When asked what I wish I knew before becoming a manager, so many things come to mind. Each organization has different expectations of the nurse manager role, and looking back I wish I had asked for a list of expectations in my first week. I had worked at another campus in the system and was blessed to work with a director who valued autonomy and growth opportunities in my previous supervisor role, which let me make many assumptions about what the manager role would include. The adage “you don’t know what you don’t know,” quickly proved true, and it felt like I found a new responsibility every day.

Learning What the Role Really Requires

The manager role was a shift away from the clinical aspects of day-to-day patient care, but not the operational aspects of the department. I had to draw a balance between presence in the department, key to building trust with a new team, and attending to the administrative tasks that had to be addressed. I was expected to be familiar with patients and throughput needs while also managing staffing, hiring, budgeting, continuous quality improvement, and creating a healthy work environment. Trial and error helped me determine what my workflow would look like, though it has continuously changed over the years; flexibility has been key, and clinging to a routine can become a barrier.

Lessons for the First 90 Days

If I could share a few points that helped me most along the way, it would be these:

• Lean into the uncomfortable and ask questions. The first 30 days are best spent observing, learning your team, their workflows, and the role. Staff will inevitably come to you for decisions during this period, and it can feel like you need to have a ready answer for every question, but it is always better to take the time to find the right answer than to quickly give the wrong one.
• Manage your calendar or it will manage you. Proactively blocking time on your calendar can help you prioritize and use it for what you need – office time if you are struggling to meet deadlines, time on the floor if you find it hard to get out of the office. There will always be meetings that appear on your calendar, work with your leader to determine what your priorities are.
• Staff will reach out to you at all times, day or night, weekday and weekend. Set your expectations up front on communication – boundaries around text messaging, what should be sent via email, and when a call is needed. Staff may feel the need to run every decision by you, especially in the beginning. Rather than making all decisions for them, help them identify decisions within their scope and empower them to do so. Autonomy is key to high functioning teams and gives time back to the leader.
• Build relationships with leaders outside of your department. They can give you clear perspective on problems you are too close to. Collaboration across departments and the interdisciplinary teams also becomes much easier when you know the leaders beyond formal emails.
   

Confidence Comes with Experience

Each year has brought a new challenge and a new era in nursing. Seasonal surges, the Covid pandemic, several natural disasters, embarking on our journey to excellence – each step has taught me so much. At this point in my leadership journey, I have the privilege of mentoring a new leader or two each year, helping them find their confidence and set goals for their career. I have a network of leaders across the organization to collaborate with and drive outcomes for patients and staff. What I most wish I knew before I started – if you are intentional about learning and building relationships, confidence will come with experience, trust will lead to influence, and you will become the leader you want to be.

About the Author

Ashley Catalano MSN, RN, NE-BC is currently a nurse manager at HealthPark Medical Center, part of Lee Health. She has been a nurse for over nine years, in leadership positions for the last five years. She worked in orthopedics, starting her leadership journey there, then managed a Covid cohort unit, adult stepdown and observation units, and now the Magnet Program.

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