Good nurses are professionals who strive to make a positive impact in their organizations. Some are able to make this impact by working in planning with hospital administrators.
The minority nurse who works in planning is in a pivotal role for making sure patients are safe, says Evelina Echols-Sutton, BSN, RN, nursing director of Women and Children’s Services at Methodist Charlton Medical Center in Dallas, Texas.
These professionals often have leadership titles, such as nurse manager or nurse director. Or they may be in specialty roles, such as nurse statistician and nursing informatics, she says. But one common theme is that they are called on to share ideas with their organization’s leadership.
“They are in those key meetings where decisions are made on the policies that we adopt, the equipment that we eventually bring in to our facility, and the streamlined workflows that will make sure our patients and family are safe,” says Glenda Totten, RN, MSN, CNS, director of nursing services at Kaiser Permanente Los Angeles Medical Center in California.
On an average workday, a nurse who works in planning may interact with the director of pharmacy, information technology, environmental services, human resources, risk management, and legal departments, says Echols-Sutton. “My typical day is probably about four hours of meetings, four hours of office work, and then four hours of follow-up on all these activities.”
Kanoe Allen, RN, MSN-CNS, PHN, ONC, is chief nursing officer at Hoag Orthopedic Institute in Irvine, California. She says that nurses who work in planning have to juggle meetings with idea generation. “One of the challenges is carving out time to sit quietly and think through the issues and to have time to develop solutions,” says Allen.
Unsurprisingly, nurse leaders are better compensated for their efforts. The median pay for a nurse manager is $77,988, while it’s only $55,447 for a registered nurse, according to Payscale.com.
Hospitals in turn get someone who engages in positive relationships within nursing, and with managers, supervisors, staff nurses, and executive leaders, says Totten. “It takes all that to make it work and have a world-class facility.”
Managing Inside and Out
In addition to working with leadership, minority nurses in hospital planning also have to help manage their organizations’ external pressures, says Totten. There are numerous outside factors to consider, such as working to meet the standards established by the Joint Commission. As an example, Totten regularly conferences with a stroke performance improvement committee to help her facility earn a comprehensive designation from the Joint Commission.
“It's ensuring that for any [stroke] patient that goes to our emergency room, or any that are inpatients, we react immediately. We get the neurology resident in there and get the team in there within seconds,” she says.
Totten also works on a nursing quality improvement committee to assess nurse sensitive measures, such as interventions that help prevent falls in the hospital. Her teams are responsible for coming up with tools to communicate with nurses so that they are quickly informed about any relevant changes within the medical facility.
“We plan for our 1,200 or so nurses to make sure that everyone, including the per diem nurses, know what’s coming, what’s changing, how they can get more education, and the kinds of tools they need so that they’re up-to-date with the changes,” explains Totten.
Another planning team is responsible for providing constructive criticism to nurses on meeting patients. This involves communicating the best ways to exhibit caring behaviors, such as pulling up a chair and sitting eyeball to eyeball with those they serve, says Totten.
“It’s evidence-based and proven that you don’t want to stand over [patients]. You want to be as close to them as possible,” she notes. “We’re trying to standardize how we greet our patients when they come in on admission and also while they’re here.”
These issues are important because of the new value-based purchasing environment, says Shawana Burnette, OB-RNC, MSN, CLNC, a nurse manager in High Risk Post Partum and High Risk OB at Carolinas Medical Center in Charlotte, North Carolina.
A portion of reimbursements received from the Centers for Medicare and Medicaid Services will be based on the patient’s value perception of the care they receive, she explains. This means nurses in planning have to encourage their teams to not only help the patient heal, but to also have a good bedside manner.
Another area where nurses who work in planning are called on to help is to find ways to improve infection rates. The Centers for Disease Control and Prevention as well as the Institute for Healthcare Improvement review these rates, and of course, the goal is to have them as low as possible, says Totten. “You have to plan how you can show that you have a stellar place.”
Medical centers also compete with other health care centers in the community. “The consumer is more astute nowadays, and they are open to shop for the best medical facility, best health care facility, and the best insurance,” she notes.
This means nurses who work in planning often need to represent their medical centers to the community. “We have a foundation that does fundraising. In order to help them, I have to go out and speak,” says Echols-Sutton. “You want to talk to those that you serve, and find out what’s important to them.”
Improving Soft Skills, Leveraging Clinical Skills
First, health care is a highly regulated industry. Second, reimbursements are based upon the customers’ perceptions of “soft” skills, explains Allen. “Putting the two together is a change for this industry.”
Fortunately, nurses are usually well-prepared. “Nurses, by their calling, have a set of innate behaviors of putting people and solutions to the front,” says Allen. “It is a team spirit, not an individual-only spirit. That is key to the success of multidisciplinary patient care.”
People come to nursing with a big heart and a desire to help others, and it serves them well in collaborative environments where they have to work together to find the solutions, she adds.
Allen notes that being successful in nurse planning requires emotional intelligence, meaning the ability to understand and have a sense of another person’s views. To achieve success in planning means being a team player, using that emotional intelligence to understand the interplay between various personalities and departments, and working in a collaborative manner to solve regulatory and other issues, she says.
Minority nurses who work in planning can also help bridge multicultural gaps. Multicultural environments are a challenge to blend and the goal is to bring out the best attributes, says Allen.
“We serve patients from many backgrounds and having a diverse staff allows us to better anticipate and understand their cultural needs,” notes Williams.
Soft skills are necessary in higher levels of planning, but practical experience is also important, explains Totten. “One thing you can never take away from a nurse is her clinical skills. It’s handy when you’re working in a clinical setting. The more you move up in your career, [the more] those clinical skills are key.”
It all comes down to ensuring that staff members have the correct resources to care for patients, says Allen. Providing the right resources allows the staff to provide strong patient care. “Staff who do not have to worry about resources and administration support provide great customer service,” she adds.
The Career Path
Minority nurses who want to work with hospital administrators, or who want to be in administration themselves, have multiple options.
“The best thing about the profession of nursing is you can pretty much take any path. You can be in a clinical track and still move up to administration. There is also the education track, nurse practitioner track, and advanced practice nursing,” says Totten. “All these elements can secure you a good position in administration.”
Totten’s own background is as a clinical nurse specialist, but she emphasizes there are many ways to advance.
As a first step, Burnette suggests becoming a bachelor’s-prepared nurse. “They have the four-year preparation that includes handling more professional issues and critical thinking,” she explains. “The classes prepare you to be in a leadership role.”
But you should also have your sights set on earning a master’s degree. “Years of experience on the nursing unit are critical, but I would strongly recommend to anyone that is interested in this path to pursue an advanced degree in nursing,” says Williams.
“Nurses who work in planning need knowledge-based skills like budgeting and financials, experience you don’t necessarily receive on the floor,” she continues. The more educated you are regarding the area you’re going in, the more prepared you will be.
Another important means for having a successful career in hospital planning is to find a mentor who can show you the ropes in a real life environment, notes Williams.
“There are many ups and downs in nursing. There are plenty of wonderful days, and there are days in which nothing seems to go right. Being able to balance the good with the bad is essential to having a long career in nursing,” argues Williams. A good mentor can instill these lessons to their mentees and help them find their way, she adds.
Mentoring is intended to help nurses develop their skills and grow within the nursing profession. “The mentor accomplishes this by sharing their years of experiences—warts and all—to help them see nursing in its true light,” explains Williams.
Mentoring also helps a person explore who they are and how they can achieve more in their career, says Allen. In some cases, it opens doors for opportunity as well. “I have had a mentor who challenges my thoughts and plans, refocuses me when I am at a loss and then cheers me on,” she continues.
Having a mentor can also help nurses develop critical work skills, such as priority setting, stress management, people management, and good communication, says Echols-Sutton. She hasn’t had an “official” mentor, but she has had role models she patterned herself after. Other nurses who aren’t in employee-sponsored mentor programs can do the same, she notes.
“I didn’t have just one person. I tried to learn from everybody, including coworkers, bosses, and even people out in the community,” says Echols-Sutton. “They were available for me to pick their brains.”
Burnette advises nurses to find mentors who are not necessarily in their departments. If you talk to someone who works in another area of the hospital, they can give you a more global view of your organization. It’s important to surround yourself with people who have different perspectives but who are committed to achieving the same goal of providing patients with the best possible health care, she adds.
Whether a nurse joins a formal preceptor program or starts an informal mentoring friendship, anyone who wants to work in planning should reach out to a health care professional with more experience to help them along, argues Totten. “It’s not just enough to sit in your position.”
Working with Administration
Hospital administrators face many challenges from staffing to budgeting, and it is impossible to have a “go alone” mindset, says Williams. That’s why nurses who are in planning are a vital part of the team. Nurses who work with hospital administration report that their careers are fulfilling, and they have a large say in improving their hospitals.
“When you’re working in planning, you’re able to communicate with all the various staff as well as patients. It gives you a love for the ways you can improve the care that’s delivered to patients,” says Williams. “That’s where you can make the biggest impact.”