Running head: ANALYZING A LEADER

Analyzing a Leader
Emily Ebright, Amanda Guy
Ferris State University

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Analyzing a Leader

The purpose of this paper is to interview and then analyze a person in a manager
role located in our clinical facility. Amanda Bourdon BSN, a loyal employee to Spectrum
Health Butterworth Hospital, is the nurse manager on unit 2 South, a
ortho/neuro/progressive floor. Bourdon has spent almost half of her life working on this
floor, 13 years. When asked her employment history, she responded saying unit 2
South was the only place she has ever worked. Bourdon has had many different job
titles while working on this floor, which include a volunteer, nurses aid, registered nurse,
charge nurse, nurse manager, and a unit supervisor. The higher the job title, the higher
the level of education she had to complete. To be able to work as a registered nurse,
Bourdon had to attend Grand Valley University's nursing program to receive her
bachelors degree in nursing. Bourdon is in the process of continuing her education to
receive her masters degree, so she is able to keep her job as a nursing manager. Not
only is Bourdon a loyal employee, she also provides great leadership skills to the unit by
providing management and support to all of the staff members. Another qualification for
the role of a nursing manager include being certified as an orthopedic nurse, which
Bourdon has already accomplished.
Roles and Responsibilities
While Bourdon has many job titles her main role is a nursing manager. The main
role for a nurse manager is to be able to guide and support all employees on the unit
to provide safe and effective care to all their patients. There are many other roles and
responsibilities that the nurse manager must address. Bourdon is responsible for the 2
South unit twenty-four hours a day, seven days a week. She must work collaboratively

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with other managers, directors of nursing, physicians, nurses and patient care staff to
improve patient outcomes, quality of care and safety goals. Hiring, retaining,
disciplining and termination are also her responsibilities. On the organizational chart
Bourdon is considered a mid-level manager She manages eighty-five employees who
all report to her, she reports to Linda Shultz, a director who is responsible for Bourdon
and six other managers. Linda Schultz reports to the chief nursing executive, Shaun
Ulrich.
When researching organizational structures, the authors believe that this unit
follows the line and staff structure. According to Smriti Chand Organization, Spectrum
Healths staff is set up in a line and staff fashion, as are most large companies (2015).
Line personnel are responsible for performing care tasks and then the staff
personnel act as resources to line personnel; they provide assistance with quality
control measures, maintenance, finance, and information management (2015). In this
type of organizational structure, communication needs to be open and there needs to be
a large amount of teamwork to ensure that tasks are completed.
Communication and Relationship-Building
American Organization of Nurse Executives (AONE) states, that managers at all
levels must be competent in communication and relationship-building, which include
effective communication, relationship management skills, and the ability to influence
behaviors of others (2011). One example of effective communication is when a
manager is able to work together with other interdisciplinary teams in meeting a
common outcome (2011). On patient satisfaction surveys, patients rated the floor
poorly on patient education when dealing with medications. To fix this problem,

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Bourdon paired together with the hospitals pharmacy and developed a pocket sized
book of medication cards that could be hung up in the patients room. This made it easy
for a simple resource to be readily available for both nurses and patients. Positive
feedback on patient satisfaction surveys increased after medication cards were
implemented.
After effective communication is established between a manager and their
employees, a relationship starts to form. One way Bourdon creates relationships with
her staff members is that she offers them to accompany her to a monthly retainment
meeting. These meetings allow staff members to communicate outside of the stressful
working community. One example of a retainment meeting is when Bourdon put on a
taco dinner at the Renucci house. She states that the goal for retainment meetings is
team bonding exercises. They get her staff members to create a better team dynamic,
which in turn creates a stronger more efficient team. The better the employees work
together, the better and more efficiently things get done on the unit. She believes a
good team dynamic leads to better patient outcomes in the long run.
A manager-staff relationship opens up the opportunity for a manager to be able
to influence staff behaviors. Bourdon influences her staff members by rewarding
appropriate behaviors. Incentive programs that Bourdon offers create influential
behavioral changes. For example, when Spectrum Health switched over their call light
system to a no pass zone, some of the employees had a hard time dealing with this
change. Bourdon used an incentive program stating that the employee with the most
answered call lights in a week would get a reward. This prompted employees to start

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adapting to the change, which in turn created better patient care. Employees with the
most answered call lights at the end of the month got gift cards of their choosing.
Knowledge of Health Environment
Quality Improvement
Organization wide benchmarks are set in order to improve quality; managers
need to make changes to meet these goals. Bourdon helps to implement quality
improvement by working with staff to set clear goals to improve the care being given to
patients. Recent quality improvement projects have included increasing patient safety
by decreasing the number of falls and increasing patient satisfaction by implementing a
no pass rule for call lights. A group of nurses and nurse technicians was created to
brainstorm ways patients could be safer concerning fall risks. The group developed
some rules that should be followed while a patient is considered a fall risk including
wearing a gait belt when walking or transferring; the care provider is within arms length
of the patient, especially in the bathroom, and ensuring that bed alarms are on before
leaving the patients room. These changes in care were implemented specifically to
decrease patient falls; the goal was for the unit to be free from a fall for 30 days.
Patients reported their needs were not being addressed quickly enough when a call light
was used. In order to help increase satisfaction, a new practice was implemented that
stated that caregivers could not pass a call light without addressing the patients need,
whether it was their patient or not. If the person that answered the call light was not
able to meet the need of that patient, the caregiver needed to immediately follow up with
someone who could. These changes were developed in order to increase patient
satisfaction and safety.

ANALYZING A LEADER

Patient Safety
One way a manager can make sure patients are getting safe and effective care is
to ensure that staff are clinically competent and trained in their role in patient safety
(2011). On Bourdons unit she makes sure all employees complete their facility clinical
competencies. Bourdon also makes sure that all employees know when competencies
are due by posting informational flyers in centrally located staff locations (i.e. break
rooms, charting areas, nursing station). Bourdon hosts all informational meetings when
the hospital has to change its policy or procedure guidelines due to new evidencedbased research. These informational settings include teaching staff on how to handle
the equipment when dealing with patient care. Staff members must be checked off on
how to use each new equipment piece. This will reduce the risk of error and promote
safe and effective care to patients.
Leadership
Change Management
Change in health care is a never-ending process. When change occurs
Bourdons unit, it is normally when new evidenced-based research suggests a new
procedure or policy implementation. Even though change is a never-ending process,
staff members have a difficult time transitioning between the new practice and what
used to be best practice. According to AONE, managers must be responsible to serve
as a change agent and assist employees in understanding the importance, necessity,
impact, and process of change (2011). Every time a change occurs on 2 South
Bourdon makes it a point to inform all staff members, have a meeting with them, and

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describe why this change is being implemented. Bourdon states that staff members are
more receptive to change when they know why it is occurring.
Personal Journey Disciplines
Through her development on the floor, Bourdon has been in many roles. As a
floor nurse she stated that she never saw herself advancing into management. After the
director encouraged her, she considered a position in management. Bourdons thirteen
years on the floor have given her the foundation of necessary skills that she needed to
start into leadership. When the nurse manager role opened, she decided to apply to the
position. After being in the role for a short time, she has been able to develop a routine
and modify her skills to fit the requirements of the position. She promotes the idea of
lifelong learning and goal setting by telling her story of personal growth throughout her
time on the ortho/neuro/progressive floor. She spoke of going back to school to pursue
a masters in nursing in order to further prepare her for her current role.
Professionalism
Advocacy
Professionalism is an important attribute for leaders to have. It allows them to
handle tough situations with respect and grace. Bourdon advocates for her nurses by
promoting the own the change philosophy. As a leader she works with her staff to help
develop and implement change in procedures and policies. Instead of her being
responsible for the entire change process, she mediates teams and allows them to
develop the changes, while being a background resource. By allowing groups of clinical
nurses to affect change, the change is more efficient and can be easily fit in a daily

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routine. When owning change, staff members are more motivated to implement the
change and will help motivate and educate others to participate in the change.
Evidence- Based Clinical and Management Practice
As a nurse leader with twenty- four hour responsibility to the unit, Bourdon must
educate her staff properly on new evidence. Educating staff on new clinical
developments keeps practice current and appropriate. New developments are used to
promote good outcomes for patients and ensure they receive the best quality of care.
As stated above, Bourdon educates staff by ensuring facility competencies are
completed and that new equipment and tools are practiced on before being used on
patients. Yoder-Wise states, that the manager should be aware of staff members
knowledge, skills, and completion of competencies. As a nurse leader, she can be
liable for malpractice if a nurse under her supervision makes a mistake. If the manager
deliberately allows a caregiver to practice below satisfactory guidelines, the manager is
putting both themselves and the facility at risk of liability. She has to ensure that she is
distributing and promoting education on proper care practices in order to protect the
patient and the facility. Managers have the responsibility of ensuring staff members are
practicing safely and competently (Yoder-Wise, 2015).
Business Skills
Human Resource Management
Human resource management is the process of hiring and developing
employees so that they become more valuable to the organization (Human Resource
Management, n.d.). In the event that an employee does not meet certain standards of
the organization, the manager must be comfortable in addressing the situation.

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Spectrum Health has a three step discipline correction plan. In this three step plan, a
crucial conversation occurs. Bourdon explained a crucial conversation as a
conversation that peers have about a problem when the problem occurs. This
addresses the problem promptly and professionally while allowing it to be corrected in a
timely manner. A crucial conversation happens in the first step of the discipline
correction plan; it is considered a warning for the employee. The second step consists
of the opportunity for the employee to resign from his or her position or stay and
develop a plan to improve practice. If the employee does not correct the action, he or
she proceeds to the third and final step, and termination occurs.
Employee Decision Making
To increase staff satisfaction rates, managers must be receptive to their ideas
when it comes to how things are addressed on the floor. Bourdon states that she is
very receptive to staffs ideas, and she has had the opportunity to implement many of
them. Employees have the opportunity to express their ideas in monthly staff meetings
with Bourdon. If a staff member has a process improvement idea, a team is formed,
and they are responsible for finding research to help develop a best practice change.
Ideas are implemented only if they are proven to be safe, effective, and evidencedbased research. For example, a group of nurses were concerned with the lack of a
standardized bowel program for the unit. The problem was patients were becoming
constipated after surgical procedures and scheduled narcotics, and there was no
specific bowel policy to implement when this occurred. Nurses were concerned that
proper steps were not taken when patients werent able to have bowel movements.
They then brought it to attention; a group of people researched it, and a bowel protocol

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was implemented on the floor. This protocol was standardized to be used on all
patients in order to improve quality outcomes.
Conclusion
Though we will not be in charge of an entire unit as nurses, we will need to
develop our leaderships skills in order to effectively lead care teams and be role models
for others. Bourdon provides many examples of skills and qualities a new nurse should
strive to learn. Conflict resolution, the ability to have crucial conversations, innovative
change, and teamwork are some examples provided by her during the interview. Ability
to change is one of the most important skills a nurse can have because the healthcare
field is constantly changing as are patient conditions. Nurses need to be prepared to
change to stay current. We learned that floor nurses are accountable for many changes
in practice in order to improve process and patient outcomes. It will be our job, as new
nurses, to help to make these changes and support implementation.

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References

American Organization of Nurse Executives.(2011).The AONE nurse executive

competencies. Chicago, Il: The American Organization of Nurse Executives.
Human resource management. (2015). In Business Dictionary online. Retrieved from
http://www.businessdictionary.com/definition/human-resource-managementHRM.html
Smriti Chand Organization. (2015). 8 Types of organizational structures: Their
advantages and disadvantages. The Next Generation Library. Retrieved from:
www.yourarticlelibrary.com
Yoder-Wise, P.S. (2015). Leading and managing change in nursing. St. Louis, MO:
Elsevier.