Turn a challenge into an opportunity.

Takeaways:

• The interim nurse manager role can be extremely complex and challenging but is crucial for department stability, leadership continuity, patient safety, and quality care.
• Transitioning from peer to nurse manager even if temporary may cause feelings of dread and uneasiness.
• While it may be challenging and a stretch to take on an interim nurse manager role, with the right strategies one can be successful in the role.

Nurse managers are the anchors of nursing departments. They’re pivotal to driving unit performance and providing staff stability. So, when a nurse manager position stands vacant, the unit can experience significant disruption—including staff turnover and poor performance and outcomes. Everyone feels the urgency to find a replacement, but administrators need time to recruit someone with the right skill set who’s also a good fit for the department.

To provide stability during this transition period, nurse administrators may appoint a staff or charge nurse from within the department (or from another department) to serve as interim manager. Taking on this demanding role with its expanded scope of control while also dealing with the transition from peer to nurse manager (even if it’s only temporary) may cause feelings of dread and uneasiness. But with the right strategies—having the right mindset, understanding the expectations, being open to learning, knowing the key performance drivers, and taking care of yourself—you can turn this challenge into an opportunity.

Have a can-do mindset

A can-do mindset can help you overcome any apprehension you may feel when taking on an interim nurse manager role. You were selected for this role for your strengths, leadership potential and abilities, effectiveness, and organizational knowledge. Step into the position knowing you’re providing short-term leadership for the department and stability for staff. You’re also paving the way for the new permanent manager.

Take time to reflect on when you first became a nurse or took on a leadership role, and ask yourself: What worked well and what didn’t? What helped you succeed? How did you prioritize work? How did you set and measure goals? Of course, you’ll have to adjust your approach knowing this is a temporary assignment, but the core principles should remain the same. Think of this as a chance for self-growth and an opportunity to build your professional portfolio.

In addition, leading your peers will help you see your team and the organization from a new perspective. If you’re assigned to a department other than your own, you’ll get to learn about a different patient population, staff, department operations, and performance indicators that drive the organization’s mission. And taking on a wider span of control may help prepare you for the next level of leadership, reinvigorate you, and open doors for promotion to a permanent manager, director, or administrator position.

Know the expectations

Meet with your nurse administrator and staff so you have a clear understanding of what they expect from you and so you can explain what you expect from them. You may or may not receive a department hand-off from the outgoing nurse manager, so good communication with the nurse administrator will be vital for success. He or she should provide a general timeline and plan for recruiting your successor, explain your areas of focus, and detail the department’s priorities. Your responsibilities may range from completing a project that’s in a critical stage to managing day-to-day department tasks such as payroll, staffing, scheduling, or staying on track with performance management for poor performers. Ask what kind of support will be available to you, especially if you’re presented with competing priorities. Know where your knowledge deficits are and work with your nurse administrator or find a mentor.

Meet with department staff as soon as possible. You may not have time to meet with team members individually, but identify key staff (such as charge nurses) for one-on-one conversations to learn the finer details of the department’s operations and challenges. For everyone else, schedule a staff meeting. Give staff an opportunity to briefly share their backgrounds, any pertinent department history, issues or concerns, and anything they feel you need to prioritize for them. Don’t commit to anything or make promises immediately; just listen and then formulate a plan for providing a quick win with the staff, such as fulfilling an equipment request or finalizing a pending process change. Discuss your communication and leadership style, let staff know how you can be reached, and set realistic boundaries around your availability.

Be open to learning and build trust

If you don’t already know, quickly learn about the new department and who the key players are. Who are the formal and informal leaders? Who outside of the department does the staff interact with regularly? You’ll need to problem solve and organize to keep the department environment stable; learning from the staff will make that easier. Recognize that you won’t know everything, so you’ll need to seek staff input. When you ask questions, you’ll build trust and the staff will respect your willingness to learn.

Remember that your role is short term, so unless patient or staff safety is compromised or your nurse administrator says something is a priority, don’t make major changes or initiate long-term projects. Don’t overstretch yourself or start work you won’t be able to complete.

Learn the key performance drivers

Key performance drivers are daily activities that must be accomplished to produce unit quality outcomes or performance indicators, such as low pressure injury rates, high patient satisfaction scores, or low or no medication error rates. Your nurse administrator should provide guidance on your role in driving overall performance. Key performance drivers can be nurse manager driven (for example, rounding on staff and patients, ensuring staff have necessary supplies and equipment, tracking and reporting metrics and making them visible to staff) or bedside staff driven (for example, ensuring best practice and evidence-based care is provided at the point of care). (See Show you CARE.)

Staff rounding

Staff rounding is an evidence-based leadership tool for checking in with staff to ensure they have what they need to do their jobs effectively. Evidence suggests that the time a nurse leader spends staff rounding has a direct effect on engagement, staff satisfaction, retention, and, ultimately, patient satisfaction and care quality. As an interim nurse manager, you may not be able to round on staff daily, but you’ll need to carve out time for occasional rounding to increase your visibility and approachability and encourage open communication. Rounding will allow you to proactively connect with staff, address their concerns, and listen to any suggestions for improvement. Failure to listen and learn about ongoing concerns and barriers will hinder top performance and may be detrimental to the department and organization. Rounding on staff also will allow you to observe staff practices, giving you an opportunity to give real-time positive feedback and recognition or coaching as appropriate.

Don’t forget self-care

To effectively care for others, you must first care for yourself (eat a healthy diet, take part in physical activity, get adequate sleep, practice mindfulness, and set boundaries). As an interim nurse manager, you’ll have 24-hour accountability and responsibility for the department and your workload will increase significantly, which may mean longer work hours and increased stress. Strive for a good work and personal life balance. Be open and honest with your nurse administrator and ask for help setting priorities, establishing what meetings you’re required to attend, and knowing what can be delegated. You’ll also need to determine what work can be left for the next day so you don’t overwhelm yourself.

Set limits and boundaries for how and when staff communicate with you. For example, keep after-hours and weekend calls for emergencies only; respond to routine emails, text messages, and voicemails during business hours. You’ll want to reserve your physical, mental, and emotional energy to help you cope with stress and reduce the potential for burnout. Practicing mindfulness (for example, with meditation, journaling, or yoga) can help you stay in tune with your feelings so any anger, discomfort, resentment, or guilt you may feel doesn’t manifest and hinder your effectiveness.

Establishing a daily self-care routine for yourself will increase your alertness, elevate your mood, help you concentrate, promote sound judgment, and improve learning.

Success is possible

At some point in your career, you may be asked to serve as an interim nurse manager. This complex role is crucial for department stability, leadership continuity, patient safety, and quality care. If you find yourself in this position, remember that success is possible if you have a positive attitude, communicate openly with administrators and staff about expectations and key performance drivers, recognize your limitations, welcome opportunities to learn, and take care of your mental and physical health.

Muriel Moyo is a clinical director of the outpatient surgery center, postanesthesia care unit, and endoscopy at PIH Health Downey Hospital in Downey, California.

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