Is it Education or Management?
Gale Kehoe

Gale Kehoe, MSN, RN, CNN,  is Renal Instructor, Winthrop University Hospital, Mineola, NY. She is a Member of the Long Island Chapter of ANNA.

There are many situations in nursing when either educational or management skills are called for. It is when the blurring of these roles happens that we must define clear cut parameters for the correct actions to be taken and to be effective. As an educator, I have been asked many times to correct situations that are not clearly educational issues. I can only be responsible to educate individuals; once they are educated, they must perform what they have learned. For example, if someone forgets to give a medication, it is not an educational deficit; the nurse simply forgot to give it. The nurse certainly knew what to do, so perhaps it is appropriate to address it from a performance management point of view. From an educator’s perspective, this responsibility rests with management.

I am one of two clinical instructors in our hemodialysis unit. There are also two RNs in leadership roles, one each on days and evenings. The rest of the nursing staff consists of RNs, LPNs, NPs, and patient care associates. Everyone understands the roles of the RNs, LPNs and PCAs as well as the roles of the NPs, MDs, researchers, social workers, and dietitians. The role of the Clinical Educator seems to be less well defined. Perhaps defining that role and differentiating it from management will help.

Defining Management vs. Clinical Educator Roles
According to Liebler, Levine, and Dervites (1984) management is defined as the process of getting things done through and with people. Two functions that they discuss are directing and actuating, meaning that guidance and leadership should be provided so that work is goal oriented. In addition, they speak about controlling, which is described as the assessment of one’s performance as it relates to the accomplishment of a goal, and the initiation of a corrective action, if necessary.

Hamric, Spross, and Hanson (2000) use the terms “educator” and “coach” interchangeably. Coaching has been used to describe interactions between experts and learners that focus on developing the learner’s knowledge and skill in an area that is within the coach’s expertise. Some of the teaching behaviors used to describe coaching are: explaining, demonstrating and role-modeling, guiding, identifying adaptive tasks, motivating, offering options, setting tasks, encouraging, praising, and listening to list just a few. Initiation of a corrective action is never used in the description of an educator.

Does providing the same information repeatedly change behavior or will the staff eventually “tune it out?” I can only think of the analogy of a parent teaching a child not to touch the stove because he could get burned, only to have the child touch the hot stove. It is the educator in the parent who gives information that this is a dangerous thing to do, but it’s the manager or supervisor in the parent that has to take the corrective measures so that the child will not repeat this action again.

From my point of view, collaboration between the manager and the educator is of utmost importance if policies and procedures are to be carried out correctly. However, the carrying out of these policies and procedures, and intervening with corrective actions when not done properly despite appropriate knowledge, are in the realm of management, rather than education.

Conclusion
In conclusion, staff members need to perceive the educator as someone who is non-threatening to whom they can go for clinical issues and questions. Educators need to be considered mentors, not managers. It is the managers who need to manage.

References
American Nurses’ Association (ANA). (2003). Definition of professional nursing. ANA’s Nursing’s Policy Statement (2nd ed.). Washington, DC: Author.

Additional Readings
Hamric, A.B., Spross, J.A., & Hanson, C.M. (2000). Advanced nursing practice, an integrative approach (2nd ed.). Philadelphia: W.B. Saunders Company.

Liebler, J.G., Levine, R.E., & Dervitz, H.L. (1984). Management principles for health professionals. Rockville, MD: Aspen Systems Corp.