Rural nursing unit managers: education and support for the role

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Nursing unit managers (NUMs) occupy the often unenviable position of first-line management in many health services in Australia. As such, their role is complex and multifaceted requiring an intertwining of their clinical and managerial responsibilities. While there is an abundance of studies that explore and describe the various management roles in many professions and industries, little is known about the experiences of nurses as managers, particularly in rural settings. This article focuses on the education and support needs of rural nursing unit managers. A qualitative study design was used to explore the stories of a number of nursing unit managers in rural New South Wales, Australia. Data was collected using semi-structured individual interviews. Data was analysed using a voice-relational method as a framework for more clearly hearing the voices of participants. This method of data analysis is particularly useful for hearing from those who do not usually have a 'strong' voice, for gaining an understanding of the context of the interviews, and for acknowledging the role of the researcher in the research process. All NUMs employed in a single regional health authority in rural Australia were invited to participate. Out of 42 NUMs in the region, 20 agreed to be interviewed. Nursing unit managers were asked to reflect on their experiences prior to and during the early days within the position. In summary, all the NUMs: believed they were promoted because of their clinical expertise; felt unprepared for the managerial and administrative aspects of their role; continued to identify as nurses rather than as managers; found the role isolated them from their former peer group. Those employed in small facilities had limited opportunities for education and peer support. Based on the NUMs' experiences and suggestions, the following information would have helped them to cope with the demands of their new role: information and discussions about the role expectations of first-line manager, from both an employee and employer perspective; human resource and financial management skill development; leadership skills; negotiation and conflict resolution; a clear and realistic role description.