Sharing the Nurse Manager Role

Lots of people will tell you that one of the draws of nursing for them was the "work-life balance." As most of us began in bedside staff nursing positions, I think we can say this was true.

Three 12-hour shifts per week were pretty great as a 20-something with no responsibilities. As I grew more passionate about my career, I wanted to change the way things were done on my unit and mentor others, and I got progressively involved until it seemed like management was the next step for me. In fact, I had filled in for my manager for two maternity leaves and knew it was something I would enjoy and that would potentially further my career. I also knew that it was all consuming.

I was on call every weeknight and some weekends, there were 100 staff to respond to at all hours of the day and night, and as a former night-shifter, I knew I needed to be available to those who worked "off-shift." I worked well over 60 hours per week during that time (in part because we moved our hospital while I was interim manager).

By the time I was ready to move into management, I was 30-something with a husband, a family in the making, and had enrolled in a PhD program. I couldn't afford to give my career more than 60 hours per week and have room for other things. I approached my then manager and asked her if she might be interested in sharing her position. I knew she too was struggling with work-life balance with having two babies at home. She loved the idea and we set to work on a proposal for our director and senior administrators.

I did the literature reviews and found a paucity of examples of job sharing in the nursing literature, and she did the number crunching on how we would save the institution money and offer them more manager availability. And we did. We gave up our health insurance and retirement options (we may not have put forward the best proposal for us) but we wanted our time most of all, and we still wanted to learn and grow in management.

So, the nurse manager job-share pilot was born, and we were in our roles together for about 18 months. We successfully met the metrics we set for ourselves and our staff, the director, and patients were satisfied. After 18 months, when my first child was born, when I learned I had to be full time in my studies thanks to support from the American Cancer Society and when I realized that I'd have a weekend internship taking me away from my family even more, I left the role. I'm happy to say that my half of the share is filled by a capable nurse who mentored me and it is no longer a pilot. I happily work per-diem on the unit I used to manage, the same place I have called home for 10 years.

Should you want to try this at your own institution, here are my suggestions:

• A good proposal: Tell the institution that this has been done successfully (you can cite us and others below) before as neither manager is full time (each of us worked three eight-hour days per week).

• Plan for an overlapping day: We had one shared day per week to meet with our leadership teams, have staff meetings, etc.
• Communicate: We had a daily sign-out system, and a shared phone number and pager number so that management was available at all hours of the day.
• Be accountable: Create metrics around quality, patient satisfaction, staff satisfaction, innovation, and growth and hold yourselves to them -- if it doesn't work, admit it! After we surveyed our staff six months in, we made changes to our system as well (even though overall satisfaction was high).

I believe this is a really good option for nurse managers moving forward and I am glad that I worked hard to create it at our institution. I learned and grew from it immensely. And isn't that the goal as well?

Does your institution have shared positions at any level? How are they done? Are they successful? What measures are used to judge success?

References:

• Creedle, C. Walton, AM, McCann, M. (2012). A Better Balance: Sharing the Nurse Manager Role. Nurse Leader 10 (6): 30-32.
• Kane, D. (1999). Job Sharing: A retention strategy for nurses. Canadian Journal of Nurse Leadership. 12(4): 16-22.
• Betancourt, EK & Lombardi, J. (1990). Job sharing in nursing management: it can work. Nursing Management. 21 (1): 47-49.