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their skills and evaluate how well they have done. It is probably not necessary (or even possible) to know everything all other professionals on the team know, but it is important to be able to assess 3663_Chapter 2_0017-0026.indd 19 663_Chapter 2_0017-0026.indd 19 9/15/2014 4:37:03 PM /15/2014 4:37:03 PM Process Cyan rocess CyanProcess Magenta rocess MagentaProcess Yellow rocess YellowProcess Black rocess Black 20 unit 1 ■ Professional Considerations the effectiveness of their work in terms of patient outcomes. ■ Business sense. Nurse managers also need to be concerned with the “bottom line,” with the cost of providing the care that is given, especially in comparison with the benefit received from that care and the funding available to pay for it, whether from private insurance, Medicare, Medicaid, or out of the patient’s own pocket. This is a complex task that requires knowledge of budgeting, staffing, and measurement of patient outcomes. There is some controversy over the amount of clinical expertise versus business sense that is needed to be an effective nurse manager. Some argue that a person can be a “generic” manager, that the job of managing people is the same no matter what tasks he or she performs. Others argue that managers must understand the tasks themselves, better than anyone else in the work group. Our position is that both clinical skill and business acumen are needed, along with excellent leadership skills. Behaviors of an Effective Manager Mintzberg (1989) divided a manager’s activities into three categories: interpersonal, decisional, and informational. We use these categories and have added some activities suggested by other authors (Dunham-Taylor, 1995; Montebello, 1994) and from our own observations of nurse managers (Fig. 2.2). Interpersonal Activities The interpersonal category is one in which leaders and managers have overlapping concerns. However, the manager has some additional responsibilities that are seldom given to leaders. These include the following: ■ Networking. As we mentioned earlier, nurse managers are in pivotal positions, especially in inpatient settings where they have contact with virtually every service of the institution as well as with most people above and below them in the organizational hierarchy.