Perhaps you’ve noticed. Neonatal nurse managers have become more difficult to recruit and even tougher to retain. In fact, it’s been reported that the nationwide vacancy rate for nurse managers has currently peaked at 8.3%.

And that’s not all.

Today’s nurse managers are at increasing risk of work-related mental health issues due to job dissatisfaction which could result in negative patient and organizational outcomes for you and your facility.

What’s the problem?

Over the last decade, nurse management roles have expanded and assumed far more responsibilities for administration, direct patient care, staff direction, and organizational resource management. Naturally, these increased demands result in the kind of heightened stress and anxiety that many neonatal nurse practitioners prefer not to take on.

These days, for instance, neonatal nurse managers tell us about the continuing pressure to do more with fewer resources and lower pay. Here are some common concerns we hear from today’s nurse managers:

Financial loss

When you factor in the long hours, on-call duties and take-home work, neonatal nurse managers often earn less than half the hourly rate of the people they supervise.

Lack of respect

These pay issues are exacerbated by a lack of respect for what nurse managers really do: they juggle multiple demands from their staff and directors while executing facility maintenance, administrative and scheduling duties—all of which typically go unnoticed until something goes awry. Nurse managers have told us, “I’m not appreciated” and “I love my job, but I’m so tired of being ignored until something goes wrong – then I get blamed for everything.”

Role overload

“There are not enough hours in the day to manage multiple meetings, deal with patient complaints, and respond to staff needs.” We get feedback like this over and again: nurse managers are asked to do too much for too many people in too little time.

At any given moment, a neonatal nurse manager might be allocating shifts, liaising with patients and families, reconciling the budget or mentoring a new hire. Plus, there are always the urgent calls that many nurse managers respond to, even when off-duty.

The combination of these complex demands can cause nurse managers to feel overwhelmed and overloaded.


Being solely responsible for managing ward-related problems can be a lonely endeavor; many nurse managers feel isolated and alone because they cannot share their problems with either the staff or their own managers. “There are many things I cannot talk about, so I keep my worries to myself.”

Role conflict

Nurse managers feel pressure to meet organizational demands from administrators, which can often conflict with the high-performance expectations of physicians and staff.  “When I try to improve the quality of care in my unit, I get warned about breaking hospital rules. This ends up making me feel either helpless or angry; I don’t know which is worse.”


A well-run nursing unit ensures the highest quality of patient care. Without it, your facility is at risk of poor outcomes and an equally dismal reputation. That’s why you owe it to yourself to invest the proper energy, time and funding into your management team.

Furthermore, studies show that nurse managers under undue stress are vulnerable to illness and compromised mental health. All the more reason to support their well-being so they can perform their duties with the highest level of professionalism. Here are ways to support them:

  • Training: Offer the proper learning and training necessary to manage stress and master new responsibilities. While your recently promoted neonatal nurse manager may have impressive credentials, she may not know the first thing about budgets, resource management or staff allocation. These are skills that must be taught.
  • Support: Check in with your nurse managers, lend a sympathetic ear and solicit feedback. When you initiate dialogue and practice active listening, you are already mitigating feelings of stress and isolation. Designate one senior manager to mentor each newly hired nurse manager: someone who will offer support and advice without judging or criticizing.
  • Empathy: Working in the healthcare industry, you know how empathy can transform attitudes. You’ve seen it work with patients; now try it out with your nurse managers. Remind them that, although they may not feel it, they are truly respected and admired by their staff on the ward. Listen to their worries, show genuine concern and offer reassurance. Work together to come up with possible solutions that might overcome on-the-job obstacles and adversities.
  • Money: Good front-line leaders pay for themselves over and over again. They energize and motivate their teams and work more efficiently with patients and physicians— all of which leads to higher quality care, higher job satisfaction, and better outcomes. Invest in your nurse management team and you’ll see higher returns than any other acquisition you could possibly make.

It’s truly unfortunate that in healthcare today, nurse management is viewed as a necessary evil, rather than a rare blend of excellent leadership, superior nursing skills, and masterful administration. If we do not change the paradigm of nursing management, our patients and facility will suffer. It’s time to recognize the value of this critical position by investing in proper compensation, coaching and leadership training.

For more information about the best way to recruit and retain qualified neonatal nurse managers, give us a call at 888.NNP.JOBS.

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