Running head: ANALYZING A NURSE IN A LEADER ROLE

Analyzing a Nurse in a Leader Role

Courtney Wright and Felicia Doolin
Ferris State University

ANALYZING A NURSE IN A LEADER ROLE

Interview and Analysis of a Nurse Manager

Leadership is the use of personal traits to constructively and ethically influence patients,
families, and their staff through a process in which clinical and organizational outcomes are
achieved through collective efforts (Yoder-Wise, 2015). Nursing leaders are not born overnight,
but are built based on many factors learned through education and work experience. In the
healthcare field, leaders are of high importance in order to assist in providing safe and effective
care to every patient. The purpose of this paper is to cover an interview with a nursing supervisor
to not only understand what a supervisor does on a daily basis, but to discover what it takes to
become a successful nursing leader.
An interview with Goosen, RN, BSN, was conducted on March 21, 2016 at Butterworth
Hospital in Grand Rapids, Michigan. During the interview Goosen spoke about her passion for
the nursing profession and what qualities she has that helps her thrive in her career. While she
was in high school she acquired a part-time job as a nursing technician at the Butterworth
hospital in Grand Rapids, Michigan on 4 heart. After she graduated from high school she went to
college for nursing and obtained her associates degree, while still working on 4 heart as a nursing
technician. The managers on 4 heart jumped at the chance to hire her as a nurse and within a year
she was already in the charge nurse position. When a job opened up for the supervisor of the
neurologic and surgical critical care floor, she knew that position was meant for her. Shortly after
she took this position, it became required to have your bachelors degree in order to hold a
supervisory position. To keep her position, she enrolled in an online bachelors degree nursing
program and finished it within six months. With her experience, education and love for the
nursing profession, she is more than qualified to be a nurse supervisor.
Roles and Responsibilities
As a nurse supervisor, Goosen has many roles and responsibilities that she must complete
on a daily basis. First and foremost, she is the supervisor for the nurses and nursing technicians

ANALYZING A NURSE IN A LEADER ROLE

for neurology critical care and surgical critical care. These individuals do not directly report to
her, but often times shes the first person they go to if there is an issue or problem that needs to
be resolved on the floor. On a daily basis, she completes rounds on the patients to ensure quality
improvement tasks are properly being taken care of. She is also responsible for overseeing the
finances on the floor to ensure they are receiving above a 92% on scanning the orange stickers
on equipment the staff uses. Goosen also is involved with hiring new staff members, scheduling,
and staff meetings on new advances in education to be implemented on the floor.
Following the organizational chart, Goosen reports to the neurology critical care manager
and the surgical critical care manager. She collaborates with these individuals often to try and
constantly improve the care that the patients receive. The philosophy that is always in the back of
Goosens mind is that Spectrum Health strives to be a top notch health care facility by 2020.
Much of her work on the floor is dedicated to this philosophy, by making sure the staff is
providing the best care they can to their patients.
Communication
On a daily basis Goosen collaborates with numerous individuals while in her supervisory
role. According to Yoder-Wise, Collaboration is both assertive and cooperative because people
work creatively and openly to find the solution that fully satisfies all important concerns and
goals to be achieved (Yoder-Wise, 2015). In the healthcare field communication and
collaboration is necessary in order to properly care for patients. In order to appropriately
communicate with one another, a relationship must first be built. If there is not a foundation
between individuals, trust may not be given right away. Trust is an important concept, because
individuals may have different perceptions on how to properly care for a patient. If there is trust
between these individuals, then they will collaborate appropriately to merge their ideas to come
up with a better way to provide patient care. The American Organization of Nurse Executives
emphasizes how important it is to have good communication strategies (The American

ANALYZING A NURSE IN A LEADER ROLE

Organization of Nurse Executives, 2015, p. 6). Goosen does an excellent job with her
communication strategies by being actively involved and collaborating with others on a daily
basis to build their relationships.
When Goosen arrives at work for the night shift, she first communicates with the charge
nurse. Out of everyone, the charge nurse is the main person she is in contact with. If the patient
census is high, the charge nurse will receive her own patients, and Goosen will take over the
charge nurse position for the night. The hospital supervisor is in constant communication with
Goosen to make sure that the floors are properly staffed. They are also one of the individuals
Goosen will call if something were to go wrong on the floor (or even if no one can get an
intravenous line started on a patient). She collaborates with all of these individuals to promote
safe and effective care to all patients.
Quality Improvement and Risk Management
Quality improvement activities are focused on using data to improve the processes and
outcome of care (Yoder-Wise, 2015). No matter how prestigious a hospital is, there is always
room for quality improvement. Quality improvement is especially important, because in the
healthcare field, patients lives are at stake. Mistakes happen far more than anyone would like to
admit, but in the end it is important to learn from the mistakes and make the hospital a safer
place.
Goosen plays a direct part in quality improvement on the surgical and neurology critical
care floor. The American Organization of Nurse Executives points out one of the tasks leaders
need to do with their risk management is to hold individuals accountable for their actions (The
American Organization of Nurse Executives, 2015, p. 6). Goosen holds individuals accountable
for their actions by the event reporting system (ERS). If an issue were to arise with patient care
and a nurse were to discover it, an ERS must be filled out. These forms are then handed over to
Goosen for review. If an ERS were to be filled out on an error you made, you would not

ANALYZING A NURSE IN A LEADER ROLE

necessarily receive discipline. Goosen looks at these forms as if they are learning opportunities
to improve the quality of your nursing skills. Goosen also completes rounds on the patients to
ensure they are receiving adequate care and looking at ways to prevent future risks. When she
goes into a patients rooms she checks to make sure they do not have an unnecessary catheter,
that they do not have bed ulcers and that they are not overly sedated by medications. These tasks
are done to ensure quality care is being provided to each and every patient.
Leadership
Leadership, is defined by Yoder-Wise (2015) as, the use of individual traits and abilities,
in relationship with others, and the ability to (often rapidly) interpret the environment/context
where a situation is emerging, and enter that situation in the absence of a script or defined plan
that could have been projected (p.5). Goosen began by describing her chosen leadership style as
servant leading. Servant leadership differs from other models of leadership in that it focuses on
leaders meeting the needs of followers, in that, if followers are treated as ends in themselves,
rather than means to an end, they will reach their potential and so perform optimally
(Waterman, 2011, p. 25). Goosen strives on being there for all the staff members including floor
staff such as nurses and nurse technicians, believing strongly in organizational support. This idea
is also seen in the Nurse Executive Competencies (NEC) as a goal for foundational thinking
skills (The American Organization of Nurse Executives, 2015, p. 7). It is her goal to keep all staff
informed and up to date, as she feels a sense of loyalty to the people she is in charge of. This idea
can relate to the nurse executive system competencies under system thinking, to provide
leadership and build loyalty and commitment throughout the system (The American Organization
of Nurse Executives, 2015, p. 7).
Professionalism
Both legal and ethical considerations are pertinent in nursing care. As explained by
Yoder-Wise (2015) Areas of concern include professional nursing practice, legal issues, ethical

ANALYZING A NURSE IN A LEADER ROLE

principles, labor-management interactions, and employment (p. 71). Goosen explained that she
encounters legal and ethical issues on a daily basis.
Some examples that were provided by Goosen included legal issues such as a case where
a dying patient had two different resuscitation orders. From this, she had to step into her role to
solve this issue to protect the patient and the staff involved. In this case she was meeting two
points made by the American Organization of Nurse Executives (2015), which are representing
perspectives of the patient's rights and holding herself and the staff accountable for the outcomes
of the patient (pg. 8). Goosen also shared that part of her role was to take on common issues seen
by the staff on the floor, an example being how long is appropriate to keep patients alive if they
are brain dead. With this, she demonstrated that as a leader she brought, role model principled,
values-based, ethical thinking to the system (American Organization of Nurse Executives, 2015,
p.8). Goosen also addressed that part of her role in professionalism is to set good examples by
using positivity and following rules, even with simple things like following the dress code.
Staff Management
Although Goosen shared that she does not have a large role in budgeting for the hospital,
she still is very active in the role of staff management. She attends all staffing meetings and plays
an active role in it, both listening and offering guidance if needed. She runs the white board and
balances numbers during staff meetings and works with other staff to troubleshoot staff numbers.
Along with staffing numbers, Goosen also deals with other staffing issues such as
conflict. Conflict can be seen in any work environment, but it is how it is handled that is most
important. Goosen discussed that there have been times that staff members were not getting
along, which required her action. Brought to attention by the American Organization of Nurse
Executives (2015), it is important that nurse executives play a role in using corrective measures
for workplace behavior problems (p. 10). In this case, Goosen addressed the individuals
separately and encouraged them to write down feelings or things needed to be said before she

ANALYZING A NURSE IN A LEADER ROLE

arranged a meeting for the two employees. Goosen mentioned that her foundation to problem
solving is being able to get the issues out in the open in order to solve them.
Conclusion
Leaders do more than delegate, dictate, and direct. Leaders help others achieve their
highest potential (American Nurses Association, 2016). From the interview with Goosen, it is
easy to see how many specific roles are taken on in the role of a floor supervisor. Goosen shared
her roles in communication, quality improvement, risk management, style, change management,
professionalism role, and in staff management. As students just about to start the beginning of
our career, it was amazing to see what perseverance and hard work can lead to. From the way
that she spoke to us, it was easy to see the amount of dedication that she has for both the patients
and the organization. We have found, as students, that often times we feel we arent making a
huge difference, but as shown by Goosen, even the smallest things can make a difference in
patient care and the healthcare environment.
References
American Nurses Association. (2016). Leadership. Retrieved from http://www.nursingworld
.org/MainMenuCategories/ThePracticeofProfessionalNursing/Leadership
The American Organization of Nurse Executives. (2015). Nurse executive competencies:
System CNE. Retrieved from http://www.aone.org/resources/nec-system-cne.pdf
Waterman, H. (2011). Principles of 'servant leadership' and how they can enhance practice:
Harold Waterman suggests that leaders can obtain the most from their staff and
deliver

better services by embracing a more egalitarian model of management.

Nursing

Management, 17, 24-26.

Yoder-Wise, P. S. (2015). Leading and Managing in Nursing (6th ed.). St. Louis, MO: Mosby
Elsevier.

ANALYZING A NURSE IN A LEADER ROLE