Bird's-eye View
Nurse managers make the most of their vantage point to initiate improvements in the workplace

By Pamela Stone
September 30, 2003

Doug Willis, RN, is not the stereotypical nurse. He is a registered nurse on the rise.

A nurse manager in the coronary care intensive care unit at Presbyterian Hospital of Dallas, he left the oil business in the 1980s to pursue a health care career. He wears cowboy boots to the office and proudly displays a sign on his door that reads, "Aggie nurse." A graduate of Texas A&M University at College Station, he owes his first introduction to emergency medicine to his alma mater.

As a student, he worked as an emergency medical technician for Texas A&M intramurals. "I was part of the Texas A&M emergency care team, where we helped build the ambulance centers that are on campus today," he said.

Although he was working on a degree in geology, EMT care gave him "an adrenaline rush" that he never forgot. As a geologist, he worked for an independent oil company in Bridgeport, Texas. On his days off, he continued to use his emergency medical training as a volunteer firefighter known as the EMT "first responder."

When the downturn in the oil business hit, though, Willis decided to make a career change. Because of his poor vision, he was unable to apply for jobs as a firefighter and police officer. So he turned to nursing.

With a bachelor's degree in science, Willis entered nursing school in 1991 at Texas Woman's University in Denton. Because many of his science courses transferred, he was able to complete his nursing degree in 2½ years.

During this time, the emergency-medical scene was improving. The pre-hospital setting for emergency care had changed after the Vietnam War. With the use of ECGs, monitors and technological advances in medicine, patients were able to get to hospitals in record time. Before, many ambulance services were run by funeral homes, which were ill-equipped to handle intense medical needs.

While Willis attended nursing school, Presbyterian Hospital hired him to be a patient care technician in their cardiac ICU unit, where he interned. In addition, it also provided him a scholarship to nursing school. Nine years later, Willis moved into nurse management, becoming a nurse manager for thoracic ICU and coronary care ICU.

"Many hospitals used to require a master's degree to get into this area, but there is currently a shortage of MS holders," he said.

Because of this, Willis plans to return to school, which will enable him to teach nursing at a university. He believes that nursing management positions await others who are interested in advancing. In the area of nursing education, opportunities are available for RNs such as a nurse practitioner, clinical specialist or as an operating room nurse.

As nurse manager of the cardiac thoracic department, Willis manages a 10-bed coronary care unit with about 25 nurses, as well as the medical/surgical ICU, which handles patients with pneumonia and postsurgical needs.

He is the liaison between the staff nurses and senior management. He looks at the ICU as a physical plant, where he oversees the equipment, rooms, payroll, budget and employees. He manages the hiring and training of nurses, and he handles any equipment malfunctions. If that isn't enough, he administers bedside care when necessary.

With his science background, Willis appreciates the technological advances of emergency care.

"It is my responsibility to make the ICU unit a safe environment," he said. "My hospital provides me with the equipment, supplies and support staff to keep things current and up-to-date.

"Today, nurses and doctors refer to one another as colleagues," he said. "The cardiologists rely on the nurses to take charge when they are not there." Because nurses are better trained today, they are able to take on more responsibility. "They are hired to be the 24-hour eyes on their patients."

Andrea Lewis, RN, agrees. Formerly the nurse manager for the pulmonary unit at Presbyterian Hospital, she believes the possibilities for nurses moving into management are endless. Three years of appropriate clinical experience and a background as a staff or charge nurse are required, she said.

"Nurse managers should have rapport with doctors, as well as the ability to identify patient issues and track nurse-patient ratios," she added.

A former resident of Alberta, Canada, Lewis migrated to Dallas in 1996. She is now a nurse recruiter for the human resources department of Presbyterian Hospital. With the increasingly aging population in the country, more qualified nurses will need to be hired. As a recruiter, Lewis uses her expertise to locate new applicants.

"Nursing opens a whole world to you," she said.

In addition, Presbyterian Hospital provides on-site training and education to individuals who want to move up the management ladder. "Individuals can apply for nurse manager positions at any time," said Lewis, who said the pay ranges from $54,000 to $70,000.

Willis and Lewis admit that working as a nurse manager requires long hours, but the results are rewarding. Lewis has entered another challenging area, with a substantial pay raise. For the moment, Willis enjoys working on the management level, because it gives him an overview of the hospital procedure.

"It enables me to have more autonomy and control," he said. "By serving on committees, I have more say about what happens, and I'm able to achieve greater results."

Pamela Stone's articles about women's isssues are distributed by the New York Times and Los Angeles Times Syndicates. Her latest book, A Woman's Guide to Living Alone: 10 Ways to Survive Grief and Be Happy, is available at national chain bookstores and online. Contact her at pamstone3@aol.com