Co-Manager Structures and After-Hours Coverage

Last month, a few posts I shared hit home for many individuals struggling with how to support overwhelmed nurse managers. After spending some time talking with managers and engaging in the literature, I want to continue to share ways to implement change. As my great colleague, @cherylsmithmiller, pointed out, ideas are fruitless without the ability to manage change. To that end, the first step is to understand if your culture is capable of innovating, changing, and growing.

Multiple-Manager Structure Implementation: Start by documenting what managers actually do over the course of a month. The administrative burden will be eye-opening. Identify people with different strengths—Create specific job descriptions with clear boundaries. Overlap should be intentional, not accidental.

Pilot with one unit before expanding. Yes, this costs more upfront, but calculate the cost of constant manager turnover and burnout-related issues-measure the ROI on a change like this as it could be incredibly useful in today’s climate.

After-Hours Coverage That Works: Nurse managers shouldn’t be the default contact for every after-hours issue. Map current after-hours calls for one month, then categorize what charge nurses could handle versus what needs a supervisor.

Create clear escalation paths and decision trees. Train nursing supervisors to handle operational issues and empower charge nurses for unit-level decisions. Use secure messaging systems with automatic routing to bypass managers for routine issues.

The hardest part: getting managers to actually disconnect. Leadership must model and enforce these boundaries.

What’s the first barrier your organization would face implementing these changes?

#NurseLeadership #HealthcareStrategy #NursingAdministration #WorkLifeBalance