What are the core competencies I need to manage a unit?
Are you like me? Are you a nurse who has been promoted into management without prior preparation, training or education on what nurse managers do?
I remember when I made this first transition many year ago now – how incompetent I felt and how stressful that was.
As soon as I became a fully-fledged registered nurse, I was put in charge. It wasn’t that I was experienced or had some knowledge of how to manage – I didn’t. It wasn’t even that I was the bossiest – I wasn’t. It was because I was the most ‘clinically qualified’. I was the registered nurse and everyone else wasn’t. I was effectively promoted to my highest level of incompetence – the ‘Peter Principle’.
I really had no idea how to manage people or units. I didn’t even know what I didn’t know! But I felt it. It was often very stressful. There were unwritten expectations of me that I only figured out when I failed to meet them. The work and the care still got done despite me most of the time. The older, enrolled nurses were far bossier than I. And they seemed to know what they were doing – they were the real ‘leaders’. I was a quick study though so I learned on my feet and was quickly promoted to ever-higher levels of incompetence.
Eventually, I realised that managing a unit or an organisation that delivers clinical care was far too complicated to leave to chance – and besides I was sick of working for people who had no idea how to manage me. So, I backed myself and enrolled into a Graduate Diploma of Business (Management). At that time, there were no health administration or management programs. My challenge was to translate this generic business management program into a health and aged care context. While I loved it, and the concepts are relevant even today, it was not an easy translation.
To this day, as a nurse I have never received any formal support to make the transitions from clinician to manager, from manager to executive. These transitions are not natural progressions. The skill sets of a clinician are not exactly the same as those needed to manage people and organisations. And if the transition is not actively and deliberately supported, the nurse can be placed into a position they are not competent to perform. Under stress, they are likely to revert to their competent zone (usually clinical and ‘doing’ – not managing) and not make the transition at all. In the process, they diminish the potential of their teams – and suffer great stress themselves.
There are core competencies and knowledge that I wish I knew when I started because they are foundational to the transition nurses and midwives make when they become managers – everything else builds on these. They are:
- Self-management first and foremost!! This is about developing an empowering management mindset
- Managing change and continuous improvement Let’s face it – change is continuous now – it is not something that happens every so often.
- Managing money – because nurses and midwife unit managers are managing multi-million dollar businesses make no mistake – so they need to know how to make their management count
- Managing people – Up to 70 of the budget is people – 99% of the issues are people – and the point of the business is caring for people – yep, it’s central
- Managing time – And probably more accurately – managing priorities so that the important stuff gets done in the endless and overwhelming demands on a manager’s time.
- Managing relationships, conflict and building collaborations – because in the end, the people that actually make the difference are at the point of care, experts who need to work with other experts to weave a complex combination of care. And conflict is inevitable – but to avoid it becoming destructive, managers need insight, skill, tools and a reliable process for turning conflict into collaboration.
I’d be interested to know what competencies you feel you need to manage a unit or a shift right now.