Administrative Supervisors and Nursing Unit-Based Managers

Collaboration and Job Satisfaction

Susan H. Weaver; Amanda J. Hessels; Mani Paliwal; Theresa A. Wurmser


Nurs Econ. 2019;37(2):67-76. 

In This Article

Abstract and Introduction


This cross-sectional study examined collaboration between administrative supervisors and nursing unit-based managers and the relationship to nurse outcomes. Nursing unit-based managers perceived a more collaborative relationship with supervisors and administrative supervisors. Nursing unit-based managers who perceived high collaboration had greater job satisfaction. Nurse leaders should foster and support peer collaboration between administrative supervisors and managers, which will benefit the organization, workforce, and patients.


Effective communication and collaboration are critical for a healthy nurse practice environment and safe patient care. The Institute of Medicine (IOM, 2004) report, Keeping Patients Safe: Transforming the Work Environment for Nurses, reminds all nurse leaders about their role in creating practice environments with effective communication and collaboration. Yet, in a recent nationwide study, administrative supervisors, the nurse leaders on the evening, night, and weekend shifts, articulated a "disconnect," poor communication, and lack of collaboration with the daytime nursing leadership team (Weaver & Lindgren, 2017). The supervisors explained that communication with these daytime leaders is by email during their shift because they typically don't see them (Weaver, 2016). Further, the supervisors are not able to attend the daytime leadership meetings due to the hours they work (Weaver & Lindgren, 2017).

For more than 100 years, the administrative/house supervisor role has existed in hospitals and continues to be the current model of off-shift management in acute care hospitals (Editor's Miscellany, 1901). During these times, the nursing leadership team consisting of nursing unit-based managers, directors, and administrators are not typically present in the hospital. Since research was lacking on the administrative supervisor role, the aforementioned nationwide, qualitative study was conducted to explore the administrative supervisors' perspectives of their managerial practices and how these practices contribute to nurse and patient safety (Weaver & Lindgren, 2017; Weaver, Lindgren, Cadmus, Flynn, & Thomas-Hawkins, 2017). The overall theme identified in the study was the administrative supervisor does whatever is necessary to get the patients, staff, and hospital safely through the shift (Weaver & Lindgren, 2017). Regardless of the size or location of the hospital, the findings revealed the administrative supervisors achieve nurse and patient safety when performing their role responsibilities (staffing, patient flow, crisis management, and hospital representative) and by establishing trust with the staff, doing rounds, educating, and providing support to the staff (Weaver & Lindgren, 2017; Weaver et al., 2017).

The administrative supervisors also identified they rarely have face-to-face collaboration with the daytime leaders and are unable to attend the management meetings because these meetings are typically held in the middle of the day (Weaver & Lindgren, 2017). The supervisors further explained that "Monday morning quarterbacking" occurs, by the daytime nurse leaders, regarding the decisions made during the off-shift and this contributes to the disconnect, because the supervisors are not there during the daytime to share the rationale for their actions and decisions (Weaver & Lindgren, 2017). Administrative supervisors have authority only during their shift, and otherwise no authority outside of their shift, which may also contribute to this disconnect. Additionally, the supervisors suggested there may be a lack of understanding of the work they do, and may be considered by some as simply the "behind the scenes crew" (Weaver & Lindgren, 2017, p. 6).

Thus, to better understand this disconnect and lack of collaboration, this study was conducted to examine collaboration between administrative supervisors and nursing unit-based managers and the relationship to the nurse outcomes of job satisfaction and intent to leave and stay.