THE MAKING OF A SUPERVISOR: AN AUTOBIOGRAPHICAL RESEARCH

Romana B. Cortes, RN, MAN, Rosalyn B. Bilog, RN, MAN

Abstract

This is an autobiographical research, combined with some principles of

phenomenology in which my serendipitous experiences when I got promoted as Nurse-
Supervisor in Dr. Paulino J. Garcia Memorial Research and Medical Center (Dr.
PJGMRMC), the biggest and the finest government hospital in Cabanatuan City and in
the Province of Nueva Ecija was the focus. This was the highlight of my nursing career,
the chapter in my professional life which I wanted to share.
The themes that were coined from my serendipitous experiences as a Nurse-
Supervisor would serve as the summary of this investigation. These are as
follows:Passion for the profession and enduring family support are ingredients for work
survival; Experience is the best teacher; Challenges are part of everyone’s life journey;
and If there’s a will, there’s a way.
May I conclude that seemingly insurmountable tasks become surmountable if
there is passion in work and the will to do it, with the enduring support of the family.
I recommend that the Manual which I designed and proposed for new nurse-
supervisors be published even in local papers or website of the Graduate School to serve
its intended purpose.

Keywords: autobiographical research, operating room nursing, nurse manager,

supervisorship

Introduction and Rationale

The nurse-manager is the accountable person-24/7 on

the front lines of care with patients and families,
with staff and administration (Anonymous).

This idea became my dilemma when I was given a new set of tasks and duties

after several years of service in the Operating Room (OR) of the biggest government

hospital in the province of Nueva Ecija, Dr. Paulino J. Garcia Memorial Research and

Medical Center (Dr. PJGMRMC). As an OR nurse and later on as an OR Supervisor

without any experience of being an understudy in this area, it was my serendipity that
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paved the way to my successful supervisory journey, a middle level managerial position,

in the same area where I was working for years, in the Operating Room.

The start of my supervisory journey was never easy; it was rough, and it was my

serendipity, my destiny and fate, that smoothened the way. But before I would delve

deeply into my serendipitous experiences, let me state briefly that just recently while I

was working on this research, I was appointed on concurrent capacity as a Surveillance

Nurse, primarily in charge of infection control, an assignment, I was not sure if I could

perform well and was reluctant to accept. But as a trained nurse, I accepted the

assignment and the challenge. And I tried to carry it on with my reflections of my past

experiences as my guidance. When I accepted the Surveillance Nurse position, I had to

organize my staff in the OR so that they could carry on smoothly with their tasks without

me. My schedule then was: in the morning I stayed outside the OR to do my surveillance

tasks, and in the afternoon I had to go back to the OR to wear my other hat - a task I did

not even know I could tackle at first.

As an OR supervisor, at first I thought that the functions of nurse-supervisors in

the other areas of the hospital where I worked with, were similar. But later on, I

discovered the uniqueness of being an OR nurse supervisor, as it required mastery in the

manipulation of the different types of OR equipment and instruments and knowledge of

supplies needed for every procedure. It also required skills in communication and

coordination with the surgical health team to smoothen the traffic in OR scheduling.

How I survived as an OR nurse-supervisor which is worth sharing to the novice

and younger generations of nurse-supervisors is the main intent of this study hoping that

through this sharing, they will become more equipped in their journey towards
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supervisorship; that they can easily cope with the challenges and difficulties they might

encounter as they continue with their supervisory journey especially in an area in the

hospital that is critical such as the Operating Room.

Hence, this study which is entitled, “The Serendipity of Supervisorship: An

Autobiographical Research” is conducted.

The Related Literature

This section contains the summaries of the related literature and studies that

provided support to this investigation. They were presented by themes or topics for ease

in organization as well as in reading.

Experiences of first-time supervisors. McNamara (2017) described the typical

experiences of first-time supervisors in a company. These are the following:

First-time supervisors rarely have adequate training. Frequently, employees are

promoted to supervision because of their strong technical expertise - expertise in building

a product or providing a service. Then unexpectedly, the new supervisor is facing a whole

new range of responsibilities, many of which have little to do with technical expertise.

Sometimes they are intimidated by a wide range of policies and procedures. The

new supervisor is suddenly faced with a wide range of rules and regulations - each of

which the supervisor is responsible to carry out. The supervisor is in charge for signing

time cards, authorizing overtime, granting compensation time, dealing with performance

problems, developing job descriptions, following hiring procedures, dealing with

grievances, conforming to a complicated pay system, and many others depending on the

job description of an institution.

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New supervisors rarely have enough time. Management activities are so hectic

and demanding. No matter how systematic the planning, managers rarely get to spend

much time on any one activity.

New supervisors often expect to have complete knowledge of everything that

goes on in their group. They don't want to encounter any surprises. So they spend more

time reading, thinking, planning, communicating with employees. New supervisors often

spend 60 hours a week on the job. Still, they don't feel they have enough time to do the

job right.

New supervisors often feel very alone. This is because the supervisor is

responsible to be an advocate for the organization and at the same time an advocate for

the employee. There are instances that the supervisor became stuck in the middle. For

example, if the organization implements an unpopular new policy, the supervisor is often

responsible to communicate and justify that new policy to the employee. In this case,

management expects the supervisor to present and support the new policy, and the

employee vents his or her frustration to the supervisor. However, if the supervisor wants

to promote the employee or present some other reward, he or she is representing the

employee's case to the rest of management.

New supervisors often feel overwhelmed, and stressed out. Since, they are

responsible, for the first time, for the activities of another employee, they must ensure the

employee knows his or her job, has the resources to do the job and does the job as

effectively as possible.

The stress and loneliness in the role of new supervisors can bring out the worst in

them. If they deal with stress by retreating, they retreat to their offices and close the door.
 5

If they deal with frustration, they become angry and unreasonable with their employees.

If they are used to getting strong praise and high grades, they work harder and harder

until their jobs become their lives.

Support for and development of new supervisors. New supervisors need

ongoing coaching and support. They need someone whom they can confide in. Ideally,

they have a mentor in the organization who remembers what it's like to be a first-time

supervisor, someone who makes himself or herself available. If the experience of first-

time supervisor is successful, this is challenging, but fulfilling. The supervisor goes on to

become a progressive and supportive manager.

There is a dearth in literature and studies pertaining to serendipitous experiences

of new supervisors; hence, this study is rare; this is an original piece of work dedicated to

the enrichment of knowledge in nursing research and nursing management.

Statement of the Problem

Serendipity means occurrence of events by chance which is pleasant and

beneficial (www.merriam-webster.com). In this study, this refers to unexpected

beneficial events and experiences which occur in the dispense of my duties and

responsibilities as a nurse-supervisor in the Operating Room of Dr. PJGMRMC and

which are vital in honing my supervisory skills. Said experiences are the main focus of

this study.

These were my guide questions in narrating my serendipitous experiences as an

OR nurse-supervisor in Dr. PJGMRMC:

1. How may my serendipitous experiences as a nurse-supervisor in the Operating

Room of the biggest government hospital in the province of Nueva Ecija be described?
2. What learnings (themes) can be derived from the said experiences?
 6

3. How may the Manual for beginning nurse-supervisors be designed based on the

themes or learnings derived from my serendipitous experiences?

Scope and Delimitation of the Study

This study which is an autobiographical research, took into account my

serendipitous experiences during the time I was designated as an OR nurse-supervisor Dr.

PJGMRMC, for 15 years, rising from the ranks of nurses in the said hospital with OR

nursing as my specialty.

This autobiographical research was two years in the making, year 2015 to 2016.

Significance of the Study

The following persons and groups may in one way or another be benefited from

the study:

Beginning nurse-supervisors. The Manual that I designed as an output of

my autobiographical research may serve as a guide for newly designated nurse-

supervisors in their day-to-day activities making them at par with what is expected of

them.

Hospital administrators. The Manual for new nurse- supervisors may guide

nurse and hospital administrators in designing programs that may help unit managers in

building up their capacities and competencies for the positions of trust.

The researcher. The process enables me to reflect deeply on my serendipitous

experiences as a nurse-supervisor which are worth sharing to new and upcoming nurse-

supervisors. The benefit that others may gain from this sharing is my noble contribution -

a priceless legacy being handed down to the next generation of nurse-supervisors.

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Future researchers. It is hoped that through this study, they will be guided as to

how to develop an autobiographical study.

Conceptual Framework

This study on the serendipity of supervisorship was made possible through deep

and serious reflections on my experiences as an OR nurse-supervisor for 10 years at Dr.

PJGMRMC (Input). As I reflected on them, I wrote them down as well to have a concrete

basis in my analysis and in the generation of themes or meanings (Process) upon which a

Manual for beginning nurse-supervisors (Output) was designed to guide them in their

journey towards supervisorship. Figure 1 provides an overview of this investigation.

Input Process Output

Serendipitous  Reflections on
Experiences the serendipity A Manual
of an OR of supervisorship for
Supervisor and an analysis Beginning
of the same Nurse-
 Generation of Supervisors
themes/meanings
 Formulation of a
Manual for
beginning nurse-
supervisors
Outcome
Well-
designed
Fig.1. Research Framework Manual for
beginning
nurse-
supervisors

MATERIALS AND METHODS

Research Design
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The researcher used the qualitative research design adopting some principles of

phenomenology and autobiographical research using life narrative.. This research design

is appropriate for this study which focused mainly on one of the most challenging

chapters of my life, my being an Operating Room Nurse-Supervisor in Dr. PJGMRMC.

Carpenter (2007) defines phenomenology as “a science whose purpose is to

describe a particular phenomenon or the appearance of things, as lived experiences”.

Those topics that are central to people’s lived experiences are best suited for

phenomenological research.

The researcher focused on her life experiences as a nurse-supervisor; thus, an

autobiographical research or a self-narrated biography was employed. It is a process of

collecting different facts in various narrative contexts and also of participating in the

elaboration of a memory which constructs meaning (Abrahao, 2008a).

Analysis of Data and Information

In data analysis, I was guided by two methodological approaches. One of them is

the autobiographical research by Marinas (2007). The other is some aspects of

phenomenology using Colaizzi’s steps (cited by Bertram and Magnusen, 2008) which is

eidetic (descriptive) rather than hermeneutic (interpretive). Eidetic phenomenology is

guided by the preposition that there are basic structures within each unique human

experience. Its goal is to gain a description of an experience from the participant’s point

of view which in this study was solely the researcher herself.

Guided by the principles of autobiographical research by Marinas (2007), I

considered a two-stage type of comprehension: the context of the past which

encompassed the totality of my serendipitous experiences as an OR nurse-supervisor, and

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the context of the present after several years of experience as an OR nurse-supervisor.

My data analysis was guided by the seven-step method of Colaizzi which

included the following:

1. Reading my whole transcripts carefully, making sense of them, and create

written descriptions or protocols to have a general picture of the entire

content.
2. Extracting significant statements; statements related to my work experiences

of being an OR Nurse- supervisor. These related statements were extracted

and were included in one file for convenience of retrieval.

3. Identifying the meaning of each significant statement. I repeatedly read each

statement and carefully provided meaning to each statement.

4. Organized the aggregated formulated meanings into clusters of themes

(referring back and forth throughout the data to validate the themes); the

formulated meanings were clustered into themes representing categories

similar to the protocols earlier identified. These themes were validated many

times giving attention to the statements where they were deduced.

5. Integrated the findings into an exhaustive description; the significant

statements including the formulated meanings and the cluster of themes were

integrated into a narrative description without leaving behind any fact or

element related to the phenomenon under study.

6. Formulated a statement of the essential structure of the phenomenon; a global

statement capturing the essence that described the phenomena.

7. Validated the findings with existing literature related to the study.
RESULTS AND DISCUSSIONS

This section features my serendipitous experiences as an OR Nurse-Supervisor for 10

years and another eight years as an OR Head Nurse in one of the most challenging areas

in the hospital, the Operating Room. I believed it was worth sharing for others to emulate
 10

or for them to have bases for critical assessment of what I did or failed to do.

My Serendipitous Experiences as an OR Supervisor

The longest time of my career was spent in the operating room where I worked as

a staff nurse for 13 years, then as a head or senior nurse for eight years, and then as an

OR Nurse-Supervisor for 10 years. My work experiences as an OR Nurse-Supervisor

comprised the highlight of my nursing career, and said experiences were made the center

of this investigation.

I became a staff nurse in the OR through the very kind endorsement of my then

immediate supervisor. I did not expect that I would become an OR nurse. In fact, I did not

know if it was an advantage for me. What I knew was that an OR nurse must be smart,

fast worker, composed when working under tension, and could render sound judgement

during emergencies.

When I began my work as an OR nurse, the OR Complex had limited OR beds

which means that it could only admit and do limited OR cases but the challenge I had to

face was to make the schedule of surgical procedures done efficiently and effectively

through a systematic staffing procedure.

As expected, I went through series of orientations with the OR set-up and

familiarization with the different instruments and equipment. I assisted the health team in

handling OR patients and as months and years passed by, I attended and handled different

post-operative procedures.

My early journey in the OR was very stressful. I became disoriented in the set-up,

instruments and equipment. I was always in a hurry and in distress thinking how I could
 11

cope up with a lot of things to learn. Besides, I had to deal with the different members of

the health team - the surgeon, the anaesthesiologist, the internist and pediatrician.

Being an OR nurse is not easy because of the full responsibility in dealing with

life; the success of the surgical procedures largely depends on the OR nurse, so as one of

the health team members, I made sure that everything was in good condition. I had to

check the normal functioning of the equipment/instruments to be used, the adequacy or

abundance of supplies, the safety of patients and environment, and compliance with

sterility procedures by the health team members.

As years had passed, I gained full confidence in handling different types of

procedures and became familiar with the different instruments, equipment and supplies

needed for every OR patient and procedure. The training which I went through was rigid

because of the nature of the tasks and functions I had to perform. But I was glad that

when I was assigned in the OR, I already had mastery of the basic nursing skills which I

gained through my previous exposure in some of the critical areas in the Hospital. This

previous exposure made me familiar with all the members of the health care team.

After 13 years of service as a staff nurse in the OR, I was lucky to be elevated to a

higher position, as senior OR nurse or head nurse. As a head nurse, besides rendering

bedside nursing care, I had to teach and orient new OR nurses, trainees and students.

Bigger command responsibilities took place as a consequence of my promotion. I gladly

welcomed the position unmindful of the added responsibilities I would be dealing with

such as handling subordinates, teaching, supervising and leading them while I still did a

handful of other tasks, and worst, serving as a model to them. I encountered conflict

stress/distress that I managed to deal with.. As a head nurse, I had to guard my emotions
 12

because some of the patients had to go, and I had to learn to be strong and firm so that I

could explain very well to the patients’ families what had happened and why it happened

and what possibilities were explored. Here, my use of judgement was improved and my

decision-making skills were enhanced.

After all the hard work and the struggles that I went through for many years, I was

promoted to the position of OR Nurse-Supervisor and more challenges came my way

because in this new job. My main concern was to take care of the concerns of others (my

staff nurses) who were placed under my care, no longer my concern to myself and how I

could render direct care to my patients to the best of my ability. In other words, I had to

learn some managerial and leadership skills such as planning, organizing, directing,

leading, implementing and evaluating.

As an OR Supervisor, I did not only acquire knowledge and skills in management.

I was also able to manage a healthy and a happy family, a task I did not know I could do

at the same time.

When I was promoted as an OR nurse supervisor, the scope of my responsibility

became wider, unlike when I was a senior nurse or head nurse where I only dealt with my

subordinates. Being an OR Nurse-Supervisor, the over-all responsibility in OR was

within my jurisdiction. I felt the pressure when I started my new position as a

Supervisor. I felt that my superior had just no choice for the position that I applied for and

which fortunately I got. I was challenged to apply for this position since I wanted to

prove that I was capable enough to handle such position. Aside from my professional

growth, career advancement and fulfillment, I also wanted to grow on my profession

simultaneously as I got older.

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The first difficulty that I encountered as a supervisor was in the preparation of

reports and records on census; consumption; and inventory of equipment, materials, and

supplies which my superior instructed me to produce, so I had to sleep late at night to

accomplish all of them and be able to submit them the following day. This happened

because my previous supervisor left the area without any endorsement at all, no files and

no reports.

I also encountered “not-so-good” treatment by my supervisors. There were times

when they scolded me in the presence of my subordinates and trainees, and I cried and

felt depressed and so sad. Although I was emotionally disturbed at that time, I continued

my daily routine as new supervisor while adjusting and discovering little by little how it

was to be a supervisor. My struggles and difficulties did not stop me from doing the

records and reports that my superiors instructed me to do. As a beginning supervisor, I

also felt the rivalry of gaining the trust of my staff with my superior which later on

resulted to hardship in leading them. There were times when I felt helpless and isolated

thinking that even my co-supervisors were not near and close to me, but I remained

composed and I demonstrated my power as supervisor that I could function well as

supervisor. Because of my desire to gain the trust of my subordinates, I just worked hard

and did my job as supervisor the best way I could. I tried to get along with them and

joined them outside our hospital work, little by little I began to gain their trust. I had

no regrets as an OR Supervisor because my experiences in the area developed my

communication skills with the healthcare team and I learned to handle different cases

intra-operatively. My journey as an OR Nurse-Supervisor for several years made me

more confident and proficient, although, up to the conduct of this study, I still
 14

encountered some challenges and difficulties. My position taught me how to be patient,

strong, calm, understanding, how to balance my emotion and be appreciative of my staff

and co-workers.

While I was in the OR, I also witnessed changes in nursing leadership in the

Hospital. I experienced being with three chief nurses and I learned a lot from each of

them.

For sure, my professional success can be attributed to my passion for my

profession, my love for my work and the enduring support and assistance of my husband

and my family. I owe them what I am today.

Learnings (Themes) Derived from my Serendipitous Experiences in the OR

The learnings or themes being derived from my serendipitous experiences as an

OR Supervisor were presented below.

Theme 1: Passion for the profession and enduring family support are ingredients for

work survival.

Part of my experiences that strongly supports this theme is cited in verbatim

below:

The longest time of my career was spent in the Operating Room …

where I worked as a staff nurse for 13 years, then as a head or senior nurse
for eight years, and then as an OR Nurse-Supervisor for 10 years.
In the OR alone, I spent about 31 years of my professional life .

in spite of all the challenges that came my way. It was my passion for the

profession that kept me going - passion for serving others. It may be difficult at times, but

it can be the most rewarding profession one can pursue.

Another supporting verbatim statement could be read as follows:

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For sure, my professional success can be attributed to my passion for my

profession, my love for my work and the enduring support and assistance
of my husband and my family.

Vallerand, Salvy, Mageau, Elliot, Denis, Grouzet, and Blanchard (2007) defined

passion as a strong inclination towards an activity that an individual likes and considers

important, and invests considerable time and energy in it. Passion represents the energy

underlying such persistent involvement. Being passionate for an activity leads individuals

to dedicate themselves fully to their activity, thereby allowing them to persist, even in the

face of obstacles, and to eventually reach excellence.

Passion for my work made me persevere, adapted to the work and became a

survivor in my chosen field or profession.

Aside from passion, I had a very strong family support, a support system that

enabled me to continuously move on and pursue higher level of work goals and not being

tired emotionally and socially.

Relatively, a partner is a resource. Partnered employees are more likely to

participate in further training and professional development. One study demonstrated that

support in the family domain positively affects behavior in the work domain, and the

ways individuals deal with conflicting demands from both domains (Adams, King, &

King, 1996; Van Daalen, Willemsen, & Sanders, 2006; Wayne, Randel, & Stevens, 2006

cited by Lebert & Antal, 2016).

I could say that family support especially my spouse plays a vital role in my work

success. “My passion for my work and family support served as contributing

factors for me to stay in the hospital for a long period of time” leading to the

development of the second theme which is described below.

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Theme 2: Experience is the best teacher.

Much of what is known and understood has been learned through experience.

Whether time is spent in classrooms or having experiences out in the world, much of

what is learned is accomplished through doing and interacting with others.

Throughout my career, experience had been my best teacher. My exposures as an

OR nurse for 13 years and head nurse for eight years are long enough for me to observe

what my previous OR supervisors had been doing. These made the supervisory

challenges quite surmountable especially during the early phase of my resumption to

office, and the very reason why I did not give-up in the midst of challenges and

difficulties. Such supervisory challenges could have been insurmountable had I not been

exposed to how my predecessors dealt with the situations.

Not only does experience leave an impression on our minds; we also learn from it.

Experience is not just about learning new skills – it is about exploring ourselves as

individuals. As years passed by, I learned to cope with the challenges. In verbatim:

My journey as an OR Nurse-Supervisor for several years made me more

confident and proficient. My position taught me how to be patient, strong,
calm, understanding, how to balance my emotion and be appreciative of
my staff and co-workers.

In support to Theme 2, here are Benner’s stages of clinical competence (1984):

Novice - a “beginner” who has no experience of the situations in which he/she is

expected to perform. A novice is taught rules to help him/her perform.

Advanced beginner - one who can demonstrate marginally acceptable

performance and has had some prior experience.

Competent - typified by the nurse who has been on the job in the same or similar

situations two or three years; begins to see his or her actions in terms of long-ranged
 17

goals or plans; conscious and deliberate planning characteristic helps achieve efficiency

and organization; lacks the speed and flexibility of the proficient nurse.

Proficient - perceives situations as a whole, has improved decision-making and

takes into account the nuances of a situation.

Expert - has an enormous background or experience and has an intuitive grasp of

each situation; operates from a deep understanding of the total situation; performance is

highly proficient.

Based on the above, I described myself as a proficient nurse-supervisor, being in

the same position for several years.

Theme 3: Challenges are part of everyone’s life journey.

To support this theme, let me restate my actual experiences:

There were times when they scolded me in the presence of my subordinates and

trainees, and I cried and felt depressed and so sad.

Although I was emotionally disturbed, I continued my daily routine as new

supervisor while adjusting and discovering little by little how it was to be a supervisor.

My struggles and difficulties did not stop me from doing my work. In verbatim: “There

were times when I felt helpless and isolated, but I remained composed and I demonstrated

my power as supervisor”.

In the same light, Horton (2015) mentioned, in an inspirational speech to the

public, that:

Facing challenges on the path to super achievement is not only likely, it is

inevitable. As you traverse the path of success, you are going to be knocked
down a number of times. This is a natural part of our creative experience on
this planet and something, which must be expected on every worthwhile
journey of excellence and growth.
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When the inevitable challenges do cross your path, do not allow yourself to
feel overwhelmed. Accept them and realize that they are integral part of the
learning process, needed to allow you to grow into the person you need to
be to attract the success you desire. Challenges are often the very catalysts,
which will reveal all the hidden possibilities, which you may have missed,
had you not encountered the challenge.

Being focused and determined is how we overcome struggles and

difficulties in life and also in our career. These challenges represent the
twists and turns on our path to success.

I have surpassed those challenges in my work, and continuously surviving and

learning through those encounters, and if there is a will, there is a way.

Theme 4: If there’s a will, there’s a way.

The following verbatim statements would explain this theme:

Because of my desire to gain the trust of my subordinates, I just worked

hard and did my job as supervisor, I tried to get along with them and
joined them outside our hospital work, and then little by little I began to
gain their trust.

“If there is a will, there is a way”, this proverb teaches us that if we really are

determined to do something (whether easy or tough), we can do it. Sometimes the task

may be too difficult, however the strong “will power” will help us to confront all the

difficulties and will find many ways toward the ladder of success..

Proposed Manual to Guide New Supervisors

Based on the findings (themes), a Manual is proposed to guide new

supervisors for survival. This is in addition to the supervisory tips that abound in

the literature (please see Appendix A – Manual for Beginning Nurse-Supervisors)

Conclusion
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Seemingly insurmountable tasks become surmountable if there is passion for

work, family support, fruitful experiences and the will to overcome challenges in the

profession.

Recommendation

I recommend that the Manual which I designed and proposed for new supervisors

be published even in local papers or website of the Graduate School to serve its intended

purpose.

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 20

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