When about half a million RN’s retire in the next decade, there will be more than just a void in important clinical care positions. These departures will also deplete many of the large pool of U.S. Nurse Managers. It makes sense that young nurses will, or should, apply and fill these voids. But as Tanya Osborne McKenzie, now the director of Critical Care Services at St. Agnes Medical Center in Fresno, CA, said in an interview, “No one wants to be a nurse manager. It’s extremely difficult to find nurse manager talent or to hire anyone.”
This is a serious issue in healthcare, since by 2020, more than 50% of the nursing workforce will be nurses born after 1980. Nurse Managers are responsible for supervising nurse staff, overseeing patient care, scheduling, meetings, and personnel and budget decisions. Since this role is so important, why do so many young nurses feel reluctant to apply to management positions?
With great responsibility comes great… stress? An effective nurse manager does just that: manages… and manages a lot. That includes juggling direction of their nursing staff, oversight of patient care, and aspects of the budget. Managers are expected to engage nurses, satisfy patients and their families, and meet certain metrics. The nurse manager must be able to operate within this high-stress, complex environment.
Nurses have also cited feeling unprepared to handle things like organizational politics, regulatory and compliance accountability, and paperwork or budgeting as hindrances to applying to nurse manager roles.
LACK OF SELF-CONFIDENCE OR QUALIFICATIONS.
Nurses often feel they do not have the proper amount of education, advanced leaderships skills, or self-confidence to move up the ladder. Many organizations have historically focused leadership development only on nurses in management or executive roles, leaving inexperienced nurses feeling less confident. In regard to education, a master’s degree, though not required, has increasingly become the minimum expectation for a nurse manager. Without proper development or the right degree, it may leave many nurses feeling unqualified.
Susan Ohlson, the director of the Office of Continuing Studies at the University of Illinois at Chicago College of Nursing, put it this way: “Nurses aren’t educated in the ways of leadership. We take clinicians and expect them to succeed in management. But it’s a completely different set of competencies.”
BAD FIRST EXPERIENCE AS A CHARGE NURSE.
If a nurse has tried his or her hand at being a Charge Nurse—a first step into supervising– and had a bad experience, their willingness to try another managerial position is probably low. Research shows that fear of failure is especially prevalent with Gen Y nurses.
Without proper leadership development, Charge Nurses may experience personal barriers in their first leadership role, such as inability to see the big picture, inability to delegate, or inability to handle stress or stay organized. See our related article, 9 leadership barriers a Charge Nurse can face.
UNSATISFACTORY COMPENSATION AND LONG HOURS.
Being a nurse manager often means committing to long hours, some of which may go unpaid because of the loss of overtime/shift differentials. The gross earnings of many new managers are less than those of senior nurses on the same unit who are eligible for overtime and other premium pay. Once the long hours, on-call expectations and work that managers take home is taken under consideration, managers often earn less than the hourly rate of some of the people they supervise. Also new Nurse Managers are often expected to work undesirable shifts in their first management role which may be perceived as too burdensome to deal with.
ANTICIPATED LACK OF SUPPORT.
Nurse managers are sandwiched between their staff and the leadership above them, leading to the feeling of being stuck with lots of hard work but with little recognition. There is fear that new managers have to know everything going into a role and that new managers have to sort out details alone in a new role.
Some young nurses notice that organizations have high expectations of leaders and low tolerance if goals are not met. When nurse leaders fail, it can be a public failure and they can be blamed, even if they are not entirely responsible for particular outcomes. A staffing issue for instance can derail goals, and be outside of a managers control.
LEAVING THE BEDSIDE.
The connections made through direct patient care and the ability to use clinical skills drive the passion for nursing. Helping patients is why most nurses applied to nursing school. Making the transition from RN to nurse management often comes at the cost of losing these types of connections and skills — something that many nurses are not willing to give up.
FAMILY REASONS OR WORK-LIFE BALANCE.
Being a nurse manager means your work doesn’t necessarily end when you walk out the door — managers may spend late nights going over budgets or reviewing resumes. This can interfere with home life obligations.
MOVEMENT TO OTHER PARTS OF THE ORGANIZATION.
The career path of a nurse does not always have to follow a straight line into managerial positions. Many people wish to move to other parts of their hospital’s organization, perhaps as a nurse educator, a director in Human Resources, or to work in case management. Many nurses are moving outside of the traditional acute care hospital to outpatient settings to have better work hours or less stress. Recent national attention on mental health issues for instance is bringing many nurses to mental health centers which may offer better hours.
There are many reasons why your young nurses may not be applying for management roles. In order to do more effective succession planning, pay attention to environmental factors in your unit that hinders willingness to accept leadership responsibilities.
A program like NCharge®: “Nurses Learning to Lead” can help prepare your Charge Nurses for their first role in management. Courses like Charge Nurse Fundamentals, Critical Thinking for Charge Nurses, and Supervisory Skills for Positive Outcomes help young nurses practice skills like managing conflict, collaboration, delegation, and critical thinking. These courses learning objectives are also tied to business skills like learning about hospital financial indicators and how nursing work ties to VBP. NCharge also helps participants understand financial indicators of success, and prepares nurses for higher level conversations to assist the Nurse Manager.