The nurse administrator is a key aspect of the nursing environment, ensuring the operational integrity, reporting and accountability of the healthcare environment. The administrator takes responsibility not only for the care of patients, but for the underlying nursing practice environment that ensures patient care. The reduction of negative behaviors and strengthening positive behaviors of the nurse administrator and in the work environment are best practices that can provide for the best possible administration of nursing as well as the direct care and other specialties which together provide for nursing care and support for patients.
Nurse administrator behaviors that do not provide a good practice environment include a failure to consult with and to listen to those who work primarily in direct care; inconsistency in the application of rules, policy and procedure; and a failure to model positive communication behaviors.
When the nurse administrator does not regularly consult with and listen to stakeholders, such as nurses in other specialties including direct care, this can have disastrous results. This failure to have an open communication channel can result in a disconnection between nursing practice and its administration. Some outcomes of such a situation are reporting which reflects workarounds when processes were improperly implemented as well as a general lack of trust between those who administrate and manage care and those who provide it.
Behaviors such as inconsistency in the application of rules, policy and procedure are more than an ethical and behavioral problem; they can be against the law when they are based on discriminatory attitudes or outcomes. Inconsistency in, for example, recruitment and promotion, which is based on gender, ethnic background or disability, can even lead to criminal charges (Bratton & Gold, 2012).
A failure to model positive communication behaviors identifies low expectations with regard to the behaviors of others, and it is a mistake for the nurse administrator in particular. This is a mistake for the nurse administrator, as this cost neutral behavior can provide a supportive environment for nursing practice as well as assurance that expectations in behavior are better understood.
Nurse administrator behaviors that I would incorporate into my own leadership style are behaviors which support the inclusion of all stakeholders, reacting to problems rather than people and keeping current with regard to one’s area of responsibility.
Behaviors which support the inclusion of all stakeholders include respect for all cultures, genders and socioeconomic circumstances among others. This includes every day and routine interactions as well as the manner in which process and policy is applied. Cultural competence is an important aspect of this. Inclusion should also ensure that all stakeholders are identified, regardless of occupation, position or status. For example, in some cases patients should be included in consultation if the outcome of an administrative change or decision will have an impact on them.
As an administrator, personal opinions or frustrations must be held in check. This requires a certain emotional intelligence, particularly when individuals, patients or colleagues are frustrated with aspects of administration or when situations are personally displeasing to the nurse administrator. One method which assists in ensuring this is to realize that one can manage problems through the application of the appropriate administrative practice, rather than to react to persons who might be upset or difficult to deal with.
These were chosen as key because they enable good behaviors in others while assuring excellence in the administration of patients, staff, data and process.
Harassment, bullying, hearsay and gossip
Harassment, bullying, hearsay, and gossip can happen in many work environments, and they can be lateral behaviors between colleagues or workers or they can come from management or clients/patients. As a leader in a nursing practice environment the nurse administrator has both the capacity and the tools to manage such situations through prevention, mitigation and enforcing policies in relation to negative workplace behaviors.
Prevention of harassment, bullying, hearsay and gossip begins with making expectations of communications in the workplace environment clear. While other policies such as the code of ethics of the regulatory nursing body may already provide for the need to treat colleagues in the nursing environment with respect, ensuring processes that clearly state expectations regarding a harassment, bullying, hearsay and gossip free workplace are a necessary duty of the nurse administrator in order to support the operations in the workplace (Shallcross et al., 2010).
Mitigation of harassment, bullying, hearsay and gossip typically involves managing allegations of such behaviors (Shallcross et al., 2010). This can include analysis of policy and determination of wrongdoing- or not- against such instruments, but it can also provide an opportunity to better understand how the context supported such negative behaviors and possible recommendations for improving the environment.
Enforcing policies in relation to harassment, bullying, hearsay and gossip, including management of consequences of breach of guidelines or policy regarding such behavior, must be handled professionally and with respect for all parties (Shallcross et al., 2010). This requires treating all parties, whether they have been found in breach of policy or whether they have been victims of such a breach equally and ensuring the integrity of the policy framework.
The nurse administrator faces many challenges, particularly in an environment of continuous improvement and reform. The capacity to model and support good communication as well as to provide an environment free of negative communication behaviors is one that is ideal, however it requires a framework which supports positive behaviors, establishment of expectations that negative behaviors will not occur as well as leaders, such as nurse administrators, to model positive behaviors.
- Bratton, J., & Gold, J. (2012). Human resource management: theory and practice. Palgrave Macmillan.
- Shallcross, L., Ramsay, S., & Barker, M. (2010). A proactive response to the mobbing problem: a guide for HR managers. New Zealand Journal of Human Resource Management, 10(1), 27-37.