Introduction
The healthcare environment is complex, characterized by a lot of challenges and dynamic changes that make decision-making at all levels of organizational hierarchy a prudent affair. Within such a complex framework, nurse managers emerge as key decision makers having the responsibility of not only steering their units towards organizational objectives but also steering while navigating through a landscape heavily influenced by external factors. Some of these external factors include health policies, regulatory requirements, accreditation standards, and the convoluted weave of healthcare financing among others. The effectiveness of the nurse managers in maintaining quality patient care, ensuring compliance, and aligning the organization with the stipulations of the Sarbanes-Oxley Act will equally depend upon the extent of the incorporation of these external factors into their decision-making processes.
Overview of Nurse Manager Role
Leadership and management are indispensable in the operations of a healthcare unit, and thus a nurse manager who sits at the helm is vital to effective functioning. The multifarious responsibilities encompass not the supervision of nursing staff only, it includes coordinating care for the patients as well, ensuring abided by healthcare standards and checking out day-to-day activities as well. Per se, the nurse manager’s role is beyond that of administrative tasks; the nurse manager is a linchpin in shaping the policies and procedures of the unit which also directly determines the quality of care given to the patient. As a leader, the nurse manager must strike an equilibrium between organizational goals with the outside factors that shape the healthcare environment. Every decision that the nurse manager makes would impact staff, patients, delivery of healthcare and how the ecology of the nursing unit is affected by their decisions. Therefore, understanding the perception of a nurse manager regarding the impacts caused due to the external environment on the decision-making process will help in gathering an idea about the obstacles faced by nurse managers and the measures adopted to pass through this complicated structure. The following analysis will pertain to the experiences of the nurse manager and will align these to extant scholarly literature to draw an understanding of how external factors impact their decision-making in health care.
The reflections that the nurse manager shares underline how much their role adaptability to changes in the said policies such as new reimbursement models and telehealth policies that were brought on during the COVID-19 pandemic can be deeply rooted in influencing their decision-making. The nurse executives were portrayed as indispensable in decoding and integrating health policies where the nurse executives are required to proactively assimilate the changes within the operational ethos of medical-surgical units. It is this kind of nurse manager who will be able to effectively manoeuvre the complicated relationship that exists between the policy dynamic and frontline care management. Regulatory agencies, notably The Joint Commission (TJC), are identified as critical influencers that lay out adherence to standards identified as essential in maintaining accreditation and assuring patient safety. The mechanisms in existence for holding up regulatory expectations identified in the interview of the nurse manager are specific and detail further on required processes hence supporting the literature regarding how critical the nurse manager is in supporting a compliance culture.
Second, another identified factor that affects these decisions is healthcare financing whereby the nurse manager pays special mention of this factor in the course of aligning the provision of care as a financial implication and strategic financial management. The experiences described, therefore, offer a practical perspective regarding negotiating the financially striking healthcare environment that will not compromise care delivery owing to its patient-centric approach. In general, the narrative illuminates how the intricate interplay of health policies, regulatory agencies and financial considerations make health decision-making complex, a task left for nurse managers to decide on.
Analysis of the Interview Supported by Literature
Integration of Health Policy
An overriding issue for a nurse manager who must operate within an ever-changing health policy landscape is given voice through these nurse manager experiences supported in the contemporary literature. Hajizadeh et al. (2021) state that nurse leaders need to stay up to date with the changes in policies, and should also be ready to change their units to meet the new healthcare specifications. The adaptability showed how these policy shifts impact their operations and decision-making in the day-to-day insights provided by the nurse manager adapted from her medical-surgical unit. Health policies are very dynamic, and so they require not just proactive measures but strategic input to understand how these policies rip through the whole health system. This delicate balancing act in integrating health policy into decision-making processes whereby nurse managers must align their units with regulatory expectations yet keep their units focused on providing excellent patient care.
Regulatory Compliance
The interview with the nurse manager, as well as the literature, underscores the crucial role far that nurse managers play in ensuring regulatory compliance for positive patient outcomes as emphasized by Laugesen et al. (2022). Implications from the nurse manager underscore the multi-faceted character of this responsibility, pointing out the painstaking processes in place designed to meet regulatory expectations within the nurse manager’s medical-surgical unit. The consequences associated with non-compliance are vividly illustrated along with the potential impact on patient care and the reputation of the organization. This follows the general literature emphasizing that nurse leaders ought to cultivate and maintain a culture of compliance stressing the direct link of adherence to rules towards the provision of care to patients in a safe, effective and efficient manner.
Financial Considerations
Financing health care illustrates an influence on the decision-making of the important required nurse manager which is a vital aspect echoing not only the set of experiences of the nurse manager but also the existing body of literature. This literature supports the view of the nurse manager thereby showing the challenge it poses in trying to balance between optimum utilization of resources and giving quality care in a constrained budget. It is in this context that making sound financial decisions is necessary for nurse leaders who aim at maintaining optimal healthcare performance. This involves a strategic allocation of resources not only to manage the day-to-day expenses but also to optimize patient outcomes as well as ensure the long-term sustainability of the units. The experience of the nurse manager provides an application lens by which to understand the financial considerations portion of decision-making, underlining the need for successful nurse managers to continue focusing on patient-centred care even amidst financial challenges.
The interview with the nurse manager brings to light the external factors that influence making decisions in this healthcare set-up. The combination of perceptions of the nurse manager with scholarly literature to date underscores the multidimensional role played by this type of administrative leader in negotiating health policy, regulatory compliance, and the financing of healthcare. Nurse leaders need knowledge and flexibility to accommodate external things into their decision-making, focusing on how to ensure quality patient care with organizational efficiency. The challenges for this nurse manager resonate within wider discussions within the literature, focusing on the necessity that nurse managers are competent to manage the complexities of the healing organizations’ operations during a time of rapid change.
References
Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nursing, 20. https://doi.org/10.1186/s12912-021-00648-6.
Laugesen, B., Albrechtsen, M., Grønkjær, M., Kusk, K., Nielsen, M., Jørgensen, L., Pedersen, B., Lerbæk, B., Haslund‐Thomsen, H., Thorup, C., Jacobsen, S., Bundgaard, K., & Voldbjerg, S. (2022). Nurses’ Clinical Decision-Making in a Changed COVID-19 Work Environment: A Focus Group Study. Global Qualitative Nursing Research, 9. https://doi.org/10.1177/23333936221109876.
Tazebew, C., Mulugeta, T., & Boka, A. (2023). Nurse Managers’ Involvement in Decision-Making and Associated Factors in Selected Government Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study. SAGE Open Nursing, 9. https://doi.org/10.1177/23779608231157992.
Wankam, M., Atanga, M., & Mbebeb, F. (2023). Role of Nursing Managers in Enhancing the Clinical Decision-Making Skills of Critical Care Nurses in Yaoundé-Cameroon: A Qualitative Study. International Journal of Health, Medicine and Nursing Practice. https://doi.org/10.47941/ijhmnp.1202.
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