Introduction
This paper represents a comprehensive leadership assessment of a nurse manager working in an acute care hospital located in New Jersey. While the exact organization and individual will remain anonymous, the assessed nurse administrator works within a 665-bed regional medical center that has attained Magnet Recognition status for nursing excellence and holds Level II Trauma Center designations due to its sophisticated treatment capabilities and positive patient outcomes across most major clinical specialties. According to Abuzied (et al., 2022), the magnet status is the highest level of honor awarded by the American Nurses Credentialing Center, and it is nationally recognized as the “gold standard” of nursing care excellence. The Nurse Manager possesses a Bachelor of Science in Nursing degree along with national certifications in ACLS, PALS, and CCRN, reflecting critical care competencies and over seven years total of nursing experience, though relatively new to this elevated leadership role compared to prior roles as a Staff Nurse and Charge Nurse. Core responsibilities that define the role of a Nurse Manager involve staff oversight, budget management, performance evaluations, quality assurance, complaint resolutions, leadership development, policy administration, and maintaining robust communications across interdisciplinary teams. This paper aims to apply leadership principles and industry best practices to evaluate observed capabilities critically.
Health Care System
The healthcare facility evaluated is a prestigious acute care medical center located in New Jersey that has earned numerous awards for cardiac and orthopedic surgical excellence. It has also attained both Magnet Status and Level II Trauma Center designations. According to the most recently compiled 2017 vital statistics, this 665-bed hospital employs a staff of over 6,500, utilizes the services of 1,704 credentialed physicians as well as 205 supervised medical residents, registers 42,232 admissions annually, assists with 4,441 childbirths each year, treats 94,352 emergency department visits, and facilitates 526,946 outpatient encounters throughout all divisions. The organization proudly communicates its mission to provide innovative and personalized healthcare that builds healthier communities and dramatically improves the lives of patients, their families, and frontline caregivers. It also conveys a brand commitment and core promise to deliver timely and attentive patient-centered care that represents an ideal balance of service quality, convenience, and affordability through the use of devoted staff members who each personally embrace professional values such as compassion, empathy, respect, dignity, involvement, and excellence. Besides, the prevailing organizational culture is focused on creating an environment where patients, employees, and physicians feel empowered to communicate openly and are valued for their contributions.
Nursing Administrative Position
The nurse manager has various roles and responsibilities, including supervision of staff, management of a $ 1.3 budget, and ensuring the organization meets required quality standards. The nurse manager is in charge of employee oversight, including NAs, RNs, and LPNs. The nurse manager ensures adequate or required staffing across the facility hospital units and performs annual reviews of unit functioning. Other critical responsibilities include direct supervision of care practices, assigning responsibilities, overseeing nurse training sessions, and responding to nurse’s concerns and significant issues such as medication errors. Interdisciplinary cooperation is also emphasized, as research shows that coordinated healthcare teams require abilities like performance monitoring, role awareness, and a teamwork mindset. When asked about top nursing priorities, the manager highlighted staff education, physician-nurse collaboration, and unwavering quality control across all care dimensions. At the same time, the department Nursing Manager provides oversight to support success in leadership roles.
Nursing Care Delivery Models and Technology
The nursing care delivery model utilized at this facility is primary care nursing, where each patient is assigned a specific RN who oversees and coordinates all aspects of their care during their stay. According to Parreira (et al., 2021), the primary care nursing model helps ensure continuity, accountability, and the development of a therapeutic nurse-patient relationship. The Epic electronic health record (EHR) system is used hospital-wide to document assessments, care plans, medication administration, progress notes, and more, as described by Forde‐Johnston, Butcher & Aveyard (2023). Epic integrates with medical devices to automatically flow vital signs and intake/outputs into charts (Forde‐Johnston, Butcher & Aveyard, 2023). Other technologies include Vocera communication badges that connect staff, Real-Time Location Systems (RTLS) for locating equipment, CareAware Connect that tracks ADL completion, and Kronos timekeeping. Telehealth options like eVisits and RPM allow RNs to monitor chronically ill patients remotely remotely.
Leadership Characteristics
The leadership style demonstrated by the assessed nurse manager is categorized as transformational leadership. The core behaviors and influences associated with this approach involve establishing clear visions for the future, motivating team members through inspiration, managing complex group dynamics, empowering staff to develop themselves, and encouraging peak performance in individuals to benefit group causes in the future (Jankelová & Joniaková, 2021; Stetler et al., 2014). Key capabilities that enable transformational leaders to spark such responses include excellent communication talents, refined emotional intelligence, and an optimistic and realistic outlook for the future (Stetler et al., 2014). As Nilsen (et al., 2020) argue, the constant and unexpected changes in healthcare delivery demonstrate the need for flexible leadership that is able to meet organizational goals and motivate employees to work toward achieving these goals. In short, Nurse Managers serve as the vital gears that enable smooth healthcare team propulsion because research shows that “Strategic behaviors included responsiveness to emerging or EBP-inhibiting issues; that is, targeted infrastructures were added or realigned on an ongoing basis to help achieve and sustain the EBP vision” (Stetler et al., 2014, p. 221). Therefore, as updated evidence-based tools and practices emerge through nursing research, this Nurse Manager scrutinizes applicability and helps redesign institutional nursing guidelines to ensure frontline staff consistently uphold the latest safety and quality standards during patient care delivery as technologies and techniques continue to advance over time.
Communication Strategies
Open communication represents the vehicle for transporting thoughts and feelings between people (Jankelová & Joniaková, 2021). For example, during weekly staff meetings, the nurse manager creates a supportive environment where all staff members feel comfortable sharing their feedback, new ideas, and concerns. According to Jankelová & Joniaková (2021), effective communication relies upon both verbal dialog and nonverbal cues such as gestures, body language, facial expressions, written prose, clothing choices, and emotional signals consciously and unconsciously transmitted by behaviors, reactions, and even smells. At the foundational interpersonal level, communication can take myriad forms when sharing information between individuals and among groups (Jankelová & Joniaková, 2021). The interviewed Nurse Manager firmly believes that certain communication strategies such as patience, compassion, focus, listening, and suspending judgment can help teach team members how to develop more positive, therapeutic relationships across clinical, personal, and professional dimensions. As one group of international nursing scholars observes, “The communication between the professionals who make up the health team is one of the aspects of great importance for the organizations, especially so that the human being reaches the desired productivity, stands out in the professional scope and develops the relational competence with the work team” (Andrade Vasconcelos et al., 2017, p. 4768).
Decision-Making, Problem-Solving, and Conflict Resolution
At an individual or group level, conflict arises when the expectations, goals, and interests of two or more parties fail to align (Nassuna, 2021). In the complex healthcare environment, ambiguity or lack of clarity within policies, procedures, and standards of care can precipitate conflict scenarios where staff members disagree over correct procedural applications, thereby increasing error risk and compromising patient safety (Nassuna, 2021). Within the studied nursing unit itself, petty personal conflicts and team communication breakdowns are often traced back to perceived inequities in patient case mix assignments and associated workload distribution based on acuity levels (Nassuna, 2021). Even small degrees of resentment over recurring assignment patterns can breed sizable staff discord. Unfortunately, unresolved nurse conflicts represent lose-lose scenarios that typically translate into unhealthy unit culture, decreased staff retention, and risk of adverse patient outcomes (Nassuna, 2021). Conflict resolution requires building teamwork through open communication channels aimed at addressing issues promptly.
When conflicts inevitably arise that nurses themselves cannot resolve through discussion, the standard practice for the interviewed Nurse Manager is to intervene by first bringing the disagreeing parties together for a private, face-to-face mediation meeting in a safe space away from the care environment. During this mediated session, both nurses clearly communicate their version of events, express thoughts and feelings about the situation, identify unmet needs or expectations contributing to the friction, and agree on fair solutions to permanently resolve the issue. Constructive conflict resolution practices such as this exemplify how transformative mediation enables improved critical thinking, enhanced communication talents, strengthened collegial bonds, and reinforced dispute comprehension skills that make renewed group harmony possible (Nassuna, 2021). For example, the nurse manager allocated enough time for team members to discuss or solve challenges they may be facing, ensuring that everyone has an opportunity to contribute to the discussion freely. Researchers conclude that “The most frequent destructive conflict happened when nurses managed their conflict poorly such as when they were involved in a confrontation or there was a lack of communication” but advise that “Nurses will benefit from understanding that conflict avoidance is poor conflict management that will likely serve only to perpetuate negativity” (Kim, Nicotera & McNulty 2015, p.18). In short, the Nurse Manager recognizes that unaddressed nurse disagreements risk patient harm. Thus, by promoting early intervention, active listening, and building conflict comprehension capabilities, destructive fallout can be minimized.
Standards of Practice, Innovations, Specific Projects
The American Nurses Association’s (ANA) Standards of Practice and Standards of Professional Performance serve as essential guidelines for nurses across all settings and specialties (Brunt & Russell, 2018). These evidence-based standards outline expectations for areas like assessment, diagnosis, planning, ethics, communication, leadership, and research utilization (Brunt & Russell, 2018). As Nurse Manager, she ensures department policies and procedures align with evidence-based standards published by the American Nurses Association (ANA) and specialty nursing organizations. She recently led a project to adopt the ANA’s staffing standard by adjusting nurse-patient ratios and implementing a more robust acuity-based staffing model. To meet the ANA’s ethics standard, she instituted new informed consent procedures. Besides she also formed a council of staff nurses to select a new fall prevention protocol adhering to the National Database of Nursing Quality Indicators guidelines.
Contributions
The nurse manager holds a crucial position and has a great contribution to the nursing field. At the facility, the nurse manager serves as one of the board members of the nurse welfare association, where she strives to expand the scope of nursing practice. Besides, she championed the creation of a residency program at the hospital to support new staff and facilitate their professional development. Besides, the nurse manager is one of the researchers for evidence-based practice and has published scholarly articles to educate nurses about evidence-based practice. In addition, the nurse also oversees nurse training sessions and leadership conferences to facilitate nurse career growth and development. Overall, her commitment to nurses empowers them to maximize their efforts and skills.
Summary and Conclusion
This leadership assessment paper provides crucial insights into how influential positions such as nurse managers can transform patient care, organizational leadership, patient outcomes, and staff satisfaction. By utilizing communication interpersonal skills such as conflict resolution and communication with technical knowledge in outcome analysis and quality assurance, nurse managers help organizations attain their goals and objectives. Through continuing nurse education, nurse inspiration and motivation, skill development, and professional growth, nurse managers elevate the nursing profession. Besides, by abiding by the ANA guidelines, nurse managers ensure caregivers deliver the right care and prioritize patient safety. While all nurses contribute to patient care quality, frontline leaders accept responsibility for enabling optimal system performance across both individual and collective levels. The future of healthcare delivery relies upon nursing visionaries translating big-picture strategy into bedside reality.
Organizational Chart
References
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