A Nurse

A Nurse's Survival Guide to Leadership and Management on the Ward

Are you managing other people?

If so, you will find this an indispensable guide to situations and problems faced by ward managers, sisters and charge nurses today. This new edition retains the book’s practical approach, providing hints and tips on cutting through bureaucracy to ensure patient care remains uppermost on your agenda.

This book will help you to

  • Manage your time
  • Create a positive work environment
  • Ensure care is patient-centred
  • Manage your budget
  • Be politically aware
  • Manage difficult staff and situations


Published: September 2012

Imprint: Churchill Livingstone

ISBN: 978-0-7020-4704-6


  • 1 - Be clear about the role of the ward manager

    Be clear about what 24-hour responsibility means

    Be clear about what makes a good leader

    Make sure your decisions are informed ones

    Clarify your objectives

    Understand your legal responsibilities

    Be clear about your matron/line manager’s role

    Remember you are the patients’ overall advocate

    Don’t take on other people’s pressures

    Balance your clinical work with administrative duties

    Be aware of the imp0act of your role on others

    2 - Manage your time
    Define your workload
    Organise your office

    Control your diary
    Keep up with your emails
    Cut interruptions

    Don’t waste time with unnecessary reading

    Handle meetings effectively

    Learn to let go through delegation

    Be proactive

    3 - Create a positive working environment
    Plan ahead

    Set meaningful objectives with your team
    Be a good listener
    Feedback with sincerity
    Know your staff well
    Never talk disapprovingly of others
    Get your staff to take more responsibility
    Have a system for dealing with patient’s relatives

    4 - Manage staff performance
    Get to know your HR advisor

    Write everything down

    Make appraisals work

    Know how to handle unacceptable behaviour

    Handle poor performance/incompetence
    Know when and how to discipline
    Actively manage sick leave
    Ensure all staff have appropriate training, development and support
    Provide additional support for mentors

    Reduce staff stress

    Inform and involve all of your team

    Consider team-based self-rostering

    5 - Make sure care is patient-centred
    Maintain your clinical skills

    Ensure all patients have a full assessment and care plan
    Be clear about what health care assistants can and cannot do
    Eliminate long handovers
    Use task-orientated care only when appropriate

    Work towards the named nurse (or primary nursing)
    Make sure patients are informed

    Performance indicators, audits and benchmarking
    Manage staffing shortages
    Take the lead on ward rounds

    6 - Manage your budget
    Know what you budget is
    Prioritise pay

    Go through your monthly budget statements

    Manage annual leave
    Manage your unplanned absence allowance
    Plan your study leave allowance
    Get your staff involved in NON PAY
    Be more active in the business planning process
    Don’t do anything without identified funding
    Meet regularly with your finance advisor

    7 Improve quality and safety

    Quality indicators

    Identify mistakes and risks

    Investigate complaints appropriately

    Tips for calling or meeting with the complainant

    Investigate incidents appropriately

    Make improvements

    8 -Instigate a rolling recruitment programme
    Review the post with the person who is leaving
    Write a good advert and application packages
    Shortlist and arrange interviews properly
    Get the best out of the interview process
    Follow up all candidates personally
    Arrange a good induction programme
    Continually explore all other avenues to get staff

    Don’t discriminate
    Keep accurate, objective records
    Succession plan
    Fully involve your team in all aspects of recruitment

    9 - Be politically aware
    Understand how health care is managed nationally

    Keep up with what’s going on

    Know your Board of Directors and their priorities
    Choose your meetings carefully
    Network - get to know the right people

    Be diplomatic
    Work with your Director of Nursing

    Get recognition for your work
    Choose your mentor and mentees with care

    Plan ahead for your own needs

    10 - Look after yourself
    Set up a peer group or action learning set
    Develop the role of your deputy

    Get yourself a mentor
    Choose carefully who you talk to and what you say

    Reduce stress
    Get over mistakes and move on
    Remember it’s only a job

    11 - Be a good role model
    Be smart
    Make a good first impression
    Always smile and be positive

    Speak clearly
    Be relaxed and in control
    Make your writing distinguishable
    Be aware of how others see you

    Set an example with your choice of language
    Never moan or gossip about others

    Don’t stagnate

    12 - Manage your manager
    Clarify expectations
    Work with, not against your manager
    Act, if an important decision has been made without your consultation
    Act, if a change in another department has a knock on effect in yours
    Don’t be pressurised into taking on extra work without funding
    If you are doing extra work without funding, take action

    Keep the communication channels open
    Write clear and timely reports

    Know how to conduct a good investigation

    13 - Manage difficult situations
    The difficult manager

    The problematic colleague

    Allegations of bullying/harassment within your team

    Staff complaints

    Helping your staff to act

    Dealing with racism or other forms of discrimination

    Unsafe staffing levels


    Be specific about expanding nursing roles

    Be proactive with enforced moves or mergers of services

    14 - Manage difficult team members

    Staff who refuse to look professional or wear proper uniform
    Staff who refuse to accept change

    Staff who can’t seem to prioritise their work

    Staff labelled as lazy

    Staff with alcohol problems

    Members of staff who don’t get on

    Staff who seem careless and sloppy

    Staff who manipulate situations for their own gain

    Staff who moan and whinge

    Staff who are continually late for duty

    15 - Get the best advice
    Know where to go for legal advice
    Know where to go for professional advice
    Utilise the chaplaincy department
    Use but don’t abuse the nurse specialists

    Help patients and relatives access the right advice

    Keep up to date with risk management issues

    Consult policies, procedures and guidelines

    Maximise computer access

    Utilise the knowledge and skills of your nursing colleagues

    Utilise the practice development team

    16 - Question external directives
    Is another link nurse role really needed?
    Has the bed manager considered all other options?

    Are you managing a team of nurses or auditors?

    Has your line manager questioned the decision ?
    Do some quality indicators actually lower the quality of care?

    Are senior managers aware of the implications of their decisions

    Are consultant/specialist decisions always appropriate?
    Does your union steward know?
    Is the Chief Executive aware of what is happening?
    Rely on your own common sense.


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