Today’s guest post comes to us from Jocie Strong, MSN, RN, and Kronos Clinical Solution Specialist. Jocie shares the importance of nurse manager engagement in relation to patient care and takes us through a few examples of how modern tools can play an important role in keeping nurse managers energized in their roles. Read on to gain insight from this industry-expert!

Relieving nurse manager administrative burden may strengthen engagement

The role of a nurse manager (NM) is complex and uniquely challenging. NMs typically have 24/7/365 responsibility for at least one patient care unit, including accountability for both clinical and operational outcomes.  Competencies of these leaders cover everything from specialty clinical care and informatics, to leadership, healthcare finance, and human resources1.  With influence in numerous different domains, it is no wonder that NM skill greatly impacts both patient outcomes2 and staff retention3. It should also be no surprise that with so many required areas of proficiency, NMs are susceptible to high stress and burnout, often making retention a challenge4,5.

Nurse managers directly impact the culture of a patient care unit and the resulting work environment of nurses.  In turn, creation of a healthy work environment can improve employee engagement and productivity, impacting fiscal outcomes such as employee retention, productivity, and absenteeism rates6.  It has also been shown that a healthy work environment leads to better clinical care7. With the estimated costs to replace a nurse manager at 75% to 125% of their salary8, replacing a single manager could average $69,000 to $116,0009. With nurse manager turnover rates typically higher than those of senior leaders, organizations would benefit from engagement initiatives targeting this group10.

A recent study has identified strategies to enhance nurse manager engagement11. Recommendations include enhancing clear communication, relieving the administrative burden, and promotion of work/life balance. So often when discussing workforce management with clients, we hear from the Chief Nursing Officer (CNO) that his or her frontline managers do not have what they need to easily, quickly, and accurately manage their clinical nurses. For NMs to avoid frustration and have the required information to make decisions in their role, they need modern tools at their fingertips. Technology can play an influential role in assisting this key group via:

  • Automation – In a world where clinicians often get more facetime with a computer screen than their patients, the ability to automate administrative tasks allows NMs more time out of the office to interact with patients and families, and to mentor their clinical staff. Tasks that can be automated with modern technology include everything from tracking attendance and approving PTO requests, to filling open shifts and creating balanced staff assignments.
  • Alerts – To adequately meet the demands of their role, NMs need to interpret and respond to dynamic real-time information. From patient satisfaction scores and quality outcomes, to financial performance and throughput, the data influencing NM decisions are often received after it is too late to make changes which would impact outcomes. Modern technology can push alerts directly to managers at regular intervals, or in real-time, so that they can correct issues proactively. Alerts include warnings of employees approaching overtime pay, notification of an employee who was unable to receive a break during their shift or reminders to staff when they need to renew required licenses or certifications. Additionally, systems can provide access to real-time data, allowing for optimal decision-making that is most likely to result in positive outcomes – for example, providing visibility to a unit that is experiencing unusually high patient churn, or access to information about a patient who is unexpectedly requiring a higher level of nursing care and additional staffing resources.
  • Mobility77% of Americans own a smartphone today12, and the ability to complete most tasks on a mobile device is a growing expectation. Adopting technology that allows NMs to utilize their smartphone to communicate with employees – whether related to critical staffing issues or to approve timecards and schedule requests – gives them the freedom to balance their management work while both attending organizational meetings at the hospital, or giving their attention to personal matters at home.

By relieving the administrative burden of some non-strategic, but required tasks, NMs can focus their energy on work that is not only important to your organization’s mission and patients, but that will also leave them energized and engaged. Let’s make it easier for them to support their employees in providing the best care possible, without being dragged down by the small stuff.


[1] American Organization of Nurse Executives. (2015). AONE Nurse Manager Competencies. Chicago, IL. Accessed at:, Accessible at:

[2] Lageson, C. Quality focus of the first line nurse manager and relationship to unit outcomes. Journal of Nursing Care Quality. 2004; 19(4):336-342.

[3] Anthony, MK, Standing, TS, Glick, J, et al. Leadership and nurse retention: The pivotal role of nurse managers. Journal of Nursing Administration. 2005; 35(3): 146-155.

[4] Shirley, MR, Ebright, PR, McDaniel, AM. Sleepless in America: Nurse managers cope with stress and complexity. Journal of Nursing Administration. 2008; 38(3): 125-131.

[5] Lee, H, Cummings, GG. Factors influencing job satisfaction of front line nurse managers: A systematic review. Journal of Nursing Management. 2008; 16: 768-783.

[6] Blake N, Leach LS, Robbins W, Pike N. Healthy work environments and staff nurse retention. Nursing Administration Quarterly. Aspen Publishers; 2013; 37:356.

[7] American Association of Critical-Care Nurses. (2016). AACN Standards for Establishing and Maintaining a Healthy Work Environment. Aliso Viejo, CA. Accessed at:, Accessible at:

[8] Titzer J, Phillips T, Tooley S, Hall N, Shirey M. Nurse manager succession planning: Synthesis of the evidence. Journal of Nursing Management. 2013; 21:971-979.

[9] National Average Nurse Manger Salaries. Glassdoor, Sept 2017. Accessed at:,13.htm

[10] Titzer J, Phillips T, Tooley S, Hall N, Shirey M. Nurse manager succession planning: synthesis of the evidence. Journal of Nursing Management. 2013; 21:971-979.

[11]Conley, KA. Nurse manager engagement: Strategies to enhance and maintain engagement. Journal of Nursing Administration. 2017; 47(9): 454-457.

[12] Smith, A. Record shares of Americans now own smartphones, have home broadband. Pew Research Center. Accessed at:


Published: Thursday, November 9, 2017