The Critical Link: How Supporting Nurse Managers Can Help Nurses — And Improve Healthcare

Americans respect and admire nurses: year in, year out, nursing is ranked as the country’s most trusted profession — and it often isn’t close. Even so, many nurses are stressed to the point of burnout, and far too many are thinking about leaving. The status quo is simply not good enough — for nurses or for patients. 

Frontline nurses name workload and feeling valued as daily challenges. These are difficult issues, but they can be successfully addressed. To a great extent, middle managers define the workplace culture and shape the employee experience. In the healthcare context, nurse managers — those who have direct reports and manage departments — play this role, serving as the link between frontline nurses and senior leadership. They make a difference: Research in 2024 found that healthcare organizations with strong nurse managers saw less turnover and better patient outcomes.  

Sixty percent of nurses reported that their managers improved their job satisfaction; it’s also encouraging that nurse managers are much less likely to want to leave the profession than frontline nurses. Most experienced nurses, however, don’t want to be managers, perhaps because they have seen over time the challenges that come with the position. “I have never met a nurse manager who can 100 percent fulfill their duty,” one nurse told us. “It is such a demanding job.” 

The implication, then, is that by supporting managers, healthcare organizations can make the workplace better for nurses. That could not only improve retention but build a pipeline of nurse managers.  

To make that happen, organizations need to meet the needs of nurse managers. Turnover rates for nurse managers vary widely, with a national average of 8.8 percent. One key differentiator is ongoing mentorship and skills development — both before taking the position and after — in areas such as conflict resolution and workforce management.

Another area to look at is how they spend their time. What nurses value most is people management, including daily huddles, career development, and one-on-ones. What they like least is administrative duties such as handling complaints, incident reports, and callout coverage. To some extent, of course, this is the nature of the job; someone has to do these less enjoyable tasks. Still, technology can be deployed to change the balance between the work nurse managers want to do and the work they have to do.  The better use of technology, including agentic artificial intelligence, could help them with unloved duties such as audits, shift-tracking, and onboarding. 

In addition, nurse managers cannot be expected to thrive, or even to like their work, if they have 250 direct reports, as is sometimes the case. Adding assistant nurse managers is one option that has proved effective. At the very least, there should be clear expectations and standardized responsibilities, so that managers in one department are not doing substantially more (or less) than their peers. Finally, a certain percentage of managerial work could be done remotely; allowing this flexibility could make the position more appealing to both incumbent and future managers. 

Nurses are at the heart of patient care—and there are not enough of them. The shortage is real, and getting worse. Making the profession more appealing could not only draw in more new entrants but help to keep experienced staff working. And while improving conditions for nurses is good in and of itself, there is an economic dimension, too; replacing frontline nurses is expensive. 

The cliché is people don’t leave their jobs; they leave their bosses. It is also true, however, that good bosses provide a reason not to leave. To address the shortage of nurses, as well as the difficulties they face on the job, supporting nurse managers is essential.

Photo: Hiraman, Getty Images

This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.