Running head: NURSE SUPERVISOR

Interview and Analysis of a Nurse Supervisor Nicole McDonald & Erin White Ferris State University

NURSE SUPERVISOR Interview and Analysis of a Nurse Supervisor The purpose of this paper is to choose a nurse who holds a management role and interview her to learn more about nursing management, and what is involved in that leadership role (Dood, 2014, p. 11). According to Yoder-Wise (2011), a supervisor is someone who

institutes and communicates goals to staff, organizes and divides the work, motivates employees, evaluates performance and addresses staff on areas of strength and needed improvement (YoderWise, 2011, p. 55). An interview was conducted with Valerie Mowat, RN, BSN who has been a supervisor at Mercy Hospital Cadillac for three years. Valerie also works as the Ferris State University Clinical Instructor, has been a critical care nurse there for ten years, and a charge nurse at this hospital for two years. She is currently in a Masters degree in Nursing (MSN) program at Ferris State University to further her education. In the interview, the role of a supervisor was investigated and its effects on patients, staff and the entire organization were analyzed. Job Duties As a supervisor, Valerie is responsible for assigning patients to beds when they are admitted, assigning nurses to patients, ensuring supplies are stocked and knowing where and how to get supplies when they are out. Valerie must be aware of the surgery schedule, and is responsible for contacting surgeons and setting up surgery schedule on the weekends when regular surgery staff is not there. As a supervisor, Valerie helps troubleshoot problems with nurses and answers questions of all staff. Along with assisting other nurses, Valerie must be available to provide direct patient care when need for assistance arises. In this supervisor role, Valerie is also responsible for obtaining consent forms for release of medical records, printing out and sending the requested medical records on weekends, as unit clerks are not present. At

NURSE SUPERVISOR the top of the chain of command at Mercy Hospital Cadillac is the Chief Executive Officer

(CEO), followed by the CNO (Chief Nursing Officer) and the Director of Nursing (DON). Next are the Unit Managers, which Valerie reports to, and then the Supervisors. In some cases Valerie may report directly to the DON as opposed to a Unit Manager. Collaboration Valerie is expected to collaborate with all departments in the hospital as a supervisor. She often counts on the other departments, such as the radiology, physical therapy, and dietary to ensure that things run smoothly, but she is also there to assist each of these departments as needed. For example, Valerie may need to provide transport for a patient down to x-ray or go down to the cafeteria to bring a tray up for a patient. According to Nilsson, Campbell and Andersson (2008), teamwork is the most important point among nurses. Valerie agrees with this and stated, teamwork is important, not only among the nurses but throughout the entire hospital (V. Mowat, personal communication, January 23, 2014). Part of her job as a supervisor is to ensure the teamwork is there and to help promote it by engaging in it herself and empowering her employees to do the same. As the supervisor, Valerie makes herself available to help out each department as needed, not just the nursing staff, and must use her time efficiently in order assist in every place she is needed. She is calm, easy-going, flexible, highly educated and experienced as a nurse, and also very familiar with Mercy Hospital. All of these factors help her be an effective leader for the staff and caregiver to the patients. Legal and Ethical Issues Valerie discussed a major ethical situation that she was faced with as a supervisor, in which an 18-year old illegal alien came in to the emergency room with kidney failure and in need of dialysis. Because the patient was an illegal alien and had no identification, job or

NURSE SUPERVISOR insurance, the dialysis center that services Mercy Hospital patients would not take him. The hospital had no choice but to provide dialysis for this patient every other day for three weeks,

which is the length of time it took to find a facility which would provide dialysis services to him as an illegal alien. The supervisor makes the decision to treat the patient based on hospital policy because it was necessary for him to survive. Valerie discussed how difficult this type of situation is, as a manager, you have to make the decision that is best for the patient even if it is not what is best for the hospital (V. Mowat, personal communication, January 23, 2014). This situation caused a large financial deficit to the hospital, due to the length of time it took to find another facility willing to treat him on a regular basis. This issue also affected the other patients, as it took many hours of paperwork and phone calls by many staff members, who normally had a role in patient care. Since this patient needed services from the hospital for three weeks, this delayed dialysis for the remaining dialysis patients for the three weeks of this patients stay. This also affected the staff of the hospital, as many were unable to complete their expected daily tasks, as they were asked to assist in figuring out this case. This put many staff behind and increased stress and frustration for many involved employees. Power and Influence With being a supervisor, comes power of making final decisions and the opportunity to influence the decisions of others. Valerie says that she tries not to use her power as a supervisor and strives more to empower her staff to use their own judgment, weigh the pros and cons, and make the best decision themselves instead of just making the choice for them (V. Mowat, personal communication, January 23, 2014). If Valerie is working with a nurse to solve a problem, and that nurse is not considering all of the options, or has a different take on the problem, she may use her own knowledge to try and influence that nurses decision, which

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according to Yoder-Wise (2011) is what it means to use power in nursing (Yoder-Wise, 2011, p. 177). According to Cummings et al. (2009), leadership styles that are more concerned with relationships and communication were associated with higher job satisfaction for nurses, than those leadership styles more focused on tasks. By promoting this type of leadership, Valerie is promoting higher satisfaction for her nursing staff, forming trusting relationships, and enabling nurses to feel the management is confident in their abilities (Cummings et al., 2009). Higher job satisfaction general improves patient outcomes (Cummings et al., 2009). According to Abraham Maslows Hierarchy of Needs Theory, a persons basic food, water and air needs, as well as safety needs must be met before she can focus on social and esteem needs (Yoder-Wise, 2011, p. 10). When a nurse feels that her supervisor trusts and believes in her abilities, she will feel more comfortable and provide better patient care. This meets the employees social and esteem needs, increases confidence and improves job satisfaction. Higher job satisfaction may reduce turnover rate, which is beneficial to the hospital, and could also improve peer relationships among nurses. Decision-Making and Problem-Solving If a decision must be made quickly, Valerie must make a decision on her own, in which case she looks at the information she has been given and uses her knowledge and judgment to make the best decision. Valerie discussed the importance of knowing all of her resources as a supervisor, because the physicians and other staff members often count on the supervisors for answers to questions they are unsure of, and the supervisors must be able to know where to find they answer if they do not know it. Valerie says that if a physician asks her a question, she does not want to say I dont know, so she is very aware of all the resources available to her through the hospital (V. Mowat, personal communication, January 23, 2014). If the supervisor is

NURSE SUPERVISOR knowledgeable of the facility and educated in the field of nursing, that is of benefit to the

patients, as this supervisor will solve problems quickly and make decisions in the best interest of the patient. This brings relief to fellow employees, as they feel less pressure to know all the answers. If a supervisor is able to find an answer quickly and efficiently, and does not reply to a patient with I dont know, it makes the hospital look more professional and its staff appear more prepared. Conflict Resolution As a supervisor, Valerie is often utilized to manage conflicts among staff and patients or between staff members. During the interview she provided an example of a conflict she had regarding staffing while she was the supervisor, she discussed the steps following the conflict to resolve it and decrease the likelihood of it happening again. During this conflict, one nurse felt there was not adequate staff, while Valerie believed there was. Following the conflict, there was a meeting with their union and the DON to discuss the situation. This provided the opportunity for Valerie and the nurse to discuss the issues in a professional environment, with management staff there to provide their input and help both staff members determine how to handle this situation better, should it arise again. Valerie stated, It is important to remember that no matter what you do as a manager, it is impossible to please everyone (V. Mowat, personal communication, January 23, 2014). She does the best she can and knows she must deal with the consequences either way. If conflicts are not dealt with promptly and professionally in a meeting, there can be hard feelings between staff members which can have an effect on working relationships. This type of conflict resolution speaks to the leadership style discussed earlier in the article by Cummings et al. (2009), which encourages relationships and communication, and promotes job satisfaction among nurses. If

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job satisfaction rates are higher, then patient satisfaction rates are likely to be higher as well, and each of these has an effect on how the hospital runs as an organization. Valerie stressed the importance of communication and not getting upset as a supervisor, even though at times it can be difficult (V. Mowat, personal communication, January 23, 2014). When there are conflicts between two staff members, the same type of meeting system is utilized to solve the problem quickly and professionally. Valerie listens to both staff, and does her best to provide insight to the situation, and help the staff talk through the problem to avoid any type of interruption in the running of the hospital and the roles of the nurses. Reflection Valeries knowledge of Mercy Hospital Cadillac, level of education, experience as a nurse, and personality traits provide her with the means to be an effective supervisor. The staff feel comfortable working with Valerie and with her as their supervisor, as she is always there to answer questions, assist with procedures and help make decisions. Valerie uses her knowledge and discretion when making nursing assignments, helping to solve problems and dealing with conflicts. She tries to do what she believes is best, while keeping in mind the effects it will have on patients, the staff and the hospital. Valerie promotes a positive working environment for her staff in which teamwork is utilized to its full extent. She is a strong leader without being overbearing, and her line of communication is always open as a supervisor.

NURSE SUPERVISOR References Cummings, G. G., MacGregor, T., Davey, M., Lee, H., Wong, C. A., Lo, E., Muise, M., & Stafford, E. (2009). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 47(3), 363-385, doi: 10.1016/j.ijnurstu.2009.08.006 Dood, F. (2014). Leadership in Nursing. Retrieved from

http://www.ferris.edu/HTMLS/colleges/alliedhe/docs/nursing/NURS_440_Leadership_in _Nursing.pdf Nilsson, K., Campbell, A., & Andersson, E. P. (2008). Night nursing staffs working experiences. BioMed Central Nursing, 7(13), 1-9. doi:10.1186/1472-6955-7-13 Yoder-Wise, P. S. (2011). Leading and Managing in Nursing (5th ed.). St. Louis, MO: Mosby Elsevier.