1 Running head: ANALYZING A NURSE IN A LEADER OR MANAGER ROLE

Analyzing a Nurse in a Leader or Manager Role Michelle M. Johnston Ferris State University

2 ANALYZING A NURSE IN A LEADER OR MANAGER ROLE Analyzing a Nurse in a Leader or Manager Role Management is an engaged process of guiding others through a set of derived practices and procedures that are evidence-based and known to satisfy pre-established outcomes based on repeated clinical situations (Yoder-Wise, 2011, p. 5). This paper will lead its reader through a process of analyzing a nurse manager in a health care setting. The nurse manager interviewed for this paper was an Infection Control Nurse named Sylvia. Sylvia has just recently received her BSN from Ohio University, but had received her ADN degree from Ferris State University previously with twenty eight total years of nursing practice. Sylvia has twenty years of past experience in psychiatric nursing and eight years of total infection control nursing practice from three different facilities dealing with patients in psychiatrics, rehabilitation, and sub-acute rehabilitation. There are no required qualifications for infection control nursing besides a registered nurse (RN) license, but a certificate can be obtained after further study and testing on the subject called a Certificate of Infection Control (CIC), which Sylvia has achieved. It is also recommended that an infection control nurse belong to a professional organization; Sylvia is a member of the Association of Professionals in Infection Control and Epidemiology (APIC). Job Description According to Duties and Responsibilities.com (n.d.), the Infection Control Nurse is to: Direct and coordinate infection control program in facility, compare laboratory reports with communicable diseases list to identify conditions that require infection control procedures, advise and consult with physicians, nurses, and hospital personnel concerning precautions to be taken to protect patients, staff, and other persons from possible contamination or infection, investigate infection control problems and arrange for follow-up care for persons exposed to

3 ANALYZING A NURSE IN A LEADER OR MANAGER ROLE infection or disease, and instruct hospital personnel in universal and specific infection control procedures (para., 1). According to Sylvia, her job duties are to: do infection surveillance of the facility or population she is working with as well as pay close attention to the surveillance data of the community, review antibiotic usage and policies to be sure that all policies are being followed as they pertain to usage of antibiotics in order to prevent over medication, review policies and procedures to be sure there are no areas where improvement is needed and to be sure that they represent current evidence-based practices, provide education to staff about different infection precautions and new evidence-based practices, report any reportable infectious diseases to the health department, and write new policies and procedures as needed (personal communication, July 5, 2013). The infection control nurse is to report to the facility administrator and there is no one that is to report to the infection control nurse. Collaboration The infection control nurse cannot complete all aspects of their job on their own. Many areas of the job require collaboration with other disciplines and departments within the facility and outside of the facility. Sylvia collaborates with the director of nursing, floor nurses, nurse care coordinator, dietician, environmental health director, and the health department in order to fulfill the responsibilities of her job. Sylvia usually collaborates with others through meetings for process improvement every month and quality of life which is also monthly. Every other week Sylvia attends a leadership meeting in which all the administrative and management team get together and share concerns and process improvement ideas. The meetings that Sylvia attends are times for her to share surveillance data and talk about any new improvements that need to be made and how changes can be made. There are times when Sylvia schedules

4 ANALYZING A NURSE IN A LEADER OR MANAGER ROLE meetings with the director of nursing, the dietician, the floor nurses, the nurse care coordinator, and the environmental health director in order to present a problem and solution to her facility team members. Sylvia collaborates with the health department mostly by phone or email when she has to report illnesses or when the health department has to report illness to the facility. Legal and Ethical Issues The infection control nurse may run into many ethical dilemmas. One dilemma that may cause great dispute is the issue of reporting infectious diseases to the state health department and conducting a health survey without consent. Currently, Sylvia has to report certain infectious diseases to the health department and conduct disease surveillance; at this time, there is no consent needed for this activity and it has been deemed justifiable through studies on the matter of its ethics. In the article by Lee, Heilig, and White (2012), the authors write about the biomedical ethics and the concerns that patients have for the sharing of their private health information without their consent. While there are issues regarding ethics of autonomy and nonmaleficience, there is larger concern of the ethics involved with a failure to report these infectious diseases or perform infection surveillance. Patients are protected in the long run from disease because of infection surveillance and mandatory reporting. Sylvia is doing constant surveillance and when the need arises, she is reporting infectious diseases to the health department by either phone or email. The process that Sylvia completes is keeping the patients within her facility as well as the community protected from infectious diseases. Patients concerns are taken into consideration, but the final decision is made based upon biomedical ethics as well as public health ethics, which ethically justify surveillance and reporting of infectious diseases to protect everyone.

5 ANALYZING A NURSE IN A LEADER OR MANAGER ROLE Power and Influence Power is the ability to influence others in an effort to achieve goals (Yoder-Wise, 2011, p. 176). Sylvia uses her power and influence to empower others to follow policy and procedure regarding infection control. As a leader, Sylvia stated that she believes the transformational leadership strategy is the most effective (personal communication, July 5, 2013). Sylvia is often seen on the unit providing information and education to floor nurses and assistive personnel making them feel that the goal and vision is shared among the nursing floor staff and administration. Influence is the process of using power (2011, p. 179). Collaboration is one way a nurse leader can use their power to help influence others. Sylvia collaborates with many other members of the administrative and management team in order to keep the patients at her facility safe. Patients and family members who come to the facility can feel safe knowing that there is a strong leader at the head of managing infectious diseases within the facility. With having a positive powerful attitude, Sylvia is able to effectively communicate with all who come into contact with her professionally and she is able to influence those people to do their best to keep everyone healthy. Decision Making and Problem Solving Critical thinking is a requirement of both decision making and problem solving (YoderWise, 2011). As an infection control nurse, Sylvia is to think critically about the decisions she is to make. When reviewing medications to be sure there is no over medicating with the use of antibiotics, Sylvia is to determine whether or not an antibiotic is needed for the illness. The disease process that the particular antibiotic was ordered for is reviewed as well as the susceptibility of the organism. Sylvia knows that there has to be substantial charting on an infection before an antibiotic can be used and she reviews this information to be sure that the

6 ANALYZING A NURSE IN A LEADER OR MANAGER ROLE charting reflects the policy. When a patient is admitted into the facility, Sylvia reviews their chart and looks for any reasons to order antibiotics or prophylactic treatments such as cranberry tablets in prophylaxis for urinary tract infections. The decisions that Sylvia makes will impact the health of the patients that are newly admitted into the facility. Along with issues of over medicating, there may be problems with policy that need to be changed in order to meet standards of care based on new evidence or in order to be more efficient. Sylvia will write policies regarding infection control using her critical thinking skills and nursing judgment. By using her knowledge of infection control to make decisions and solve problems, the health outcomes of the patients she cares for will remain protected. Management and Resolution of Conflict The infection control nurse does not have many under their management. Many infection control nurses act alone in their position, but count on other members of management to manage and resolve conflict. Sylvia does not come in contact with much conflict, though she collaborates with others who do. Sylvia may come in contact with nurses who are not properly following policy or procedure. In the instances that Sylvia finds nurses who are noncompliant, she will assertively address the area that needs improvement. Sylvia acts as a leader by empowering employees to follow the policy and procedure to help keep patients safe against infection. Overall, an infection control nurse is a valuable asset to the management team. Sylvia acts as a leader using a transformational leadership style which she believes to be the most effective leadership style. Sylvias knowledge of infection control helps her to empower others to care for patients and keep them as well as the members of the community safe from infection.

7 ANALYZING A NURSE IN A LEADER OR MANAGER ROLE References Duties and Responsibilities.com. (n.d.). Position duties and responsibilities. Retrieved from http://www.dutiesandresponsibilities.com/JobDescription.asp?JobID=075127034&JobTit le=Infection+Control+Nurse Lee, L. M., Heilig, C. M., & White, A. (2012). Ethical justification for conducting public health surveillance without patient consent. American Public Health Association, 102(1). Retrieved from http://0search.proquest.com.libcat.ferris.edu/docview/1004791739?accountid=10825 Yoder-Wise, P. S. (2011). Leading and managing in nursing (5th ed.). St. Louis, MO: Mosby.