1 Running head: ANALYZING A LEADER IN NURSING

Analyzing a Leader in Nursing Sarah Elser Ferris State University

2 ANALYZING A LEADER Analyzing a Leader in Nursing Like any other business industry, the nursing and healthcare field relies on good managers and leaders to pave the way and guide the actions to shape the industry as we know it. By studying the responsibilities and actions of a good manager, one can achieve not only a look into one of the many career options of a registered nurse, but also gain insight into and respect for an important position in the nursing field. One of these hardworking managers is Patricia Hall, BSN, RN. A Ferris State University alumnus, Patricia is currently attending The University of Cincinnati as she is working towards her Master of Science in nursing (MSN) degree to become a certified nurse practitioner. She started out as a staff nurse on a general medical unit at the Community Health Center of Branch County (CHCBC) in Coldwater, Michigan and after ten years of bedside nursing experience, she accepted a position as the Assistant Director of the medical and surgical units at CHCBC where she was an exceptional manager, leader, and role model for the nursing staff for several years before moving to Sturgis in her current position as the Nurse Director of Pain Management at Sturgis Hospital. Throughout this paper, Patricias responsibilities and actions in her management position will be analyzed with respect to her job duties, legal and ethical issues she has faced, as well as resolving conflicts among her staff and patients. Job Duties As the Nurse Director of the Pain Management Center at Sturgis Hospital, Patricia has many job duties. She is responsible for balancing the budget and payroll for the Center, along with writing, editing, and implementing policies (P. Hall, personal communication, September 8, 2013). Patricia is also solely responsible for the hiring and orienting of new staff, administering staff evaluations, and resolving any staff conflict that surfaces. The Pain Management Center of

3 ANALYZING A LEADER Sturgis Hospital also participates in quality improvement measures such as project performance improvement audits of which Patricia is in charge. Part of the description of this position is participating in direct patient care one shift a pay period when staff and physicians perform any scheduled procedures in the operating room, which was one of the primary reasons that Patricia states she accepted the position to change employing facilities (personal communication, September 8, 2013). Patricia acknowledges that she is required to report to the Vice President of Patient Care Services who reports to the C.E.O. of the hospital; she is also required to report to the Pain Management Group, who partners with the Pain Management Center where she works (personal communication, September 8, 2013). Patricia presides over the staff of the Pain Management Center as well as the staff of the operating room on the day of which they perform any scheduled procedures with the physician (personal communication, September 8, 2013). In order to perform all of these job duties, effective communication and professional collaboration must occur. Collaboration Role Collaboration with other disciplines and departments is an essential part of any nurses job; perhaps even more important for a nurse manager, it is very necessary to deliver quality, competent care in any clinical setting and must be mastered by all disciplines (Yoder-Wise, 2011, p. 74). Patricia states that she works closely with the laboratory department to ensure her patients get the necessary labs drawn on the morning of their procedure (personal communication, September 8, 2013). Stating that she must also collaborate with central scheduling to have her patients procedures, physical therapy, and any radiological tests set up, Patricia acknowledges that she spends a great amount of time working with other disciplines and

4 ANALYZING A LEADER she would not be able to properly care for patients if she did not (personal communication, September 8, 2013). Management of Legal and Ethical Issues Patricia admits that she has faced several legal and ethical issues which were difficult to manage. One of those issues pertains to the proper procedures by which to obtain an informed consent. According to Yoder-Wise (2011), nurse managers should be aware of the health literacy of patients which contributes to their ability to understand the medical jargon of informed consents (p. 81). The issue that Patricia faces includes the physician using abbreviations on the informed consent; when this is recognized, Patricia states that the procedure team stops during the time out process and asks him to redo the entire consent (personal communication, September 8, 2013). She admits that this may be an autocratic way of handling the issue, but when it comes to legal matter, Patricia states that sometimes that is the best and most effective way to solve the problem (personal communication, September 8, 2013). While this may be more of a legal issue, Patricia must also manage ethical issues, as well. Yoder-Wise (2011) states that if a situation of inadequate staffing arises, a nursing manager must do whatever is within his/her control to alleviate the circumstances (p. 77). During the interview, Patricia was able to recall a day not long ago that her staff was scheduled for a very busy day of procedures when over half of the staff called-in sick (personal communication, September 8, 2013). Faced with pressure from the physician and upper management to fill the positions so that the procedures could be completed, Patricia had to make an ethical decision whether or not the patients safety would be compromised with less than adequate staff; many people were upset because of the cancelled procedures, but Patricia knew

5 ANALYZING A LEADER that she could not ethically allow them to take place with such inadequate staff (personal communication, September 8, 2013). A frequent ethical debate includes that of pain management, of which Patricia is all too aware as this is the medical issue with which her clinic deals solely. According to Amy Haddad (2001), chronic pain is very hard to treat and is often overlooked by many healthcare providers (p. 25). However, healthcare providers have an ethical duty to provide efforts to relieve a patients pain, and Patricia must monitor and assess the progress of pain relief in the patients that are treated at the Pain Management Center (personal communication, September 8, 2013). One of the standards in pain management as identified by the Joint Commission (2013) includes educating patients about their options for pain management, which nurses have both an ethical and moral duty to do. Use of Power and Influence A manager has the power to influence people to achieve goals (Yoder-Wise, 2011, p. 177). By possessing a high level of emotional intelligence, a good leader and manager can positively affect the organizational culture, which will lead to higher productivity rates and job satisfaction, pride, and respect (Momeni, 2009, p. 42). Patricia strives to create a high morale on her unit and states that she frequently arranges for lunches to be brought in for the staff and physicians as well as group outings to conferences and educational seminars; she states that by creating a positive work environment and getting to know one another on a more personal level, the group is able to foster a mutual respect for each other and for her (personal communication, September 8, 2013). The staff in her clinic is frequently asked for their opinion, which can help to empower nurses; empowered nurses make professional practice possible and are more satisfied (Yoder-Wise, 2011, p. 181).

6 ANALYZING A LEADER Use of Decision-Making and Problem-Solving Process Patricia uses a democratic or participative decision-making style, as she usually always involves the appropriate personnel in the process (Yoder-Wise, 2011, p. 101). When she first started to work at the Pain Management Center, Patricia notes that the order that patients were seen and the way appointments were handled was disorganized and ineffective; there were long wait times, numerous staff in and out of the patients rooms, and a lack of communication between that staff. (P. Hall, personal communication, September 8, 2013). In this situation, Patricia held a meeting with all of the staff along with the physician and together they all collaborated to develop a new process of seeing patients. By allowing the entire group to participate in this significant change, Patricia was demonstrating her democratic leadership style as well as increasing the likelihood of compliance and commitment to the new process by involving the entire group in the decision-making and problem-solving process (Yoder-Wise, 2011, p. 104). Management and Resolution of Conflict Patricia tries to use a collaborating mode of conflict resolution whenever possible; she feels that by analyzing the situation and coming up with a mutual agreement, both parties will be happy and best able to meet the criteria of the agreement (Yoder-Wise, 2011, p. 473). A specific example includes that in which one of the staff nurses under her sent a patient home without the scheduled treatment because he was continuously late for his appointments; the patient voiced a complaint to Patricia and she worked out an arrangement with both the patient and the nurse for a different time for the patients treatment that enabled the patient to be on time (P. Hall, personal communication, September 8, 2013). Patricia exhibited effective leadership skills by facilitating collaboration between the nursing staff and the patient to resolve the conflict at hand.

7 ANALYZING A LEADER Conclusion In conclusion, Patricia demonstrates many quality characteristics that contribute to her success as a manager and leader. She uses a democratic leadership style while allowing her staff to participate in as many decisions as possible to increase compliance and raise morale, all while practicing legally and ethically. Using her power as a manager and leader to positively influence the Pain Management Center and its staff, Patricia works hard to develop a strong and effective group whom respect and trust her to lead them in providing quality pain management care to their community. She is a great example of a just and ethical nurse making a difference in a management role.

8 ANALYZING A LEADER References Haddad, A. (2001). Acute care decisions. Ethics in action... ethical problem of poor pain management. Rn, 64(11), 25. Joint Commission, The. (2013). Facts on Pain Management. Retrieved from: http://www.jointcommission.org/topics/pain_management.aspx Momeni, N. (2009). The relation between managers' emotional intelligence and the organizational climate they create. Public Personnel Management, 38(2), 35-48. Yoder-Wise, P. S. (2011). Leading and managing in nursing (5th ed.). Saint Louis, MO: Mosby.