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Problem Project? - Get me a Nurse!

Updated: Apr 22, 2018

This isn't intended to be a comprehensive and well-researched piece; it should get people thinking about parallel roles in the work-place and support the idea of looking for similarity in experience rather than difference. When you work with your colleagues, why not consider what useful stuff they bring from their previous careers? It could be the making of your team to appreciate the skills that they have as much as the ones that they've been employed for.

Classic Irony

21 years ago I left my last Nursing-related role where I was supporting the implementation of ward and theatre nursing systems. It has taken the passage of those years to see why it makes sense for me to be in project management. The education/training and experience I received as a Nurse prepared a lot of the ground and allowed me to make some great mistakes on my change and project journey. Fortunately no-one died or was injured in the writing of that history.

​So what good reason would I have for wanting a nurse to run a project?

​Plenty of reasons and I'll start with common ground...

What do Nurses and Project Managers have in common?​  

  1. Well there's the good old iron triangle for starters; both have to balance time, cost and quality.

  2. Then there are the process perspectives of projects (Management Control, Benefits Management, Financial Management, Stakeholder Engagement, Risk Management, Organisational Governance and Resource Management. To a greater or lesser extent these describe the key processes in any organisation (not just Portolio, Program and Project structures).    

  • Management Control including the prioritisation of care for multiple patients with predictable and unpredictable changes is non-stop.

  • Nurses are constantly outcome focused for their patients - they want to see the best and for the patient to gain the optimum benefit that they can from the care that they can give.

  • Financial Management is consistently in the front of mind in both the public and private health sectors - possibly a little more so for the latter where typically every last dressing and pill can have a cost associated with it. Certainly those nurses leading a team in ward, clinic or theatre will be across a degree of financial management.

  • Nurses have to manage one of the vastest arrays of stakeholders that exists - and it  is one that constantly changes as patients, medical staff and relatives come and go.

  • Risk Management is second nature and so is issue identification. From safe handling of patients, through administration of drugs (with potential interactions) to identifying cardiac/tissue viability/self-harm risks, nurses are constantly aware of what can go wrong and often what actually will.

  • Organisational governance may not look as if it is a good fit; however, nurses understand specific roles, hierachical positions and also when to 'talk truth to power'.

  • Finally from this list of seven perspectives comes a big one... Resource management! Running a team of nursing staff with common and different skills and experiences to match the expected ebb and flow of patients coming through a department or a ward is not just luck. There are all the human factors and ensuring that there isn't an oppositional team on shift together, cost control, management of leave and sickness plus the need to help the team debrief from critical incidents. Nurses get resource management.

Project-like roles in a ward environment

  • Patient Care Assistants/Auxillaries are project resources assigned on a task by task basis to the different projects (patients). As they gain experience they may take on specific project coordination roles as well...

  • The junior nurse may be a project manager with a group of patients who are the projects in her/his care. Each one will have their own intended outcome, timeline, quality imperatives and associated cost - mind you the focus to control cost will be to reduce the time needed whilst maintaining the quality of the outcome.

  • The more senior nurse will be a program manager and may have a few less-dependent patients but will oversee one or more junior nurses/PMs and ensure that the resources are shared across the program (their wing of the ward, their shift, etc) appropriately and dynamically.

  • The Charge Nurse is more akin to the Portfolio Manager - seeking the direction from the Subject Matter Experts (Doctors and allied health professionals) and Governance structure (organisational management) and ensuring compliance with standards and protocols whilst having overall budgetary and management control.

  • All of these roles will be undertaking risk and stakeholder management to a certain extent - varying degrees of complexity accompanying each layer in the model.

Could there be any other reasons for using a nurse for project management?

Connectedness

  • With people - Nurses are natural connectors and can complement or criticise change initiatives - always good to have them actively involved in the changes that affect them or others - they will always assess for the impact of change.

  • Of facts and figures and trends and 'stuff' - there is an interesting ability to spot the connections between a whole series of disparate data. Nurses look for the connections all the time, between signs and symptoms, drugs and their interactions, environment and personal condition; whilst not endless there is a long list of things that they are used to considering - they often see the metanarrative of the patient problem and work within the bigger picture rather than just seek treatment for the symptoms.

​Documentation

  • Love it or hate it, Nurses have to document almost everything; literally. Which means they have to be observers and interpreters

  • And with the documentation comes the need for confidenitality - they get what can be shared and what can not.

Problem identification

  • ​Nurses have patient risks that turn into issues on a daily, sometimes hourly basis. This means that they are well experienced in categorising and describing problems as well as finding solutions that will work.

Why not use a nurse for project management?

  • Firstly, because we often seem to have too few to run the health services that we rely on. But maybe some judicious use of those who have suffered physical injury but still have all these fantastic project management skills can be good for everybody. A win:win!

  • Secondly, because they are used to running lots of concurrent projects at a really fast pace - they see the overall benefits being accrued on a daily basis whereas in business and technical projects it can be weeks, months or years to accrue benefits. Mind you, perhaps we need to use their outcome focus to improve the way we look to add as much value as possible, as soon as possible whilst ensuring that quality outcomes are maintained.

  • Lastly; well perhaps you have some good reasons not to use them that you would like to share here? Or some other positive observations as to why we should use them? Over to you!​

  • #nursing #skills #processperspectives