RN-BSN Portfolio
Analyzing a Leader or Manager RoleShanda ChristiansenFerris State UniversityIntroductionI have chosen to interview my nurse manager, Jackie Seymour, RN. Jackie works for a home infusion pharmacy. The pharmacy provides specialty home intravenous therapy for acute and chronic conditions to a wide variety of patients, including pediatrics and the elderly. Jackie’s educational background includes an associate degree in Office Management and an associate degree in Nursing. Jackie is a registered nurse. She earned her nursing degree from Montcalm Community College in Sidney, Michigan. Jackie has been practicing nursing for almost twenty years. She first started her nursing career working in an emergency department for a large hospital in Detroit. She then worked for a different infusion company as a field nurse. She also managed an outpatient infusion center for many years until she started her current employment as a nurse coordinator. She has been recently promoted to nurse manager.Job DutiesThe job duties for Jackie as a nurse manager are making sure all the nurses are in compliance with core competencies and all nurses are up to date with their CPR certification, immunizations, and TB testing. There is no longer a nurse supervisor, so Jackie has taken over those responsibilities also. They include, supervising the field nurses, payroll, and making sure that nursing skills are up to date. She also helps out with nurse coordinating when needed with new referrals. A new, nurse coordinator, has recently been hired, so Jackie is training and helping her make the new transition. This seems to be Jackie’s main duty, as of right now, until things settle down with all the new changes. The pharmacy consists of a branch manager, pharmacy manager, nurse manager, pharmacists, nurses, warehouse supervisor, warehouse staff, and office support staff. Jackie reports to the branch manager in the office. The nurses and office support staff report to Jackie. Jackie collaborates with many people and areas other than nursing. She collaborates with the pharmacists and pharmacy manager regarding patient medications, dosages, and refill status. She collaborates with the reimbursement department regarding insurance authorizations. She collaborates with our sales representative regarding new referrals. She is often in collaboration with the warehouse supervisor regarding medication delivery times for the nurses and patients. She is also support for patients, during normal business hours, if patients have nursing related questions or issues when they call the pharmacy. She must collaborate with the corporate office involving any adverse reactions due to medication infusions that a nurse reports.Ethical IssueAn ethical issue Jackie has and is managing is one that is affecting all of us who work for the company. This issue has to do with a much larger organization that has purchased the company that Jackie and I work for and wants to put it up for sale and keep all of our chronic care business. This means patients who have been on service with us for many years would have to switch over to this different infusion company. This would mean a new nurse and new office staff. This has placed a real concern for Jackie and all nurses involved. For me, this means I would lose every patient that I have built a relationship with in the last five years, to a different company. Patients have expressed concerns about wanting to keep the same nurse and stay with the same infusion company. They are happy, comfortable, and satisfied with the care they are receiving. The actions of this company are unethical. They are willing to sacrifice patient and nurse continuity, which could also be detrimental to the patients’ safety and well-being, with this type of business decision. Often, people do not accept change well and this decision does not allow patients to make their own medical choices. This type of action is preventing patient autonomy. “The principle of autonomy addresses personal freedom and the right to choose what will happen to one’s own person” (Yoder-Wise, 2011, p.89). Jackie has kept us well informed of any changes that take place and has maintained veracity through this whole process. She expressed that patients have a right to what company they use and ultimately it should be there decision. Power and InfluenceEvidenceJackie describes her managerial skills using influence over power. She states that having a positive attitude usually ends up with a positive result. Manfredi (1996, Conceptual framework, para 4) describes influence is often viewed as an informal strategy used to gain the cooperation of others without exercising formal authority. Jackie explains that trusting and respecting the nurses make them more independent and self-sufficient. She believes that letting nurses make independent decisions about patient care, allows the nurse more self-confidence which leads to better patient outcomes. She states that maintaining patient continuity is extremely important for home infusion, especially for patients with chronic therapies. Requiring the nurse to case manage a patient keeps things running smoothly for the nurse, the office, and most importantly the patient. Jackie describes there are times when power is used over influence. Mainly, it is used to make changes in the office environment with the office support staff. Manfredi (1996, Conceptual framework section, para 5) states that power is the ability to exert actions that result in the change in behavior/attitudes of an individual or group. Support and AnalysisJackie is right when she describes her type of managing as using influence over power. She is really a great support system for nursing staff. She is very good at listening to nurses’ needs and concerns. “Managers and other leaders who are good listeners develop reputations for being fair and consistent” (Yoder-Wise, 2011, p.183). One thing I have noticed that Jackie does and the past nurse manager did not do, was tell us nurses that we are a great asset to the company and always thanking us for a job well done. “Nurse managers exercise referent power by asking staff for support, and by communicating to staff that they are valued and important” (Manfredi, 1996, Summary responses section, para 20). I feel that acknowledging a job well done motivates and inspires growth in the staff. Decision Making and Problem-SolvingEvidenceWhen asked about her decision making process and problem solving skills, Jackie describes that her years of experience has led her to efficiently solve problems within the nursing scope of practice. She explains that sometimes she isn’t aware that she is solving problems on a regular basis. It is almost second nature when it is nursing related. She describes that decision making is almost always a group effort. She often collaborates with pharmacist and the general manager when getting the final approval for certain decision making processes. She is also a voice for the nurses when collaborating with upper management “Organizational culture, top managerial support, and even adequate staffing can affect decision making” (Effken, Verran, Logue, and Hsu, 2010, para 24). The general manager ultimately has the deciding factor but often collaborates with Jackie before doing so when he needs support when it is nursing related. Effken et al. (2010, para 1) found generally nurse managers are at the center of the action and are the “go-to” people when organizational leaders want something implemented. Support and AnalysisJackie takes on the participative approach to managing. “A manager who uses a democratic or participative approach to management involves the appropriate personnel in the decision-making process” (Yoder-Wise, 2011, p. 101). Jackie often asks us nurses for our input and feedback during patient related issues. A weakness that some people might perceive Jackie to have regarding her decision making skills is that at times she can get high strung about the situation. Some people have stated that she often wears her heart on her sleeve. Some people may take this as a weakness but others may take it as passionate and caring. I believe patients like this type of approach because it shows that she does care about their situation and she is willing to fix the problem. The pharmacists or pharmacy manager may view Jackie as emotional or taking issues too personally. ConclusionI enjoyed interviewing Jackie for the nurse manager role. I found it to be interesting getting to know her on a more personal level. Previously, I did not know all of her previous work or educational experience. This paper has enlightened me to all the dynamics that go on in the life a nurse manager.ReferencesEffken, J., Verran, J., Logue, M., & Hsu, Y. (2010). Nurse managers' decisions: fast and favoring remediation. Journal Of Nursing Administration, 40(4), 188-195. doi:10.1097/NNA.0b013e3181d40f7cEgan, J. (2007). Managing conflict resolution. Laboratory Medicine, 38(3), 145-148. Manfredi, C. M. (1996). A descriptive study of nurse managers and leadership. Western Journal of Nursing Research, 18(3), 314+. Retrieved from , P. S. (2011). Leading and Managing in Nursing (5th ed.). St. Louis, MO: Mosby ................
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