"[Nurse managers] are critical to the mission of the organization and meeting the strategic initiative at that point-of-care service. We need to make sure that they're competent to do the job that they're put in charge to do," McKay says. "It's really about how we are orchestrating to train these nurses to be agents of administration, to be fiscally responsible, to understand what the strategic mission and values of the organization are, and to follow those."
Fortunately, some organizations across the country are creating well-thought-out, intentionally designed programs to help nurse managers develop the skills they need to succeed in a value-based care environment.
Leadership development is lacking
Developing strong nurse managers is important for many reasons, says Paula McKinney, DNP, RN, NE-BC, vice president of nursing and CNO at Scotland Health Care System in Laurinburg, North Carolina. The healthcare system had 23,244 hospital patient days (all patients) in fiscal year 2016.
"If they don't learn how to be a good leader, and they're just managing the processes, then they [could] set their unit up to create an unhealthy work environment," she says.
Results from the decadelong RN Work Project, a multistate, longitudinal panel study of new nurses' turnover rates and their intentions and attitudes about work, highlight the importance that nurse managers have on the work environment.
According to the study's findings, poor management was one of the top three reasons newly licensed RNs gave for leaving their first jobs, and 17% reported that, because of their supervisor, at least once a month, it was difficult or impossible to do their job.
Lack of proper training affects the longevity of nurse managers as well.
"If you promote someone to nurse manager and [he or she leaves] you within 12 to 18 months, you're losing a great deal of money. It could be up to $100,000," McKinney says. "I think there's some cost savings involved in better preparing them to be leaders and managers instead of letting them be out there on their own to flounder and then they end up leaving the job."
In McKinney's recent study, "Improve Nurse Manager Competency With Experiential Learning," published in the October 2016 issue of Nurse Management, 86% of the respondents said they had no formal leadership development when they first became a nurse manager.
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.