Improve manager competency with experiential learning.

F rontline nurse manager responsibilities are extensive. Nurse managers are torn between the demands of clinical nurses, physicians, patients, and administration, which require a blend of clinical skill, leadership ability, and managerial knowledge.1,2 Nurse manager competence and retention can be improved by creating structured leadership development programs that better prepare nurses to lead in today’s complex healthcare environment.3-6 Many hospitals have poorly designed nurse manager orientation and professional development programs, or none at all.6,7 The primary reason many nurse managers aren’t prepared to successfully lead in our current multifaceted healthcare environment is a lack of formal leadership training.6 Often, RNs who demonstrate outstanding clinical skill, knowledge, and behavior are promoted to nurse manager positions despite a lack of formal leadership and management preparation.7-9 Unfortunately, good clinicians don’t necessarily develop into good nurse managers. Nevertheless, 61% of nurse leaders are internally promoted.10 Nurse managers who’ve been in their position 5 years or less have turnover rates as high as 50%.11 It’s estimated that in the next few years, 75% of nurse manager positions will be vacant.12 These statistics create an urgent need for developing current and future nurse leaders at every level.13 The first step in preparing future nurse managers begins with an organizational commitment to nurture and develop the next generation of leaders. We present a model for evaluating and improving current nurse managers’ leadership and management competency at a community hospital, including the experiential learning activities developed based on an evaluation of competency gaps and the resulting competency of nurse managers following the training. A pretest/posttest descriptive study was conducted to assess current nurse manager perceived level of leadership competence. Program evaluations occurred immediately after the experiential learning session and at the end of the study. For this study, the nurse manager was defined as a unit-based nurse leader with 24-hour responsibility for the financial and operational aspects of an inpatient nursing unit.