NHS managers think nursing directors lack ‘clout’

More than 1,400 nurses, managers and nursing directors took part in the anonymous online survey, with specific sets of questions targeting each staff group.

More than one in 10 managers also said their director of nursing “lacks the clout” to contribute to the strategic thinking of their organisation

The findings show just over half of directors of nursing are optimistic they can protect the quality of nursing during the coming financial squeeze. But other results from the survey suggest they could lack power in their organisations to do this.

For example, 80 per cent of nursing directors who responded said they had “influence over major decisions about investment and the strategic direction” of their organisation. But only half of managers agreed.

More than one in 10 managers also said their director of nursing “lacks the clout” to contribute to the strategic thinking of their organisation.

Yet managers showed considerably more confidence in their nurse directors’ skills than the directors have in themselves.

For example, 40 per cent of other managers said their nursing director had a “full overview” of the strategic issues which faced their organisation and did not need any more support or training, compared with 25 per cent of nursing directors themselves.

Asked which strategic management areas outside of nursing they felt they needed more support and training in a third of nursing directors selected finance while around a quarter identified understanding data and legal issues.

In general, fellow board members had more confidence in their director of nursing than more junior managers.

Asked about the positive impacts they had on their organisation half of nursing directors said they had saved money. But just a quarter of managers agreed with this.

One manager commented: “All senior nurses see the financial position as secondary to their job, not part of their job. If they don’t join in then it will lead to silly cost cutting exercises, rather than a joined up whole systems approach.”

Nursing directors are also not as visible to their nursing staff as they believe. Two thirds claim they do a ward round at least once a fortnight and the rest said they did a round at least every two months. But 75 per cent of nurses said their directors did not do a regular ward round and a third said they had never seen their nursing director.