PROFESSIONAL DEVELOPMENT
Written communication: Relationships: from from staff staff nurse nurse to to nurse nurse consultant consultant
Part 6: with senior managers John Fowler
546
■■ She
was very professional. But, possibly because of her age, she was seen very much as a mother figure by all the junior staff ■■ She knew her strengths and limitations, and organised her junior staff accordingly. The complexity of the relationship at this level comes when the various roles—mentor, manager, clinical specialist, off-duty and annual leave allocator, performance reviewer, sickness monitor, standards reviewer—begin to merge and overlap with professional friend and work colleague. It is the role diversion and role diffusion that makes the relationship at this level complex. Balancing the various sub-roles that the ward manager has is a massive skill that is difficult to teach on any management course. When you move beyond the ward manager and begin to look at wider healthcare management relationships, the interactions become quite different for a number of reasons. If you are at the level of ward manager, clinical nurse specialist or nurse consultant, ask yourself the following questions: ■■ Who is the person you relate to in terms of human resource (HR) issues such as booking annual leave or disciplinary issues? ■■ Who do you turn to for clinical advice and supervision of your patient care? ■■ Who would you discuss a difficult decision with? ■■ Who would you discuss your career development with? Many senior nurses will have three or four different ‘managers’ who take on specific aspects of the management role that the ward sister has for her staff. For these more senior staff, no one person encompasses all the management roles that the traditional ward sister has for her staff. The managers of the senior and specialist staff may well be in different buildings, come from different professions or different clinical specialties, and quite often will not have a clinical healthcare background at all. In many ways, the relationships between more senior and specialist nurses and their managers is far less complex than those of the staff nurse and
the ward sister. They spend less time physically with their managers and when they do meet, it is for a specific purpose. Because their roles have become more specialised, there is less role confusion and diffusion about which particular role they are seeking managerial advice or direction on. There may be more disagreement between individuals, but the actual relationship is far more straightforward. The relationships involved in the management of your own staff and the relationship you have with your managers are thus quite varied. It is useful to step back and reflect on the relationships in your own management role, and on how you relate to your managers. There are no simplistic answers and magic formulae for management. My advice for staff trying to develop their management skills is always to take a good honest look at their own strengths and weaknesses.This is not as simple as it sounds and it is easy either to belittle your own strengths or to ignore your weaknesses. If you really want to carry out this exercise, try going for a 40-minute walk on your own with these two simple questions: what are my strengths? What are my weaknesses? Take a small notebook with you and aim to write down five points for each. If you can honestly recognise your five strengths and five weaknesses, you can use this as a basis for how to manage others, and how to manage your relationship with your seniors.BJN Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books
© 2015 MA Healthcare Ltd
T
his is the sixth article in the staff nurse to nurse consultant series, which is exploring ‘relationships’. Subsequent articles will examine relationships with terminally ill patients and families, people with mental health problems, and some tips on how to handle personality clashes. This article examines relationships with senior managers. Whatever our nursing role and our position in the national or private health service, there is always someone higher up in the hierarchy to whom we are managerially responsible. When I was a staff nurse, my managers and their roles were fairly obvious: the ward sister for day-to-day management; the unit manager for professional development issues; and the senior hospital managers for promotion and secondments. Professional and clinical management followed a very similar hierarchy. The ward sister advised and managed my everyday clinical practice with patients and was a source of greater knowledge and clinical experience. The unit manager would occasionally be involved in clinical management relating to patient care, such as moving a patient from the ward or finding us extra staff during a particularly busy period. I remember just one occasion when the senior hospital manger became involved in patient care and that was when a particular patient had become so disruptive to the unit that a hospital case conference was called. At the staff nurse level, the ward sister or charge nurse is the key person who provides management, leadership and clinical direction. That position has always been recognised as a key role in the health service. The relationship that junior members of staff have with the ward manager is quite complex. Take a few minutes to reflect on the type of relationship you experienced as a staff nurse with your first ward manager. Here are some thoughts on my own: ■■ I respected her, as she was an experienced nurse and ward sister who seemed able to cope with any clinical or managerial problem ■■ An authority figure, she was definitely in charge. And the patients and doctors knew it
British Journal of Nursing, 2015, Vol 24, No 10 © MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 129.059.095.115 on September 21, 2016. Use for licensed purposes only. No other uses without permission. All rights reserved.
Written communication: Relationships: from from staff staff nurse nurse to to nurse nurse consultant consultant
Part 6: with senior managers John Fowler
546
■■ She
was very professional. But, possibly because of her age, she was seen very much as a mother figure by all the junior staff ■■ She knew her strengths and limitations, and organised her junior staff accordingly. The complexity of the relationship at this level comes when the various roles—mentor, manager, clinical specialist, off-duty and annual leave allocator, performance reviewer, sickness monitor, standards reviewer—begin to merge and overlap with professional friend and work colleague. It is the role diversion and role diffusion that makes the relationship at this level complex. Balancing the various sub-roles that the ward manager has is a massive skill that is difficult to teach on any management course. When you move beyond the ward manager and begin to look at wider healthcare management relationships, the interactions become quite different for a number of reasons. If you are at the level of ward manager, clinical nurse specialist or nurse consultant, ask yourself the following questions: ■■ Who is the person you relate to in terms of human resource (HR) issues such as booking annual leave or disciplinary issues? ■■ Who do you turn to for clinical advice and supervision of your patient care? ■■ Who would you discuss a difficult decision with? ■■ Who would you discuss your career development with? Many senior nurses will have three or four different ‘managers’ who take on specific aspects of the management role that the ward sister has for her staff. For these more senior staff, no one person encompasses all the management roles that the traditional ward sister has for her staff. The managers of the senior and specialist staff may well be in different buildings, come from different professions or different clinical specialties, and quite often will not have a clinical healthcare background at all. In many ways, the relationships between more senior and specialist nurses and their managers is far less complex than those of the staff nurse and
the ward sister. They spend less time physically with their managers and when they do meet, it is for a specific purpose. Because their roles have become more specialised, there is less role confusion and diffusion about which particular role they are seeking managerial advice or direction on. There may be more disagreement between individuals, but the actual relationship is far more straightforward. The relationships involved in the management of your own staff and the relationship you have with your managers are thus quite varied. It is useful to step back and reflect on the relationships in your own management role, and on how you relate to your managers. There are no simplistic answers and magic formulae for management. My advice for staff trying to develop their management skills is always to take a good honest look at their own strengths and weaknesses.This is not as simple as it sounds and it is easy either to belittle your own strengths or to ignore your weaknesses. If you really want to carry out this exercise, try going for a 40-minute walk on your own with these two simple questions: what are my strengths? What are my weaknesses? Take a small notebook with you and aim to write down five points for each. If you can honestly recognise your five strengths and five weaknesses, you can use this as a basis for how to manage others, and how to manage your relationship with your seniors.BJN Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books
© 2015 MA Healthcare Ltd
T
his is the sixth article in the staff nurse to nurse consultant series, which is exploring ‘relationships’. Subsequent articles will examine relationships with terminally ill patients and families, people with mental health problems, and some tips on how to handle personality clashes. This article examines relationships with senior managers. Whatever our nursing role and our position in the national or private health service, there is always someone higher up in the hierarchy to whom we are managerially responsible. When I was a staff nurse, my managers and their roles were fairly obvious: the ward sister for day-to-day management; the unit manager for professional development issues; and the senior hospital managers for promotion and secondments. Professional and clinical management followed a very similar hierarchy. The ward sister advised and managed my everyday clinical practice with patients and was a source of greater knowledge and clinical experience. The unit manager would occasionally be involved in clinical management relating to patient care, such as moving a patient from the ward or finding us extra staff during a particularly busy period. I remember just one occasion when the senior hospital manger became involved in patient care and that was when a particular patient had become so disruptive to the unit that a hospital case conference was called. At the staff nurse level, the ward sister or charge nurse is the key person who provides management, leadership and clinical direction. That position has always been recognised as a key role in the health service. The relationship that junior members of staff have with the ward manager is quite complex. Take a few minutes to reflect on the type of relationship you experienced as a staff nurse with your first ward manager. Here are some thoughts on my own: ■■ I respected her, as she was an experienced nurse and ward sister who seemed able to cope with any clinical or managerial problem ■■ An authority figure, she was definitely in charge. And the patients and doctors knew it
British Journal of Nursing, 2015, Vol 24, No 10 © MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 129.059.095.115 on September 21, 2016. Use for licensed purposes only. No other uses without permission. All rights reserved.
