A Nurse's Survival Guide to Leadership and Management on the Ward, 2nd Edition

A Nurse's Survival Guide to Leadership and Management on the Ward

2nd Edition

By Jenny Thomas, BSc(Hons), RGN, CertM, Independent Consultant in Health Care Management; Senior Lecturer, South Bank University, London, UK


1 - Be clear about the role of the ward manager

Be clear about what 24-hour responsibility means

Be clear about what makes a good leader

Make sure your decisions are informed ones

Clarify your objectives

Understand your legal responsibilities

Be clear about your matron/line manager?s role

Remember you are the patients? overall advocate

Don?t take on other people?s pressures

Balance your clinical work with administrative duties

Be aware of the imp0act of your role on others

2 - Manage your time
Define your workload
Organise your office

Control your diary
Keep up with your emails
Cut interruptions

Don?t waste time with unnecessary reading

Handle meetings effectively

Learn to let go through delegation

Be proactive


3 - Create a positive working environment
Plan ahead

Set meaningful objectives with your team
Be a good listener
Feedback with sincerity
Know your staff well
Never talk disapprovingly of others
Get your staff to take more responsibility
Have a system for dealing with patient?s relatives


4 - Manage staff performance
Get to know your HR advisor

Write everything down

Make appraisals work

Know how to handle unacceptable behaviour

Handle poor performance/incompetence
Know when and how to discipline
Actively manage sick leave
Ensure all staff have appropriate training, development and support
Provide additional support for mentors

Reduce staff stress

Inform and involve all of your team

Consider team-based self-rostering

5 - Make sure care is patient-centred
Maintain your clinical skills

Ensure all patients have a full assessment and care plan
Be clear about what health care assistants can and cannot do
Eliminate long handovers
Use task-orientated care only when appropriate

Work towards the named nurse (or primary nursing)
Make sure patients are informed

Performance indicators, audits and benchmarking
Manage staffing shortages
Take the lead on ward rounds


6 - Manage your budget
Know what you budget is
Prioritise pay

Go through your monthly budget statements

Manage annual leave
Manage your unplanned absence allowance
Plan your study leave allowance
Get your staff involved in NON PAY
Be more active in the business planning process
Don?t do anything without identified funding
Meet regularly with your finance advisor

7 Improve quality and safety

Quality indicators

Identify mistakes and risks

Investigate complaints appropriately

Tips for calling or meeting with the complainant

Investigate incidents appropriately

Make improvements

8 -Instigate a rolling recruitment programme
Review the post with the person who is leaving
Write a good advert and application packages
Shortlist and arrange interviews properly
Get the best out of the interview process
Follow up all candidates personally
Arrange a good induction programme
Continually explore all other avenues to get staff

Don?t discriminate
Keep accurate, objective records
Succession plan
Fully involve your team in all aspects of recruitment


9 - Be politically aware
Understand how health care is managed nationally

Keep up with what?s going on

Know your Board of Directors and their priorities
Choose your meetings carefully
Network - get to know the right people

Be diplomatic
Work with your Director of Nursing

Get recognition for your work
Choose your mentor and mentees with care

Plan ahead for your own needs


10 - Look after yourself
Set up a peer group or action learning set
Develop the role of your deputy

Get yourself a mentor
Choose carefully who you talk to and what you say

Reduce stress
Get over mistakes and move on
Remember it?s only a job

11 - Be a good role model
Be smart
Make a good first impression
Always smile and be positive

Speak clearly
Be relaxed and in control
Make your writing distinguishable
Be aware of how others see you

Set an example with your choice of language
Never moan or gossip about others

Don?t stagnate


12 - Manage your manager
Clarify expectations
Work with, not against your manager
Act, if an important decision has been made without your consultation
Act, if a change in another department has a knock on effect in yours
Don?t be pressurised into taking on extra work without funding
If you are doing extra work without funding, take action

Keep the communication channels open
Write clear and timely reports

Know how to conduct a good investigation

13 - Manage difficult situations
The difficult manager

The problematic colleague

Allegations of bullying/harassment within your team

Staff complaints

Helping your staff to act

Dealing with racism or other forms of discrimination

Unsafe staffing levels

Cliques

Be specific about expanding nursing roles

Be proactive with enforced moves or mergers of services


14 - Manage difficult team members

Staff who refuse to look professional or wear proper uniform
Staff who refuse to accept change

Staff who can?t seem to prioritise their work

Staff labelled as lazy

Staff with alcohol problems

Members of staff who don?t get on

Staff who seem careless and sloppy

Staff who manipulate situations for their own gain

Staff who moan and whinge

Staff who are continually late for duty


15 - Get the best advice
Know where to go for legal advice
Know where to go for professional advice
Utilise the chaplaincy department
Use but don?t abuse the nurse specialists

Help patients and relatives access the right advice

Keep up to date with risk management issues

Consult policies, procedures and guidelines

Maximise computer access

Utilise the knowledge and skills of your nursing colleagues

Utilise the practice development team

16 - Question external directives
Is another link nurse role really needed?
Has the bed manager considered all other options?

Are you managing a team of nurses or auditors?

Has your line manager questioned the decision ?
Do some quality indicators actually lower the quality of care?

Are senior managers aware of the implications of their decisions

Are consultant/specialist decisions always appropriate?
Does your union steward know?
Is the Chief Executive aware of what is happening?
Rely on your own common sense.