Running head: ANALYSIS OF THE NURSE MANAGER ROLE

Analysis of the Nurse Manager Role

Amanda Hubbard
Ferris State University

ANALYSIS OF THE NURSE MANAGER ROLE

The purpose of this paper is to analyze the role of a nurse manager. Tanya Jury a
registered nurse (RN) with Memorial Health Cares Home, Health, and Hospice was interviewed.
Tanya started her medical career as a medical assistant while going to nursing school. She has
been a nurse for eleven years. She was a staff nurse on a med/surg unit for five years before
switching to hospice. She started as a field nurse before moving into an intake position. Since
November she has been the manager of the hospice and at times covers home health as well.
Tanya currently holds an Associates degree in Nursing. She is two classes away from
obtaining her Bachelors degree. She plans on taking a year off and then pursuing her Masters
degree in management. She holds no other certifications. She did say that, there is a certification
for hospice but never thought it was necessary (T. Jury, personal communication, March 17,
2014). When she started her nursing career, she never thought about management being in her
future.
Job Duties
As a manager there are many roles that they are responsible for. Some of the job duties
that she is responsible for include, supervision of staff, informational visits, staffing, the budget,
chart audits, collection and reporting of data to various agencies, and education of staff. In order
to supervise staff when they go into the homes of patients she does a supervisory visit. During
the supervisory visit she follows the nurse through their visits with multiple patients. It allows
her to see where if there are any issues with care. She also audits patients charts to make sure that
staff is charting correctly. From time to time she does informational visits with patients and their
families that are trying to decide whether hospice is the right choice for them.

ANALYSIS OF THE NURSE MANAGER ROLE

The toughest part of her job duties comes from the budget, staffing and collecting and
reporting data to her supervisors along with other various reporting agencies. Although she has
not dealt with preparing the hospice budget for the current fiscal year, she stated that it is difficult
to stay within such a small budget. Staffing is the biggest issue with staying within the budget.
Hospice currently employs five nurses, four fulltime nurses and one part time. There are three
nurses on each day. They rotate weekends and call. The problem she has is that there is not
enough room in the budget for another nurse, so they are getting some overtime. At other times
there are not enough patients to staff all of the nurses she currently has. Lately Tanya has been
able to have the nurses review charts and prepare for the computer upgrades. This allows the
nurses to get all of their hours if they wish.
Collaboration
Tanya collaborates with several disciplines within the hospice community and others
when she covers home health. Hospice collaborates with social work, spiritual care, various
nurses and managers on floors at the hospital, doctors, nurse practitioners and physician
assistants. In home health she collaborates with a lot of the same departments as she does with
hospice but also collaborates with physical therapy, lab, and radiology.
Home Health and Hospice is not located within the hospital like all of the other services.
Therefore, Tanya has to use other means to collaborate not only with her staff but the managers
of the other areas she has contact with. The biggest way that she speaks with her staff and other
managers is through Outlook. She can email her staff and managers through that. With her staff
she texts them on the company phones. If the situation warrants, Tanya will call the manager and
discuss the issue or request a meeting to clear up the issue.

ANALYSIS OF THE NURSE MANAGER ROLE

Legal or Ethical Issues

Hospice can have many legal and ethical issues throughout the practice. Death and dying
are very much in the forefront of media coverage over its issues. Since Tanya is such a new
manager, she has not had to deal with either of these issues in her position as a manager. She did
say that there are always ethical issues within hospice. As a nurse she saw cases where some of
the family felt like the others were trying to kill the patient by placing them in hospice. There
were also cases where the family member that had the power of attorney was trying to hasten the
patients death in order to receive monetary gain. As a nurse she would explain to family
members that hospice was not about killing the patient but making sure that they were
comfortable until they passed away. That usually would get the family members to a point where
they could accept the situation. Tanya also said that at times the manager was called in and then
the ethics board at the hospital when family members could not agree. She has not had to
participate in an ethics hearing in her career and is unsure how it works.
As far as Tanyas legal and ethical practice as a nurse manager goes, there is a lot of
uncertainty that could be had by staff and patients. According to Yoder-Wise (2014), In ethics,
there are no right and wrong answers, just better or worse answers, and nurses seek mentorship
and counseling from nurse managers when they encounter difficult situations, (pg. 91).
Although this knowledge could easily be obtained, until a situation occurs, Tanya may have a
hard time leading her team of nurses in ethical issues. The effects of this on patients, staff and
organization could have untoward effects. Patients and families would have difficulty getting the
issues resolved and staff would not be able to turn to their manager for questions or concerns.
Use of Power and Influence

ANALYSIS OF THE NURSE MANAGER ROLE

Power and influence can have and used to have negative connotations. Power and
influence does not have to mean control or bullying. According to Merrium-Webster, influence
is, the power to cause changes without directly forcing them to happen, (MerriumWebster.com). Tanya although new to the management arena, has used her power and influence
to help her patients, family members and peers. She uses her experience to educate which in
turns influences the people she is educating. Sharing knowledge expands ones power and in
turn empowers others, (Yoder-Wise 2014, pg. 181). She empowered her patients, families and
peers by educating them.
There are many types of power. Some managers possess many of them while others only
a few. Tanya could have personal power just like any person can have based on her reputation
and credibility. She does have some expert power based on her length of time in the hospice
department as a nurse. Position power, perceived power, informational power, and connection
power may be something she does not have as of yet. With her being a new manager, power may
not be something that she feels about herself but could come with time in the position.
Use of Decision-making and Problem-solving
Decision-making and problem-solving is not the same thing but are both used together.
Decision-making by a manger can help to empower both staff and patients depending on how it
is done. Tanya makes decisions based on the situation. At times she will make the decision
without any input from staff and at other times she will seek out their opinions. It depends on if
the decision needs to be made right away or if there is time to have staff members put in their
own thoughts.

ANALYSIS OF THE NURSE MANAGER ROLE

Tanya, when encountering a problem will break the problem down into smaller pieces in
order to come up with a solution. As with decision-making, there are times where she does this
on her own and times where she has staff bring in their ideas and thoughts. She does use the fishbone method especially with the staff to help solve the problem.
Tanya does not use just one decision-making style but two. She uses both an autocratic
style and a democratic/participative style. A manager who leans toward an autocratic style may
choose to make decisions independent of the input or participation of others, (Yoder-Wise 2014,
pg. 103). She uses this style when there is no time to get staff input. She also uses the democratic
style when allowing the staff to participate in decisions that affect them. All of this shows that
she uses the optimizing decisionmaking model. In this model, the decision maler selects the
option that is best, based on an analysis of the pros and cons associated with each option,
(Yoder-Wise 2014, pg. 103).
Management and Resolution of Conflict
Resolution of conflict does not have to involve management. Staff members that can
resolve their own issues are better at working together as a group. Tanya has not had a lot of
conflict issues to deal with. However, she would let staff try and work it out among themselves.
If that is not successful then she would meet with the individuals and help them to resolve the
issue. Her hope being, that staff can work together to be a cohesive team.
With Tanya being a nurse that came from the hospice department, she already knows her
staff well enough to figure out where most of the conflict lies. She has the ability to help the staff
communicate with each other to resolve conflict issues. Nursing managers need to support their
staffs use of effective conflict-management strategies by modeling open and honest

ANALYSIS OF THE NURSE MANAGER ROLE

communication, including staffing decision making, and securing resources that meet the staffs
need in delivering quality care, (Yoder-Wise 2014, pg. 475). By allowing staff to resolve the
conflict on their own or with help from her sets the tone for resolving conflicts for the
department. Knowing when to step back and when to help her staff shows that she knows how to
lead.
By interviewing a manager one can gain insight into how they lead. Analyzing the
process that managers take with staff, coworkers, patients and families in various management
duties shows how the decisions are made and problems are solved. Lack of experience in a
management role can impact the organization in which they work for. The knowledge that great
leaders and managers have can be learned and applied to practice areas. Managers are not born
overnight, the grow with knowledge and leadership.

ANALYSIS OF THE NURSE MANAGER ROLE

References
Merrium-Webster Dictionary. Retrieved from: http://www.merriumwebster.com/dictionary/influence.
Yoder-Wise, P. 2014. Leading and managing in nursing. St. Louis, Missouri: Elsevier Mosby.