for nurse managers to provide for proper nurse staffing. In the institution that I am
currently working at, Nurse staffing is a major problem. At the moment, 1 nurse is on duty for a
4-bed Intensive Care Unit, 3 nurses (sometimes 2 nurses and 1 midwife) is on-duty for a 20-25
bed unit which means that these nurses cannot provide the best nursing care he/she could
possibly give due to number of patients they need to attend to. I, too, as an Operating Room-
Delivery Room Nurse, experienced having 2 procedures and 3 Normal Spontaneous Deliveries at
the same time while having 4 nurses on duty. However, nurses are people who are best at multi-
tasking that is why they can do their jobs properly given these situations. But, nurse managers
should also look into these kinds of situations. Maybe giving a reward for their hard work will
give them the motivation that they need to stay in the institution.

Also, ensuring patient and staff satisfaction is one of the things that nurse managers
should put in mind. Patient satisfaction can be measured by satisfactory surveys answered by the
patients themselves or their relatives or going through their rooms and asking them personally.
However, staff satisfaction is a hard thing to measure as sometimes, nurses tend to answer job
satisfaction surveys untruthfully due to the fear of termination. This situation should be
addressed by nurse managers. Staff nurses should feel comfortable talking about what they feel
to the nurse managers for them to formulate policies to address such issues.

As I’ve said earlier, the job of the nurse manager is not easy. They need to consider all of
the factors mentioned above and many more for a better health care delivery. I think that the first
thing to consider if you wanted to become a nurse manager is if you have the heart for nursing.
Because not having this fundamental qualification, your work as a nurse manager will not be as
effective. Having the heart to serve and the heart for your staff nurses will make you an ideal
person for the job.