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Managing up….how to get what you want from your nurse manager

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Andy Dean | Veer + Scrubs


I looked up the definition and the root of managing or management and found that it is a Latin phrase meaning “to lead by the hand.”  I think that is a little out dated of a term, especially in nursing where we strive for shared governance and really expect each other to practice in a professional and responsible manner with some autonomy.  But, I think it really gets to the point of what managing really is….leading.

So, what do you do when you want something from your manager?  You lead them down the path to what you want or need.  Let’s just use asking for time off as an example.

First thing you need to do before you go to them is remember, your manager is looking at the picture of the unit and hospital.  Although your unit looks like it’s staffed well enough or even overstaffed for that time period, your manager also has to look at the rest of the organization and prepare for calls off during that time period.  It may not be as black and white as it seems by just looking at your unit’s schedule.

Next, see if there is anything your manager may need. Try to find something you can negotiate with. Say you need this day off, and you see that there is another day that week that is understaffed; be willing to offer to work so that you can have that day.

One of the first things I used to do when I was a staff nurse on a new unit is survey the landscape and be the one that the other nurses rely on for things. I called it building equity on the unit.  When somebody wanted to trade, I would almost always say yes if I was able to, even if it is not really what I wanted. I would do this for a while to “build my equity.”  Eventually, I would know that when I needed something like a trade they would owe me.  Managers see this too when they are posting holes or asking for volunteers for committees or other activities. If you are helping the unit out and really making an effort to help out the team, you manager will see that and that equity you built up with them will pay off when you really need it.

Does it always work? No. There will always be a manager who doesn’t notice things, or a coworker who just takes advantage of you and will not help you out. In that case, I say call them out on it. Tell them about all the times you helped them out when they were in a pinch and you are asking for this now from them. I think this will show what kind of manager or coworkers you actually have and if you can trust them.

On the flip side, if you manager helps you out before you built up that equity, be prepared to pay it back. When I started a job once, my wife was pregnant with my daughter. I was unable to build up the equity with my manager before my wife went into the hospital. He gave me the time I needed to be with my family which I was truly grateful for. But I made a point of it to repay his kindness by helping him out when he needed it.  This is what helped me when I needed something again from him.

So, I guess my advise is: Be flexible, be prepared to give a little something back and be prepared to be told no.

Rob Cameron
Rob Cameron is currently a staff nurse in a level II trauma center. He has primarily been an ED nurse for most of his career, but he has also been a nurse manager for Surgical Trauma and Telemetry unit. He has worked in Med/Surg, Critical Care, Hospice, Rehab, an extremely busy cardiology clinic and pretty much anywhere he's been needed. Prior to his career in nursing, Rob worked in healthcare finance and management. Rob feels this experience has given him a perspective on nursing that many never see. He loves nursing because of all the options he has within the field. He is currently a grad student working on an MSN in nursing leadership, and teaches clinicals at a local university. Away from work, Rob spends all of his time with his wife and daughter. He enjoys cycling and Crossfit. He is a die hard NASCAR fan. Sundays you can find Rob watching the race with his daughter.

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