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Meet Muireann Wynne, a Nurse Unit Manager and Nursing Director. Originally from Dublin, Ireland, and after qualifying in 2006, she has spent the last 15 years have been spent nursing within emergency departments. Muireann has written for us about nursing leadership.
Nursing Leadership and Management
Walk us through a Day in the life of a Nursing Director?
A day in the life of a Nursing Director (ND) is difficult to describe. I’m very new to this position and so far, there has not been a typical day. I try to get to go and speak with the teams that I manage and find out any issues that need to be addressed. I attend hospital meetings so that I can feed relevant information back to the team. I also spend a lot of time thinking and working on strategies to improve what we do e.g. be more efficient, be better supported, tell a better story about our business.
I think one thing that I did not know before doing this role is just how diverse it is. The ND input is required across a whole range of activities, not just nursing. It makes it exciting but it’s also a very steep learning curve!
Walk us through a Day in the life of a ED ‘Nurse Unit Manager’
My substantive position is the NUM of a large ED. We have over 300 nursing staff so it can be a challenge to remain connected and visible to a team that size. My day-to-day involves catching up with staff, recruitment, HR, Business management, financial delegation, KPI management, attending meetings and working groups and responding to thousands of emails!!!
Its really varied and my role is really the escalation point for nurses in the department. Its dynamic, exhausting but also exciting and really satisfying. I thought I would miss clinical work when I first took the role on as a maternity leave relief but found quickly that I really enjoyed it. I feel that the NUM role can still have positive effects in the clinical space by supporting safety and quality initiatives and finding the right staff for our team.
Misconceptions that you want to debunk about nursing leadership and managers?
That we are in management because we can’t cut it clinically. I was a CNC before my role as NUM and loved working clinically (I think I was pretty good at it too ????). I also think people think we are in management/leadership because we love telling people what to do. I don’t see it like that, I see my positions in management/leadership as a privilege and as a journey where my role is to support others to do their best and to drive us forward.
I think it’s possible to have high standards and expectations and still support people to meet those standards in a positive way. I think that’s why I get so much enjoyment out of it, I see it as moving us into the future, making sure we are contemporary and that we are doing our very best we can in everything that we do.
Can you tell us about the challenges you faced and the lessons you’ve learnt as a leader?
The biggest challenge in the early phases of the pandemic was the rapidly changing information. It was incredibly difficult to keep our team up to date with the information they needed to do their job. We have gotten a lot better at that since those early days and have some more refined processes now. I think the latest challenge is fatigue with the pandemic and everything that it brings for our team in their work.
We are tired of the PPE, the constant moving goal posts and the worry about what may come our way. The challenge now, is how we keep our team safe when we have been living this for so long, how do we maintain the momentum to keep going forward? How do we focus on business as usual as well as covid? Its very challenging and we are by no means perfect, but we work on new initiatives to do this all the time. The biggest lesson for me has been about taking a step back, not being reactive, not taking the stress of it home with me at the end of the day.
What are your 3 biggest pieces of advice for a nurse interested in nursing leadership positions?
1) Take a leap and give it a go. You might just enjoy it!
2) Ask loads of questions and don’t pretend you know if you don’t! There is so much that as nurses we don’t get taught about how to be a manager, seek help, there are people who will have the answers.
3) Don’t take it personally, by default your role will mean that some people won’t like what you do. I think if you perform with honesty, integrity, and transparency, you are on the right track.
ED Nursing & Violence
Why do you love ED nursing? What keeps you passionate about it?
Where do I start? I love the ED because it’s the first place in my career that I felt autonomous in my role and like I could really make a difference. I felt that nursing had a greater level of respect and that there was less hierarchy between disciplines in the ED. The ED team truly work together as a team and there is great appreciation for everyone’s value.
I also love the fast pace, the exciting cases, the trauma, the not knowing what was wrong with your patient when they arrive and then being a part of figuring it out. I love the team, the nurses in ED are second to none, they are dynamic, solution focused and inclusive. We become like family to each other.
Occupational Violence is rife in nursing, especially in ED. Can you discuss your work in this space?
We, like other ED’s see a significant amount of OV in our department. We are working on this all the time. Knowing what resources we actually need to make significant change in this space is a challenge. Different initiatives work in different facilities, it’s not a one size fits all solution. We have implemented some new local level responses that allow our staff to escalate early and have early access to senior clinical support and safety officers.
We are working on changing how we report incidents of OV to better reflect the problem that we have. We are working on improving the process of follow up and support given to our staff. It is a constant uphill battle with OV and it has obvious negative effects on our staff and their wellness. Our wellness group has also been helpful in strategies and activities to support our staff.
Can you give us some examples of violence and injuries you have seen throughout your careers, against nurses?
I can give so many examples. I have seen staff be punched and kicked. I, myself have had shoes thrown at my head, been chased down a corridor, had furniture thrown at me and been scratched and hit. The verbal abuse is reaching new heights all the time as I think patients and consumers don’t necessarily see it as a problem.
]They often think that it can be repaired by apologising after the fact. What they don’t see is that they may be the 5th person to verbally abuse one nurse that day…it has a cumulative effect and can be incredibly damaging to the individual on the receiving end. I think as nurses we have a very high sense of moral responsibility to our patients so often incidents of violence that can be attributed to a patient’s medical condition can be dismissed and go unreported.
They dismiss it as real violence because the patient had dementia or didn’t have full capacity. What’s important to remember is that even if that is the case, the effect on the staff member is still the same, we shouldn’t down-play it.
Ireland
What would you say was the biggest shock for you when you first nursed in Australia?
I felt nurses had a lot less autonomy here and that ED nurses here had no idea what being busy was! I came from Ireland where at the time it was not unusual to have 50 admitted patients in an ED so it was chronically over-crowded, and access blocked. When I came here first, I couldn’t believe that it was so efficient. I had also never seen a patient intoxicated from ICE…now that was an eye opener. ICE doesn’t really exist in Ireland, so it was a steep learning curve!
What advice do you have for Aussies wanting to nurse in Ireland and nurses in Ireland wanting to work in Australia?
For Aussies wanting to nurse in Ireland…Start your application early, like working here, the application process is lengthy and complicated so the more time you give it, the better. The same for Irish nurses coming here. I would encourage any nurse to work in a different country, it really is eye opening and it makes you better at what you do. It shows you different ways of doing things and you have the bonus of a travel adventure!
What’s one of the greatest lessons you’ve learnt in your journey so far?
To take the opportunity when it presents itself and to listen with intent (to patients, families and colleagues)
Who are the 3 people who have been most influential to you and why?
1) My mum…she’s a nurse and has taught me a lot. She is the ultimate cool, calm and collected person, I hope that I have inherited some of these qualities from her and use them in my work.
2) My family…who have always supported me to be true to myself and who are also quite happy to take me down a peg or two!
3) My mentor…for all things leadership and work related. Invaluable!
