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

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

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


CHAPTER 1 - BE CLEAR ABOUT YOUR RESPONSIBILITIES
? Be clear about what 24 hour responsibility means
? Be clear about what makes a good leader
? Don?t just use your line manager for guidance
? Agree your Personal Development Plan
? Be clear about your legal responsibilities
? Be clear about your 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
? Promote good working relationships with other health professionals in your unit

CHAPTER 2 - PRIORITISE YOUR TIME
? Define your workload
? Organise your office and diary
? Keep up with your emails
? Cut interruptions
? Learn to speed read
? Choose carefully which meetings to attend
? Beware non-clinical managers
? Under promise and over deliver
? Be proactive, not reactive (Question decisions and directives)
? Delegate effectively
CHAPTER 3 - CREATE A HAPPY WORKING ENVIRONMENT
? Have a plan
? Set objectives with your team
? Know your staff well
? Feedback with sincerity
? Be a good listener
? Never talk disapprovingly of others
? Empower your staff to take more responsibility
? Have a system for dealing with patient?s relatives
? Deal with conflict
? Implement Clinical Supervision
CHAPTER 4 - MANAGE AND TREAT YOUR STAFF WELL
? Develop a close professional relationship with your HR advisor
? Keep file notes
? Make appraisals work
? Deal with poor performers
? Know when and how to discipline
? Keep tabs on sickness
? Deal with unauthorised absence promptly
? Inform and involve your team in everything
? Ensure all staff have appropriate training, development and support
? Ensure your staff consider each others needs
CHAPTER 5 - MAKE SURE CARE IS PATIENT-CENTRED
? Know your stuff
? Ensure all patients have a full assessment and care plan
? Be clear about what HCSW?s can and can?t do
? Make sure patients are involved and informed
? Eliminate long handovers
? Work towards a Primary Nursing model
? Stop task orientated care
? Use Essence of Care wisely
? Prioritise when short-staffed
? Take the lead on ward rounds
CHAPTER 6 -GET YOUR BUDGET RIGHT
? Know what you budget is
? Prioritise PAY
? Make sure your budget matches your ?off-duty? numbers
? Manage annual leave allowance
? Manage sickness/absence (and maternity leave!) allowance
? Forward 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
CHAPTER 7 - RESPOND WELL TO COMPLAINTS
? Work on the content, not number of complaints
? Make sure your staff are equipped to deal with verbal complaints
? Write a draft response before investigating
? Investigate sensitively
? Maintain contact with the complainant
? Hold a meeting if appropriate
? Know what to do if you suspect misconduct, negligence or criminal intent
? Put up a complaints/comments board
? Take action to put things right
? Share all complaints with your team
CHAPTER 8 - BE POLITICALLY AWARE
? Keep up with what?s going on
? Choose your meetings carefully
? Get to know the right people in your Trust
? Plan ahead
? Be diplomatic
? Talk of ?we? rather than ?I?
? Make time for your line manager and Director of Nursing
? Know your Trust Board and their priorities
? Network
? Choose your mentor and mentees with care
CHAPTER 9 - BE A GOOD ROLE MODEL
? Never moan or gossip
? Be smart
? Always smile
? Always make a good first impression
? Be relaxed and in control (never lose your temper)
? Talk with confidence
? Make your writing distinguishable
? Work on your strengths
? Be aware of your weaknesses
? Mind your language
? Socialise with care
CHAPTER 10 - LOOK AFTER YOURSELF
? Recognise symptoms of stress
? Recognise and deal with any staff stress
? Get yourself a mentor from the Trust Board
? Join or set up a peer support group
? Get over mistakes and move on
? Train up your deputy ward manager
? Choose who you talk to carefully
? Get a union rep on your team
? Drink plenty of water and eat!
? Remember it?s only a job
CHAPTER 11 - HAVE A ROLLING RECRUITMENT PROGRAMME
? Review the post with the person who is leaving
? Write good adverts and recruitment packages
? Shortlist and arrange interviews
? Get the best out the interviews
? Follow up all candidates personally
? Keep accurate, objective records
? Arrange 2-week induction + PDP?s for all new recruits
? Continually explore all other avenues to get staff
? Involve your team
? Succession plan
CHAPTER 12 - MANAGE DIFFICULT SITUATIONS
? Deal with your difficult manager
? Deal with members of staff who don?t get on
? Deal with any allegations of bullying/harrassment properly
? Deal with grievances appropriately
? Take action if staffing levels are dangerously low
? Break up any cliques
? Take action when morale is low
? Protect your staff from being used by others
? If the work is not funded, don?t do it
? Deal with that problematic colleague
CHAPTER 13 - MANAGE DIFFICULT STAFF
? Don?t allow bad behaviour
? Deal with staff who refuse to undertake a task
? Deal with staff who refuse to wash/wear proper uniform/look professional
? Deal with staff who refuse to accept change
? Deal with staff who work too hard
? Be fair but firm with staff who demand more than others
? Don?t put up with difficult agency nurses
? Know what to do when staff allege unacceptable behaviour from a colleague
? Deal with any drug / alcohol problems immediately
? If you suspect criminal activity, take action
CHAPTER 14 - MAKE TIME FOR YOUR MANAGER
? Be clear about your 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 to taking on extra work without funding
? If you are doing extra work without funding, take action
? Keep your manager informed
? Present solutions, not problems
? Write good and timely reports
? Be careful about taking on extra projects
CHAPTER 15 - GET THE BEST ADVICE
? Know where to go for legal advice
? Know where to go for professional advice
? Tap into the resources within your chaplaincy department
? Use but don?t abuse the clinical nurse specialists
? Be clear what PALS is for
? Use those policies
? Get the best Health & Safety advice
? Build external links
? Consult HR at the earliest stage
? Use your mentor
CHAPTER 16 - QUESTION EXTERNAL DIRECTIVES
? Is another link nurse role really needed ?
? Has the bed manager considered all other options ?
? Is that audit really necessary ?
? Has your line manager questioned the decision ?
? Is that performance target worth lowering the quality of care for?
? Are HR aware of the implications of their decision?
? Are consultant/specialist decisions always right ?
? Use your union steward
? Don?t be afraid to contact the Chief Executive directly
? Rely on your own common sense