Running head: ANALYZING A NURSE IN A MANAGER ROLE 1

Analyzing a Nurse in a Manager Role

Charity L. McKinnon
Ferris State University
NURS 440







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Introduction
The manager that I had the privilege of interviewing for the analysis of a nurse in a
manger role assignment is a registered nurse named Mary Terryberry. Mary Terryberry, RNC is
the obstetrical nurse manager of Charlevoix Area Hospital and has held this role for thirty-eight
years. Mary is a Registered Nurse Certified in obstetrical nursing by earning nursing board
certification through the National Certification Corporation, making her an expert in her field.
She attended St. Josephs School of Nursing in Flint, Michigan in which she earned her
education through a three year diploma program that consisted of living at the school and
attending a strict curriculum of Monday through Friday eight hour school days. Mary has been a
practicing RN for forty-four years, all of which she has specialized in obstetrical nursing. She
has worked at three different hospitals in Michigan throughout her nursing career and has been at
Charlevoix Area Hospital for the majority of it.
To become a nurse manager for the obstetrics department, Mary stated that the
qualifications have changed in the last ten years. Requirements are to have extensive obstetrical
nursing experience due to the size of a community hospital compared with that of a large facility
with a higher population of patients. The manager is to have a baccalaureate degree of science in
nursing. Mary is grandfathered in because she has performed this role for a long period of
time successfully. Mary states that under the realm of personal traits a unit manager needs to
have in order to be successful, the person must be fair to employees to keep a high morale and
smooth work environment. Mary discussed the importance of her job duties, collaboration roles,
and how she strategizes to move her department through difficult situations and keep conflict at a
minimum during this interview.
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Job duties
Mary has many job duties that fall under the realm of nurse manager. She is responsible
for scheduling, shift coverages for vacation/personal leave time for her employees, employee
competencies and education, and staffing safely according to the unit census. Mary states that
the main job duties of this management position are the safe staffing of the obstetrics department
and orientation of the nurses caring for the patients. Mary participates in decentralized
scheduling, meaning that she prepares the schedule for just the obstetrics department to cover all
shifts (Yoder-Wise, 2014). If a shift is unable to be filled by a trained staff member, Mary leads
by example, covering the shift herself.
Education and competence in nursing care are very important because both affect overall
patient outcomes (Yoder-Wise, 2014). Mary assesses staff members by orientation checklists
that are task oriented to obstetrical nursing care when hired in to the department. She assigns
mandatory competencies for continued evidence-based nursing care education to make sure that
her staff is meeting a higher standard in care delivery, which is a key role in managing (Cipriano,
2011). In the organizational chart, Mary reports to the chief nursing officer of the hospital and
the obstetrical staff nurses report to Mary (Yoder-Wise, 2014).
Collaboration role
Mary works with her staff nurses, physicians, and occasionally administration to obtain
patient care goals. An example of collaborating with staff nurses would be assigning patients
appropriately. If a nurse is experienced with post-partum care and not labor, Mary will assign a
nurse who is experienced in labor and delivery to the laboring woman. This is staffing safely
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until the nurse who is less experienced has had a proper orientation to the task, allowing for the
nurse to achieve the goal of a safe learning environment, promoting professional growth
(Cipriano, 2011). Mary meets with the obstetricians once per month to review incidences,
policies and procedures, and to discuss whether or not patients were satisfied with their overall
care. Mary is then responsible to deliver the information of any changes or improvements to the
staff nurses, coordinating communication (Yoder-Wise, 2014). Mary will meet with
administration if any policy or procedures are in need of change or a new policy needs to be put
into place to deliver a safer environment for the patients in obstetrics. Mary collaborates with
managers of other departments relating to staffing safely for all units and when low census
occurs in obstetrics. Guidelines for nurse assignments on float units are discussed and agreed
upon for the safety of the patient because a different work environment for the nurse can
jeopardize quality care (Fye & Nellis, 2013).
Legal/Ethical Issue
An issue that the obstetrics department was facing not long ago was unsafe staffing due
to floating to other departments of the hospital. Mary initiated a policy on staffing guidelines for
the obstetrical unit and when it is appropriate to float staff to other units of the hospital. The
obstetrical nursing staff was having issues with being assigned to another unit by request of
supervisors to receive heavy assignments when the obstetrical unit had patients. This caused
nurses to violate safety of the policy and procedures recommended by the Association of
Womens Health, Obstetric and Neonatal Nurses (AWHONN) for safe staffing on any obstetrical
unit (AWHONN, 2010). Mary requested a meeting with the Chief Nursing Officer after
constructing a policy and procedure that reported appropriate staffing guidelines as evidenced by
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reports and statistics from AWHONN (AWHONN, 2010). Marys implementation of this new
staffing guideline has improved the working environment of obstetrics and other hospital units,
along with patient safety by defining float nurse guidelines in the policy (Fye & Nellis, 2013).
This policy will allow the obstetrical nurses to legally and ethically promote patient safety with
appropriate staffing.
Power and Influence
Mary states that she has used her power that comes with the title of nurse manager to
construct protocols with physicians for the benefit of patient safety and unit staffing, overall
effecting the entire organization. An example of this would be making sure that scheduled
procedures such as inductions or cesarean sections are safely managed with appropriate staffing
by communicating with the physicians who schedule the procedure with the patient (AWHONN,
2010). Mary wishes to provide the best care possible for the patients of the unit, and if multiple
procedures are scheduled in one day that does not allow for safe staffing, she will request
cancellations respectfully to the physicians. Mary initiates protocols as described in the previous
paragraph with the nurse manager title, supporting safe professional practice (Cipriano, 2011).
Decision Making and Problem Solving Process
Mary states that when a decision has to be made on behalf of the patient, it almost
always depends on the staffing of the unit. Each nurse that she employs has a different skill set
and Mary uses her judgment when making assignments and which nurses are assigned together
on each shift. Mary considers the complexity of the patients on the unit and the circumstances
around these cases before making the best decision possible for the safest care to be
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accomplished. She uses empowerment strategies and uses timely feedback when an issue arises
so employees feel safe, as well as the patients (Yoder-Wise, 2014).
Management and Resolution of Conflict
Mary states that the way she resolves conflict in a manager role is to communicate
effectively with all parties involved. She believes in bringing people together as a way of
conflict resolution. This allows each person to voice what happened, how they felt, and what can
make the situation better so that no person involved is assuming wrong ideas about the situation.
An example that Mary provided was that she consulted with the emergency department unit
manager when an obstetrical nurse floated to the emergency room to assist with patient care and
was treated with incivility by an emergency room nurse. Both managers and nurses held a
meeting to resolve the issue and it was successful. Strategies to avoid this certain situation from
repeating were developed through this meeting because Mary and her colleague participated as
organizational leaders to reduce lateral violence (Yoder-Wise, 2014).
Conclusion
Mary is a nurse leader because she shows her staff what a true patient advocate and nurse
is capable of with leading by example. She believes that a nurse manager has to be fair. She
takes patient assignments and assists her staff any way that she can, showing integrity and
respect to everyone she encounters. She has power and influence because of the traits she
exhibits everyday in her professional practice and personal meetings with people. These factors
affect the organization and patients because the staff nurses deliver the best care possible due to
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having an effective leader who spends time mentoring with clear information and direction
increasing productivity for the unit and hospital (Yoder-Wise, 2014, p. 290).















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References
Association of Womens Health, Obstetric and Neonatal Nurses (AWHONN). (2010).
Guidelines for professional registered nurse staffing for perinatal units. Retrieved
from: https://www.awhonn.org/awhonn/
Cipriano, P. (2011). Move up to the role of nurse manager. American Nurse Today. 6 (3).
Fye, P. & Nellis, D. (2013). Obstetric float nurse role redesign in a small rural community
hospital. MCN The American Journal of Maternal/Child Nursing. 38 (3). 157-162.
Yoder-Wise, P. (2014). Leading and managing in nursing. (5
th
ed, Rev). St. Louis, MO:
Saunders.