The evolution of the nurse manager has taken place in the midst of a greater discussion on the development of management and hierarchy. In the nineteenth century, the transition from feudal to capitalist economy facilitated the entrepreneurial efforts of an emerging middle class and necessitated the creation of an administrative structure to coordinate the production process. These changes spawned a new field, now referred to as organizational behavior to create theories and models that would develop an efficient and cost effective strategy for large-scale manufacturing, distribution and marketing, as well as the supervision and training of the workforce.
Leadership skills such as the ability to develop and communicate a vision for the future, command the respect of peers and subordinates and address unforeseen elements quickly and decisively, is vitally important to any successful group process. Equally imperative in the formation of businesses was the need to address structural elements such as budgeting, prioritizing, allocation of resources and the creation of systemic processes. These skills are not necessarily complementary and often individuals who were extremely competent at organizing a myriad of details were incapable of strategic planning or of motivating workers. Thus was born the idea of a manager and the enduring question of how to balance divergent needs and how to select and train the kind of individual who is capable of these multiple functions.
Medical care in the United States has become incredibly complex, with the addition of an increasingly diverse workforce and the demands of maintaining proficiency in the face of rapidly changing technology. Nurs...
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...pace, barely stopping to eat, rest or to spend any extended time with patients (Tevington, 2011). At the same time, hospitals offer enormous financial incentives to remedy the shortages that are incurred when nurses leave the field. There appears little insight into the ways in which the very policies written to increase efficiency, serve to undermine professionalism, promote burn out and marginalize clinical proficiency (Gordon, 2005).
The current nursing culture in which the experienced “eat their young” is easily understood given the atmosphere present in many hospitals. The question remains, not how to develop the manager, but how to gain empowerment for the nurse manager so that they can assume a place of true accountability, trust and responsibility that is required in order to achieve success and to lead, develop and manage a team of professionals.
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