Running head: ANALYZING A NURSE IN A LEADERSHIP ROLE

Analyzing a Nurse in a Leadership Role Shannon Sheffer Ferris State University

ANALYZING A NURSE IN A LEADERSHIP ROLE Analyzing a Nurse in a Leadership Role In the operating room (OR) at Munson Medical Center (MMC) in Traverse City, Michigan there reside leaders of a unique caliber and quality. It is composed of a manager who oversees the entire surgical unit as well as five clinical coordinators who make sure the daily workings of the department run smoothly for staff, surgeons, and patients. Misha Keenan is one of these clinical coordinators. Misha is in charge of the orthopedic service that is comprised of seventeen surgeons and multiple staff members. Misha graduated from an associate degree nursing program in 1999 and began her nursing career by working in a nursing home with geriatric patients in the Lansing area. She then made the move to work within Sparrow Hospital in the OR in 2000 as a circulating nurse. Making a move to Traverse City in 2012, Misha joined the MMC ranks in the OR as a circulating nurse and moved into the role of clinical coordinator in early 2013 ready to take on this challenging new position. Misha is currently pursuing her bachelor degree in nursing as well as obtaining her certification in the operating room later this year. Job Duties Mishas job as a clinical coordinator keeps her extremely busy with constant trouble

shooting and managing of issues. She reports problems directly to the OR manager and is able to discuss issues and seek advice from other clinical coordinators. Misha is responsible for directly managing fifteen employees which consist of both registered nurses and surgical technologists whom all specialize in orthopedics. When Misha explained her daily job duties and tasks, she noted the requirements to attend meetings on budgets, staffing, and consultations. Misha stated that .the entire healthcare system is going through times of change with the new regulations and requirements for citizens. We have meetings about how the management team can adapt and

ANALYZING A NURSE IN A LEADERSHIP ROLE conform to keep the quality of care high for our patients while keeping the environment in the department positive and engaging to the employees (M.Keenan, personal communication, March 10, 2014). Other duties Misha manages everyday are discussing surgeons requests for new products or instruments, corresponding with instrument and product representatives, arranging staff members according to surgeon block schedules for surgery cases, assisting staff members in daily responsibilities, and responding to daily emails to various ancillary departments. Collaboration Role Misha considers collaboration an important aspect of her job as a clinical coordinator. She states that on a daily basis she is collaborating with various people; from surgeons and nurses to secretaries and aides. Misha regularly has interactions with surgeons to discuss

upcoming specific cases that may need a particular instrument, implant, or product. According to Misha, she also collaborates with staff from surgeons offices to ensure she has the proper measurements and dimensions for their total joint replacements and the surgeons preferred joint replacement company. After discussing these types of collaboration roles that Misha plays, she states collaboration is the pinnacle of communication with surgeons, staff, and ancillary departments. It is essential in this health care climate to provide seamless, complete, and quality care that each of our patients deserve (M. Keenan, personal communication, March 10, 2014). Ethical Issues One ethical issue that Misha deals with on a regular basis is having product system representatives in the operative suites. Munson Medical Center has a stance that any representative is permitted into the operative suite if a need arises that requires their assistance. Misha had been noticing that more frequently, a few certain representatives were coming in the

ANALYZING A NURSE IN A LEADERSHIP ROLE operating rooms at inappropriate times, such as before the patient was prepped and draped.

According to the American Nurses Association (2014a), the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient (provision 3). This includes the patients right to privacy and confidentiality, especially in their vulnerable state in the operating room where they are unable to enforce their own rights. In the operative setting, the patient relies on the nurse to protect, care for, and keep their best interests first and foremost. Misha realized the situation as an intrusion into these patients privacy and decided to take action. She understood the necessity of having the product representative in the room for the surgical procedure, but also determined more restrictive boundaries needed to be instated and followed for all outside ancillary resource individuals. Misha addressed the issue with the management team and developed a new policy that was instituted to allow ancillary person to enter an operative suite after the patient had been anestitized, disrobed, prepped, and draped. This new policy helps preserve and protect the rights of the patient while in the operating room. Power and Influence to Others Misha recently displayed her influential skills and power to develop a no enter rule on all total joint surgeries. She spoke about a situation that she received a request from a surgeon, performed literature gathering, and spoke with the infection prevention services. She then brought her findings to the surgical services management team and discussed the benefits, necessary education to staff and surgeons, financial expectations for possible decrease in infection rates, and how this change in practice would affect the department. Misha used her power within the department to help invoke this change to provide better patient care by potentially helping reduce infection rates by restricting traffic in and out of surgical suites. Misha also used her influence in the department to introduce this new policy to staff and made it

ANALYZING A NURSE IN A LEADERSHIP ROLE successful. Misha empowered her staff to provide feedback and helped facilitate the participation of others in the decision making (Yoder-Wise, 2014). Misha utilizes this position of power to enhance the communication skills between staff in order to make room turnovers

more streamlined and decrease the amount of traffic in and out of the operating rooms. This all in turn helps provide better patient outcomes by decreasing infection rates, recurrent surgical visits, and ultimately saves the hospital money. With all of these positive outcomes, the management team was enthusiastic about enforcing this new change in practice. Decision Making and Problem Solving On a daily basis, Misha implores decision making and problem solving as a clinical coordinator. Misha believes one way she utilizes these skills is through the scheduling of staff. Misha is responsible for dividing staff into teams of a registered nurse and surgical technologist for each surgeon every day according to the surgeries they have boarded. According to an article by the American Nurses Association (2014b), staffing solutions require leadership, support, and recognition to assure an appropriate number and skill mix of registered nurses who are able to deliver safe quality patient care (para. 2). This statement shows the necessity of health care leaders to be aware of the need to properly staff nurses in order to be most effective in providing the safest most competent care to patients. The appropriate scheduling of staff also contributes to build a safer environment for patients and registered nurses (American Nurses Association, 2014b). As a leader, Misha realizes the importance of finding the balance of staff satisfaction and the obligations of the hospital. Misha must be conscious of the amount of surgeons that are working on each day in order to ensure adequate staffing to work the cases. It is important that Misha organize and utilize her critical thinking skills in order to make these daily assignments. She must look at the complexity of the cases, competence of the staff, block times of the

ANALYZING A NURSE IN A LEADERSHIP ROLE surgeons, and staff work hours. If Misha does not critically think through each of these issues, she could potentially cause undo grief to the surgeons and staff as well as the patients. Management and Resolution of Conflict with Others Another important role Misha encounters frequently is defusing arguments, developing

resolution to issues, and enhancing relationships of staff and surgeons. Misha continuously deals with disagreements between staff members or management. Misha believes that her leadership style closely reflects that of transformation leadership. This type of leadership is used when employees are encouraged to transcend their own self-interest (Yoder-Wise, 2014). This type of leadership covers five critical points which include challenging the process,inspiring shared vision or bringing everyone together,enabling others to act,modeling the way,encouraging the heart by giving attention (Yoder-Wise, 2014). Misha handles any disagreement by first getting the foundation of the resolution by referring to the policies of the hospital. By doing this, Misha is confident that her actions and resolutions are supported by the department and organization. I always refer to the procedures of the unit as well as what Munsons mission is to our community. As long as I follow the guidelines of the hospitals policies and I am looking out for the interests of a patient, I know I am doing the right thing (M. Keenan, personal interview, March 10, 2014). Misha also makes her decisions for conflict resolution to be fair and reasonable to all parties involved. Misha encourages her staff to participate in coming to the table to solutions that are manageable for both employee and organization. Conclusion Misha embodies all of the characteristics of a great leader; she is knowledgeable, fair, concise and consistent, assertive, and effective. She is always willing to make time for her staff

ANALYZING A NURSE IN A LEADERSHIP ROLE to listen to issues both about their jobs in the OR and in their personal lives. Misha is a leader that is always evolving her professional practice and encourages others to do the same. Her goal for engaged work environment and positive patient outcomes drives her to continue her difficult work as one of the essential clinical coordinators in the operating room.

ANALYZING A NURSE IN A LEADERSHIP ROLE Reference American Nurses Association. (2014a). Code of ethics for nurses with interpretative statements. Nursing World. Retrieved from http://www.nursingworld.org/provision-3 American Nurses Association. (2014b). Nurse staffing. Nursing World. Retrieved from http://www.nursingworld.org/nursestaffing Yoder-Wise, P.S. (2014). Leading and managing in nursing. (5th ed). St. Louis, MO: Elsevier Mosby.