Reimagining the nurse manager role to drive workforce stability and patient outcomes

Despite growing evidence of strategies that can positively impact the nurse manager role, there is limited understanding of hospitals’ and health systems' progress in implementing efforts aimed at improving workload and well-being.

The survey focused on: (1) nurse manager and CNO perceptions of current state implementation of strategies to support improved nurse manager workload and (2) nurse manager prioritization of evidence-based strategies for improving workload and well-being.

This joint effort offers a clearer understanding of where alignment — and misalignment — exists between managers and senior leaders around workforce strategy. CNOs can leverage the collective voice of nurse managers to better understand their priorities and support successful implementation.

Nikki Gruebling

SVP, Vizient Member Networks and Operations

Key insights from the survey

• Nurse managers identify clear “quick wins”: Nurse manager respondents identified manager-centric software platforms and administrative support roles, such as assistant nurse managers, as high-impact, low-effort solutions that immediately ease operational strain. These tools support critical workflows — from staff recognition and check-ins to performance tracking — enabling nurse managers to lead more effectively.
• Flexible scheduling is imperative: Nurse managers overwhelmingly rated remote work, alternative scheduling and reduced after-hours responsibilities as top well-being priorities. However, these strategies remain underutilized.
• Mind the perception gap: While both nurse managers and CNOs recognize the importance of leadership development and workplace safety initiatives, their perceptions around implementation progress differ significantly. This underscores the need for executive visibility, intentional dialogue and shared strategy development between nurse leaders and executive teams.

Invest strategically

CNOs should use nurse managers’ input to guide implementation of strategies that support workload and well-being, particularly around manager advocacy, perceived value and opportunities for partnership. Beyond the “quick wins,” here are other top priorities:

• Defined assistant nurse manager scope: Nurse managers often view assistant roles as quick wins, while CNOs may see them as long-term investments requiring resource reallocation. Clearly defining the assistant nurse manager’s role can help clarify responsibilities and ensure shared understanding across leadership levels.
• The well-being triad: Remote work, flexible scheduling and reduced after-hours responsibilities form a roadmap for targeted well-being interventions. These strategies should be viewed not as perks, but as powerful levers for improving retention and sustaining nurse leadership.
• Support for workplace violence initiatives: Continue progress in this area and increase awareness by reviewing progress with managers — especially given the perception gaps identified in the survey.
• Broaden implement across departments: Apply criteria for strategy adoption across interprofessional teams, including managers in departments with 24/7 patient care responsibilities such as respiratory therapy, environmental services and radiology.

There has never been a more important time for healthcare leaders to elevate the voice of the nurse manager. They are central to workforce stability and excellence in care delivery — from safety and quality to engagement and operational sustainability. Investing in their success is essential.

“By focusing on high-impact, manager-endorsed workforce and well-being — and fostering collaborative execution — CNOs and health system executives can drive measurable improvements in nurse satisfaction, retention and patient care outcomes,” Gruebling said.

Learn more about the new Vizient Nurse Manager Fellowship Program to empower nurse managers with the skills, confidence and strategies to lead with excellence and drive meaningful change.