Running head: Nursing Manager 1

Analyzing a Nurse in a Manager Role

Patricia Beemer
Ferris State University
NURS 440



2
Nurse Manager


Introduction
Through an interview process, information was gathered regarding the management role of
Mischelle Peel, RN. Mischelle has been a Registered Nurse for thirteen years. Throughout the
thirteen years, multiple experiences and opportunities have been presented. For the first eight
years of her nursing career, Mischelle was a bedside nurse in a long term care facility.
Following that experience was an opportunity as a Unit Manager for a long term care facility.
After a few years of experiencing a management role, she decided to continue her education to
advance further into a management position. Mischelle currently attends Spring Arbor College
in pursuance of her Bachelors in nursing degree which she will complete in May, 2014. In
August of 2013, Mischelle was offered a position as the Nurse Manager for a growing
rehabilitation hospital.
Job Duties
Job duties include managing the brain injury and stroke units. This involves the management of
approximately forty-two registered nurses and twenty-eight nurse techs. This includes
evaluations, disciplinary actions if needed, monitoring incidental over time and making sure all
employees are performing at an optimal level. On a daily basis, Mischelle assists the admission
department to ensure the nurses are trained in all areas necessary to provide care according to
training previously provided. This also involves communication with our infection control
department to make sure patient is appropriate for admission and will not put other patients at
risk. The majority of the beds at the facility are in semi-private rooms. Due to this, bed
management consumes a great deal of her day. The need is great to make sure patients sharing a
room are compatible and appropriate according to diagnosis. It is essential to the productivity of
her departments that staffing and incidental overtime is monitored closely on a daily basis. This
3
Nurse Manager


is monitored both by herself and the staffing coordinator. If there are any patterns of incidental
overtime, it is addressed with the staff member. Disciplinarian is another role as nurse manager.
This involves following up on concerning issues of staff members. Mischelle and an additional
nurse manager both report to the Director of Nursing. Reporting to Mischelle are nurse techs,
registered nurses and clinical care coordinators.
Role
Collaboration with other staff members is essential to be clear on what areas need to be
addressed and how changes need to be implemented. Mischelle has developed a unit based
council including nurse techs and registered nurses from both brain injury and stroke teams.
This council was developed to make sure concerns and ideas from those working closest to the
patient were taken into consideration. There are program and therapy managers that work very
close with Mischelle to develop new ways of running the units. They work as a team if concerns
are brought forward, developing a plan to solve the problems. This team addresses any issues or
concerns with the physicians once an improvement plan is in place.
Legal Issues
Within the facility there are multiple physicians who work within a group. At times, a patient is
not satisfied with the service a physician is providing. In that case, there is a need to address
concerns, speak with the physician and transfer service if all involve are in agreement. At times,
this is very difficult to deal with because there is a need to make sure the transfer is handled
correctly so no further action is needed by the patient. Usually there are a number of reasons
why the transfer has been requested. It is then Mischelles position to investigate and follow up
on these reasons to make sure they were all handled correctly and follow up was made to the
4
Nurse Manager


physician. If there are any concerns regarding the physician care, Mischelle is responsible to
relay the information to the Director of Nursing for additional investigation.
Use of Power and Influence
Staffing concerns are one of the major issues Mischelle is addressing. Due to the recent changes
within healthcare, nurse to patient ratios have been influenced. Journal of professional nursing
states: During the last 4 years, most of the public universities across the country have faced
major budgetary cuts. (Yucha, 2014) This is a major concern for her and one she is taking to the
leadership team for evaluatation. With this, she is researching the number of falls and
medication errors since the ratio had changed and providing some financial information to the
facility to show that the reduction of nurses may not be the most beneficial when all areas are
factored in. If the point is taken by the leadership team, this may mean nurses will have more
time to spend providing quality care to the patients.
Problem Solving
Problem solving is an area where Mischelle recognizes she needs to pull in members of the team
for assistance. When figuring out a plan for solving a problem, she works with her fellow nurse
manager to collaborate a solution. At times, the Director of Nursing and the two nurse managers
work together with nursing to develop a solution. Most recently, they have been discussing the
budget for the new fiscal year. This is the first year Mischelle will be a part of this and she is
finding it difficult to grasp. One of the major issues to address is nurse staffing. Yoder-Wise
states: For hospitals, in particular, nurses are the largest group of employees and often account
for most of the personnel budget. (Yoder-Wise, 2014) This seems to be a struggle with the
need for more nurses working bedside. Mischelle is receiving more training from the facility to
develop a better understanding.
5
Nurse Manager


Resolution of Conflict
Many of the nurses at the facility have been employed there for many years. Where this is a
positive for the facility, it also poses a problem when staff is not willing to make changes
necessary to stay up with the changes in health care. More and more patients are being admitted
with high acuity. Olshansky states: The combination of transitional care, necessitating care
both inside and outside the hospital, and the large number of chronically ill persons who require
care outside of the hospital highlight the importance of community health as integral to nursing
education. (Olshansky, 2011) This means staff needs to be provided with education to safely
care for these patients. It is within Mischelles position to develop a way to encourage nurses to
stay positive and embrace the change. This is being done by her providing more educational
funding and finding continuing education classes in the areas most needed at the facility.
Providing these opportunities has been beneficial to some, but others are refusing to change with
the times. This then forces Mischelle to then evaluate the performance of these staff members
and follow any disciplinary action needed.









6
Nurse Manager


References
Olshansky, Ellen, DNSc, RN, WHNP-BC, FAAN. September 2011. Volume 27. Issue 5, pages 265-266.
Community/Public Health Nursing: One Way Nursing Can Make a Difference. Journal of
Professional Nursing.
Yoder-Wise, P. (2014). Leading and managing in nursing (5
th
ed.). St. Louis, MO: Elsevier.
Yucha, Carolyn, RN, PhD, FAAN. Smyer, Tish, DNSc, RN, CNE. Strano-Perry, Sybil, BA. January 2014.
Volume 30, Issue 1. Sustaining Nursing Programs in the Face of Budget Cuts and Faculty
Shortages. Journal of Professional Nursing.