Nurse managers and leaders carry a great deal of responsibility for creating a container in which their nursing colleagues can safely and happily practice.

A nurse manager must keep her eye on many aspects of a healthcare environment. In a complicated healthcare milieu, how does a thoughtful nurse manager ensure the nurses under her charge are working in an environment that is balanced, functional and healthy?

Out of touch

A complaint often heard from nurses is that their supervisors are "out of touch" and disconnected. A nurse manager who is perceived by her direct reports as being disconnected from reality has lost traction within the team. This type of perception can drive a wedge between management and nurses.

No matter how many pieces of the puzzle a nurse manager must attempt to hold together, she cannot lose sight of the daily struggles of the nurses on her team. Budgetary challenges, pressure from administration and other issues cannot stand in the way of keeping her finger on the pulse of the team.

However, even the most perceptive nurse manager may sometimes lose her way among the many claims on her time and attention.

The macro and the micro

Despite myriad demands, the nurse manager must maintain keen 10,000-foot awareness of the overall environment, as well as the microcosmic issues that may threaten the cohesion and well-being of the team, individually and collectively.

In cinematic terms, the nurse manager must be like the director of a film, panning the camera back for the big view, then focusing the camera more steadily on the intimate moments that are an intrinsic part of the larger picture.

Maintaining some level of focus on the micro and the macro can support the nurse manager in being aware of the currents running through the team. Just like a movie, focusing too exclusively on the minutiae or the broad sweeping view will leave one aspect of the action out of balance — a balanced awareness is necessary.

Fingers on the pulse

The thoughtful nurse manager must keep her fingers on the pulse of the nursing team. She may ask herself questions such as:

  • How is each nurse functioning?
  • Is there discontent simmering below the surface?
  • Are there nurses who have lost their focus?
  • Are there interpersonal challenges that must be addressed?
  • Who on the team seems dispirited or deflated?
  • Is the team cohesive and functional?
  • Are there negative dynamics that require ongoing attention and redirection?

Once answers to such questions are ascertained or intuited, the manager must take inspired action to address them. Individual attention for troubled nurses is paramount, as is attention to dysfunctional team dynamics.

21st-century nurse leaders indeed have their hands full, but no matter how complex healthcare becomes, nurse managers must keep their fingers on the pulse of team health. They must address challenges, dysfunction and individual nurse discontent on an ongoing basis.

If the members of the team feel cared for and supported, the team will function smoothly. Conversely, if members of the team feel neglected or isolated, the team will splinter and lose ground. The thoughtful nurse manager applies a holistic approach to management, and maintains a team that feels supported, seen and heard.