Reflective Journal : Nurse Manager Position

There are many different fields to choose from while working as a Registered Nurse. “Registered nurses work in hospitals, physicians' offices, home healthcare services, and nursing care facilities. Others work in correctional facilities, schools, or serve in the military.” (bls.gov). You can also specialize in a specific type of nursing by seeking employment in that individual line of work or by taking a certification test. “The Nursing2011 Salary Survey reports that nurses certified in a specialty earn an average of $10,200 per year more than nurses who are not.” (pncb.org). If you choose to go further with your education you can continue past a bachelor’s degree and get a master’s degree becoming a nurse practitioner.

The nurse manager should also be able to convince the union representatives if any, senior nurses and the nurses in the unit about the problems of understaffing in the unit. Empowered nurse managers at all levels who feel supported by their organizations always played an important role in staff nurse retention (Wong, 2012). A satisfied staff is happy and more productive.

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.

Nursing guidance is a complex but essential part of the nursing workforce. Guidance can come in the form of management and in the form of leadership. The two terms are often used interchangeably, but do not always mean the same thing. The nurse manager is often someone who has authority from the facility to be in management. The nursing leader may not have authority over other nurses, but may be a strong guide in the workplace for other nurses and nursing staff. Nursing as a profession is ever-changing and increasingly challenging. Nurse managers are tasked with an enormous variety of functions in their respective workplaces, budgeting, scheduling, hiring, disciplinary actions, implementing facility policies and procedures, and the

One mistake that new nurse leaders make is that they believe that the only way to get things accomplished, is to be direct and autocratic (Kerfoot, 2008.) The new leader’s fear of failing can influence them to take on the autocratic role to try and earn respect from their employees. However, this is not considered to be very effective among staff. When the professional nurse takes on the autocratic leadership trait and uses it on a daily basis, employees feel micromanaged. When a manager micromanages their employees they take the risk of lowering morale, and losing good workers (North, 2011.) Nurses have a lot of autonomy in their profession. They work independently and take responsibility for their actions. When they become micromanaged by their nurse leader, it takes away that autonomy and creates a work environment that is very low in morale, and can hurt the relationship between manager and employee. Often managers are experiencing a substantial amount of stress from the administration concerning budgets, deadlines, and high performance issues, but this does not justify micromanaging employees (North, 2011.) It is important to give your staff some independence; this lets them know you trust their judgment (North, 2011.) A nurse leader may also change their leadership style depending on if they are dealing with an inexperienced new graduate nurse, or an experienced veteran nurse.

In today’s rapid changing world, leaders are very pertinent, especially in the field of nursing. Good nursing leaders have the ability to provide direction, facilitate structure to reach goals, and cohesiveness throughout team members. Leader by definition is “someone who uses interpersonal skills to influence others to accomplish specific goals” (Sullivan & Decker, 2009, p. 329). On the other hand a manager is different. Their goal is geared toward being responsible and accountable for the goals of the organization. Below is the summary of an interview with L.A. Patient Care Manager of Endoscopy/ Special

My career in nursing spanned 9 great years in the NICU. During this time, we had the same manager and clinical coordinator. Being a manager and leader are two roles we see as being intertwined as they lead followers on a path to success. As a floor nurse in the NICU, I worked directly with the babies. On numerous occasions there would be a switch in roles to “charge-nurse” in the unit. This role as a charge nurse proved very different from floor nursing, The task of taking on responsibility and charge of all the babies and their nurses was arduous, while keeping the unit running as smoothly as possible. It was a job I loved as was it challenging to work with so many diverse personalities.

Leadership is a much broader concept than is management. Although managers should also be leaders, management is focused on the achievement of organizational goals. Leadership, on the other hand occurs whenever one person attempts to influence the behavior of an individual or group (Groher-Murray & Langan, 2011). In order to become a good manager you also have to be a great leader. Leadership is a role not all nurse managers possess. As a nurse manager I would

The proudest accomplishment in my educational career has been graduating with a college degree in a field I absolutely love. With all honesty, I cannot attest that I have always wanted to be a registered nurse. As my college transcripts reflect, I have taken a hodgepodge of classes in attempt to find something; anything I can be passionate about. I found that passion in my first nursing class, Introduction to Healthcare Careers, that I took at the community college. Initially, I planned on taking a few medical terminology and anatomy classes to assist me at work as a paralegal. At the time, I worked for an attorney who specialized in personal injury and medical malpractice law. I would work 40+hours a week at the law firm and nursing school/clinical hours were done on nights and weekends. I survived and graduated with my Associates degree in nursing.

The nurse manager I selected to interview is a Baccalaureate degree nurse and has attended several in-house training sessions related to her position within the hospital. She attended Lenoir Rhyne University to obtain her BSN and has been employed with the institution for 13 years and has been in nursing for nearly 20 years. She is currently certified as a Certified Emergency Nurse (CEN) and is also a Sexual Assault Nurse Examiner. The Hospital that she is employed with is a private hospital she manages a 15 bed emergency department and 6 bed express care facility, which also holds several involuntary commitments for several hours at a time waiting on placement.

The current and growing shortage of nurses is posing a real threat to the ability of hospitals, long-term care facilities, and others to provide timely access to quality care. Nurse staffing shortages and nurse turn-over contributes to the growing reduction in the number of staffed patient beds available for services, increasing costs, and rising concerns about the quality of care. Health care organizations highly depend on nurse managers and leaders to reverse this trend. This paper discusses the reasons for nursing shortage and turn-over, different approaches to solve this issue, and my personal philosophy about this issue.

Leadership traits associated with nurse executives are honesty, credibility, supportiveness, visibility, and flexibility. Nurse executives analyze nursing functions and empower nurses through participatory decision making, shared governance, and employee involvement. Nurse executives share the vision and goals of the hospital and promote application of a nursing theory into the nursing care delivery system. They anticipate the future of health care and nursing and serve as monitor, role model, and preceptor to lower level management (Upeniecks, 2003). Nurse executives in the Magnet program are required to have advance practice degrees with certification in their specialty (ANCC). Understanding evidence-based management and enabling the use of evidence-based knowledge provides the nurse executive with the tools to improve patient outcomes. The transformational leader will remove barriers to improvement and encourage outcome based thinking. While nurse leaders are charged with questioning the status quo, nurse managers in the transformational approach to leadership are charged with maintaining the status quo.

Leadership does not always come with a title or prestige. Every nurse has within themselves qualities that make them a great leader. Leadership by definition, “is a combination of intrinsic personality traits, learned leadership skills, and characteristics of the situation (Cherry& Jacob (2013 p. 335). A leader is one who has the capacity and skills to direct or encourage others in efforts to achieve an outcome. I recently completed a self-assessment on my perceived leadership abilities. The survey was called the Nurse Manager Skills Inventory (Nurse Manager Leadership Partnership, 2008). It consists of four content areas of which I will address and identify my strengths and weaknesses.

As nurse manager Barbara is responsible for managing the staff, scheduling and budgeting for the unit. Her staff includes twenty-five registered nurses and eight patient care assistants (PCA’s). The unit is known for its culture of confrontation, blaming, and favoritism. The staff is dissatisfied, unmotivated, and not functioning as a team to deliver quality patient care. In Barbara’s first month she has lost two RN’s and due to a hiring freeze at EMU Barbara was not able to replace the positions. The unit is short staffed, stress levels are high and employee morale is low. Barbara meets individually with twenty or so staff members and comes to the conclusion that no one is happy and she has a lot of work to do. There are multiple groups that Barbara has identified issues with and she must come up with an action plan to manage the discrepancies. She has found issues in downward management which involves senior nurses, newer nurses, and patient care assistants, and in upward management including administrators and physicians,

Before I started this leadership/management coarse I had no idea what qualities a good leader manager needs to hold. I had no idea a registered nurse was considered a leader/manager. Now that I have reviewed all the chapters in the Leadership Roles and Management Functions in Nursing (Marquis & Huston, 2015) I have a full understanding of how important leadership/management functions play in a nurse’s career. Chapters 12-25 describe roles and functions that are needed for a nurse to become a successful leader/manager. These chapters discussed the roles and functioning of organizing, staffing, directing, and controlling.