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Good managers are a lot of things: they’re supportive, empowering, compassionate — and potentially transformational. With the leadership of a good manager, people and organizations can change rapidly for the better. The positive change that one manager brought about at 8 West is proof of this potential.

History and Transformation of 8 West

Opened in January 2022 as a 22-bed, general medicine overflow space, 8 West was staffed entirely by float nurses, while managers were cycled through on a weekly basis. There was a lack of consistency and structure, making it a hectic place to work. In July 2022 alone, there were six falls in the unit. 

During this time, Ginny Cramer was in the float pool and preassigned as a charge RN to the COVID unit with new manager Ryan MacDonald.  After a few months of working with Cramer, nursing manager MacDonald observed, “When you're here, I can breathe.” It wasn’t long before she was asked by nursing director Leigh Gauriloff to step in as interim manager for 8 West.

After months of excessive staff turnover, lack of a permanent manager, and a general need for support and structure, 8 West was not running smoothly. Cramer brought her best self to the job every day, which started with connecting with her colleagues. “No one is here because they want to be a worker bee,” she explains. “Everybody has some core ‘why’ for being here. And that's what's important — identifying how you connect with people. I never start any conversation about work.”

Leadership Inspired by Summer Camp

Within two weeks of accepting the role of interim manager, Cramer had done what she had set out to: getting 8 West out of crisis mode, and making it a place where everybody wants to work. By March 2023, 12 traveling nurses from 8 West had converted to UVA employees — all of whom will follow Cramer to 3North when 8 West closes this Spring.Though she won’t take full credit, Cramer’s managerial style, reflecting a career of leadership and mentorship, made 8 West’s success possible. 

Cramer didn’t set out to be a manager any more than she set out to be a nurse. Both roles started in the same spot: a summer camp in Virginia. For three straight months, week after week, in the course of eight years, Cramer was in charge of keeping 350 teenage campers and 75 staff safe while making sure they had fun — two objectives she sees now align with those of a nursing manager. 

“Being a camp director is really where most of my leadership training comes from,” laughs Cramer. “I learned that community is all about relationships — if you make room for fun and make the effort to participate, you start to build a family.” 

Summer camp is also where Cramer first decided to be a nurse. Hearing about the need for a second nurse at the camp, she decided to attend night and weekend classes at a local college, eventually obtaining her RN degree and going on to work at Martha Jefferson Hospital before finding a home at UVA Health. “I am very much a people person. Every decision I've ever made has been about people,” she explains.

Tips From Coaches for Other Managers

Since Cramer took over 8 West, falls have decreased drastically, patient experience scores are consistently high, and nurses actively want to work there. “We have a culture here where everybody wants to be together,” says Cramer.

It’s a dramatic change that hasn’t gone unnoticed by performance improvement coach Evie Nicholson and nursing manager Scott Austin, who say “change comes easily” to Cramer and others can learn by “observing her leadership style in action.” Based on their experience and what they have seen work well for Cramer, Nicholson and Austin offer the following tips to other nursing managers: 

• Set clear expectations around patient safety and outcomes.
• Perform Patient Safety Risk Rounds to ensure patients receive the care that’s expected and offer real time feedback and mentoring.
• Introduce the Daily Management System — a high reliability, health care system to deliver appropriate care to every patient every time.
• Be open minded and willing to learn from your team.
• Attend shift change huddles so you can be totally engaged.
• Support your team by escalating problems you’re not able to solve.
• Work collaboratively with other disciplines and within your service line leadership team. 
• Communicate effectively while listening with compassion.
• Inspire team members to maximize their potential.
• Meet team members where they are through honest conversations.
• Be an agent of positive change.

While Cramer doesn’t claim to have all the answers for what makes a good manager, she attributes her success with 8West to being a team player. “I don't separate myself from other nurses just because I'm in a different role," she says. "I am very much a part of their work and their lives. I may be doing my job over here and you may be doing your job over there — but we’re in this together!”