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

1. The role of the ward manager

1.1. Be clear about what 24-hour responsibility means

1.2. Be clear about what makes a good leader

1.3. Make sure your decisions are informed ones

1.4. Clarify your objectives

1.5. Understand your legal responsibilities

1.6. Be clear about your matron/line manager's role

1.7. Remember you are the patients' overall advocate

1.8. Balance your clinical work with administrative duties

1.9. Be aware of the impact of your role on others


2. Manage your time

2.1. Define your workload

2.2. Organise your office

2.3. Control your diary

2.4. Keep up with your e-mails

2.5. Cut interruptions

2.6. Keeping abreast of your reading

2.7. Getting the best from meetings

2.8. Chair meetings effectively

2.9. Learn to let go through delegation

2.10. Be proactive


3. Create a positive working environment

3.1. Plan ahead

3.2. Set meaningful objectives with your team

3.3. Be a good listener

3.4. Feedback with sincerity

3.5. Know your staff well

3.6. Never talk disapprovingly of others

3.7. Get your staff to take more responsibility

3.8. Have a system for dealing with patients' visitors

3.9. Deal with conflict

3.10. Implement clinical supervision


4. Manage staff performance

4.1. Get to know your HR advisor

4.2. Write everything down

4.3. Make appraisals work

4.4. Know how to handle unacceptable behaviour

4.5. Handle poor performance/incompetence

4.6. Know when and how to discipline

4.7. Actively manage sick leave

4.8. Ensure all staff have appropriate training, development and support

4.9. Provide additional support for mentors

4.10. Reduce staff stress

4.11. Inform and involve all of your team

4.12. Consider team-based self-rostering


5. Make sure care is Patient-Centred

5.1. Maintain your clinical skills

5.2. Ensure that all patients have a full assessment and care plan

5.3. Be clear about what health care assistants can and cannot do

5.4. Eliminate long handovers

5.5. Use task-orientated care only when appropriate

5.6. Work towards the named nurse (or primary nursing)

5.7. Make sure patients are informed

5.8. Performance indicators, audits and benchmarking

5.9. Manage staffing shortages

5.10. Take the lead on ward rounds


6. Manage your budget

6.1. Know what your budget is

6.2. Prioritise pay

6.3. Go through your monthly budget statement

6.4. Manage annual leave

6.5. Manage your unplanned absence allowance

6.6. Plan your study leave allowance

6.7. Get your staff involved in non-pay

6.8. Be more active in the business planning process

6.9. Don't do anything without identified funding

6.10. Meet regularly with your finance advisor


7. Improve quality and safety

7.1. Quality indicators

7.2. Identify mistakes and risks

7.3. Investigate complaints appropriately

7.4. Tips for calling or meeting with a complainant

7.5. Investigate incidents appropriately

7.6. Make improvements


8. Instigate a rolling recruitment programme

8.1. Review the post with the person who is leaving

8.2. Write good adverts and application packages

8.3. Shortlist and arrange interviews properly

8.4. Get the best out of the interview process

8.5. Follow up all candidates personally

8.6. Arrange a good induction programme

8.7. Continually explore all other avenues to get staff

8.8. Don't discriminate

8.9. Succession plan

8.10. Fully involve your team in all aspects of recruitment


9. Be politically aware

9.1. Understand how health care is managed nationally

9.2. The Value of The Board of Directors

9.3. Choose your meetings carefully

9.4. Network – get to know the right people

9.5. Be diplomatic

9.6. Work with your director of nursing

9.7. Get recognition for your work

9.8. Choose your mentor and mentees with care

9.9. Plan ahead for your own needs


10. Look after yourself

10.1. Set up a peer support group or action learning set

10.2. Develop the role of your deputy

10.3. Get yourself a mentor

10.4. Choose carefully who you talk to and what you say

10.5. Reduce stress

10.6. Get over mistakes and move on

10.7. Remember it's only a job


11. Be a good role model

11.1. Be smart

11.2. Make a good first impression

11.3. Always smile and be positive

11.4. Speak clearly

11.5. Be relaxed and in control

11.6. Make your writing distinguishable

11.7. Be aware of how others see you

11.8. Set an example with your choice of language

11.9. Never moan or gossip about others

11.10. Don't stagnate


12. Manager your manager

12.1. Clarify expectations

12.2. Work with, not against, your manager

12.3. Act, if an important decision has been made without your consultation

12.4. Act, if a change in another department has a knock-on effect in yours

12.5. Don't be pressurised into taking on extra work without funding

12.6. If you are doing extra work without funding, take action

12.7. Keep the communication channels open

12.8. Write clear and timely reports

12.9. Know how to conduct a good investigation


13. Manage difficult situations

13.1. The difficult manager

13.2. The problematic colleague

13.3. Allegations of bullying or harrassment within your team

13.4. Staff complaints

13.5. Helping your staff to act

13.6. Dealing with racism or other forms of discrimination

13.7. Unsafe staffing levels

13.8. Cliques

13.9. Be specific about expanding nursing roles

13.10. Be proactive with enforced moves or mergers of services


14. Manage difficult team members

14.1. Staff who refuse to look professional or wear proper uniform

14.2. Staff who refuse to accept change

14.3. Staff who can't seem to prioritise their work

14.4. Staff labelled as lazy

14.5. Staff with alcohol problems

14.6. Members of staff who don't get on

14.7. Staff who seem careless and sloppy

14.8. Staff who manipulate situations for their own gain

14.9. Staff who moan and whinge

14.10. Staff who are continually late for duty


15. Get the best advice

15.1. Know where to go for legal advice

15.2. Know where to go for professional advice

15.3. Utilise the chaplaincy department

15.4. Use but don't abuse the nurse specialists

15.5. Help patients and relatives access the right advice

15.6. Keep up-to-date with risk management issues

15.7. Consult policies, procedures and guidelines

15.8. Maximise computer access

15.9. Utilise the knowledge and skills of your nursing colleagues

15.10. Utilise the practice development team