One-on-One Mentoring for Nurse Managers Is Key

Empowering nurse leaders with business training is a passion for Debbie McCartney, RN, MBA. “We really need to invest time and energy with the people who make decisions at the front line,” she says. “We need to give them the tools and training so they can make good decisions at the time care is being delivered.”

McCartney knows of what she speaks. As the former CNO of two Ohio hospitals—Lutheran Hospital and then St. John Westshore—McCartney personally led initiatives to ensure her frontline managers increased their business and financial aptitude.

“Typically, I do a needs assessment to find out what the nurses know and what they do they not know,” says McCartney who is now associate director, health care, at Navigant Consulting, Inc.

McCartney finds that many nurse leaders need education on the following topics:

• What are the strategic goals of the organization?
• How can you manage time, people, and budgets?
• How much does nursing turnover cost the organization money?
• How do you read and understand a balance sheet?
• What are the key financial drivers of the organization—for instance, how do productivity swings impact the bottom line?
• What financial indicators and reports do the CFO and CNO care about?
• Where does hospital revenue come from? Why do we need preauthorizations?  Why do we care about denials from insurance companies?

“However, it’s not just finance that nurse managers need to know,” says McCartney. “You also need to teach them project management. That way when they identify a problem in their budget numbers, they can identify the broken process that is causing that problem—and then resolve the issue.”

Formal education and training sessions on these topics do not have to be expensive—and can be developed internally, says McCartney. “Most hospitals and health systems have plenty of individuals who can teach these classes,” she says.

However, classroom training is just one part of a successful empowerment program, she says. Also key: The CNO—or someone appointed by the CNO—needs to regularly sit down with each nurse manager one on one to go over budget limits, staffing plans, etc.

“You can do all the teaching you want with nurse managers, but the real key is working line item by line item with them and giving them the project management skills to resolve issues that come up. Once you sit down with them one on one, you really teach them,” she says. 

McCartney recalls how this training plus mentoring approach helped one of her managers at St. John Westshore. “The ED manager was intimidated at first, but she really began to learn the business side of health care and in the end she very much owned her department. She was coming to me to strategize when her productivity or budget numbers did not meet target.”

“This is what you ultimately want. If the budget is off one month, managers should be able to tell you where and why, and be ready to strategize on how to fix the problem.”