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A Head Nurse as a Hospital Manager


The profession of a head nurse occupies an important place in the modern world since the person in this position bears tremendous responsibility for organizing the treatment process. Patients and their relatives or friends trust the head nurse’s words and look forward to being active in the workplace. This position is a managerial one since a lot of the health care system depends on it. The head nurse must perform many challenging tasks and have specific skills.

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Managerial Functions

Mrs. Lee has been a head nurse for a long term; during this time, she has learned to perform several managerial functions: organizing, planning, leading, and controlling. Each day Mrs. Lee organizes the process of treatment and admission of new patients. She turns to doctors to have up-to-date information and spends a lot of time on papers and computers. She solves issues with the placement of patients in the wards and their daily routine. Mrs. Lee plans, according to hospital resources, how doctors will treat the patient. She does not prescribe medications or operations but plans the process and details of the treatment. She is also a leader for other nurses, and junior nurses consult with her. Mrs. Lee controls hospital processes, patients, and doctors trust her since she has access to crucial information.

Kinds of Managers

The head nurse is an organizational manager with a control manager. The main work of the head nurse is related to the organization and maintenance of order in the hospital or in the department where she works. She must know all doctors, their schedules, remember patients’ needs, and organize patients’ access to medicines. Head nurses often communicate with patients and their relatives, answer their many questions and advise them on various occasions.

Managerial Roles

As for the roles of the manager (interpersonal, informational, decisional), in the situation with the head nurse, the parts are unevenly distributed. The interpersonal part is rare, as nurses rarely speak at conferences and represent the medical community. More often, doctors or non-medical media personnel play this role. They are actual middle managers who know who they lead and who they report. The informational role is manifested in the nurse informing the higher authorities of the patients’ needs and bringing the information to the higher power. Sometimes it can be concluded that the decisional role in the career of a head nurse is the most important since in the absence of a doctor, it is the nurse who makes the essential decisions on which the patient’s life can depend.

Managerial Skills

Mrs. Lee needs technical skills to know the aspects of complex medical devices. In addition, she requires human skills as her work is closely related to communication and the emotional aspects of human life. Patients expect constant support and words of comfort from her. It is often the cause of professional burnout, as the employee may have poorly developed this skill. She also needs conceptual skills to grow in a managerial path and keep up with the hospital bosses.

Environmental Assessment

The external environment of the hospital for the head nurse looks constantly tense and filled with pain. It leads to psychological problems or emotional roughness. In addition, the scarcity of resources (medicines, beds, equipment, and doctors) also falls on the shoulders of the head nurse. The uncertainty of the environment can cause anxiety, but the medical field rarely contains tension, as it is regulated. Only emergencies (to which the head nurse gets used to) introduce uncertainty in management.

General Environment

When it comes to trends to be monitored by the head nurse, the economic trend matters. The drug market is a complex topic, sometimes controlled by intelligence agencies and always controlled by the police and government. The aspects of payment for drugs and procedures are directly related to the head nurse. Technological trends also need to be checked by a nurse as the technical development of medicine grows, and complex equipment appears in hospitals. The nurse should also monitor sociocultural trends to avoid discrimination in the provision of care. The sphere of law and medicine overlaps, including ethical aspects, so a nurse must monitor this so as not to violate the direction of their state.

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Specific Environment

The head nurse is responsible for looking after the patients; this is one of her key responsibilities. Given the specificity of medicine, the hospital’s competition does not significantly develop since the initial goal is to save the patient. Mrs. Lee needs to know the suppliers of drugs and equipment to know who to trust. In the text above, the reader can see that the field of medicine is regulated. Mrs. Lee constantly monitors regulatory changes in documents, patient questionnaires, forms to fill out, etc. However, head nurses usually do not have enough authority as managers to answer questions from interest groups.

Internal Environment

The hospital culture, as mentioned above, is full of tension because the area of responsibility of medical professionals is the lives of people. In addition, this culture is full of formalities (documents, certificates, permits, and stamps). All these formalities have legal value; therefore, they are essential for both the hospital and the patients. Readers can assume that the hospital has a solid and enduring culture of tension and formalities.

Stakeholder Identification

One of the stakeholders in the patient, to whom the healthcare professional, such as the head nurse, is responsible. The hospital is responsible for the well-being and health of patients, which is the private life of individual citizens of the country. The hospital staff, including the hospital management, are responsible for the quality of the services provided. Other stakeholders are the government (the government keeps citizens healthy, working, and spending money) and security forces such as the police. At the local government’s request and the police, the hospital is obliged to report to them on medications, taxes, and emergencies.

Social Responsibility

The hospital requires a severe responsibility of Mrs. Lee, which is a burden on her shoulders. The head nurse should be responsible for the hospital budget, as she has access to expensive drugs; it is economic responsibility. Legally, the nurse is responsible for the drafting of important documents and the operation of these documents. The field of medicine in civilized countries is subordinate to the legal area, and complaints from patients may not be just oral complaints but lawsuits. Mrs. Lee has an ethical responsibility to her patients and other staff. She keeps medical secrets, makes decisions about helping the patient in urgent situations. Her discretionary responsibility is to love and respect patients unconditionally, regardless of the path in life that led them to their illness.


The head nurse, as a manager, must have unique skills and take on large-scale responsibility for the lives of patients. Basically, as a manager, the head nurse performs an organizational and supervisory function. She works in a challenging environment of anxiety, stress, and formalities. As a manager, she is responsible for the lives and destinies of her patients, and she is also accountable to the government and the police, as she has access to dangerous and expensive drugs.

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