Running head: NURSE MANAGER

Nurse Manager Analysis Erica Gamble and Rachel Prudhomme Ferris State University

NURSE MANAGER Nurse Manager Analysis

The role of a nurse manager can come in many forms depending on the area in which the nurse works, the skills required for the position as well as the responsibilities that come with their job description. In order to gain a better understanding of what it takes to be a nurse manager, an interview was conducted on Becky Johnson-Himes, supervisor of the Osceola County Branch Office of Central Michigan District Health Department (CMDHD). JohnsonHimes has her Bachelors Degree of Science in Nursing and is currently working on obtaining her Masters Degree (B. Johnson-Himes, personal communication, March 13, 2014). She has been a nurse for about twenty-three years and has worked at the health department for seventeen years, twelve of which were in the supervisor position (B. Johnson-Himes, personal communication, March 13, 2014). Prior to working at the health department, she was a labor and delivery nurse in two separate hospitals (B. Johnson-Himes, personal communication, March 13, 2014). She is also the main supervisor over immunizations throughout the six counties that are part of CMDHD (B. Johnson-Himes, personal communication, March 13, 2014). Job Duties As a manager at the health department, Johnson-Himes oversees and participates in many programs. The health department offers twenty-seven different health-related programs including: Women, Infants, and Children (WIC), Maternal Infant Health Program (MIHP), STD screening, lead testing, family planning, immunizations, communicable diseases, breastfeeding support, and many others (Central Michigan District Health Department, 2013). Johnson-Himes stated in the interview that she feels that her main job within CMDHD is to oversee and control immunizations (Personal communication, March 13, 2014). She covers all six counties in order to ensure that certain standards are met within the health department as well as area schools (B.

NURSE MANAGER Johnson-Himes, personal communication, March 13, 2014). She creates and updates all of the local policies and procedures regarding immunizations and handles the funding for this program (B. Johnson-Himes, personal communication, March 13, 2014). In order to do this thoroughly, Johnson-Himes creates reports regarding immunization statistics for CMDHD and the schools within the six counties (B. Johnson-Himes, personal communication, March 13, 2014). She sends letters to the other branch offices within CMDHD, schools, physicians offices and any child welfare homes within their district to keep them updated (B. Johnson-Himes, personal

communication, March 13, 2014). Schools and child welfare homes are partially funded through governmental agencies based on their immunization status (B. Johnson-Himes, personal communication, March 13, 2014). Johnson-Homes also states that she is required to report these results to the state government and her direct supervisor (Personal communication, March 13, 2014). Within her branch office, Johnson-Himes is responsible for not only immunizations but also for ensuring that each of her employees is doing their job correctly (B. Johnson-Himes, personal communication, March 13, 2014). She has a nurse practitioner, three nurses, a social worker, a breastfeeding peer counselor, a hearing and vision screening person and three secretaries that work under her within Osceola County (B. Johnson-Himes, personal communication, March 13, 2014). Within CMDHD, Johnson-Himes also has approximately sixty more people that report to her in regards to immunizations (B. Johnson-Himes, personal communication, March 13, 2014). Collaboration For the Central Michigan District Health Department (CMDHD) to be successful, collaboration is very important. This includes collaboration between staff members of each office, managers and staff of the other offices and between CMDHD and other community

NURSE MANAGER agencies. Other agencies that the health department works with on a regular basis include Department of Human Services (DHS), mental health agencies, physicians offices, Council on Aging, local and state police, local and state governments, Child Protective Services (CPS) and animal control (B. Johnson-Himes, personal communication, March 13, 2014). In order to ensure proper collaboration between all of these agencies, there are monthly meetings that Johnson-Himes is required to attend (B. Johnson-Himes, personal communication, March 13, 2014). This gives each agency a chance to voice concerns or to give new information that may be important to the daily functions of the health department. There are also quarterly meetings within the CMDHD system that many of the staff members are required to attend (B. JohnsonHimes, personal communication, March 13, 2014). These meetings are necessary to give the latest statistics for each county in regards to client numbers, immunization status, funding and any other changes that may be implemented. Legal and Ethical Issues At the health department, there are many legal and ethical issues that could arise. This could include things such as patient care, child abuse or neglect, issues with staff or changes in

federal, state or local governments. Johnson-Himes gave a specific example of a case where she had to report poor living conditions that were detrimental to a young childs health to Child Protective Services (Personal communication, March 13, 2014). In a situation like this, JohnsonHimes is informed of the issue that is occurring within her branch and then is to report the case to the appropriate local authorities (B. Johnson-Himes, personal communication, March 13, 2014). Johnson-Himes is always included in any cases such as these in order to provide the best information to handle cases appropriately (B. Johnson-Himes, personal communication, March 13, 2014). According to Yoder-Wise, most states have reporting laws for suspected child abuse

NURSE MANAGER and older adult abuse and laws for reporting certain categories of disease and injuries (2014, p. 81). In addition, many states now also have mandatory reporting of incompetent practice, especially through nurse practice acts, medical practice acts, and the National Practitioner Data Bank (Yoder-Wise, 2014, p. 81). These laws not only protect patients and communities members from harm, but also protect healthcare workers from legal implications. It is beneficial

for everyone involved to report any suspected issues to the authorities. Johnson-Himes practices in a legal and ethical manner by following proper guidelines for resolving issues that arise. Power and Influence Power is the ability to influence others in an effort to achieve goals (Yoder-Wise, 2014, p. 178). At the health department, setting and achieving goals are vital in order to successfully promote health and wellness. As a leader within the health department, Johnson-Himes is required to influence her staff members to meet certain standards of care. Influence is the process of using power (Yoder-Wise, 2014, p. 181). Each staff member at the health department is required to do their job effectively and efficiently and having a strong leader is necessary to ensure goals are met. Johnson-Himes is able to greatly influence the outcome of various goals set by CMDHD. Johnson-Himes stated that she feels that she has the power and influence to make changes within the programs she is in charge of at the health department (Personal communication, March 13, 2014). Two types of power coexist within the healthcare setting (Nugus, Greenfield, Travaglia, Westbrook, & Braithwaite, 2010). Competitive power involves a clinician or clinicians from one occupation dominating others. Collaborative power involves interdependent participation (such as through role distinctiveness and role interchangeability) and decision-making, and staff evaluating their own performance to hold themselves accountable to team members (Nugus et al., 2010, p. 907-908). The power that

NURSE MANAGER Johnson-Himes displays in her role is collaborative power. She works as a team with her staff and takes their opinions into consideration. Decision-Making and Problem-Solving Decision-making and problem-solving are very important skills for all nurses to possess. As a nurse leader, these two skills can make a huge difference in an organizations ability to be successful. Decision-making is a purposeful and goal-directed effort that uses a systematic process to choose among options (Yoder-Wise, 2014, p. 101). Problem-solving is focused on

trying to solve an immediate problem (Yoder-Wise, 2014, p. 101). Both of these skills require a higher level of thinking and as a leader, are skills that are always evolving and improving. Johnson-Himes has the power to problem solve and make decisions on her own within the programs that she is in charge of, however, she likes to work with her team in order to make decisions that have everyones best interest in mind (B. Johnson-Himes, personal communication, March 13, 2014). Johnson-Himes is a successful manager because she is able to make decisions that are purposeful and goal-directed in a timely manner, while still taking into consideration the input her staff has on the topic. Conflict Management and Resolution There are five ways of managing and resolving conflict and these include: avoiding, accommodating, competing, compromising and collaborating, (Yoder-Wise, 2014, p. 469). Each of these methods has positive and negative aspects. As a leader, knowing which method, or combination of methods, will be most effective is important. Every situation that involves conflict needs to be addressed on an individual basis and managed once the most appropriate and effective method has been identified. If conflict is not dealt with properly, it may significantly affect employee morale, increase turnover, and even result in litigation, ultimately affecting the

NURSE MANAGER overall well-being of the organization (Iglesias & de Bengoa Vallejo, 2012, p. 73). Studies have shown that the conflict resolution styles most frequently used by nurses for managing workplace differences were compromising (which corresponds to a no win--no lose situation) and competing, and the least-commonly used was collaborating (Iglesias & de Bengoa Vallejo, 2012, p. 78). Johnson-Himes stated that she uses a combination of compromising and collaborating when dealing with conflict resolution (Personal communication, March 13, 2014). Johnson-Himes is able to use these methods, along with her leadership skills, in order to successfully manager conflict within her role. Conclusion

After interviewing Johnson-Himes and observing her in the clinical setting, it is clear that she is a successful leader and nurse manager within CMDHD. She is able to manage a large group of staff spread out across numerous counties without difficulty. The skills and behaviors that she demonstrates of an effective manager help to create a positive work environment for her staff. Johnson-Himes also displays excellent patient care through respect and opencommunication. She is an asset to the leadership team at CMDHD.

NURSE MANAGER References Central Michigan District Health Department. (2013). Personal health services. Retrieved from http://www.cmdhd.org/main.htm Iglesias, M. E. L., & de Bengoa Vallejo, R. B. (2012). Conflict resolution styles in the nursing profession. Contemporary Nurse, 43(1), 73-80.

Nugus, P., Greenfield, D., Travaglia, J., Westbrook, J., & Braithwaite, J. (2010). How and where clinicians exercise power: Interprofessional relations in health care. Social Science & Medicine, 71(5), 898-909. Yoder-Wise, P. S. (2014). Leading and managing in nursing (5th ed.). St. Louis, Mo.: Elsevier Mosby.