Running head: ANALYZING A LEADER OR MANAGER ROLE

Analyzing a Leader or Manager Role Joella M. Show Ferris State University

ANALYZING A LEADER OR MANAGER ROLE Analyzing a Leader or Manager Role Interview I interviewed Amy Barnhart RN, Nurse Manager of Medical Oncology, at MidMichigan Medical Center-Midland for my Analyzing a Leader or Manager Role assignment. A. Barnhart

worked at Sparrow as a float patient care technician (PCT) for four years. She attended Lansing Community College where she earned her Associate Degree in Nursing (ADN). She then worked for one year as a registered nurse (RN) on a general surgical unit at Sparrow Hospital. After gaining one year of nursing experience at Sparrow Hospital she moved to Midland and was hired at MidMichigan Medical Center, where she worked as a float RN. After three to five months, A. Barnhart became a night supervisor for the entire medicalsurgical patient care unit. She worked as medical surgical night supervisor for three years. A. Barnhart stated that while she was a supervisor she noticed that the medical oncology unit staff needed their own manager (personal communication, September 25, 2013). At that time medical oncology shared a supervisor with the progressive care unit (PCU). Eventually a position was created for a medical oncology nurse manager and A. Barnhart applied. A nurse with a higher degree also applied for the job and then decided to not accept the offer. A. Barnhart accepted the position as Nurse Manager of Medical Oncology. A. Barnhart has an Associate Degree in Nursing and is not currently pursuing a Bachelors or Masters of Science Degree. She believes she would have more resources to use in her position as manage if she had a higher nursing degree (personal communication, September 25, 2013). I became concerned for A. Barnhart during the interview because she is attempting to be the best manager she can, but she feels she is lacking the proper training to do an excellent job.

ANALYZING A LEADER OR MANAGER ROLE

A manager needs to be an expert in their area of management (Yoder-Wise, 2011). I was surprised to learn that A. Barnhart has worked as a registered nurse in direct patient care for less than two years. I encouraged her to continue her education immediately even if she can only handle taking one class at a time. A. Barnhart states that her goals are to continue on in school until she has a MSN (Master of Science in Nursing), to become ONC (Oncology Nursing Certified), and to make the medical oncology unit a success (personal communication, September 25, 2013). Job Duties A. Barnhart states that her responsibilities are complex, but her primary job duty is to support the fifty-eight staff including RNs, PCTs, and unit secretaries that report directly to her. A. Barnharts job responsibilities include interviewing, hiring, and paying her staff. A. Barnhart also maintains the unit budget and staff schedule. She is responsible for making sure that her staff has the supplies they need to do their job. She addresses customer service and patient issues. If staff need discipline regarding attendance or performance issues, A. Barnhart is responsible for administering the discipline. These are just some of her responsibilities as nurse manager of medical oncology. According to Yoder-Wise, the basic expectations of a manager include: establishing and communicating goals and objectives; organizing, analyzing, and dividing work into tasks; motivating and communicating; analyzing, appraising, and interpreting performance and measurements; and developing people, including self (Yoder-Wise, 2011). Caring for a patients medical needs includes many laws and ethical responsibilities. A. Barnhart is responsible for making sure she and her staff follows all governmental laws, state regulations, and accrediting organization requirements. A. Barnhart has a competency book where all of her staff has to document their ability to do the skills required to perform their job

ANALYZING A LEADER OR MANAGER ROLE description. She needs to make sure that all staff are properly trained, that staff are not performing tasks outside of their job description, and that HIPPA laws are followed. The practice of nursing is a right granted by a state to protect those who need nursing

care. Safe, competent nursing practice is grounded in the law as written in the state nurse practice act (NPA) and its rules (NCSBN, 2013). Most states have a nurse practice act that must be followed. Michigan does not have a nurse specific nurse practice act. Instead, Michigan has what is called the Occupational Regulation Sections of the Michigan Public Health Code (LARA, 2013). This health code covers regulations for twenty-five health care occupations in Michigan (LARA, 2013). According to A. Barnhart, the most common ethical issues that come up relate to end of life care (personal communication, September 25, 2013). If information relating to end of life care is not properly presented to the patient and their family many unnecessary ethical issues may arise (A. Barnhart, personal communication, September 25, 2013). End of life care requires careful communication with the patient and their family (A. Barnhart, personal communication, September 25, 2013). A. Barnhart makes an attempt to always be in the patients room when a doctor is speaking to a patient and their family on her unit about the possible decision to stop further life sustaining treatment and pursue end of life care (A. Barnhart, personal communication, September 25, 2013). A. Barnhart describes herself as assertive, but never authoritarian (Personal Communication). When staff does not have the equipment necessary to provide excellent patient care A. Barnhart assesses the situation and if she agrees that the equipment is necessary she gets the equipment as soon as possible. Recently the staff made A. Barnhart aware that there were no more urinals available for several days until a shipment arrived. The secretary called central

ANALYZING A LEADER OR MANAGER ROLE supply and verified that this information was true. A. Barnhart called several people and within thirty minutes the urinals arrived on the medical oncology unit. A. Barnhart does everything within her power to provide the staff with the equipment needed for them to provide excellent patient care.

A. Barnhart states that she uses the nursing process in her decision making. She assesses, diagnoses, plans, acts (implements), and then evaluates. She is able to naturally use the nursing process with success. According to the American Nurses Association (ANA), the common thread uniting different types of nurses who work in varied areas is the nursing processthe essential core of practice for the registered nurse to deliver holistic, patient-focused care (ANA, 2013). A. Barnhart reminds her nursing staff of the importance to use the nursing process in their daily patient care. Collaboration Role The nurse manager needs to cultivate specific characteristics in order to have long-term success as a nurse manager (Mackoff & Triola, 2008). A. Barnhart needs to create a culture of learning, a culture of regard, a culture of meaning, a culture of generavity, and a culture of excellence (Mackoff & Triola, 2008). MidMichigan Medical Center Midland has a functional organizational structure. This means that departments providing similar functions report to a common manager (Yoder-Wise, 2011, p. 147). There are several medical-surgical nursing units which include medical oncology, observation, neuro-medical, specialty surgery, and general surgery. A. Barnhart and the other medical surgical unit managers all report to Jerri Liphard the Director of Inpatient services. A. Barnhart collaborates with Jerry Liphard, director of inpatient services, Cathy Ahearn, manager of neuro-medical, Michelle Hurd, previous manager of PCU and medical oncology, and

ANALYZING A LEADER OR MANAGER ROLE Shelli Wood, previous vice president and previous chief nursing officer (personal

communication, September 25, 2013). When A. Barnhart collaborates with these individuals she often discusses her goals to increase patient satisfaction, decrease hospital readmissions, and increase staff satisfaction (personal communication, September 25, 2013). Every day the manager and supervisors in the different hospital units meet together and collaborate regarding patient census and staffing in their departments. A. Barnhart discusses with the other managers and supervisors about whether staffing is appropriate. They decide whether a staff member needs to be sent home or whether a staff member needs to be brought in to meet patient census needs. When A. Barnhart collaborates with other managers she talks with them, shares concerns, and shares ideas about the hospital and the medical oncology unit. When A. Barnhart collaborates with her nursing staff she tries to help them come up with the solution themselves (personal communication, September 25, 2013). When a conflict occurs, A. Barnhart asks the staff members to go to the individual and address the problem directly. She always listens to both sides of the story and then makes a determination regarding the matter. If the staff members are not able to work out the problem themselves then she will act a mediator for them as they try to resolve the problem. She coaches and councils the staff members. A. Barnhart states that her ultimate goal for her staff is to encourage their learning from the situation (personal communication, September 25, 2013). The medical oncology unit that is managed by A. Barnhart continues to receive reviews that show improvement and growth. A. Barnhart does not have many years of direct patient care nursing experience and she has never taken a class in nursing leadership or in nursing management. She has learned how to be a nurse manager through on the job training and mentoring by more experienced nurse managers and nurse leaders.

ANALYZING A LEADER OR MANAGER ROLE References American Nurses Association (ANA). (2013). The Nursing Process. Retrieved from http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-YouNeed/Thenursingprocess.html

Department of Licensing and Regulatory Affairs (LARA). (2013). Is there a nurse practice act in Michigan? Retrieved from http://www.michigan.gov/lara/0,4601,7-15435299_63294_27529_27542-295888--,00.html Mackoff, B. L., & Triolo, P. K. (2008). Why do managers stay? Building a model of engagement; Part 2. Cultures of engagement. Journal of Nursing Administration, 38(3/4), 118-124; 166-171. National Council of State Boards of Nursing (NCSBN). (2013). Find your nurse practice act. Retrieved from https://www.ncsbn.org/4319.htm Yoder-Wise, P. S. (2011). Leading and managing in nursing (5th ed.,pp.48-59). St. Louis, MO: Elsevier.