Our ward leaders need to be supernumerary
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Our ward leaders need to be supernumerary

Nicola Davis-Job Acute care and leadership advisor, RCN Wales

Leadership takes time, so ward managers should not be counted as part of the nurse staffing needed for safe care

Ward managers provide valuable clinical leadership in the delivery of quality care to patients. Their role should be supernumerary – not counted as part of the staffing needed for safe care – affording those in post the time to lead and manage.

Nursing Standard. 39, 1, 25-26. doi: 10.7748/ns.39.1.25.s13

Published: 03 January 2024

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Picture credit: iStock

Protecting the supernumerary status of ward managers

Having been a ward manager and now as RCN Wales acute care and leadership adviser, I was proud to be part of the college’s project to ensure this status is protected, at a time when workforce pressures are compromising it.

The ward manager project in Wales involved gathering real-life evidence and is influenced by the college’s new UK Nursing Workforce Standards, which set out detailed expectations on issues including setting staffing, practice development and rostering for employers, regulators and organisations to support nurses’ work and patient safety.

The project puts forward to the Welsh government recommendations on the necessity that the ward manager role be supernumerary.

Ability to lead often hampered by short-staffing

Much of the ward manager’s role and responsibilities directly enables the workforce standards to be met, by ensuring nurses can work safely and effectively.

But with increasing pressures and staff vacancies, ward managers are being taken further away from their primary role and are assisting in direct patient care to make up for this shortfall. When this happens, it makes leadership more difficult.

Ward managers put compassionate leadership into action

Effective, compassionate leadership in nursing is important to staff, patients, and their loved ones. It is a leadership style to which many people working in healthcare aspire.

Emphasis is being placed on the role of nurses as advocates for their patients and profession, whereby they speak up and use their expertise to improve processes and outcomes and make meaningful change.

The ward manager is a perfect example of what this can look like, as they establish the values and culture of their ward, and can lead by example with authenticity and expertise.

All these qualities build personal and team resilience, an indispensable asset during challenging times.

Ward managers can be advocates for staff well-being, ensuring their colleagues avoid burnout. Exhibiting bravery in making decisions that uphold the core values and best interests of your team and patients is just as important as planning and delegating the workload.

What are the duties of a ward manager?

A ward manager is the leader of a given ward and undertakes managerial, operational, administrative, pastoral and clinical tasks to ensure that their unit runs efficiently, using expert clinical judgement.

The duties of a ward manager includes, but is not limited to:

  • » Data collection and collation

  • » Allocating and auditing of staff and equipment

  • » Managing overall patient flow across the whole patient journey

  • » Clinical teaching, upskilling and assessment

Stability and consistency for staff and patients

Having a mentor is beneficial at any point in a nurse’s career. As role models to their team members, ward managers should be supported with continued professional development to reach their full potential.

The ward manager is the face of the ward for most patients, and their daily presence and interaction with patients provides consistency and stability.

Their knowing patients clinically and personally greatly assists with continuity of care during times when the make up of teams can change often, due to the inclusion of agency staff or a high staff turnover, for example.

The ward manager can facilitate handovers, briefings and seamless integration of staff wider teams. Given all this, and their wider-ranging responsibilities and leadership role, can we afford for them not to be supernumerary?

Having time to lead as a ward manager: what are the benefits for patients?

Some of the benefits of ward managers being free to lead their teams, according to the RCN project findings, include:

  • » Happier staff, happier patients It is proven that increased emotional well-being in staff (being well-rested, motivated and happy in their work) correlates to better patient care and better working relationships

  • » Fewer incidents By allowing the ward manager to manage data, plan, delegate and anticipate, there is far less opportunity for missed details and mistakes

  • » Quicker discharge rates Better overall patient journey and so potentially increased space for patients waiting for treatment

  • » Implementing existing legislation Ward managers use their professional judgement to determine the number of staff and the skill mix required for the setting and can monitor if, for example, government standards are being met

  • » Assisting Upskilling, role modelling and supporting career development for their colleagues

Looking for the next challenge in your career?

We are excited to be developing an RCN Wales clinical leadership programme for ward managers in the NHS and independent sector. This is for ward managers who want to strengthen and develop their leaderships skills, such as emotional intelligence, conflict management, coaching styles, establishing a vision and direction.

If you are thinking about whether the role of ward manager is right for you, there has never been a more relevant time to strengthen the voice of nursing in a leadership role that directly impacts patient care.

Nurse leadership: why compassion can work wonders for morale rcni.com/compassion-morale

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