Clinical Nurse Manager Emergency Room

Clinical Nurse Manager (CNM) Emergency Department

The Clinical Nurse Manager (CNM) Emergency Department provides 24/7 operational and clinical leadership to ensure safe, timely, efficient, and patient-centered emergency care. The CNM is directly accountable for the execution, validation, and reliability of Emergency Department processes that impact patient experience, quality outcomes, patient safety, staffing effectiveness, throughput, regulatory compliance, and staff readiness.

This role maintains a visible, hands-on leadership presence across all shifts and serves as the operational authority during assigned coverage. The Clinical Nurse Manager plays a critical role in managing Emergency Department throughput, patient flow, and real-time operational decision-making in a high-acuity, fast-paced environment.

The Clinical Nurse Manager partners closely with the Director of Critical Care and Leadership to translate organizational priorities into consistent frontline practice. The role supports American Nurses Credentialing Center (ANCC) principles through staff engagement, accountability, shared governance, and continuous improvement.

Accountable for unit operations and performance across all shifts

Responsible for execution, validation, follow-through, and escalation of operational, quality, and patient experience standards

Serves as clinical and operational leader during assigned shifts.

The position has supervisory authority including responsibility to hire, assign, direct, evaluate, discipline, and recommend termination of employees, using independent judgment and discretion. Recommendations regarding personnel actions are given significant weight by senior leadership.

Works closely with direct report to review operation, patient experience, and quality outcomes and adjusts to the needs of the unit accordingly

Builds strong working relationships across all service lines, including but not limited to Critical Care, Medical Surgical, Telemetry, Maternal Child, Surgical Services, Case Management, Radiology, Laboratory, EVS, Security, and ancillary services.

Collaborates with Nursing Leadership to ensure safe staffing, skill mix, and equitable assignments

Manages real-time staffing challenges including unplanned absences

Ensures appropriate coverage for high-risk patients, including constant observation (1:1)

Communicates staffing updates and escalates trends using data-supported recommendations

Responds timely to Protests of Assignment (POA) utilizing the Management Response form as outlined per policy

Conducts patient experience rounds during assigned coverage

Assesses responsiveness, communication, comfort, pain management, and understanding of care

Initiates real-time service recovery and documents interventions

Reviews patient experience data and addresses unit-level trends

Validates patient experience tactics (i.e. Bedside Shift Report, Hourly Rounding) through direct observation

Provides real-time coaching and reinforcement of best practices

Escalates repeated non-compliance patterns through appropriate channels

Leads real-time Emergency Department patient flow from arrival through disposition

Monitors ED census, arrivals, holds, and throughput metrics

Identifies and removes barriers related to diagnostics, consults, transport, and discharge readiness.

Collaborates with physicians, case management, ancillary services, and receiving units to reduce delays and ED boarding.

Balances throughput decisions with patient safety, staffing capacity, and patient experience.

Responds to patient surges, EMS volume, disasters, staffing shortages, and system disruptions.

Lead throughput rounds when boarding inpatients holds.

Ensures clarity of care plans, disposition goals, and identified barriers.

Ensures timely ICU downgrades and appropriate utilization of critical care services.

Tracks unresolved throughput issues and escalates delays impacting safety or Emergency Department length of stay.

Monitors key performance indicators including medication scanning, hand hygiene, restraints, falls, and observation compliance

Collaborates with Risk/PI on occurrence reviews and follow-up actions

Identifies trends, near misses, and opportunities for improvement

Conduct real-time Root Cause Analysis in response to unexpected patient safety events as needed

Supports prevention strategies for all Hospital Acquired Conditions and patient safety outcomes

Validates prevention practices and timely interventions related to patient quality and safety outcomes

Partners with Infection Prevention, Wound Care, Pharmacy, and Quality teams

Conducts routine environment of care and safety rounds and documents accordingly

Maintains continuous readiness for regulatory and accreditation standards

Works with Emergency Management and Environment of Care team to develop attainable action plans for environmental risks

Identifies and escalates environmental, equipment, and safety risks

Conducts employee rounding across all shifts

Provides real-time coaching, feedback, and support

Facilitates safety huddles and reinforces quality and safety priorities

Escalates recurring performance or operational concerns

Leads or supports pre-shift huddles and unit communication

Encourages staff participation in shared governance councils

Supports ANCC initiatives

Supports compliance with mandatory education, competencies, and certifications

Collaborates with Nursing Professional Development, Human Resources, and Employee Health on annual employee requirements

Tracks compliance and escalates gaps for remediation

Qualifications

• Bachelor of Science in Nursing (BSN) required; Master's degree preferred
• Active RN license in NY
• Minimum of 35 years nursing leadership experience, preferably in ED
• Strong communication, critical thinking, and operational leadership skills
• National Certification in Nursing Leadership or clinical specialty preferred

St. Johns Riverside Hospital