Analyzing a Nurse Leader

Stephanie Olson
Ferris State University

Analyzing a Nurse Leader

Leaders, managers, supervisors are just some of the people who make up the healthcare
organization team. They play a role not only in your job as a nurse, but also in the lives of our
patients. When interviewing Michelle Walker, RN, BSN, CCRN, TNCC, I found it important to
focus on her holistic views that involve, ethical issues, patient relationships, and the nursing staff
that she oversees. However, in order to understand her holistic views, one must start at the
beginning, and understand her background that lead her to become a Clinical Supervisor of the
critical and progressive care units.
Nurse Leader
Background
Michelle Walker is a living soul that shows that if you have the drive and will power you
can accomplish your dreams, and that is exactly what she did. At the young age of 19 Michelle
was attending Northwood University where she was studying to obtain a degree in business;
however, after a year, she was married and decided to quit school. After she was married she and
her husband were living in Florida and once again she started back at school to obtain a degree in
accounting. However due to her husbands job and them moving frequently she found it difficult
to maintain her academics and quit. As personal influences took effect, Michelle was back in
Michigan and attending Davenport University where she obtained a certification as a
Phlebotomist. She than sought employment with MidMichigan Health in 1998 as a phlebotomist,
and then went on to pursue her Associates in Nursing (ADN) from Mid-Michigan Community
College with honors. After her ADN was completed, Michelle sought more education and
graduated from Ferris State University, Summa Cum Laude, BSN.

When she obtained her ADN degree and was working on her BSN, she worked as a nurse
ad MidMichigan health on the medical-surgical, orthopedic, and critical care units. While
working on her BSN it was during this time, that she was recruited for the Clinical Supervisor of
the critical and progressive care units. Like any other job with specific duties, it is the Michelles
job to coordinate with the staff of the medical intensive care unit (MICU), surgical intensive care
unit (SICU), neurotrauma intensive care unit (NTICU), and progressive care unit (PCU) in order
to provide the best possible care for the patient population. She also teaches new techniques as
needed, supervise, teach and document the proper use of equipment such as finger stick blood
sugar machines. Checking charts in both the EMR system and paper charts to ensure that care,
orders are being completed, and provides assistance in procedures when requested by the staff.
Finally she is also responsible for delivering disciplinary actions when needed. When not busy
with the staff Michelle reports to the 4 managers of MICU, SICU, NTICU, and PCU.
Additionally she will report to their manager as well as the shift administrator for the hospital.
Goals
Goals are important for staying up to date on certifications, and gaining knowledge about
your profession. One a year Michelle is given a JPR, at which time if she is not meeting
expectations set forth by her supervisors and managers than she is given additional goals to try to
meet for the following year. She also maintains her certifications which include her CCRN,
ACLS instructor, BLS instructor and TNCC certification. She also collaborates with managers to
achieve teaching goals for the staff through attending staff meetings and assisting with team
building, and encouraging them to always do their best. She has personally been a huge
supporter in my career.

Ethical and Legal Issues

As a nurse we are always faced with many ethical and legal issues, some are easy to
handle while others are not. Health insurance portability and accountability act (HIPAA) is one
of the leading ethical debates found in our profession. Knowing that Michelle has probably dealt
with this issue, I was intrigued that she discussed another ethical issue that I have not thought of
before. The ethical issue that Michelle discussed was about a patient and the code status being do
not resuscitate (DNR). There was a patient who wanted to be made DNR, however, the patients
family was not willing to accept this. The family asked to speak to the supervisor, Michelle, to
help discuss this issue with the family and the patient involved. By doing this the family thought
that she would back them up, and help them push the patient to be a full code. However, she did
not do what they wanted her to do, Michelle states, First and foremost I am a patient advocate.
She then preceded to talk with the patient while family was present and expressed to her that the
decision was truly hers and that she only needed to have peace between her and God (patient was
very religious). Finally in the end the patient did decide to stay a full code for the remainder of
that stay. Since Michelle step in and was a patient advocate she was able to have the patient
express themselves in a safe place with the family present, and what was all said is between the
patient, family, and Michelle. She did not side with one or the other, but made it known the only
the patient can choose what is best for them.
For nurses who have to deal with ethical issues, they do not have to stand alone. Michelle
has suggested that nurses make supervision aware of these types of issues, and then get risk
management and patient relations involved as well. This is a suggestion that Michelle has more
than once offered me, and I always turn to her when I need help. She makes you look at the
situation from both sides and tells you not to choose a side. If a patient is having problems

getting through to their family or vice versa than as the nurse we need to step in and help explain
matters in the best way possible. However always be a patient advocate first and foremost.
Influences
When looking at how Michelle influences the staff I think she does an excellent job. She
does not try to intimate, put down, or embarrass you. She challenges you to use your critical
thinking skills. Does everyone like this and uses it as a chance for a learning experience; I do not
know. However for me, I use it as a learning experience and a way to enhance my career. For
instance I had a patient that was a stable gastrointestinal bleed (GI), which went from a full code
to a DNR that day. My patient went from being very stable, going to go home the next day, to
vomiting blood. Her hemoglobin dropped to 4.5 and she was hemorrhaging. Needless to say
within a few hours my patient passed away. I was very affected by this, to the patient I was
crying on Michelles shoulders wanting to quit my job, and leave nursing all together. She took
me aside and had me walk her through everything that happened with this patient that night.
Then she asked me, what could I have done differently, and I looked at her and said I do not
know, nothing, nothing could have changed her outcome unless she was a full code. She looked
at me and smiled and said that is right, you did everything you could, and you are not going to
quite nursing. You will pull yourself together and it will hurt, but that is what makes a good
nurse, having feelings, and you did everything you could, she told me. Her influence over me
and making me see that there was nothing else I could have done, was something I would never
forget. She is someone you can count on, and I have seen her to this with other nurses as well;
she is someone you can look up to.

Decision-making Process
Nurse patient ratios is an issue that seems to happen in every hospital; my place of
employment is no different. There are always nights when there is a higher acuity of patients and
we are not prepared with the number of staff who might be able to help. However, Michelle does
a fairly good job at problem solving this issue, to make sure that our assignments allow each
patient the best possible care. According to Pamela Tevington (2011), The ANA acknowledged
determination of appropriate nurse staffing levels is problematic due to budget realities nursing
shortages, and apparent lack of data to guide and make adequate staffing decisions (p. 267). I
cannot speak for what other floors do, but I know when I am working PCU or in the ICUs, we
are always talking with Michelle. Letting her know when we are getting a patient and if we have
adequate staff to take care of certain patients. More than once has Michelle come to the floor and
worked as a nurse. She has passed medications, taken patients to CT, among countless other
duties that I have not seen other supervisors do. Sometimes, she will ask other supervisors to
lend us their patient care technician (PCTs) to help out, even if it is only for a couple of hours.
She works very hard to make sure we are never short staffed, this is just one example that
explains her problem solving skills.
Conflict
Nurse conflict is another issue that Michelle has seen, and has had to discipline for.
Under stress many times people get snappish and occasionally mean to one another. It tends
to be tolerated and explained as nurses responding to stress, but from this behavior nurses have
left their position at MidMichigan Health. John Murray (2009), describes workplace bullying as
any type of repetitive abuse, in which the victim of the bullying behavior suffers verbal abuse,
threats, humiliating or intimidating behaviors (p. 273). Michelle does not tolerate bullying,

whether that be nurse to nurse, nurse to patient/family, or patient/family to nurse. She is always
willing to step in and disengage the bullying, either before it happens, or should it already have
happened, so tries to make it stop. There is one time, a family was bullying their loved ones
nurse, they felt that they were not getting the proper care that they thought this patient
deserved. Remarks were to the nurse, that they knew people at our hospital and they would see to
it that this nurse would lose their job, if they did not give up to their standard of care. For fear of
losing their job and now being on edge because of the family and patient the nurse sought
Michelles advice on how to handle the situation. Michelle went in to talk to the patient and the
family and found out, that it was not personally the nurse they had a problem with. It was the fact
that the patient was just in the hospital a week prior and now back in for the same diagnosis, and
thought that the doctors discharged this patient too early. Michelle talked with the nurse and they
discussed how they would further treat the patient, and there was not an issue again. Bullying can
happen in many forms and this is one form that should not be tolerated.
Conclusion
In conclusion I fully stand behind Michelle Walker. She too me meets the definition of
leadership that is set forth by Yoder-Wise (2014), The ability to elicit a vision from people and
to inspire and empower those people to do what it takes to bring the vision into reality (p. 39).
She has repeatedly shown her support for the nurses, and whether right or wrong she does not
use her power to intimate them, but make them see learn from their mistakes. She is always
encouraging and seeks out new educational opportunities that nurses can learn from and that
might better their career. She also takes the time to know each and every one of us and does not
take advantage of that relationship.

Reference
Murray, J. (2009). Workplace bullying in nursing: A problem that cant be ignored. MedSurg
Nursing, 5(18), 273-276.
Tevington, P. (2011). Mandatory nurse-patient ratios. MedSurg Nursing, 5(20), 265-268.
Yoder-Wise, P. S. (2014). Leading and managing in nursing (5th ed.). St. Louis, MO: Elsvier
Mosby.