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Delegation Prevents Nurse Manager Burnout

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   August 17, 2010

These are the dog days of August. We’re roasting in high temperatures and dreaming of trips to the beach. This is the time we should be taking vacations and using the time to relax, refresh, and return to work rejuvenated and reinvigorated.

Vacations are essential to everyone’s mental health, especially in the stressful world of nursing, where burnout is all too common. Nurse manager burnout is a topic that should be on the minds of senior leadership. Nurse managers are the critical layer of management that makes the difference between organizations meeting their goals or falling short. They make the difference in retention, turnover, patient satisfaction, financial success, and quality patient outcomes.

Nurse managers are often promoted without enough training or support, which leads to burnout. As I’ve written before, there are many ways senior leadership can support nurse managers. One of them is to encourage vacation time.

It’s easy to say take a vacation, but harder to do, and many nurse managers feel they can’t take time away. If they do, they are constantly in touch with the unit, answering emails and calls at all hours.

Last week, I polled a nurse manager audience to ask them about the best way to beat burnout. More than 60% responded “take a vacation.” The next highest response was attend a professional development conference, and it’s heartening to hear that focusing on their professional development rejuvenates them.

While they know in theory that it’s beneficial to take time off, in practice they are hindered by the fear of what will happen while they are gone.

I spoke with Shelley Cohen, president of Health Resources Unlimited, who teaches new nurse manager survival skills. She says nurse managers often feel things will fall apart if they are not there, especially if they are inexperienced.

Cohen says nurse managers need to learn how to delegate, which will reduce their stress, allow them to focus their attention on the most important priorities, and increase the skills of their staff.

She says nurse managers do not delegate for several reasons:

  • They are afraid to add more responsibilities to an already overworked staff
  • They are afraid staff cannot complete tasks as well as they can
  • They don’t have anyone on the staff who they trust to handle the project
  • They feel they can do it more effectively and efficiently themselves
  • They fear their boss would not want them to delegate any of their jobs functions or tasks

She notes that mangers get comfortable with feeling this way, leaving them with little motivation to do anything to change the situation.

“Every day, when nurse managers continue this pattern of not delegating, they are disempowering the staff, discouraging professional accountability, sending a message that they do not respect or trust the staff, and sending a message that they believe their staff does not have the knowledge or skill,” says Cohen.

She says one way leadership can help nurse managers learn delegation skills is through role modeling effective delegation themselves. If you’re the type of person who thinks the best way to get something done is just to do it yourself, then you’re not setting a good example to your nurse managers.

Cohen says start by asking staff what they would like to see delegated and whether there are areas of your job they’d like to be more involved in. For example, nurse managers can add great insight to patient safety work or budget planning. From the nurse manager perspective, they could delegate the task of planning the unit’s staffing. Giving responsibility to a unit staffing committee can increase staff satisfaction with the schedule as they are the ones who created it.

Cohen offers the following tips for learning how to delegate:

  • Be specific—describe in detail what you are delegating and your expectations
  • Consider what you delegate and to whom
  • Start with small elements and build from there, allow staff to see successes
  • Be available as a resource but do not take over

  • Set realistic timelines
  • Always provide the tools/resources they need to be successful
  • Grant the authority necessary for them to carry out what you delegate
  • With enough practice, nurse managers may be able to delegate enough that they finally feel comfortable taking a vacation.

    Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at

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