A Day in the Life of an Assistant Nurse Manager

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Amanda Caravelli, BSN serves as an assistant nurse manager in the otolaryngology and plastic surgery unit at her hospital – otherwise known as Ear Nose Throat (ENT) and Plastics. As she’s learned, the skills needed for the role extend far beyond clinical expertise. 

“To be a good nurse manager, you need to be a leader who is not be afraid to advocate for patients and other staff on the unit – the nurses, the technicians and everyone that’s involved,” she said. “You have to know how to solve every single problem – it means you need to know how to use your resources to get things done.” 

To gain the tools she needed, he first step on her journey was Chamberlain University, where she earned a Bachelor of Science in Nursing degree. The experience set a strong foundation for her career as a nurse.

“As I’m going through my career, I still think about the instructors I had at Chamberlain,” she said. “I think about how much they pushed us, in a loving way, to make us better and learn more and be more. I sometimes still pull from that.”

We recently talked with Amanda about what it’s like to work in nurse management.
 
How did you get to where you are today?
My mom was a nurse, so it was kind of in my blood. I wasn’t sure that’s what I wanted to do when I was just out of high school, though. I did a few other things first and eventually found my way back to nursing.

I graduated from Chamberlain in 2008. I initially hoped to work in the Intensive Care Unit (ICU). One of my fellow classmates held a job in this unit and was kind enough to refer me. I’ve been here ever since. 

For the first seven years, I was a staff nurse. I also worked as the relief charge nurse on my shift since about the first year. In that role, I would have patients but also be in charge whenever the manager wasn’t there.

About two years ago, I was approached about moving up to a management role. I’m an assistant nurse manager now and my goal is to continue moving up.

What’s a typical day like for you?
Being an assistant nurse manager is a challenging position. You’re basically overseeing everything in the unit. You’re responsible for every single patient, mentoring and coaching nurses and patient care techs, budgeting and scheduling. Any questions come to you. It’s very busy, but it’s also very rewarding.

In my unit, we mostly treat head and neck cancer – throat cancer, tonsil cancer, tongue cancer and anything from the clavicle up. We do a lot of reconstruction surgery, remove abscesses, perform total laryngectomies –where we remove the voice box – and place a lot of tracheostomies. 

As assistant nurse manager, I see each patient every day. With some patients, I perform a quick touch base and see how everything is going. With other patients, I’m much more involved. It could be that there is some sort of issue, or it could be that staff nurses need assistance with a certain procedure.

After surgery, a lot of our patients go home with a new tracheostomy in their neck or the need for tube feedings. Our staff nurses provide the majority of the teaching, but sometimes we have patients who struggle a bit to learn their home care or we have difficulty coordinating with the families. In those cases, I’ll step in. 

I also field a lot of general questions about how to navigate the system, how to communicate with the doctor and what the next steps are.

What’s your favorite thing about your role?
My favorite thing about being an assistant nurse manager is that I get to work closely with the nurses on the floor and help develop them. 

I especially like working with the recent graduates. I have a very challenging specialty, so many times they’ve never learned about some of the things that we do. There’s a lot of teaching, coaching and mentoring involved to get them to where they need to be to be successful. 

What are some challenges you face as an assistant nurse manager?
The biggest challenge in my role is the amount of work I have. There really is a lot to do.  

Another challenge is just the complexity of the patients that we see. We have a lot of patients who are underserved and underinsured – they typically wait longer to come in, so at that point they’re more severe cases. We also take in a lot of referrals from across the country and even around the world – these are often challenging cases. 
This all means we are caring for a high acuity of patients. It can be a challenge to help our nurses, especially the recent graduates, learn what they need to learn so they can provide the best care.

What would make someone a good fit for your role?
To be a good nurse manager, you need to be a leader who is not be afraid to advocate for patients and other staff on the unit – the nurses, the technicians and everyone that’s involved. 

You need to be good at delegating and solving problems creatively. That doesn’t mean you have to know how to solve every single problem – it means you need to know how to use your resources to get things done. 

Whenever I’m looking to promote somebody to a charge nurse role, I look for those qualities. I also look for someone with strong clinical skills because a good leader needs to know how to do the job. 

Any advice for those looking to pursue something similar?
Find a place where you love to work, that will challenge you and offer you opportunities for advancement. Once you find that place, keep learning. Read those nursing journals, do everything that you can, find a mentor and keep listening to them, and just keep growing. 

Amanda was able to use the skills she learned while pursuing her Bachelor of Science in Nursing degree to build a solid foundation for her work as an assistant nurse manager. Interested in learning about more nursing specialties? Check out our blog series to hear from our alumni on their specialty. 

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