Praise for The Nurse Manager’s Survival Guide, 4th Edition “Tina Marrelli has created another important resource for nurse managers, leaders, chief nursing officers, administrators, and rising clinicians alike. This well-written edition is a road map outlining several important issues and management techniques not commonly treated in a didactic manner. Specifically, it is truly a ‘survival guide’ that covers significant ground on the evolution of the clinical manager role. Marrelli’s voice and passion for building strong nursing leaders in our rapidly changing industry can be heard in every chapter—whether you begin on page one or skip to a particular section of interest. You owe it to yourself and every clinical leader in your organization to own and read this important resource!” –Lisa J. Salamone, MPA Executive Vice President and Chief Operating Officer Visiting Nurse Association of Northern New Jersey “The Nurse Manager’s Survival Guide, 4th Edition, offers a comprehensive approach for aspiring, new, and seasoned nurses to be successful managers and leaders. Focusing on skills and knowledge necessary for nurse managers, this book provides guidance for new managers at various levels of leadership roles and serves as a refresher for nurses who have been in managerial roles for many years. Tina Marrelli gives voice to the many difficulties and challenges any new manager faces in today’s healthcare environ- ment and also provides a road map for success.” –Margaret Terry, PhD, MS, RN Senior Director National Quality Forum “Tina Marrelli has written an excellent book for nurse managers that covers all aspects of a manager’s role in today’s healthcare environment. The content is valuable for someone new to the role, but a seasoned manager would also benefit from reviewing the book as a refresher or for new skills and knowledge. The book should be required reading for nurse managers.” –Carolyn V. Donohue, MSN, RN, NE-BC Vice President, Chief Nursing Officer Roper Hospital, Charleston, SC “What a wonderful resource! This book contains foundational management concepts in a quick reference format for new managers as well as areas that serve as reminders for experienced managers. Including the section on stress and supporting yourself speaks to the importance of these concepts—not only in relation to being a healthy nurse manager but also in relation to being a healthy nurse.” –Nathalie Rennell, MSN, RN Instructor/Honors Faculty Arizona State University College of Nursing and Health Innovation RN-BSN/CEP Program “Tina Marrelli provides an insightful, easy-to-navigate guide that not only teaches valuable leadership skills but also empowers managers to apply them in day-to-day operations. I found this guide to be helpful and applicable to new as well as experi- enced nurse managers.” –Marilyn Cornman, BSN, RN, HCS-D, COS-C Regional Vice President, AHN Healthcare at Home, Home Health “The fourth edition of The Nurse Manager’s Survival Guide is a welcome resource to new and seasoned nurse leaders who are continually evolving to ensure that the needs of diverse populations are met in complex healthcare environments. This updated publication maintains Tina Marrelli’s long tradition of offering sensible, relevant, and energizing content as well as easy-to-use tools that readers can readily implement in practice.” –Mary Jo Vetter, DNP, RN, AGPCNP-BC Clinical Associate Professor Director, DNP Program New York University Rory Meyers College of Nursing “The Nurse Manager’s Survival Guide is a must-read for every nurse manager or director working in healthcare today. Grab your highlighter and bookmarks because this is more than a one-time read—it is a tool to reference as you navigate the complex healthcare systems we work in every day. The nurse manager is the glue that holds our institutions together. My thanks to Tina Marrelli and the Honor Society of Nursing, Sigma Theta Tau International (STTI) for investing in our nurse leaders and their success.” –Jennifer Gentry, MS, RN, NEA-BC Chief Nursing Officer, Christus Spohn Hospital-Corpus Christi Chapter 9: Conclusions iii “The Nurse Manager’s Survival Guide, 4th Edition, is comprehensive, realistic, and applicable to both new and seasoned nurse managers, regardless of practice setting. It covers multiple topics, all of which are practical in today’s healthcare environment. The references to nursing theory and organizational behavior serve as an academic basis to practical application. The lists, tables, and illustrations make the book an easy read and quick reference. Additionally, each chapter ends with topics for discussion, making it ideal for group study. Finally, Marrelli’s attention to nurturing oneself in the nurse manager role is refreshing. It demonstrates her compassion for those of us who become so engrossed in our day-to-day responsibilities that we overlook the impor- tance of self-care in maintaining maximum effectiveness in our demanding roles. As an active nurse manager over multiple decades, I will incorporate The Nurse Man- ager’s Survival Guide into the orientation of newly hired managers in my organization because of its breadth and realistic approach to encountering and solving real-life problems in the healthcare setting.” –Margie Harvey-Griffith, MS, RN Vice President of Medicare Firstlantic Healthcare Inc. iv The Nurse Manager’s Survival Guide, 4th Edition Chapter 9: Conclusions v NURSE the MANAGER’S su r v i val GuiDE 4 th ed. With assistance From Cat Armato Copyright © 2018 by Marrelli and Associates, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Any trademarks, service marks, design rights, or similar rights that are mentioned, used, or cited in this book are the prop- erty of their respective owners. Their use here does not imply that you may use them for similar or any other purpose. This book is not intended to be a substitute for the medical advice of a licensed medical professional. The author and publisher have made every effort to ensure the accuracy of the information contained within at the time of its publication and shall have no liability or responsibility to any person or entity regarding any loss or damage incurred, or alleged to have incurred, directly or indirectly, by the information contained in this book. The author and publisher make no warranties, express or implied, with respect to its content, and no warranties may be created or extended by sales representatives or written sales materials. The author and publisher have no responsibility for the consistency or accuracy of URLs and content of third-party websites referenced in this book. The Honor Society of Nursing, Sigma Theta Tau International (STTI) is a nonprofit organization whose mission is advancing world health and celebrating nursing excellence in scholarship, leadership, and service. Founded in 1922, STTI has more than 135,000 active members in more than 85 countries. Members include practicing nurses, instructors, researchers, policymakers, entrepreneurs and others. STTI’s roughly 510 chapters are located at approximately 706 institutions of higher education through- out Armenia, Australia, Botswana, Brazil, Canada, Colombia, England, Ghana, Hong Kong, Japan, Kenya, Lebanon, Malawi, Mexico, the Netherlands, Pakistan, Portugal, Singapore, South Africa, South Korea, Swaziland, Sweden, Taiwan, Tanzania, Thailand, the United States, and Wales. More information about STTI can be found online at www.nursingsociety.org. Sigma Theta Tau International 550 West North Street Indianapolis, IN, USA 46202 To order additional books, buy in bulk, or order for corporate use, contact Nursing Knowledge International at 888.NKI.4YOU (888.654.4968/US and Canada) or +1.317.634.8171 (outside US and Canada). To request a review copy for course adoption, email [email protected] or call 888.NKI.4YOU (888.654.4968/US and Canada) or +1.317.634.8171 (outside US and Canada). To request author information, or for speaker or other media requests, contact Marketing, Honor Society of Nursing, Sigma Theta Tau International at 888.634.7575 (US and Canada) or +1.317.634.8171 (outside US and Canada). ISBN: 9781945157417 EPUB ISBN: 9781945157424 PDF ISBN: 9781945157431 MOBI ISBN: 9781945157448 _________________________________________________________________________________________________________________________________ Library of Congress Cataloging-in-Publication Data Names: Marrelli, T. M., author. | Sigma Theta Tau International, issuing body. Title: The nurse manager’s survival guide / Tina M. Marrelli. Description: Fourth edition. | Indianapolis, IN : Sigma Theta Tau International, [2018] | Includes bibliographical references and index. Identifiers: LCCN 2017032071| ISBN 9781945157417 (alk. paper) | ISBN 9781945157424 (EPUB) | ISBN 9781945157431 (PDF) | ISBN 9781945157448 (MOBI) Subjects: | MESH: Nursing, Supervisory | Nursing Services--organization & administration | Personnel Management--methods Classification: LCC RT89 | NLM WY 105 | DDC 362.17/3068--dc23 LC record available at https://lccn.loc.gov/2017032071 _________________________________________________________________________________________________________________________________ First Printing, 2017 Publisher: Dustin Sullivan Principal Book Editor: Carla Hall Acquisitions Editor: Emily Hatch Development and Project Editor: Rebecca Senninger Editorial Coordinator: Paula Jeffers Copy Editor: Charlotte Kughen Cover Designer: Katy Bodenmiller Proofreader: Todd Lothery Interior Design/Page Layout: Katy Bodenmiller Indexer: Larry Sweazy Reviewers Nancy E. Allen, BSN, RNC, CMC CEO, Solutions for Care, Inc. Jacksonville Beach, Florida Cathleen “Cat” Armato, RN, CHC, CHPC, CHPN Armato and Associates, Inc. Healthcare Compliance Consulting, LLC Blairsville, Georgia Nancy J. Brent, MS, JD, RN Nancy J. Brent Attorney at Law Wilmette, Illinois Carolyn V. Donohue, MSN, RN, NE-BC Vice President of Nursing/Chief Nurse Officer Roper Hospital Charleston, South Carolina Lynda Hilliard, MBA, RN, CHC, CCEP Compliance Consultant Mt. Shasta, California Sue T. Miner, MSN, RN, CCRN, SCRN Critical Care Consultant Richmond, Virginia Teresa J. Schleimer, MSN, CNP, ACNP-BC Alumnus CCRN Acute Care Nurse Practitioner Cincinnati, Ohio Patricia Zabell, MBA, BS, RN, CHCE, HCS-D, COS-C Interim Management Consultant Sarasota, Florida viii The Nurse Manager’s Survival Guide, 4th Edition Dedication I dedicate this book to my husband, Bill, who always encourages me and helps me with numerous initiatives and details. These include meeting deadlines; feeding, housing, and otherwise entertaining numerous colleagues who come to visit and work on projects; and more! Bill, I never could have wished for a better hubby— smart, kind, and funny. Thank you. Acknowledgements ix Acknowledgments I would like to acknowledge and thank all the nurse managers and clinicians across many years who asked me great and interesting questions. As healthcare and its complexity have grown, so too has this book and its scope and information. I would also like to acknowledge Cat Armato for her kind sense of humor, formatting skills, clarity in writing, enhancing content, meeting deadlines, and more. Reviewers of a manuscript always strengthen and enhance the content, and I also thank the reviewers listed on the “Reviewers” page. New eyes are always a good thing, as there comes a time when one can no longer “see” what was written! Other nurse colleagues I would like to recognize for their support and counsel when needed are Anita Finkelman, Elizabeth Madigan, Elizabeth (Ibby) Tanner, Nancy Valentine, and Dean Marion Broome. Thank you for your assistance and wisdom across the years. It was and is very much appreciated. Finally, thank you to nursing managers, leaders, chief nursing officers, chief clinical officers, vice presidents and presidents of nursing, and those with many other titles (too many to list). You are the future of healthcare and the answer to myriad, continually emerging complexities. As healthcare has become more specialized and official initiatives are developed around being patient- or person-centered and more compassionate, I worry. However, I know that nurse managers and leaders are already doing these activities every day and am heartened that we might be getting back to the fundamentals of healthcare, caring, and health. This book is dedicated to you—those nurse managers, leaders, and others who are inspiring, mentoring, and otherwise supporting team members to provide the best care for patients in many set- tings for health and care!