Coastal Surgical Institute 's Structure

My second clinical day took place on September 24th, 2015 at Saint Barnabas Hospital in Livingston, New Jersey. My preceptor Maria Brilhante, MSN, RN, allowed me to observe the morning huddle that took place with all the nurse managers that are in the hospital. The purpose of this huddle was to keep the director of nursing informed about the census on each unit. I found this processed to be very uniformed and professional because the DON was engaged. The day went on with me attending meetings on how managers could implement plans to contain cost for the hospital. Maria did her daily rounds on her patients and her nursing staff. She has a folder that contains papers on how each nurse is progressing from the time they get off orientation. Her motto to the nurses is, “You are good at what you do, so when I coach don’t take offense. I am only trying to get you to be great”. This boost their confidence which I thought to be important.

For this essay I will be reflecting on the influences on, how the role of the operating department practitioner (ODP) has developed within the multi-professional healthcare team. I will also be discussing in this text some of the historical, political, legal, social, and cultural influences of the ODP. And I will be reflecting on my personal experience working within the operating department for the first time as a student, using the Gibbs cycle (1988.).

The most common styles she employs are democratic leadership, laissez-faire leadership, and shared leadership. Her position as a liaison between upper management and the nurse leads contributes to her need to regularly switch from a position of leader to follower and back again, keeping her not only extremely busy, but out of the office for most of the day. To lead her team, she must change tactics all day long, from one task to another. The leadership styles democratic leadership, laissez-faire leadership, and shared leadership all have one thing in common, these styles allow for the nurse manager to permit her team of nurse leads, the power to lead themselves. The nurse manager is capable of putting large amounts of responsibility in their subordinate’s hands, knowing that they are skilled and qualified to make decisions without interference (Giddens, J., 2013, p.376). These styles tend to work effectively for the Surgical Services Nurse Manager because her team of nurse leads are experienced and capable of performing their jobs with little to no feedback. While each of these three leadership styles: democratic leadership, laissez-faire leadership, and shared leadership, share some similarities, they are all slightly different, with some being more effective than others. Of the leadership styles she engages in, her use of shared leadership is most effective, while her use of the laissez-faire

Debra Bournes is the Provincial Chief Nursing Officer in Ontario. As a governmental employee, she spends a lot of time influencing policies and implementing important changes related to nursing practice. Her leadership style is perceived as relational (Orazietti & Singh, 2014). Leadership is perceived as unifying people around values and constructing the social world for others around those values which helps people to get through the change (Stanley 2009; as cited in Taylor, 2009). Relational leadership is the ability to create, maintain, and

There are many challenges facing today’s nursing leaders and managers. From staffing and scheduling, to budget cuts and reduced reimbursements, today’s nursing leaders must evolve to meet the ever changing health care environment. Constance Schmidt, Chief Nursing Officer at Cheyenne Regional Medical Center (CRMC), identified retaining experienced registered nurses (RN) as one of the biggest problems she faces as a nursing leader. She went on to state “Nationally, most hospitals have more than 60% of their nurses with at least 5 years of experience. At CRMC, it’s the reverse. We have more than 60% of our nurses with less than 5 years of experience” (personal communication, March 28, 2014). The two largest factors affecting those numbers are the nursing shortage and nursing retention. The first, the nursing shortage, was identified years ago and has been researched countless times. Some projections indicate the number representing the gap between available registered nurses, and the positions needing to be filled, could be over a million before the end of the current decade. The latter, retention of nurses, is a problem in every health care facility in the nation. Nursing turnover results in both a significant financial cost to hospitals, and a significant impact on the community through its effects on patient outcome.

I recently accepted the Neuroscience ICU (NSICU) Nurse Manager position at the Medical University of South Carolina. The principals of transformational leadership and nursing distinction radiate throughout the facility, extending the brand of excellence towards nursing. Onboarding as a new leader requires agility and flexibility. I was able to capture the union of course content and application of my leadership practice.

Mindy Alternot is an administrator at Seaside Convalescent Care Center (SCCC). She has begun to have major issues at this facility and the longevity of this company is at a crossroad. Mindy was hopping that she could turn this facility around; however, it proved to be much more difficult than she thought. SCCC has a fine of $3000 a day for noncompliance because they were dined payment for a new admission. Mindy has begun to blame her nurse’s aides (NAs), because they account for more than 90% of the hands-on patient care. Mindy cannot find good NAs and is having well over a 100% a year turnover rate. She tried to motivate and improve training her NAs so that they would find new meaning and purpose for their jobs. Her intensions was

Coastal Surgical Specialist Incorporated does business as Coastal Surgical Institute (CSI). CSI operates in conjunction with Dignity Health (which runs the hospital in Arroyo Grande) and the governing body or board (comprised of 49% [22-23] physicians who work within CSI and 51% shareholders from Dignity). The Medical Executive Committee (comprised of five board member physicians, among them the Medical Director and Anesthesia Director) answers to the board, and beneath the Medical Executive Committee is the medical staff. Medical Staff includes the Administrator: Director of Nursing, the Pathology Lab, and the Anesthesia Services. The structure of CSI follows Mintzberg’s five-sector model (Bolman & Deal, 2008) in that it is a top-down organization with a clear strategic apex consisting of the governing body of CSI. This administrative component funnels down to the Medical Executive Committee and ultimately the Director of Nursing who is directly in charge of the operating core, which consists of the nursing staff. The technostructure seems to be those specialists such as pathology and anesthesia services, while the support staff is comprised of front office and medical records personnel.

For my health care interview, I conduct an interview with Ayanna Randle Banks she is Quality Assurance Nurse at Kensington Place located at 3405 S. Michigan, Chicago IL. Kensington Place is a nursing home and rehabilitation facility. She has worked at Kensington Place for three years and was recently promoted to a Quality Assurance Nurse. As a Quality Assurance Nurse, she works to the review of clinical cases that may be related to quality of care issues identified by appeals and grievance process, adverse events occurring in the hospital or an outpatient setting, which provides clinical interventions. She also evaluates the work and behavior of employees in her departments. And also educate other nurses on the best practices and implement innovative procedures to improve the quality of work. This managerial role is often considered to relate more closely to the business side of health services than patient care.

Coastal Surgical Specialist Incorporated operates as an S corporation and does business as Coastal Surgical Institute (CSI). In business there are different types of corporations and an S corporation, which is often referred to as an S Corp, is a unique type of corporation created through an IRS tax election (S Corporation | The U.S. Small Business). This means that the owners (shareholders) of the corporation are protected from liability. Essentially, an S corporation 's shareholder 's personal assets cannot be seized to satisfy business liabilities, and an S corporation can avoid being taxed twice (taxing both the corporation and the shareholders). In addition, S corporation shareholders can be employees of the business and draw salaries as employees. These advantages to shareholders have helped to create a vested interest in CSI, which seems to be one of the structural keys to the organization 's overall success - there are multiple parties involved who want CSI to do well.

The most anxious and exciting time for any new employee is the first few days of their new job. A high priority for every organization should be the on-boarding of the newest employees and making sure they are equipped with the right knowledge or at a minimum knowing how to access information when they need to in the future. Having been through a few new employee and departmental orientation’s, the amount of information that is given in a very short period of time can seem overwhelming. Retaining new employees must be a top priority for any organization especially in the healthcare field. Some studies have shown that it costs an organization approximately $64,000.00 to replace each Registered Nurse who resigns or is terminated (George, 2011).

The dynamic healthcare system prompts health institutions to source an all-around registered nurse. Nurses play a greater role in improving the patients experience and population health and lowering the cost of care. They are charting new paths in developing fields such as informatics, telehealth, genetics, and genomics and as scientist and leaders in the community that are essential to the practice. In finding answers on what potential employers in the field require, I sought the assistance of a human resource manager in Juravinski hospital. Drawing on both the literature and experience, she infers that though emphasis should be on clinical training in multiple settings potential employer must also weigh both interpersonal skill and professionalism.

Upon analyzing GWC’s human resource frame, we recognize that GWC does not align organizational needs with human needs. For example, people need salaries, benefits, and opportunities for growth to enrich their livelihood (Bolman & Deal, 2013). GWC does not provide health insurance or benefits for their employees and their medical assistants (MA) are paid below the state minimum wage. Additionally, the morale at GWC declines as frontline staff verbalize pressure of being overworked with high stake responsibilities. The nurse practitioners (NP) express their frustrations stating they are not treated respectfully by the BM. As conflict at GWC escalates, the organization does not appear to have a strategy for resolution. If GWC cannot meet their employees’ basic human needs, self-actualization cannot be expected.

An interview was conducted with the Chief Nursing Officer (CNO) at an acute care facility. This discussion revolved around the following: her style of management, style of communication, decision-making skills, technical skills and delegating skills. Before sharing specific responses to each of these, the CNO wanted to clarify that because she was new to the organization and following someone who had been in this position for over 20 years, during the first year and transition phase, there were certain situations in which she was consciously adjusting her leadership style to fit the culture of the organization. She strongly felt over time the staff would adjust and become more familiar with her natural style of leadership and

1. What are the key issues that Barbara Norris faces at the GSU? Why are they important to the organization?