Running head: 5 SOUTH: ONCOLOGY

5 South: Oncology
Andrea J. Crapsey, Lindsay M. Johnson
Ferris State University

5 South: Oncology

5 SOUTH: ONCOLOGY

Yoder-Wise (2000) defines a manager as one who addresses complex issues by

organizing, planning, budgeting, and setting target goals; they meet their goals by organizing,
staffing, controlling, and solving problems (p. 55). 5 South is an oncology unit at Butterworth
Hospital in Grand Rapids, Michigan. Knight, the manager of 5 South, had a great deal of insight
about the ins and outs and day-to-day work of the manager role. As the manager of a busy
oncology floor, Knight has many responsibilities and finds ways to manage her many roles and
have great camaraderie with the staff on her unit.
Knight has a Bachelor of Science in Nursing (BSN) degree, which is the standard for
managers at Spectrum Health. She has been the manager of 5 South for eleven years total, but
started her relationship with the unit as a nurses aide, moving to nurse extern in 1992, then a
staff nurse, and finally the manager in 2004. The longstanding relationship with the unit makes
Knight a great manager because she has been present for the evolution and many changes of the
unit over the years. She has seen many positive changes that have made the unit the cohesive
floor it is today. In an article by Seagraves (2010), she mentions that staff are blooming where
theyre planted, Knight is a great example of a staff member who has evolved with the
company, as Spectrum Health has evolved from employee recruitment to retention (p. 12).
Role and Responsibilities
The role of the manager includes ensuring that the day to day operations of the unit are
completed, while problem solving for issues that are not working for the unit. Being in the role
of manager of a unit at a large Magnet hospital comes with many responsibilities. A big
responsibility is to keep a pool of staff for the unit - keeping enough staff nurses to effectively
care for patients is important. Knight is responsible for hiring and firing staff for her unit and
she works closely with the Human Resources department to complete these processes. Also

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needed on the unit are nurse technicians who must have a passion for the care they deliver and
collaborate with the nurses. Finally, unit secretaries are pertinent to the flow of the days on the
unit. They handle phone calls, help nurses stay organized, and greet visitors among many other
tasks they complete each day.
Making sure that staff are up to date on education is another responsibility that falls on
the manager. Knight is responsible for seeking out educational opportunities for the staff and
collaborating with the nurse educator to be sure that the staff are completing this education. As
an oncology unit, the most current evidence based practice is of utmost importance. Knight
works diligently to ensure her nurses, nurse technicians, and other members on the treatment
team are aware of the ever changing practices. Education based on evidence-based care is
something that Knight seeks out for her staff, as she knows this will promote the best care given
to the patients in return. Along with Knights many other roles as a floor manager, she
collaborates closely with a Clinical Nurse Specialist and Nurse Educator to keep the floor up to
date on evidence based practice.
Another main responsibility of Knights is to be involved in budgeting for the unit. This
involves budgeting for adequate staff, necessary supplies, and the occasional reward. Correlating
with charge nurses to ensure that staffing is being completed properly is essential. Supplying the
unit is also extremely important. As Knight mentioned, she loves when the hand sanitizer bill is
a little high because this means that her staff is following protocol! Knight admits that the
budgeting responsibility of her job is a constant learning process - its difficult at times. In an
article written by Kathy Douglas (2010), she explains that nurse managers often struggle with
budgeting for their units - they did not go to school for financial advising and budgeting. She

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argues that this responsibility should not necessarily fall on nurse managers as much as it does but, that nurse managers do need more education on budgeting (p. 270).
The American Organization of Nurse Executives: Nurse Executive Competencies
The American Organization of Nurse Executives: Nurse Executive Competencies, also
known as the AONE NEC, sets the standard for what a nurse manager and leader should be.
This organization has laid out the qualities for leaders, which are also something that a manager
should possess. According to the AONE (2015), The AONE Nurse Executive Competencies
detail the skills, knowledge, and abilities that guide the practice of nurse leaders in executive
practice regardless of their educational level, title or setting (p. 2). Knight possesses qualities
that reflect each of the categories that the AONE has laid out and implements these toward her
staff as well.
Communication and Relationship Building
After interviewing Knight, it is evident that she has excellent communication skills.
According to the AONE (2015), for a leader to portray effective communication they have to
facilitate group discussions and demonstrate skill in interpersonal communication (p. 3).
Knight excels at this as she approaches the team on 5 South to gather their opinions and
comments on topics affecting their unit. In helping with a new Bone Marrow Transplant unit,
Knight takes opinions from the staff about things they believe should or should not be
implemented as they are working first hand in the environment. The AONE (2015) also
recommends that leaders should manage relationships by building collaborative relationships,
exhibit effective conflict resolution skills, and create a trusting environment (p. 3). One way
Knight portrays a trusting environment correlates directly with her conflict resolution skills. She
mentioned a time in particular about a patient requesting to not have a specific nurse, she talked

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to the nurse openly to see why the patient would have made that request. She allowed the nurse
to explain the relationship with the patient and did not make the nurse feel at fault for the issue.
Knowledge of the Healthcare Environment
Running an oncology unit would be a challenge for anyone, but Knight is able to succeed
because of her vast knowledge of the environment specific to her field of work. Knight is
assisting to open a new Bone Marrow Transplant (BMT) unit because of her knowledge of the
environment these patients require. Quality improvement is achieved by Knight because she has
years of experience working with this patient population. She is able to adapt new practices
from her own experiences and feedback from staff on the unit. To open a new BMT unit, Knight
took all of the practices that worked and didnt work on 5 South and will use these strategies to
run the new unit. This demonstrates quality improvement (AONE, 2015, p. 5).
As she analyzes the processes that work well, Knight is also looking at issues that could
pose a risk for her unit. According to the AONE (2015), problems such as non-compliance or
lack of education for staff, patient safety issues, or errors that are happening with medications or
equipment could pose a liability problem (p. 6). Assuring that staff education is completed and
that staff are properly using medications and equipment is a large responsibility of Knights to
avoid liability. Additionally, looking for early warning signs of processes that are not working
will help Knight to fix problems before they arise, again, avoiding liability.
Leadership
A leader should portray foundational thinking skills, personal journey disciplines,
systems thinking, succession planning, and change management (AONE NEC, 2015). For
personal journey disciplines, the leader should learn from personal setbacks and failures as well
as successes (p. 7). Not only is she helping in the creation of the new BMT unit, she helped

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design the unit 5 South is today. She takes the experiences that are difficult on 5 South due to the
way the floor was modeled and takes it into consideration with the remodel. For change
management, the leader adapts leadership style to situation needs (p. 7). Knight mentioned
that she has to adjust the way she leads different staff. For example, different generations need
to be motivated in different ways. Knight says this can be a difficult part of her job some days.
Professionalism
The AONE NEC (2015) states that for professionalism, the leader should depict personal
and professional accountability, mindfulness of ethics, and be an advocate. Knight mentioned a
great example for being an advocate for patients on her floor of 5 South. She expressed that
many of the patients on the unit are fall risks related to medications and chemotherapy. There
was a patient on the floor who was a fall risk, but for reasons strictly like medications and was
not portraying physiologic reasons for needing to be a fall risk. The nurse was not willing to take
the patient off fall risk precautions until Knight mentioned that at this point, we are negatively
impacting the patients care because we are inconveniencing them. They were safe to be taken
off fall risk precautions as the medication was not adversely affecting them. Also, while Knight
holds herself to professional standards, she expects the same of her staff as they represent her
directly.
Business Skills
One aspect of Knights role that she truly enjoys is her collaborative work with the
Human Resources Department and the task of interviewing and hiring potential employees. By
participating in workforce planning and environment decisions she meets the AONE NEC
guidelines for business skills (2015). From Knights perspective, it is crucial that she take part in
this process as she knows her staff best and who will collaborate well with them. Another part of

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this requirement is the implementation of a healthful workplace environment (AONE NEC,

2015). Knight stated she understands that life can get in the way of a career sometimes and she
understands that the patients come first and that sometimes that means that a nurse take some
time off to deal with personal life problems so it does not interfere with the care they provide on
the floor. This leads to a healthier workplace environment because it helps the staff not let their
personal lives interact with their professional life and, ultimately, to not let the patients care be
sacrificed.
Conclusion
From a student nurse perspective, Knight is an exemplary role model and leader for the
unit of 5 South. She exceeds the expectations of the AONE NEC and goes above and beyond for
her employees. She also works diligently to achieve her roles and responsibilities to ensure that
the patients of 5 South are receiving the safest and most up-to-date practices known. Knight is a
leader that nurses can look up to and seek out for advice, guidance, and support in their nursing
practice. Education and patient advocacy are at the top of Knights priority list, so patients on 5
South are receiving care on an evidence-based basis. Patient safety is constantly looked out for,
which is another reason Knights practices are commendable. With many qualities that fulfill
each category of the AONE NEC best practice standards, communication, knowledge of the
health care environment, leadership, professionalism, and business skills, Knight is a manager
and nursing leader that has developed her own career and the careers of her staff and has kept
patients at the center of care on 5 South.

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8
References:

Douglas, K. (2010). Taking action to close the nursing-finance gap: Learning from success.
Staffing Unleashed - Nursing Economics, 28(4), 270. Retrieved from
https://www.nursingeconomics.net/necfiles/staffingUnleashed/su_JA10.pdf
Seagraves, K. B. (2010). Growing in your nursing career. 2010 Nursing Career Directory, 40(1),
12-14. Retrieved from http://www.nursingcenter.com/journalarticle?Article_ID=959743
The American Organization of Nurse Executives. (2015). Nurse executive competencies. AONE
The Voice of Nursing Leadership, 2-10. Retrieved from
http://www.aone.org/resources/nec.pdf
Yoder-Wise (2015). Leading & Managing in Nursing (6th ed). St. Louis, MO: Saunders.