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Revamp Your Nurse Managers' Job Scope

News  |  By Jennifer Thew RN  
   February 01, 2018

Changes to Cincinnati Children's Hospital's nursing management structure led to increased professional development opportunities and greater interest in nursing management positions.

This article first appeared in the January/February 2018 issue of HealthLeaders magazine.


Hoying has sought feedback from targeted conversations with nursing directors and managers, and they have reported positive changes in their workload. Feedback was collected through email, interviews, and conversations.

In qualitative statements during these conversations, nurses reported increased managerial coverage on the off-shifts, and directors and managers said they fielded fewer calls in their off-hours, particularly during the evening.

Directors reported being able to delegate items to their managers for follow-up rather than staying to resolve issues themselves.

They also reported having the time for strategic planning, networking, process improvement, education, and mentoring. One-to-one time with direct reports has also increased, and onboarding and communication with new staff members has improved.

"The mentorship between directors and nurse managers has been wonderful," Hoying says. "When a director position came open recently, seven managers applied for it."

Indeed, applications for nurse manager and director positions have risen. In 2010, there were 19 overall applicant submissions for manager and director positions in the patient services department. In 2011, the numbers rose to 179 applicants for 16 positions. In 2016, there were 240 applicants for 31 positions.

"We have been able to fill these open positions internally rather than seeking these candidates from the outside," Hoying says.

"What we incorporate into our programs is the science and the art of nursing, because we feel it is a solid foundation professionally. So it's creating the leader within yourself and coaching others."

—Cheryl Hoying, RN, PhD, NEA-BC, FACHE, FANN, senior vice president of patient services, Cincinnati Children's Hospital Medical Center

The manager-to-FTE ratio has helped free up time for managers and directors to pursue internal and external professional development opportunities.

"We build in [time] for the director to help mentor and coach the nursing group that's coming up in the ranks," Hoying says.

Since 2008, the organization has had one participant in the Executive Fellowship in Innovation Health Leadership offered by AONE and Arizona State University; two participants in the AONE Nurse Director fellowship; 11 participants in the AONE Nurse Manager Fellowship, and two participants in the AONE Healthcare Finance for Nurse Executives Certificate Program.

"As the CNO, it is my responsibility to make sure the right resources are provided to enable the unit leadership to be successful and enjoy their role. If not, and that role turns over, it affects everybody on the unit," says Hoying.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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