Nurse managers deal face-to-face with overworked and union-susceptible employees, and those front line managers fear confrontation. At a high level, nurse execs know that ample staffing is crucial for high-quality care. In fact, nurse leaders ranked nurse-to-patient ratios as the most important factor for providing high-quality patient care. But ongoing needs to trim expenses leave little room for investment in staffing.
Nurse managers, most of whom are baby boomers themselves, see their staff getting older by the year and wonder how their units will continue when these staff begin to retire. Fifty-seven percent of nurse execs reported being unprepared for the expected mass exodus of baby boomer nurses. Not only do organizations have to plan for who will fill the day-to-day care needs of patients, they also need to plan for the brain drain of losing so much clinical and professional knowledge. Baby boomers are often the first to volunteer to join a new committee to solve a patient safety issue or implement a new practice change and their leadership will be sorely missed.
As healthcare reform and reimbursement deliberations continue in 2011, nurse execs would do well to keep an eye on the short-term fears of frontline managers as well.