ANALYZING A NURSE LEADER 1
Analyzing a Nurse Leader
Kristina Swann
Ferris State University
Analyzing a Nurse Leader
A leader is one who exhibits creativity and flexibility through times of change and demonstrates energy, excitement, and passion for quality work. A leader is one who takes charge and promotes the advancement of their profession by participating on committees, teams, and organizations (ANA, 2004). Lyn Johnson is a registered nurse and nurse leader in the Emergency Department at Metro Health Hospital. Lyn started working as a nurse’s aide after graduating high school. She then worked as a Licensed Practical Nurse in the Obstetrics Department. Lyn went to school at Baptist College, Grand Rapids Community College, and Cornerstone College. After obtaining her Associate’s Degree in Nursing (ADN) Lyn knew that she wanted to work in the Emergency Department (ED). After obtaining her ADN she took a position at Metro Health Hospital as a Registered Nurse on a telemetry floor. She worked as a floor nurse for six months and then transferred to the Emergency Department. Lyn worked as a staff nurse in the ED for twenty five years. She then took a position as the Emergency Department Clinical Coordinator which has been her role for the past five years. Along with having her nursing license, Lyn is a Certified Emergency Nurse and is also a member of the Emergency Nurses Association.
Job Duties
As a Clinical Coordinator of the Emergency Department, Lyn is responsible for mentoring and managing staff employees. She is responsible for performing evaluations on each staff member and performscounseling for employees who may not be performing at the expected level. She sits in on interviews for potential new hires and also is a member of several different groups including the Medication Use and Safety Committee, the Nursing Leadership Committee, and the Disaster Committee. Lyn helps facilitate patient flow and oversees daily operations of the department. Lyn reports her main job duty is being a leader by mentoring and managing staff and ensuring that policies and procedures are being followed on a daily basis. Lyn reports to the nurse manager which is Trish Coon, and if her needs are not being met she will report to the nurse director of the Emergency Department which is Helen Berghoef. Registered nurses, patient care technicians, and clinical secretaries of the ED report to Lyn. In the organizational chart, the chief executor officer is head of the hospital. Under him is the chief nursing officer, follow by each departments nurse director. Under the nurse director is the department nurse manager. Lyn falls under the nurse manager in the organizational chart. Under the clinical coordinator would be the staff nurses.
Collaboration
The nurse leader should work as a team to promote positive outcomes for the patient and their family. Collaboration and working together with the patient, their family and the healthcare team is required in the nursing profession and almost automatic (ANA, 2004). Lyn collaborates with other nursing units such as the Intensive Care Unit, Surgery, Obstetrics, and the Medical Surgical Unit to ensure that patient flow and daily operations are working well. Lyn collaborates with managers of other areas and nurses by email, over the phone, or in meetings. If there is an issue that needs to be worked out she will meet with other units on a weekly basis until a solution is worked out and then the meetings will be backed down to monthly to evaluate the changes that were implemented.
Legal and ethical issues
Evidence
An example of a legal and ethical issue Lyn has dealt with was in regards to a specific patient. This patient presented to the ED on a weekly basis if not more frequently. She threatened staff verbally if she did not receive the medications she wanted and also threatened staff physically by swinging at them and pushing them into corners.
Support
The nurse leader should be delivering care in a manner that promotes the patient’s dignity and rights, while maintaining patient confidentiality. A nurse leader should also serve as a patient advocate, while maintaining a therapeutic relationship with the patient. “Respecting autonomy and promoting patient well-being – the values served through informed consent – are fundamental to good medicine” (Levine, 2010, p.8). An ethical nurse leader demonstrates a commitment to practicing self care, managing stress, and also reports incompetent or impaired practices (ANA, 2004, p. 39). Yoder-Wise states that, “ethics is an area of professional practice in which nurse leaders should have a solid foundation” (Yoder-Wise, 2011, p.83).
Analysis
Lyn became aware of the patient’s behavior and also the staff’s fear of caring for this individual. She implemented a care plan with this patient which she was required to sign stating that each and every time she presented to the ED she would have security at her bedside and that when the physicians deemed her ready for discharge she was to leave the premises and if she did not the police could be called to escort her off our hospital premises. This contract led to staff feeling more safe and comfortable when caring for this individual and also led the patient to know the expectations the department had of her and the limits she had. Implementing this care plan for this patient led to a decrease in her visits to the ED as well as an improvement in her behavior when she did present to the ED.
Use of power and influence
Evidence
Lyn is responsible for setting a good example for others and treating others and their ideas with respect and dignity. She is responsible for maintaining the highest standards of honesty, integrity, and communication while building group cohesiveness and pride through teamwork. She realizes that she is to be open and understanding to her staff in a way that they will come to her with issues and concerns. She tries to deal with issues on a one on one basis first getting both sides of the story and then trying to figure out a solution to the problem so that both sides win.
Support
Yoder-Wise (2011) talks about key factors for developing a powerful image. Having self-confidence, a positive self-image, and career commitment are all important factors for an individual to gain and build power (Yoder-Wise, 2011). A nurse leader must be able to work with other disciplines as a team in order to have the best outcomes for staff and patients.
Analysis
Lyn is a powerful nurse leader who is involved with evaluations of the staff in which she rates each staff member as a high, middle, or low performer. By evaluation time there are no surprises to the staff members because she has already connected with them and either encouraged their good behavior and attitude or has counseled the poor performers so that they have had an opportunity to change. Lyn focuses on real time interventions to problems as the best solution to having good outcomes.
Decision making and problem solving
Evidence
As clinical coordinator, Lyn is involved in many decision making and problem solving processes. Some decisions are department specific while others are hospital wide decisions. Lyn tries to have her staff have as much input as possible by sending out emails and asking for suggestions. Lyn reports a couple of incidents in the ED where babies were delivered in the ED waiting room. The ED nurses realized a problem when they did not have the supplies they needed or the education they needed. Lyn took this problem and started with the ED staff finding out what their specific needs were in this situation. She then collaborated with the OB clinical coordinator to figure out a solution to the problem. The solution was taught to the staff and safer outcomes were resulted for staff, mothers and their newborns.
Support
Problem solving and decision making are constant and ongoing. “Problem recognition and identification are considered the most vital steps in the problem solving process” (Yoder-Wise, 2011, p. 109). Yoder-Wise discusses two different styles of decision making. One being autocratic where “the nurse leader makes decisions independent of others” and the other being democratic where “the nurse leader involves the appropriate personnel in the decision-making process” (Yoder-Wise, 2011, p. 101). Lyn tries to rely on staff who are actively involved on the unit, such as charge nurses or unit base council representatives, to get their opinions.
Analysis
Lyn involves the ED staff whenever it is possible in regards to decision making and problem solving. She has found that this leads to more staff being on board with the change and more staff being satisfied with their job due to them having a say in the needs and problems of our department. Lyn reports that after any change or decision, evaluation occurs to see whether the results yielded a desired outcome or not. She reports problems solving and decision making as being a constant ongoing process.
Management and resolution of conflict
Evidence
As a leader and clinical coordinator, Lyn reports that resolution of conflict should be immediate. Lyn tries to abide with Metro Health’s best practice standards when dealing with conflict by using effective communication while treating those involved with integrity, respect and compassion. She tries to resolve conflict by not letting it happen in the first place. Lyn is involved with patient and staff rounding. She rounds on staff asking them what works well, what does not, and if there is any equipment they need in order for them to perform their job at the optimal level.
Support
“The role of the leader is to create a practice environment that fosters open communication and collaborative practices” (Yoder-Wise, 2011, p. 475). This approach allows conflict to be resolved and those involved to feel understood in the matter. How well a conflict has been resolved depends on if the goals were achieved and assessing the outcomes of the conflict. Relationships should be monitored for those involved in a conflict to ensure that there continues to be a healthy working environment.
Analysis
Patient rounding involves asking patients if their needs are being met, if there is anything else they need, and if there is anyone they would like to recognize as being a stellar healthcare professional. Rounding on patients and staff helps dissolve dissatisfaction. She also reports that being proactive helps. By not waiting for frustrations to build and explode whether it be from staff or patients she tries to recognize their needs first.
References
American Nurses Association (2004). Nursing: Scope and standard of practice. SilverSpring, MD: American Nurses Association.
Levine, Carol.Taking Sides Clashing Views on Bioethical Issues. 13th ed. New York: McGraw-Hill, 2010. 1-14. Print.
Yoder-Wise, P. S. (2011). Leading and managing in nursing. 5th Edition ed. St. Louis: Elsevier Mosby.
Grading Rubric for Analyzing a Nurse in a Leader or Manager Role
POINTS POSSIBLE / POINTS AWARDED / CommentsIntroduction Provide intro to what the paper is about and the type of area of expertise of the person you interviewed. Background on this person to include education, employment history and current role, additional qualifications for role, etc. / 10 / 10
Describe job duties 1. What are the job duties of this person? 2. What does the person state as their main job duties? 3. Where in the organizational chart do they fall – who do they report to? Who reports to them (if anyone)? / 10 / 10
Discuss the collaboration role for this manager. 1. Who does this person collaborate with in other areas to achieve goals of their job (nurses, lab, billing) 2. How does this person collaborate with mangers of other areas and nurses? / 10 / 10
Describe & analyze a legal or ethical issue this leader or manager has and is managing (include effect on patients and organization) / 10 Evidence = 2 Support = 3 Analysis = 5 / 10
Describe & analyze use of power and influence (include effect on patients and organization) / 10 Evidence = 2 Support = 3 Analysis = 5 / 10
Describe & analyze use of decision-making and problem-solving process (include effect on patients and organization) / 10 Evidence = 2 Support = 3 Analysis = 5 / 10
Describe & analyze management and resolution of conflict (include effect on patients and organization) / 10 Evidence = 2 Support = 3 Analysis = 5 / 10
Sentence structure, spelling, grammar & punctuation; APA Format / 30 / 19 / headings (-2); 1st person referencing (-1); lacked personal communication citations (-3); incorrect citation format (no conclusion (-3); spacing (-2)
TOTAL POINTS / 100 / 89