Running Head: NURSE LEADER AND MANAGER

Analysis of a Leader and a Manager

Andrew Smith
Ferris State University

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Interview of a Nurse Leader and Manager

As the healthcare landscape continues to change in the recent years following the passage
of the Patient Protection and Affordable Care Act (ACA), the need for highly skilled and
knowledgeable leaders and managers is on the rise. Nurse managers are included in this and must
possess qualities and skills such as knowledge, integrity, ambition, judgment, courage, stamina,
enthusiasm, communication skills, planning skills, and administrative abilities (Yoder-Wise,
2014). Their role is to ensure effective operation of a defined unit of service and to contribute to
the overall mission of the organization and quality of care (Yoder-Wise, 2014), with patient
safety, privacy, values, and beliefs the foundation of the care provided.
I chose to interview my good friend Jackie Schroeder, RN, BSN, a Clinical Coordinator
in Ambulatory Neurology at Rush University Medical Center in Chicago, IL which she just
started this past couple weeks. I attended Northern Michigan University with Jackie, where she
eventually graduated with her BSN in 2012. Following graduation she moved backed to Chicago
and became a staff RN and charge nurse at Loyola University Medical Center on the
neuroscience floor. This floor specialized in neurology, neurosurgery and otolaryngology (ENT)
but this was also the largest floor of the hospital so she was familiar with medical/surgical,
gynecology, urology, and trauma patients. She also has specialized training with the NIHSS
stroke scale for stroke victims requiring tracheostomy, radiation isolation, and EEG monitoring.
Her experiences at Loyola allowed her to gain the required skills and knowledge to become
Clinical Coordinator at Rush Medical Center.

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Job Descriptions and Duties

As a charge nurse at Loyola, Jackies primarily worked with patient placement to place
patient in certain rooms. She stated that this was always a challenge because at Loyola the rooms
were semi-private so all the patient had roommates. This became problematic when issues
involving isolation precautions and other safety precautions came into the picture. She also
assigned patients to their specified nurses and patient care technicians. Other general job duties
included working with the nursing supervisor to meet staffing needs, auditing EPIC charts,
rounding, cleaning, stocking, and handling grievances.
Collaboration
Healthcare is now delivered in a collaborative, and most often, an interprofessional
manner: (Yoder-Wise, 2014), and occurs all the time according to Jackie. As a charge nurse she
had to constantly work with the nursing supervisor, her staff, patient placement team,
housekeeping, security, patient transportation, imaging technicians, other floors, and her own
manager. She stated that everyone had to work together all the time to treat and help with care
for Loyolas challenging patient population. An example of this that she recalls is with a patient
who was severely withdrawing from alcohol. He only spoke Korean and he was becoming a
danger to himself and others throughout the night as it progressed. Eventually the staff and she
had to restrain him with security, escort him to MRI, use an interpreter and eventually with the
physicians evaluation they transferred him to the ICU to receive an IV Ativan drip to calm him
down for his and others safety.

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Legal and Ethical Issues

Legal and ethical issues are always a factor for a nurse manager to consider when
providing patient-centered care and often involve professional boundaries. Professional
boundaries need to be established and roles should never go beyond providing care needs.
According to Griffith (2013), a breach of professional boundaries occurs when a nurse uses
words, acts or behavior designed to arouse or gratify sexual impulses or desires, particularly
words, actions or behavior that could reasonably be interpreted as sexually inappropriate or
unprofessional (Griffith, 2013). Jackie, while working at Loyola, often ran into legal and ethical
issues, particularly involving patients visitors. Loyola is a Catholic institution and because of
the semi-private rooms, family and friends of the opposite sex were not allowed to spend the
night. It was often an issue and constant struggle because of the individuals frequent mistrust of
the health-care system. At times, family members would need to be escorted out by security
because they did not want to leave their loved ones. Another example, this time a legal issue,
occurred when a friend of a patient had determined the patients house was to be condemned
and that he had to make medical decisions for the patient, but the patient did not agree. While it
may not seem like a nursing issue, the friend would constantly harass staff members and nurses
for health related information. Management had to eventually step in to ensure the patients safety
and primarily privacy needs and concerns were dealt with in accordance to HIPAA.
Power and Influence
As a charge nurse Jackie stated that they generally have lots of power with how patients
feel and are treated (J. Schoeder, personal communication, January 29, 2015). Before leaving
Loyola, Jackie initiated the floors (2NE) Professional Practice Committee. It was an opportunity
for the staff to meet without the manager to come up with solutions for unit-based problems. She

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stated that they came up with creative plans for common problems including call-lights and
blood work mislabeling.
Decision Making and Problem Solving
Nursing managers need to possess the skills and knowledge needed to address complex
situations with decision making and problem solving at the forefront. An example of this is the
use of adaption to quickly and effectively respond to the changing environment in health care
(Weberg & Weberg, 2014), while still maintaining patient safety. As a charge nurse, the most
difficult decision making that Jackie made was who to assign new patients to and when. It was
often a difficult challenge because nurses never want to accept adding another patient to their
current load and thats why nurses need to be quickly able to adapt to a changing workload.
Problem solving occurred for Jackie often when dealing with safety situations such as high fall
risk patients or confused patients, which often tends to occur with neuro patients. A lot of placing
of patients in certain rooms was based on their proximity to the nurses station.
Conflict Resolution
According to Jackie, with nursing, particularly on a challenging floor, you are dealing
with conflict resolution on a daily, even hourly basis (J. Schoeder, personal communication,
January 29, 2015). She stated that its all about how you communicate with people, you need to
be clear, concise and courteous when dealing with both staff and patients. Its easy for people to
feel offended or that you are doing something unfair to them, but if you are clear and kind,
people tend to remember that they are in a stressful environment and that we are all doing the
best we can do (J. Schoeder, personal communication, January 29, 2015).

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Conclusion
Jackie represents the nurse that I want to be following graduation with all the skills and
knowledge that make her a great leader and effective clinical coordinator. Her background as a
charge nurse allowed her to grow and further develop her skills that eventually allowed her to
acquire the clinical coordinator position at Rush Medical Center.

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References
Griffith, R. (2013). Professional boundaries in the nurse-patient relationship. British Journal of
Nursing, 22 (18), 1087-1088.
Weberg, D., & Weberg, K. (2014). Seven behaviors to advance teamwork. Nursing
Administrative Quarterly, 38 (3), 230-237.
Yoder-Wise, P.S. (2014). Leading and managing in nursing: revised reprint. St. Louis, MO:
Mosby Elsevier.