Nursing and Midwifery Unit Managers
Manage health service units and sub-units of hospitals and community health care facilities to enable the provision of safe, cost-effective nursing and midwifery care.
A Monday on the surgical ward
You are the nurse unit manager of a thirty-bed surgical ward, responsible for the team, the beds and the patients' care. It is 6:10am. One nurse has just rung in sick, a second is likely to follow, and the hospital's bed manager wants to talk about the day's admissions. Your coffee is still on the bench.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
We are full in emergency and I need three beds from your ward by midday. Can you discharge some people early? I know your team is short, but the pressure is on all of us.
Say yes to all three, because the whole hospital is under pressure and emergency needs the beds now
Three beds open, but one patient goes home before the team is sure they are ready and returns to emergency that evening. Pushing everyone to help can leave somebody worse off.
Go through the list with your senior nurses and tell Rob how many beds you can safely offer
You offer two beds with confidence and explain why the third is not safe yet. Rob is not delighted but can plan around a real number. Honest numbers beat hopeful ones.
Say no, because you are short staffed and cannot take on more work this morning
You protect your team for the morning, but emergency is jammed and Rob feels you did not even look at the list. The hospital runs on give and take.
I can cover the sick call, but I did a double shift last week and my back is playing up. I'll do it if you really need me. I just wanted you to know I'm tired.
Thank her and take her up on it, since she offered and the ward needs her
The ward is covered and Dina gets through it, but she looks drawn by lunch. Covering the gap this way will work once. It is a bad plan to repeat.
Accept her honesty, ask the staffing office for an agency or casual nurse, and let her work her normal shift
Your instinct to protect her is right, but no casual nurse is free until the afternoon. The morning is tough for everyone and you wish you had a back-up plan ready.
Thank her, ask the staffing office first, and agree a limit with her if no one else is available
A casual nurse is found for the afternoon, and Dina covers only the morning with a clear end point. She trusts you more for asking. Looking after the team is how you keep a team.
My father waited four hours for pain relief yesterday and nobody told us why. I'd like an explanation, and I want to know who is in charge of this ward.
Tell her you are the manager, listen, then find out what happened and report back
She calms as she is heard. You learn that a shift change caused the delay, apologise honestly, and tell her what is changing. People usually want to be listened to before they want to be told.
Explain that the ward was extremely busy that day and ask her to be understanding about the delay
What you say is true, but it sounds like an excuse. She leaves angrier than she arrived, and the complaint moves up a level.
Apologise straight away and promise it will never happen again
She is touched by the apology, but you cannot promise that. Later, when something similar happens, the promise comes back at you. An honest apology and a real fix go further.
How it went
By evening the ward is safe, three beds were found and one complaint is on its way to being resolved. A nurse unit manager does less hands-on nursing and more balancing: people, beds, budgets and families. It takes calm and good judgement under pressure. Would you enjoy running the whole picture?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: The roster that was quietly burning people out
A fictional case set in a surgical ward at a fictional city hospital, run by a nurse who manages the team and the beds.
The situation
Catherine managed a thirty-bed surgical ward. Her budget report looked fine, but she noticed that the same four nurses were picking up most of the extra shifts. Two had stopped joining the Friday team lunch, and one had turned down a day off. Nobody had complained. The next month's roster was due that afternoon, and filling it the easy way would use the same four people again.
What they did
Catherine held off publishing the roster and spoke to each of the four nurses on their own. They told her they said yes to shifts because they felt guilty leaving the team short. She changed how extra shifts were offered so everyone had a fair turn, asked the hospital's staffing office for help with the gaps, and told her manager the ward needed more regular nurses, not more overtime.
How it turned out
The new roster was slower to organise and a little more expensive for a month. Two of the four nurses stayed who might have left. The staffing office gave her an extra part-time nurse, and Catherine kept checking who was working extra every few weeks.
What would you do?
- How could you tell that someone was tired if they never complained?
- Would you find it hard to say no to your own manager on behalf of your team?
- Which would you choose first: a smooth month or a healthier team?