As a CNO of more than 20 years, I have observed the nurse manager role evolve from what we would typically think of now as a charge nurse to that of essentially serving as the CEO of a multi-million-dollar enterprise. Nurse managers are responsible not only for clinical quality and patient satisfaction, but also for financial performance, employee engagement, operational efficiency, accreditation, regulatory standard compliance, and more. They are the linchpins to achieving hospitals’ strategic objectives. Many are leading teams of 60 to 100 people, a significantly larger team than most small U.S. businesses. Yet our tools and processes for supporting their roles are more akin to treating them as task managers than as the CEOs they are.
While nurse managers are constrained by a lack of tools to support their advanced leadership roles, they are also dealing with dynamic changes in workforce expectations. Gallup research on employee engagement indicates newer generations in the workforce are far less attached to organizations and brands; rather, they have a mobile mindset where they see themselves as consumers in the workplace. They want their relationship with their manager to look more like a coach than a boss. Essentially, they are looking for relationship-based leadership. This leadership approach advances employee engagement and commitment. It is also supportive of manager resilience. My observations have been that high-performing teams improve manager resilience and manager resilience improves team performance, a virtuous cycle moving both manager and team forward.
For teams to be high-performing, now more than ever, employees need to sense that their managers know them individually, are giving them both their physical and emotional presence, and are making investments in their professional and personal growth through coaching and relationship-building. However, this level of relational leadership is time-intensive, and often out of reach for managers who are drowning in administrative work and absent automation to help them not only lead the operational performance of their areas but also free them up to spend more time engaging with their team members. Hospital leaders need to integrate technology that moves managers closer to their teams.
Healthcare Leaders Must Invest in High Tech that Supports High Touch
While it may seem counterintuitive at first, the most supportive action healthcare organizations can take to build manager resilience and enable the high-touch leadership today’s workforce expects, is to invest in high-tech. AI-powered technologies and large language model systems of intelligence are emerging rapidly. These developing capabilities can support incorporating leadership best practices into everyday manager workflows in a more standardized and consistent way. To create space and time for managers to take a relationship-based approach to leading their teams, they need the support of technology that can automate mundane tasks, pull from systems of record, and create insights that drive team engagement, operational efficiency, clinical quality, and patient experience.
Harness Technology to Streamline Nurse Managers’ Primary Workflows
As hospitals consider innovations to foster manager resilience, a focus on managers’ primary workflows is key. Namely, those that are part of their daily leadership activities. New technology should aid in the incorporation of leadership best practices into each workflow. Technology must help managers cut through the noise of all the “could dos” and “should dos” to do more of what matters.
Employee Rounding and Engagement
Technology can empower nurse managers to build strong unit cultures. Moving check-ins from outdated HR systems to the nurse managers’ desktops, integrating with calendars for seamless follow-ups, is a key example. Manager-friendly tech can also launch customizable surveys to capture employee sentiment, analyze trends, and recommend actions, pulling these insights directly into workflows. This approach far surpasses relying on annual surveys with delayed action plans. Annual or bi-annual workforce surveys leave managers behind the eight-ball trying to recover culture rather than build a culture based on ongoing real-time feedback. Nurse managers already live accreditation survey-ready; with the right technology, they can stay culture and engagement-ready too. It’s time to move past the old ways and leverage technology to support managers in real time.
Time & Attendance Management
Time and attendance management is the bane of a nurse manager’s existence. The cumbersome process of merging scheduling systems and clocking information, organizational policies, and individual personnel records for even one employee can be overwhelming. When managers are swamped, time and attendance accountability is often the first thing to slip. As large language models increasingly move to the forefront, they should be harnessed to do the heavy lifting by linking all these data points and providing recommended actions that align with policy and promote a culture of equity. We need to capitalize on the power of technology to remove administrative drudgery, so nurse managers can focus on what is most important, which is connecting with the employee about what is driving the late clock outs, missed lunches, or absences. Those conversations not only help uncover the root causes of these issues but also foster a supportive environment, leading to improved employee engagement, satisfaction, and overall productivity.
Personal and Professional Employee Development
With large spans of control, staying on top of each team member’s personal and professional growth can seem insurmountable in the status quo. Few healthcare managers have as many direct reports as nurse managers. This challenge peaks during annual evaluations when managers are swamped writing evaluations, scheduling one-on-one meetings, and closing out reports. Technology that pulls data from HRIS and other core systems can create a 360-degree view of every employee. Technology should help managers generate meaningful recognition and connect employees to growth opportunities aligned with their professional goals, elevating employee engagement. While the purpose of annual evaluations is to connect with each team member on performance and goals, the cumbersome mechanics of the process can lead to a less meaningful annual review, missing the full opportunity to elevate the employee’s engagement and commitment to the organization.
Patient Rounding
Leader patient rounding is a nationally recognized best practice, yet many organizations lack the technology to help nurse managers develop the consistency needed for better clinical outcomes and excellent patient experiences. Rounding tools should be integrated with EHRs for easy patient movement tracking and continuity between clinic or hospital visits. These systems should be interconnected with organizational emails and tracking systems to quickly resolve concerns, file complaints, and celebrate teammates who go above and beyond. Recognition should feed into each employee’s profile. Managers will be more consistent in these leadership best practices when processes are user-friendly. These capabilities are essential for driving high reliability in healthcare and should be in the hands of every nurse manager.
Healthcare Next Steps to Move Managers Forward
Nurse managers are the backbone of hospital operations. Despite this, the means at their disposal for managing their teams are often inadequate. It’s imperative that we shift our approach and provide nurse managers with the technological support they need to thrive.
Adopting high-tech solutions that streamline administrative tasks and enhance managerial workflows is not just about efficiency; it’s about empowering nurse managers to focus on what matters most – their teams and patients. Developing technologies can automate routine processes, offer actionable insights, and integrate with existing systems, allowing managers to devote more time to their teams and less to administrative work. This shift is crucial in a workforce that values coaching and personal connection over traditional hierarchical models.
The future of healthcare hinges on the well-being of our nurse managers. By investing in technology that supports high-touch leadership, we not only enhance their capacity to lead effectively but also foster a more engaged, satisfied, and high-performing workforce. It’s time to stop making task managers out of CEOs and start equipping our nurse leaders with the technology they need to lead with excellence.
About Joel D. Ray, Colonel
Joel D. Ray, Colonel (Ret.), USAF, NC, MSN, RN, NEA-BC serves as the Chief Clinical Advisor at Laudio. He has over 40 years of nursing and health system management experience. Previously Joel was the Vice President of Patient Care Services and Chief Nursing Officer at UNC Rex. Prior to UNC Rex, he served 26 years in the United States Air Force Nurse Corps, retiring with the rank of Colonel.