Nurse managers are leaders of the nursing team. They walk a fine line between balancing the needs of the nursing staff with the needs of the organization. As liaisons between the two, there are challenges that they must overcome.

One challenge is ensuring the nursing staff is adequately trained, and the units are adequately staffed. Any staff nurse can attest that staffing is often problematic and insufficient. When nurses are short staffed, they report directly to the manager. The manager must solve staffing issues by communicating directly with float staff or with a staffing office. They must approve overtime occasionally, and ask nurses to come in on their day off. Meanwhile, staff nurses may express frustration over staffing issues, and often directly to the manager.

Nurse managers must also act as "cheerleaders" to motivate staff and keep them engaged in everyday work. Nurses have a high rate of burnout and sometimes need extra support. Staff meetings and team building activities help keep staff motivated, and nurse managers often act as the facilitator.

Leaders also help to implement changes from upper management or the organization. This can be challenging as some staff is resistant to change. Not only must nurse leaders implement and facilitate change, but they must also assess and remediate staff who have difficulty or are resistant to change. This can include further education, training, and sometimes discipline.

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Speaking of discipline, this can be another challenge for nurse managers. Many nurse leaders develop a close working relationship with staff, so when discipline or counseling is required, it can be difficult for them. It's important to take a step back and look at the big picture- many times discipline is required for the good patient care and the organization. Staff should not take it personally, and nurse managers should not take it personally if staff go through a period of resentment. Difficult conversations are not easy to give, but it's not easy to receive either.

Another challenge is meeting the needs of organizations. Nurse managers must meet metrics as well as state and federal requirements. Performance measures need to be examined and improved upon frequently. Nurse managers and leaders need to recruit help from staff to help meet performance measures and sometimes coaching and education is needed to do so.

Budgeting and cost containment is another challenge. Staffing, supplies, and resources must be carefully balanced to keep costs down. Doing more with less is a common theme in many organizations, so nurse leaders must continuously work on improving efficiency.

Nurse managers and nurse leaders have a challenging job. Feeling pressure from upper leadership and staff can make them feel caught in the middle. Maintaining a balance between the two and being able to anticipate and manage challenges is a necessity.

Amanda Bucceri Androus RN, BSN

Amanda Bucceri Androus RN, BSN

Amanda Bucceri Androus is a Registered Nurse from Sacramento, California. She graduated from California State University, Sacramento in 2000 with a bachelor's degree in nursing. She began her career working night shifts on a pediatric/ med-surg unit for six years, later transferring to a telemetry unit where she worked for four more years. She currently works as a charge nurse in a busy outpatient primary care department. In her spare time she likes to read, travel, write, and spend time with her husband and two children.
Amanda Bucceri Androus RN, BSN

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