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Analyzing a Nurse in a Leader or Manager RoleNURS-440Ferris State UniversityMichelle Bettis Analyzing a Nurse in a Manager Role As nurses, we are constantly analyzing every situation, and likewise for our managers. Nursing managers or nursing leaders are there to support and guide our nursing judgement. According to The AONE Nurse Executive Competencies (2005), “The vision of the American Organization of Nurse Executives (AONE) is “to shape the future of health care through innovative and expert nursing leadership. Innovative nursing leadership requires that nurses in leadership positions are competent” (p 1). Nursing managers or leaders focus on multiple areas within nursing practice. These areas include but are not limited to budgeting, staffing, organization, managing, delegation, and educating. This paper will focus on the qualifications and roles of a selected nursing manager and leader of a healthcare team. After sitting down and performing an interview with D.M. Registered Nurse (RN), Bachelors of Science in Nursing (BSN), Director of Nursing (DON), at a local long-term care and rehabilitation center my interest was intrigued. As a Registered Nurse, D.M. started off in a Trauma Intensive Care Unit, and gradually expanded her experience as a nurse by becoming a shift supervisor in the emergency room and Critical Care Unit. Furthermore, from a shift supervisor she continued to climb in the management positon becoming a nursing director in a Critical Care Unit. After the acute care setting experience D.M. decided that a change was needed and became program director of medical services at a local community mental health. She then found that there was another area in which she had interest and this was long term care and rehabilitation. Two years ago she stepped up from assistant director of nursing (ADON) to director of nursing (DON). D.M. also is Wound Care Certified (WCC) and provides education and treatment to patients at her current place of employment. With thirty plus years of nursing experience, she currently continues to work on her masters in science of nursing (MSN) degree. After this interview with D.M. this encouraged me to continue my education as a nurse. According to Yoder-Wise (2015), “Managers are able to focus on both the individual and the larger goals of the department and organization. Their aim is to enable people to develop their abilities and strengths to the fullest and to achieve excellence, thus contributing to the department’s overall success” (p 54). There are many traits that both a manager and leader share such as, “knowledge, integrity, ambition, good judgement, courage, stamina, enthusiasm, communication skills, planning skills, and administrative abilities” (Yoder-Wise, 2015, p 54). D.M. now manages a ninety-three bed health and rehab center located in Tawas City, Michigan. She identified that, “The role of a Director of Nursing (DON) within a facility is to assume responsibility and authority for the nursing care being delivered.” During the interview she stated her responsibilities within the facility as to, “Oversee the care and management of the residents as well as provide the nursing staff with direction and education to care for our residents.” Additionally, D.M was asked her perspective regarding the philosophy and organizational structure of the facility. She stated that, “Our focus is to make people live better lives.” Likewise talking about organizational structure D.M. stated that, “The organizational structure may be bureaucratic in nature.” She added that the order in which people report within the facility is as follows: “Administrator reports to cooperate Administrator, DON reports to Administrator and cooperate DON. ADON reports to DON and Administrator. Unit managers, Staff nurses, Nursing assistants, Director of education and Medical records reports to DON.” D.M mentioned a final note that, “The chain of command in which everyone reports, “works well within the facility.” Thus, further into the interview, D.M. and I discussed communication and relationship building. According to D.M., “Communication and relationship building is done daily with walking the walk with staff. I have spent a lot of time building trust first then knowing their strengths and weakness. My personal philosophy is never ask your staff to do anything you would not do. I spend time with letting the staff know what my expectations are and always give them my rational for what has to be done or why it has to be done a certain way. The result should equal quality nursing care. This provides optimal individualized nursing care within the organization for our patients. Allowing for families to place trust and confidence in our staff and organization.” According to Kourkouta, (2014), “Good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient” (p 65). A journal article by Rosenblatt and Davis (2009), states that, “Effective communication involves two distinct aspects: adequately articulating our ideas and understanding the listening audience with whom we're communicating in order to perceive how they best learn and receive information” (p 52). Additionally, D.M.’s statement regarding communication and relationship building coincided with the material that I have analyzed. The next topic that we discussed was knowledge of the health care environment and what that meant coming from D.M. in a managerial nursing perspective. She stated that, “In the nursing home setting the culture is very different from acute care, however the advent of our new health care system, this is changing. The environment was more conducive with maintaining quality of life or end of life care along with the safety of patients. We are now moving into community care with focus on prevention and maintenance of illness. This provides a challenge in the setting with limited funding and resource associated to the setting. Education is the key which makes our families and residents more aware and smarter consumers along with the safety of our patients. It is necessary to provide our staff with education regarding upcoming changes within the organization and allowing for proper courses needed to fulfill these requirements.” D.M. also went on to talk about her role in making suggestions to the organization using both evidence based and best nursing practices as a guide for updating and improving policies and procedures. Along with putting any updates into practice immediately and enabling all resources be easily accessible to staff. Furthermore, D.M. ensures that the facility is in compliance with requirements from the State of Michigan. “Identifying risks and deficits within the facility is essential and creating a plan of action to eliminate or minimize the risks’ from occurring in the future,” she further stated. After analyzing D.M.’s answer, I found that literature states, “Maintaining a safe environment reflects a level of compassion and vigilance for patient welfare that is as important as any other aspect of competent healthcare” (Stone, Hughes, Dailey, 2008). Furthermore according to Haughom, (n.d.) “Knowledge management efforts typically focus on strategic objectives such as improved performance, competitive advantage, innovation, the sharing of lessons learned, integration, and continuous improvement” (p 1). Reflecting from a managerial position within a long term care and rehabilitation facility, her leadership role was discussed. D.M. answered this question with ease stating that, “Leadership is where guidance is provided to everyone within the healthcare setting. I am able to provide a therapeutic trusting relationship with my staff, and patients allowing for effective communication within the healthcare team. This also allows for evaluation to make sure competent safe nursing care is being provided to our patients. The organization is focused on individualized quality care for our patients.” According to, Stetler et al. (1998), “The role of nursing leadership in creating a major change, such as integrating EBP into a division of nursing, can be conceptualized as involving three major activities: establishing a new culture, in this case, of EBP; creating the capacity for organizational members to change in this direction; and sustaining that shift through revisions in the system's infrastructure” (p 45-53). According to Yoder-Wise (2015), “Leaders build a culture of teamwork, set a direction, develop a vision, and communicate that direction to staff” (p 54). Nearing the end of our conversation, professionalism was discussed. D.M stated, “Professionalism is critical.” She went on to mention how it affects the healthcare workplace by stating that, “Being a professional is someone who is willing to accept responsibility, has a well-developed work ethic and can think beyond self. They possess the ability to communicate well with others and treats everyone with dignity and respect. The patients will in turn feel like they are being valued thus promoting trust and mutual respect. This allows for the organization to be successful as a whole.” Professionalism is defined according to Black (2014) as, “Professional behavior, appearance, and conduct” (p 354). Furthermore, according to Yoder-Wise (2015), “Professionalism is all-encompassing and reflects the manager’s professional philosophy as to how he or she interacts with personnel, other disciplines, patients, and families. Professional nurses are ethically and legally accountable to the standards of practice and the accompanying nursing actions delegated to others” (p 66). Lastly, D.M concluded that business skills affect both patient care and the healthcare organization. She stated that, “One must possess the ability to handle financial issues well and the ability to find resources. This allows us as an organization to be able to provide optimal care to our patients and the proper education to our staff. Therefore, allowing us to be successful and recognized for the optimal patient care that we provide.” According to Yoder-Wise, (2015), “Nurse Managers must create and foster an environment that supports the continual quest to achieve excellent patient outcomes, thus demonstrating the important economic value that nursing brings to healthcare” (p 63). In conclusion, after analyzing a nurse in a manager role, D.M. discussed how she successfully fulfills her role as a Director of Nursing (DON) at a long-term care and rehabilitation center. In doing so she reflects on her roles and responsibilities, communication and relationship building, knowledge of the healthcare environment, leadership, professionalism and business skills. After conducting this interview, I was inspired to continue my education as a healthcare provider in hopes to build my nursing experience toward a managerial position. I viewed D.M. as a structured, organized individual who conducted herself in a professional manner and was viewed as a true leader of the healthcare team. All of these qualities in which I would hope to possess in a similar role. ReferencesBlack, B. (2014). Professional Nursing Concepts & Challenges (7th ed). St. Louis, MO: Elsevier.Haughbom, J. (n.d.) Knowledge management in healthcare: its more important than you realize. Health Catalyst. Retrieved from:, L., & Papathanasiou, I. V. (2014). Communication in Nursing Practice. Materia Socio-Medica, 26(1), 65–67. , C., Davis, M. (2009). Career scope: effective communication techniques for nurse managers. Nursing Management. 40 (6), 52-54.Stetler, C., Brunell, M., Giuliano, K., Morsi, D., Prince, L., & Newell-Stokes, V. (1998) Evidence based practice and the role of nursing leadership. JONA The Journal of Nursing Administration, 28 (7/8), 45-53.Stone PW, Hughes R, Dailey M. Creating a safe and high-quality health care environment. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 21. Retrieved from: American Organization of Nurse Executives. 2005. Retrieved from: , P.S. (2015). Leading & Managing in Nursing (6th ed). St. Louis, MO: Elsevier. ................
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