Caught in the middle

The individual and organisational adversities faced by nurses at the forefront of patient care remain a constant challenge within healthcare institutions. These often lead to feelings of being undervalued, discontent, or burnout. Frontline nurse managers are not exempt from this as they also carry the load of handling the daily demands of their department's operation. 

But how often and how extensive do we check on these nurses on this level?

Frontline nurse leaders are expected to manage services that cater to a multitude of patients with varying health presentations, manage diverse staff personalities, as well as translate executive plans and projects as direct patient care initiatives. The difficulty with these tasks is that they are non-technical skills that no single theoretical framework, coaching, or study day can teach. This can generate a sense of confusion and isolation among those in this group that can flow to the rest of their team members, affecting overall patient care. 

Personally, as a band 7 nurse manager, I find great joy knowing that my role still allows me to practise my core bedside nursing skills and at the same time have the opportunity to facilitate service improvement measures. In my experience, especially during the height and immediately after the onslaught of COVID-19, I often feel like I am navigating through uncharted waters. That it is either I ride the waves or I sink and worse, drag others with me.

Leadership programmes and literature certainly help greatly in teaching one the fundamental guiding principles of team and clinical decision making. However, no one could teach you how to exactly deal with the great balancing act that you have to do to keep the floor together every day, how to manage patient expectations, work through the pressures of financial cuts, etc.

Within the context of ophthalmic services where the demand often exceeds capacity, the other challenge that remains is how we can develop interest among younger nurses towards the specialty; as well as how to retain, develop and foster motivation and confidence among current staff to also make them want to lead and innovate so the service can continue to thrive in the coming years. 

Scrutiny is intense among individuals in high level management. Bedside staff have been given better, much-deserved recognition by the public. Nurses in supervisory roles on the other hand often find themselves caught in the middle of busy, sometimes conflicting, networks. Senior enough to be relied on to be self-sufficient in troubleshooting, but not too in there yet to be calling the shots. The hope is for their pillars to be strengthened to enable them to continue supporting rather than letting them end up crumbling.