Table Of ContentPraise for
The Nurse Manager’s Survival Guide,
4th Edition
“Tina Marrelli has created another important resource for nurse managers, leaders,
chief nursing officers, administrators, and rising clinicians alike. This well-written
edition is a road map outlining several important issues and management techniques
not commonly treated in a didactic manner. Specifically, it is truly a ‘survival guide’
that covers significant ground on the evolution of the clinical manager role. Marrelli’s
voice and passion for building strong nursing leaders in our rapidly changing industry
can be heard in every chapter—whether you begin on page one or skip to a particular
section of interest. You owe it to yourself and every clinical leader in your organization
to own and read this important resource!”
–Lisa J. Salamone, MPA
Executive Vice President and Chief Operating Officer
Visiting Nurse Association of Northern New Jersey
“The Nurse Manager’s Survival Guide, 4th Edition, offers a comprehensive approach
for aspiring, new, and seasoned nurses to be successful managers and leaders. Focusing
on skills and knowledge necessary for nurse managers, this book provides guidance for
new managers at various levels of leadership roles and serves as a refresher for nurses
who have been in managerial roles for many years. Tina Marrelli gives voice to the
many difficulties and challenges any new manager faces in today’s healthcare environ-
ment and also provides a road map for success.”
–Margaret Terry, PhD, MS, RN
Senior Director
National Quality Forum
“Tina Marrelli has written an excellent book for nurse managers that covers all
aspects of a manager’s role in today’s healthcare environment. The content is
valuable for someone new to the role, but a seasoned manager would also benefit
from reviewing the book as a refresher or for new skills and knowledge. The book
should be required reading for nurse managers.”
–Carolyn V. Donohue, MSN, RN, NE-BC
Vice President, Chief Nursing Officer
Roper Hospital, Charleston, SC
“What a wonderful resource! This book contains foundational management concepts in
a quick reference format for new managers as well as areas that serve as reminders for
experienced managers. Including the section on stress and supporting yourself speaks
to the importance of these concepts—not only in relation to being a healthy nurse
manager but also in relation to being a healthy nurse.”
–Nathalie Rennell, MSN, RN
Instructor/Honors Faculty
Arizona State University College of Nursing and Health Innovation
RN-BSN/CEP Program
“Tina Marrelli provides an insightful, easy-to-navigate guide that not only teaches
valuable leadership skills but also empowers managers to apply them in day-to-day
operations. I found this guide to be helpful and applicable to new as well as experi-
enced nurse managers.”
–Marilyn Cornman, BSN, RN, HCS-D, COS-C
Regional Vice President, AHN Healthcare at Home, Home Health
“The fourth edition of The Nurse Manager’s Survival Guide is a welcome resource to
new and seasoned nurse leaders who are continually evolving to ensure that the needs
of diverse populations are met in complex healthcare environments. This updated
publication maintains Tina Marrelli’s long tradition of offering sensible, relevant, and
energizing content as well as easy-to-use tools that readers can readily implement in
practice.”
–Mary Jo Vetter, DNP, RN, AGPCNP-BC
Clinical Associate Professor
Director, DNP Program
New York University Rory Meyers College of Nursing
“The Nurse Manager’s Survival Guide is a must-read for every nurse manager or
director working in healthcare today. Grab your highlighter and bookmarks because
this is more than a one-time read—it is a tool to reference as you navigate the complex
healthcare systems we work in every day. The nurse manager is the glue that holds our
institutions together. My thanks to Tina Marrelli and the Honor Society of Nursing,
Sigma Theta Tau International (STTI) for investing in our nurse leaders and their
success.”
–Jennifer Gentry, MS, RN, NEA-BC
Chief Nursing Officer, Christus Spohn Hospital-Corpus Christi
Chapter 9: Conclusions iii
“The Nurse Manager’s Survival Guide, 4th Edition, is comprehensive, realistic, and
applicable to both new and seasoned nurse managers, regardless of practice setting.
It covers multiple topics, all of which are practical in today’s healthcare environment.
The references to nursing theory and organizational behavior serve as an academic
basis to practical application. The lists, tables, and illustrations make the book an easy
read and quick reference. Additionally, each chapter ends with topics for discussion,
making it ideal for group study. Finally, Marrelli’s attention to nurturing oneself in the
nurse manager role is refreshing. It demonstrates her compassion for those of us who
become so engrossed in our day-to-day responsibilities that we overlook the impor-
tance of self-care in maintaining maximum effectiveness in our demanding roles. As
an active nurse manager over multiple decades, I will incorporate The Nurse Man-
ager’s Survival Guide into the orientation of newly hired managers in my organization
because of its breadth and realistic approach to encountering and solving real-life
problems in the healthcare setting.”
–Margie Harvey-Griffith, MS, RN
Vice President of Medicare
Firstlantic Healthcare Inc.
iv The Nurse Manager’s Survival Guide, 4th Edition
Chapter 9: Conclusions v
NURSE
the
MANAGER’S
su r v i val
GuiDE
4
th
ed.
With assistance From
Cat Armato
Copyright © 2018 by Marrelli and Associates, Inc.
All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the
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erty of their respective owners. Their use here does not imply that you may use them for similar or any other purpose.
This book is not intended to be a substitute for the medical advice of a licensed medical professional. The author and publisher have
made every effort to ensure the accuracy of the information contained within at the time of its publication and shall have no liability
or responsibility to any person or entity regarding any loss or damage incurred, or alleged to have incurred, directly or indirectly, by
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and no warranties may be created or extended by sales representatives or written sales materials. The author and publisher have no
responsibility for the consistency or accuracy of URLs and content of third-party websites referenced in this book.
The Honor Society of Nursing, Sigma Theta Tau International (STTI) is a nonprofit organization whose mission is advancing
world health and celebrating nursing excellence in scholarship, leadership, and service. Founded in 1922, STTI has more than
135,000 active members in more than 85 countries. Members include practicing nurses, instructors, researchers, policymakers,
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Indianapolis, IN, USA 46202
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ISBN: 9781945157417
EPUB ISBN: 9781945157424
PDF ISBN: 9781945157431
MOBI ISBN: 9781945157448
_________________________________________________________________________________________________________________________________
Library of Congress Cataloging-in-Publication Data
Names: Marrelli, T. M., author. | Sigma Theta Tau International, issuing body.
Title: The nurse manager’s survival guide / Tina M. Marrelli.
Description: Fourth edition. | Indianapolis, IN : Sigma Theta Tau
International, [2018] | Includes bibliographical references and index.
Identifiers: LCCN 2017032071| ISBN 9781945157417 (alk. paper) | ISBN
9781945157424 (EPUB) | ISBN 9781945157431 (PDF) | ISBN 9781945157448 (MOBI)
Subjects: | MESH: Nursing, Supervisory | Nursing Services--organization & administration | Personnel Management--methods
Classification: LCC RT89 | NLM WY 105 | DDC 362.17/3068--dc23 LC record available at https://lccn.loc.gov/2017032071
_________________________________________________________________________________________________________________________________
First Printing, 2017
Publisher: Dustin Sullivan Principal Book Editor: Carla Hall
Acquisitions Editor: Emily Hatch Development and Project Editor: Rebecca Senninger
Editorial Coordinator: Paula Jeffers Copy Editor: Charlotte Kughen
Cover Designer: Katy Bodenmiller Proofreader: Todd Lothery
Interior Design/Page Layout: Katy Bodenmiller Indexer: Larry Sweazy
Reviewers
Nancy E. Allen, BSN, RNC, CMC
CEO, Solutions for Care, Inc.
Jacksonville Beach, Florida
Cathleen “Cat” Armato, RN, CHC, CHPC, CHPN
Armato and Associates, Inc.
Healthcare Compliance Consulting, LLC
Blairsville, Georgia
Nancy J. Brent, MS, JD, RN
Nancy J. Brent Attorney at Law
Wilmette, Illinois
Carolyn V. Donohue, MSN, RN, NE-BC
Vice President of Nursing/Chief Nurse Officer
Roper Hospital
Charleston, South Carolina
Lynda Hilliard, MBA, RN, CHC, CCEP
Compliance Consultant
Mt. Shasta, California
Sue T. Miner, MSN, RN, CCRN, SCRN
Critical Care Consultant
Richmond, Virginia
Teresa J. Schleimer, MSN, CNP, ACNP-BC
Alumnus CCRN
Acute Care Nurse Practitioner
Cincinnati, Ohio
Patricia Zabell, MBA, BS, RN, CHCE, HCS-D, COS-C
Interim Management Consultant
Sarasota, Florida
viii The Nurse Manager’s Survival Guide, 4th Edition
Dedication
I dedicate this book to my husband, Bill, who always encourages me and helps me
with numerous initiatives and details. These include meeting deadlines; feeding,
housing, and otherwise entertaining numerous colleagues who come to visit and
work on projects; and more! Bill, I never could have wished for a better hubby—
smart, kind, and funny. Thank you.
Acknowledgements ix
Acknowledgments
I would like to acknowledge and thank all the nurse managers and clinicians across
many years who asked me great and interesting questions. As healthcare and its
complexity have grown, so too has this book and its scope and information.
I would also like to acknowledge Cat Armato for her kind sense of humor,
formatting skills, clarity in writing, enhancing content, meeting deadlines, and more.
Reviewers of a manuscript always strengthen and enhance the content, and I also
thank the reviewers listed on the “Reviewers” page. New eyes are always a good
thing, as there comes a time when one can no longer “see” what was written!
Other nurse colleagues I would like to recognize for their support and counsel
when needed are Anita Finkelman, Elizabeth Madigan, Elizabeth (Ibby) Tanner,
Nancy Valentine, and Dean Marion Broome. Thank you for your assistance and
wisdom across the years. It was and is very much appreciated.
Finally, thank you to nursing managers, leaders, chief nursing officers, chief
clinical officers, vice presidents and presidents of nursing, and those with many other
titles (too many to list). You are the future of healthcare and the answer to myriad,
continually emerging complexities. As healthcare has become more specialized and
official initiatives are developed around being patient- or person-centered and more
compassionate, I worry. However, I know that nurse managers and leaders are
already doing these activities every day and am heartened that we might be getting
back to the fundamentals of healthcare, caring, and health. This book is dedicated to
you—those nurse managers, leaders, and others who are inspiring, mentoring, and
otherwise supporting team members to provide the best care for patients in many set-
tings for health and care!
