Running head: NURSE MANAGER

Analysis of a Nurse Manager

Kimberly Nix
Ferris State University

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Elishia Stillwell a Nursing Supervisor at Spectrum Health Reed City Rehab and Nursing
Center in Reed City Michigan; was asked questions concerning cultural diversity, legal and
ethical issues, power and influence, decision making and problem solving, and resolution of
conflict. She was interviewed regarding her management styles and duties in her current
position. The information gathered in the interview was analyzed using the book Leading and
Managing in Nursing by Patricia S. Yoder-Wise on her management techniques.
I would like to introduce Elishia Stillwell, RN. Elishia graduated from Morley Stanwood
in Morley Michigan in the year 2000. She went on and attended Ferris State University from
2000-2005 studying nursing. During her last year at Ferris State University she worked as a
Nurse Extern at Spectrum Health Big Rapids Hospital. She left Ferris State University in 2005
and transferred to Montcalm Community College and obtained her Licensed Practical Nursing
(LPN) degree in 2006. She worked at Metron Nursing Facility in Big Rapids Michigan as a LPN
in 2006. She felt she needed more experience and chose to leave Metron and try her nursing
skills at Grand Oaks Nursing Facility in Baldwin Michigan. She felt overwhelmed and didnt
feel like she was utilizing her skills as much as she would have liked. So, after a few months at
Grand Oaks, she decided to leave. She applied and was offered a LPN position at Holland Home
in Grand Rapids Michigan. She was employed there from 2006-2008. She liked working at
Holland Home and felt like she was developing her nursing skills. She enjoyed her job but again
felt like she was missing something. She decided to try home health care. She became a private
duty nurse for a little girl that had epilepsy. She was seven years old and Elishia adored this little
girl. She cared for her from 2008-2009. While working as a LPN; she decided to further her
education and attend Montcalm Community College and obtain her Register Nurse (RN) degree.
She succeeded and obtained her RN degree in 2009. It was a difficult decision, but she chose to

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leave private duty and apply at a local hospital. Elishia began her employment at Spectrum
Health Reed City Rehab and Nursing Center (SHRC-RNC) in 2009. She started out as a floor
nurse caring for approximately 26 patients. Some of her duties included; overseeing nurse aides,
passing medications, dressing changes, admitting and discharging patients; and communication
with the physician. She was promoted to Clinical Care Coordinator (CCC) shortly after
beginning at SHRC-RNC. Some of her duties included; overseeing the floor nurses, insuring the
staff have all the tools they need, and assisting the clinical supervisor. Stillwell was then
promoted to Clinical Supervisor. In this role she directly reports to the Director of Nursing. She
works closely with the staff and assists the Director of Nursing. She collaborates with other
supervisors throughout the facility.
Legal and Ethical Issues
Evidence
According to Stillwell, nursing supervisors have to deal with many legal and ethical
issues. Most of the legal and ethical issues that she deals with involve her staff members. Some
of the issues she has had to deal with include employees signing out narcotics for a patient and
taking the medication for themselves, interventions that were charted on patients that never
happened, and employees giving a wrong medication to a patient. In order to fix issues like
these, it takes a lot of time and dedication. Although I dislike punishing my employees it has to
take place in order fix the problem said Stillwell (2014). Stillwell states in order to take the
appropriate action it is important for her to put aside the friendships, and take care of the
situation because it is jeopardizing and/or harming a patient.

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Support
According to Yoder- Wise Malpractice also known as professional negligence is the
failure of a person with professional education and skills to act in a reasonable and prudent
manner (p. 76). One of the roles of a nursing supervisor includes making sure that all employees
are following the nursing standards of care such as the Nurse Practice Act and Common Law
developed by both the federal government and state government (B. Sonny Ball, 2009). Injury
describes the finding of physical harm to a patient that had resulted in injury to the patient.
Damages describes that the injured patient would be able to prove that he/she has been harmed in
some way (Yoder-Wise, 2014).
Analysis
One of the issues that Stillwell has most recently dealt with is drug abuse. The situation
that was presented consisted of a staff member who had signed out a narcotic for a patient and
was taking the medication herself. In this case of malpractice the element of damages was
described due to the staff member causing financial harm to the patient by taking out narcotics
under their name and taking them home when the patient themselves were not receiving the
medication (Yoder- Wise, 2014). Duty owed to the patient is disrupted because they are not
providing the highest quality of care for the patient even though it may look like they are in the
charting. They may also be causing the patient more harm by not having the patient do the
appropriate interventions for their specific disease/illness (Yoder- Wise, 2014).
Power and Influence
Evidence

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Stillwell stated that she does not agree with using ones power to influence her staff and
piers, but then on the other hand she states that power can help to influence people. It is
important as a supervisor to maintain a powerful image and set this image for her employees.
Stillwell states that it is important to have a good self- image, be well groomed and
professionally dressed, have proper manners, use correct body language, and speak with
confidence using correct grammar. These are all important qualities although the most important
quality for a supervisor to have is a good self- image. Stillwell maintains a very powerful image
and is very knowledgeable and confident in her work and shows it. She treats her staff, patients,
and peers with courtesy and respect. She demonstrates correct grammar with a strong variety of
vocabulary and confidence.
Support
The definition of power means to be able; therefore power is the ability to influence
others in order to achieve goals. According to Yoder- Wise 2014, having a high status position in
an organization immediately provides stature, but power depends on the ability to accomplish
goals from that position. Another aspect of power is knowledge; someone may be very
knowledgeable, but if they do not share the knowledge or act on it then the power tends decline.
In order for supervisors to be able to assess and evaluate situations it is important for them to
have good listening skills. It is important for a supervisor to believe in themselves as being a
powerful person and others will tend to view them in the same manner. The key factors of a
powerful image include: self- image, grooming and dress, good manners, body language, and
speech (Yoder-Wise, 2014).
Analysis

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Stillwell is a powerful person she demonstrates the qualities that powerful people use to
set the correct image for her peers. Stillwell has developed a powerful image for her staff and
peers, which is very important in a supervisor role in order to gain respect from others.
According to Yoder- Wise knowledge is power. Stillwell uses her knowledge to be viewed as
powerful because she continues to be educated and knowledgeable about new health topics.
Decision Making and Problem Solving
Evidence
In the decision making process Stillwell knows that some of the decisions that she has to
make will impact her staff, so she believes that it is important for her to involve her staff
members in the process. This will allow her staff members have a say about what is going to
happen and they will be much more open to the changes. When asking staff member she can get
different views and it will help her to come up with one decision from all the different opinions
that she has gathered. She is not always aware of the different issues that are happening on the
floor and the way she finds out is by asking the floor nurse for their opinions. Stillwell also
stated that some of the decisions that she needs to make as a supervisor will take place without
seeking input from her staff. These types of decisions are usually decisions that she has to make
on the spot and does not have the time to seek the input from her staff or involve other staff
members which require her to keep the issues confident.
Support
According to Yoder- Wise decision making is a purposeful and goal directed effort that uses a
systematic process to choose among options. While problem solving consists of a step to
decision making that involves solving a problem immediately which is defining the difference

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between what something is and what something should be. Democratic decision making can
increase the morale, motivation, and creativity of staff members, then on the other hand it can be
very time consuming and less efficient.
Analysis
Stillwell demonstrates that she uses both the democratic and autocratic styles of decision
making. She uses the democratic style most of the time by involving her staff to be active in the
decision making process. She states that by using this style that it allows for her to be much more
open to change and motivated because they were involved in the decision. Using this method
helps to get different points of views from the staff members who are working on the floor and
will be the ones implementing these decision into their practice. Stillwell uses the autocratic
approach sometimes when she needs to make decisions on the spot and does not have the
available time to seek input from her staff. Some of the decisions that she makes involving her
staff have to be autocratic in order to keep their confidentiality. It is important for supervisors to
use a variety of decision making styles in order to adapt to the needs of the different types of
decisions that need to be made in this type of position.
Resolution of Conflict
Evidence
Stillwell usually prefers that issues between staff members to be worked out between the
members who are involved. When that approach does not work then she will step in if needed.
Another situation is when a patient states that they have not been happy with the care that they
have received from a staff member. This may cause an issue between the patient and the hospital

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and it is important to Stillwell to listen to the patient without being defensive and being open by
validating the patients feelings (Rust, 2014)
Support
Intrapersonal, interpersonal, and organizational conflicts are three types of conflict that
can occur. Intrapersonal conflict occurs within a person, while interpersonal conflict refers to a
person realizing that everyone sees the world in different ways and not how the person sees
something. Organizational conflict happens when someone confronts a facilities/organizations
policies and procedures for patient care and personnel and has accepted the norms of behavior
and communication (Yoder-Wise, 2014). Avoiding, Accommodating, and collaborating are all
different approaches to deal with conflict. People being cooperative and assertive by analyzing
the situation and defining the conflict at a higher level which involves the people involved to
identify the issues and commit to working as a team to solve the conflict (Rust, 2014)
Analysis
Stillwell uses both the avoiding and collaborating methods when dealing with conflict.
She states that when there are issues between staff member that they need to work things out
between themselves without her involvement. This refers to the avoiding approach and Yoder Wise states that this type of approach is appropriate when the conflicts are temporary and trivial.
Collaboration allows for people to work together openly and creatively find a solution that will
satisfy both of the people involved.