The relationship between managers and nurses might not be a match made in heaven. But both partners accept, albeit reluctantly, that they have to work together. And they do, in a dysfunctional kind of way. Like any tempestuous relationship, theirs is generated by necessity but built on suspicion, a lack of mutual respect and understanding.
There is no smoke without fire. Nurses and managers often buy into the stereotypes of each other depicted on this week's cover - the manager as the devil incarnate, the self-interested pen pusher, and the nurse as the self-sacrificing angel. But how useful is the cliche?
There are hopeful signs for this relationship. What motivates good managers is what motivates good nurses - positive outcomes in patient care. Many managers do not have a clinical background, but they are responsible for driving clinical agendas. And to do this they must work effectively with their clinical colleagues and draw on the experience of nurses.
Perhaps an initial, elementary step to managers and nurses working together better is for them simply to take stock of how much common ground they share. It is ignorance of what they hold in common which gives rise to the prejudice that hampers the mutual respect they ought to show each other. Tackling that ignorance is the main purpose of this special issue produced jointly with our sister publication, Nursing Times - the first occasion in our long history on which we have co-operated in this way. The articles in our features section (pages 24-30) examining the relationship between managers and nurses all appear in this week's Nursing Times too.
Nurses may sometimes have good reason to complain about their managers. But they must be realistic about the demands they make, and appreciate the constraints managers work within.
Good nursing means taking a stand against decisions which may risk compromising the quality of care. But nurses have to allow managers the chance to manage.
Managers in their turn - whatever the pressure they are under - have to respect nurses' professional obligations to their patients.
One answer to breaking down the divide is for more nurses to become managers.
Trusts could help by ensuring they provide better access to good-quality management training for nursing staff. In the past, some nurses who have done this have been quick to deny their nursing roots. Even now, some would regard it as selling their soul to the devil.
Clinical governance, shared governance and the nurse consultant posts offer opportunities for managers to devolve control over practice to nurses which have yet to be grasped. Managers, as the power-brokers, need to get the ball rolling.
There will always be tension between manages and nurses, and both parties have a role in turning this tension into a positive force. There are many environments where the nurse/manager relationship works perfectly. Tell us about it.
No comments yet