I have 2 questions:

I am a nurse manager over 2 nursing units currently so I have a large number of direct reports (42 to be exact). Part of my job incorporates direct patient care in which I work directly with my staff in addition to my management duties. I would like to incorporate one on ones but I am faced with three problems:
1) large number of direct reports
2) 20 hours or less of managment time each week
3) staff that work 12 hour night shifts whose nights rotate so it is difficult to set a regularly scheduled time without either them or I coming in on a night off.

My second issue (oddly enough) is that nursing being primarily female profession (only 2 males out of 42 directs) , that I am overwhelmed by the "personal" items. How do I stay on track with work-related items during one-on-ones.

Mark's picture
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Boy, this is a GREAT question! And to reassure you, I've had this very problem with several clients. Heidi Cantrell, a client nurse manager, had NINETY directs. what a crazy situation... but she loved her one on one time.

Since you're busy, I'll get right to my recommendations.

!. Prioritize your O3s. For those few key directs (are there team leaders, or some other folks with special authority, like charge nurses?) keep with weekly O3s. For everyone else, go to every OTHER week, or even every third if you have to.

No, this is not ideal. But neither is 42 directs. What you're dealing with is a terrible org structure. But I know how hospitals are, and you're unlikely to change things in the near term. (If you want advice on how to, I can help, but that's a different conversation).

2. Regarding shift change effects on scheduling. Under the circumstances, the normal rules don't apply. Use your best judgment. You can post a sign up schedule. You can set up the next one when you're doing one (right at the end). For some, you can ask them to come in during off hours (give them the option - some will). They will see this, since they know how hectic things are, as you really committing time to them. In fact, TELL THEM that you're committing to it.

3. Personal issues. First, I'm glad you've noticed - that's a good sign, even if their openness is causing a problem. Believe me, the problem of them sharing is a lot less than them NOT doing so. Keep two things in mind.

A. They get their 10 minutes, maybe 15 every so often. But you get YOUR 15 minutes too...and THAT is when you get to talk about work. If they want to talk personal stuff during their time, let them, but be willing to assert yourself for your "half" of the time, to cover what you need to. If you have to cut them off politely, that's okay. Just say, "I want to hear it, AND (not but) I want to cover my stuff too... There's just always a lot to talk about." Do this with a smile, after having genuinely listened to their concerns, and it should be fine. That's what I do (and I have more women working here than men).

B. Just because they share doesn't mean you have to DO anything about what they're sharing. All you're doing is LISTENING. This is NOT a place where they get to dump their problems on you. There is NOTHING wrong, and a lot to be said in favor of, telling them, "That's hard, you're right. What are you going to do?" I joke with managers all the time that when folks come to them and say, "I have a problem," managers should be entitled to say, "Yes, I agree. YOU have a problem." Let's remember - THEY ARE ADULTS. Treat them so. Don't try to solve their issues, many of which seem big to them and petty to you. (Both of you are right). DON'T!! When you solve their problems, you're REINFORCING behavior you don't want - them expecting you to solve their problems. Good nurses solve their own problems.

They sweet spot here is LISTENING. Let go of any sense you have of fixing things. Leave that to the projects and work you talk with them about during your half.

There you go. This was down and dirty... let me know if I need to clarify anything.

Glad to serve you. Nurses are under-appreciated, and nurse managers have the hardest jobs I've ever seen (other than hospital CEOs). Bless you for what you do. When my daughter was 5 and got cancer, it was the nurses that were our heroes.


mydesygn's picture

Thanks so much. That was really helpful. I found that I was focusing a lot of attention on my ancillary and newer staff and not much on my seasoned staff , assuming they needed less interaction with me. Found out that those were the indiviuals who had the highest expectation of "face time" and were the most "needy".

Mark's picture
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YES! BRILLIANT! Those long term, solid to high performers deserve differentially MORE of your time than the newer folks (though it's hard to keep to as a rule).

Managers should spend their time where their results come from.

Glad we could help.


dauriach's picture
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I really enjoy Manager Tools and Career Tools.

I have a similar issue where I just inherited ~35 direct reports in a technical organization executing improvement projects in a manufacturing environment (not IT). Some are leading projects while everyone is contributing to projects (with a lot of matrix work). I was thinking of having weekly O3s with the key contributors and going every 3rd week with everyone else. I was thinking of installing team leaders and I assume you would recommend that approach based on the response above. Other than what's above, any other advice? If I can make it work, would you go with weekly O3s? How would you handle staff meetings? How often, if at all, would you get the team together for a Town Hall type of meeting?



mporter's picture

When I first started doing O3s many years ago, I had 35 directs.  It was difficult but worth it and it took a very short time to fall into a rythm.  I started by having O3s every other week with each person.  I set aside 1 full day each week for O3s and had 17 one week and 18 the next week.  I made a few not thinking about bathroom breaks!  Every other week worked and I wouldn't recommend every third week; it's too long in between for effective follow up and relationship building.  Your idea about having O3s weekly with the key contributors is a good one.  I was able to change the reporting structure after a while and had supervisors/team leads.  Once that structure was in place, it was the supervisor/team lead's responsibility to have O3s with the people on their team and my responsibility to have O3s with the supervisors.  It may sound counterintuitive but giving 1 full day each week gave me more time to get work done on the other 4 days!  It was like magic.  O3s don't diminish the need for staff meetings; if anything, they will show you that more frequent staff meetings are needed.  You're going to hear things in the O3s that need to be shared with the entire team and you don't want to wait too long to share them.  I ended up having 2 staff meetings per month, 1 for the information I needed to pass along from top management and the other was to cover all the items that had been identified in the O3s.  I usually had the person who brought the item to the O3 cover the topic in the staff meeting.  The main thing is to get started and keep going.  You'll quickly identify what works and what doesn't for your particular situation.