Running head: MANAGER ROLE

Manager Role
Amber Johnson and Amanda Mckellar
Ferris State University

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Manager Role

The nurse in the role of manager ensures that the day-to-day elements of the workplace
are done correctly. Just as the effective manager pays attention to employee selection, hiring,
orientation, continuing employee development, and financial accountability, in the role of leader,
the manager raises the level of expectations and helps employees reach their highest level of
potential excellence (Yoder-Wise, 2015, p. 45). Without an effective leader, the organization is
bound for failure. An example of someone who is a successful leader is Timothy Scholten, the
manager of 4 North at Butterworth hospital in Grand Rapids, Michigan. Tim started off as a
nursing technician in the emergency room at Butterworth. After getting his RN degree, Tim
stayed in the ER with a special interest in Trauma. He became the emergency manager and then
climbed the ladder to hospital supervisor. He quickly learned that this job did not suit his wants
or needs because he wanted control of a single floor. At this time, the neurological intensive
care unit was being transformed into a progressive orthopedic neurological trauma floor.
Tim jumped at the opportunity to become nursing manager of this new floor. This job
did not come without specific qualifications. The job required a bachelors of science in nursing
and a certification in orthopedic nursing within a year after being hired. Leadership experience
was preferred and with Tims experience in the ER especially in trauma, he was a perfect fit for
the job.
Roles/Responsibilities
Tim has many roles and responsibilities. During our interview, Tim explained the four
pillars concerning his job. Staffing, patient/staff satisfaction and quality of care, financing, and
safety are his main concerns. Mentioned below are detailed descriptions of the four pillars.
Specific examples of the four pillars on the 4 North unit are also given.

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The philosophy is important because it focuses on aspects of the future. Tims

philosophy is to improve health care of the communities as well as the patients status with
staffs best effort. The organizational chart, or chain of command, reinforces structure of the
business. The organization of 4 North starts with staff reporting to the supervisor or charge
nurse. The charge nurse reports to the manager, the manager reports to the director. The director
reports to the vice president nurse and the vice president nurse reports to the president. The
concept of using face-to-face messengers to communicate personally and bidirectional was
rooted in the organization's nursing model, which is based on caring relationships (Turner,
Milligan, Whitefeild, & Stiffler, 2011, p. 53). This helps make the facility run smoothly as well
as maintaining the hospital magnet status to allow a nurse to report directly to the president,
essentially recognizing nursing as a quality profession.
Communication and Relationship Building
Communication is the key resource for success with both the organization and the
patients. Over 100,000 deaths annually in the United States alone occur from medical errors,
most of which are a result of poor communication (Lowe, 2013). Regarding the patients, the
focus is on therapeutic communication and setting limits. It is extremely important to build
relationships with the patients as well as with the staff in order to help the communication
process and further prevent any complications. For the staff, professional communication is
important. When discussing manager to staff relationship, communication is precise with
expectations. Crucial conversations focus on effective discipline. It begins with having a
productive conversation with the employee and setting expectations. If the expectations are not
met, then confrontation is needed. Finally, termination may be required if the problem is not
resolved through this communication process.

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Health Care Environment

One pillar is safety, which is the most vital within this organization and patient care.
Patient safety practice is defined as, a type of process or structure whose application reduces the
probability of adverse events resulting from exposure to the health care system across a range of
diseases and procedures (Babaie, 2006, p. 54). Almost every process on the floor is designed to
promote safety. For example, medication scanning and two-nurse checks, chair/bed alarms, and
isolation or communicable diseases. All of these safety measures are in place to prevent
potential disasters such as allergic reactions, falls, or unnecessary transmission of diseases.
Safety also effects the organizational funding. Insurance funding has the potential to be cut to the
hospital if safety is breached. An example of this would be an elderly patient coming in for a hip
replacement and contracts a catheter associated urinary tract infection during her stay.
Leadership
One main role of the manager, whom is also the floor leader, is to focus on staffing. The
nurse manager strives to have his staffing at 100% productivity. This means that staffing is at
the perfect level for patient acuity. If productivity goes above 100%, staffing is too high and
vise-versa. Not only is this important for patient acuity, but also for effective care. For example,
the nurses strengths and weaknesses might determine how many nurses may be needed for that
day. If there are two trauma patients and two patients with horrific infections it may be
necessary to call in nurses with qualifications specific to these conditions. A newly graduated
nurse just off on her own likely will not be able to care for both of the big trauma cases. An
experienced and qualified nurse might be able to take both of these patients, thus reducing the
staffing need. For Tim to be an effective leader, which he certainly is, he must look at staffing as
a dynamic and ever-changing task.

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Professionalism

Another pillar is satisfaction of patients and staff to provide and quality care. If patients
on the unit are dissatisfied with the services provided, they will not return, and are likely to
persuade others to avoid the unit, as well. To achieve patient and satisfaction, surveys are
frequently given anonymously to give feedback about the current level or happiness of care.
Another area of concern is keeping the staff satisfied; this can be achieved in many different
ways. For example, offering incentives for staff members, praising for a good job done, and
keeping a team with different dynamics to help support staff weakness and strengths.
Professionalism is a part of patient satisfaction. If a patient is unhappy with something that
occurred on the unit, they may be very upset. When Tim steps in to speak to this patient to
promote satisfaction, he must remain professional and businesslike in his demeanor.
Business Skills
Finance is the last pillar in Tims management strategy. Financing has changed a lot over
the years that he has been a manager. He explained that managers have much less control over
the budget currently than in previous years. He used to sit down with pen, paper, and calculator
to figure all numbers concerned with the budget. Now, there is a financing board that handles
the majority of financing. Nursing is the biggest expense to the floor costing over 50% of the
hospitals operating budget (Ruland & Ravn, 2003). With nursing being the most exponential
cost it is important that Tim has the right amount of staff throughout the day. He achieves this
by calling time outs throughout the day to determine patient acuity as well as the amount of
nursing staff present. A manager role is not just being the boss however; it involves strategy in
time management, effective communication, budget, professionalism, and prioritizing. All of
which are business skills and necessary for optimal operation.

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Conclusion

A nurse manager/leader is a powerful yet challenging position to conquer. There are

many different aspects and considerations that are essential in order for the floor/facility to
thrive. If there is a defect in the structure, everything else falls like dominos. Therefore, it is
vital to have a leader whom is a great multitasker, critical thinker, optimist, and most importantly
passionate about the job at hand. After interviewing Tim Scholten, we have decided that he
possess all of our listed traits, which makes him an excellent manager.

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References

Babaie, K. (2006, November-December). Promoting Patient Safety: One Companys Example.

The Case Manager, 17, 54-59. http://dx.doi.org/doi:10.1016/j.casemgr.2006.08.004
Lowe, N. K. (2013, May 17). Leadership, Accountability, and Safety in Health Care. Journal of
Obstetric Gynecology, and Neonatal Nursing, 42, 247-248.
http://dx.doi.org/10.1111/1552-6909.12039
Ruland, C. M., & Ravn, I. H. (2003, April 11). Usefulness and Effects on Costs and Staff
Management of a Nursing Resource Management Information System. Journal of
Nursing Management, 11, 208-215. http://dx.doi.org/10.1046/j.1365-2834.2003.00381.x
Turner, P., Milligan, L., Whitefeild, C., & Stiffler, D. (2011, April). Multidisciplinary
Communication Strategies for Magnet Success. Nursing Management, 42, 49-53.
http://dx.doi.org/ 10.1097/01.NUMA.0000395392.62160.56
Yoder-Wise, P. S. (2015). Leading and Managing in Nursing (6th ed.). St. Louis, MO: Elsevier
Mosby.