Running Head: NURSE MANAGER

Interview of a Nurse Manager

Jason Conk & Matthew Vivian
Ferris State University

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Interview of a Nurse Manager

The nursing profession is a profession of options within the Healthcare Village.
Through experience and training, a nurse can pursue a range of careers from staff nurse to chief
executive officer (CEO) of a hospital. Patient care occurs throughout this continuum, being
direct bed-side care or indirect policy management. No matter the position a nurse holds, the
patient comes first. It is the patients safety, quality of care, and overall wellbeing that the nurse
promotes. For this paper, an interview was conducted with a service line administrator to gain
further insight into the managerial aspect of the nursing spectrum.
Renay Gagleard, current Women and Childrens Service Line Administrator at Hurley
Medical Center in Flint, MI, was interviewed via phone call on July 2, 2014. Her education is
admirable. After obtaining her Bachelors of Science in Nursing from Mercy College of Detroit,
Michigan in 1990, she completed her Masters of Science in Nursing, Parenting and Families
from Wayne State University in 1992. In 2010, she completed her Masters of Science in Nursing,
Finance, Leadership and Health Care Administration from the University of Detroit Mercy and is
currently working on her Doctorate of Nursing Practice from the University of Detroit Mercy
which will be completed later this year.
Renays employment history is just as impressive: Postpartum Staff Nurse (Hutzel
Hospital, 1988-1990); Clinical Instructor of Maternity Nursing (Schoolcraft College, 90-91);
Pregnancy Risk Assessment Monitoring System (PRAMS) Project Hospital Interviewer
(Michigan Department of Public Health, 89-97); Family Childbirth Center Staff Nurse (Cottage
Hospital, 4/1991-98); Family Childbirth Center Clinical Nurse Specialist (Cottage Hospital,
6/1995-1/1999); Birth Care and Pediatrics Clinical Nurse Specialist (Bon Secours Cottage Health

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System, 11/1998-1/1999); Hospital researcher/Consultant (Michigan Department of Community

Health, 92-95); Clinical Nursing Instructor (University of Detroit, Mercy, 91-99); Clinical
Nursing Instructor (Madonna University, 1997-2002), Clinical Nurse Specialist (Providence
Hospital and Medical Center, 4/1999-4/2002); Maternal Child Health Clinical Nurse Specialist
(William Beaumont Hospital, 4/2002-12/2009); and Administrator for Women and Childrens
Services (Hurley Medical Center, 12/2009-5/2012).
Job Description and Duties
The Women and Childrens services Renay manages at Hurley Medical Center is
comprised of a 45 bed level III Neonatal Intensive Care Unit (NICU), 14 bed Pediatric Intensive
Care Unit (PICU), 28 bed Pediatric unit, 14 bed Antepartum unit, 9 bed Labor and Delivery
Room unit (LDR) with 3,000 deliveries per year, a 28 bed Mother-Baby unit, Maternal Fetal
Medicine Clinic, Obstetric Resident Clinic, and Health Start and Maternal Infant Health
Programs. Renay is the direct supervisor to the managers of each of the aforementioned
departments. She reports directly to the Vice-President of the hospital who reviews work
through conferences and reports. General direction is also received from the Vice-President for
Nursing in relation to nursing matters. She has held this position since May of 2012.
Job duties include effectively managing a large service line as a productive business.
Providing service line leadership with sustainability that has effectively measured, balanced,
improved quality, increased margin, and increased volume at Hurley Medical Center. Key
elements of this service line plan are: organizing product lines, engaging physicians, forming
strategic relationships across the community and linking the care continuum.
Collaboration

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Renay confers and consults with medical staff and the medical community for various
services. She acts as a liaison for the medical center with outside agencies, contractors for
inpatient and outpatient services, and physicians to maintain effective relations. She participates
in the investigation, identification, and resolution of complaints and grievances by patients,
patient relatives, physicians, and staff. She collaborates with the department managers for
interviewing, hiring, assigning work, employee evaluations, and when necessary discharging
personnel. Renay serves on internal and external committees including policy-making boards.
She also assists in planning cooperative projects with other medical center departments and
community agencies.
Legal and Ethical Issues
As the head of the entire Womens and Children Center at Hurley Medical Center, Renay
encounters numerous legal and ethical issues. Renay is responsible for staying abreast on all
laws and regulations and ensuring that all employees in her department know of current federal,
state, and local regulations. It is her responsibility to know when laws have been introduced or
changed and that that all subordinates are informed of the new policies and is adhering to them.
One of the biggest issues Renay reports is nurses not knowing their Scope and Standards
of Practice. She reports that nurses, especially new hires, do not know everything that is
required of them or they perform duties that are beyond their abilities especially if asked by a
physician to perform the task. There are many ethical and legal issues that can arise from nurses
not practicing within their realm of ability. Legal ramifications can occur if a patient is harmed
or mistreated while acting above and beyond their scope of practice. Ethical issues likewise can
result if the nurse is delegating tasks to other staff that is within their job duties.

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Renay reports that social media and technology are other very pertinent and recurring
issues that are constantly in need of attention. Younger nurses are very accustomed to and use
social media and smart phones on a daily basis with which legal and ethical issues can stem
from. Posting information about patients to social media such as Facebook and Twitter have
been cause for many problems at Hurley Medical Center, as this is in direct violation of HIPAA
regulations. This is also a major ethical concern as patient privacy is of the utmost important.
According to Yoder-Wise (2014) the law implicitly states the patient has the right to protection
from Public disclosure of private facts by the hospital or staff (p. 82). With high quality
cameras and video cameras standard on smart phones the issues of taking pictures and videos of
clients or their personal information is also a serious concern with which violation of patient
rights can easily occur. The law also dictates that patients have the right of protection from
Appropriation of the patients name or picture for the institutions sole advantage (YoderWise, 2014, p. 82). Renay must be very diligent and works tirelessly to ensure all staff does not
violate these policies. Hurley Medical Center as a zero tolerance policy on HIPAA violations
and is grounds for immediate dismissal with which she must adhere to, even if it is a close friend
and colleague.

Power and Influence

With her educational background, previous employment opportunities, and current job,
Renay does hold a significant amount of power and influence. One example of this influence is
her collaborating with the Michigan Supreme Court to establish legal paternity at birthing
hospitals with Friend of the Court in May 2014. The Friend of the Court provides services to
parties with minor children involving divorce, family support, interstate and paternity cases [with

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their duties being] custody, parenting time, and child support (Friend of the Court, Oakland
County, 2014). Besides using her influence to help develop policy guidelines, Renay used her
power to obtain three $25,000 March of Dimes grants to support and implement a Postpartum
Depression Support group, a Maternal Diabetes in Pregnancy Program, and a Neonatal
Abstinence Program and a $10,000 Verizon Wireless grand to implement a Domestic Violence
awareness program. It is clear that Renay uses her power and influence to promote public health
operations for the betterment of all people at both the community level and state level.
Decision Making and Problem Solving
With her current position, decision making and problem solving occurs mainly at the
administrative level which includes project management. One of the questions she poses to
herself when a project begins is How do I get the nurses to do what they need to do?
(R.Gagleard, personal communication, July 2, 2014). Renay points to her Leadership and Health
Care Administration degree where she learned how to properly manage projects. She stated that
generally, decisions are made through collaboration where an entire team is put together and
everyone is assigned certain areas to address. Even though she may be the leader of a project,
input comes from many other sources (i.e. finance, marketing, and manufacturing divisions) and
she must be able to collaborate effectively to make an appropriate decision (Competency Model,
American Nurse Association Leadership Institute, p. 3).
Conflict Resolution
Conflict management and resolution is a major function of Renays position. Conflict
constantly arises between nurses and patients, physicians and patients, nurses and physicians,
along with all other medical staff. Gagleard states that regardless of the conflict, the patient

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always comes first (personal communication, July 2, 2014). She says that for all disputes that
revolve around a patient that the patient is the number one priority and that outcomes must focus
on what is going to be best for them. She uses an autocratic approach when dealing with patient
issues as this is the most appropriate style. When dealing with patient safety and satisfaction
there is no room for compromise, the patient must be well taken care of regardless of staffing
members feelings.
For interpersonal issues between staff members Renay uses a compromising approach.
She states that In nearly all cases of conflict that the truth lies somewhere in the middle
(Gagleard, personal communication, July 2, 2014). Yoder-Wise (2014) states Compromise is
very often the exchange of concessions as it creates a middle ground. In this mode, nobody gets
everything he or she needs, but a sense of energy exists that is necessary to build important
relationships and teams (P472). She likes to talk to all parties involved and get their opinion on
what would be the best way to resolve the conflict. She believes compromising on most
situations allows for resolution without resentment. As Scott and Gerardi (2011) state successful
conflict resolution integrates a collaborative mind-set and individual conflict competency with
non-adversarial processes (p. 59). Quality patient care must always be of the utmost concern so
effective resolution of conflicts allows for better patient care and more efficient organization as a
whole.
Reflection
Through completing this assignment, we gained further insight into one of the more
administrative roles the nurse can take. As the current Women and Childrens Service Line
Administrator for Hurley Medical Center in Flint, MI, Renay does not provide direct patient care
but she works indirectly to promote patient and public health through program development,

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gaining funding, and reviewing/rewriting policy at the hospital, community, and state levels. But
she does not do this by herself. Collaboration is a key to her success and she works with people
from various divisions outside of the hospital as well as nurses and physicians within the
hospital.

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References
Competency Model (2013). American Nurses Association Leadership Institute. Retrieved from
www.ana-leadershipinstitute.org
Friend of the Court (2014). Oakland County Courts. Retrieved from www.oakgov.com
Gagleard, R. (2014). Personal Interview. July 2, 2014.
Scott, C., & Gerardi, D. (2011). A strategic approach for managing conflict in hospitals:
Responding to the joint commission leadership standard, part 1. The Joint Commission
Journal on Quality and Patient Safety, 37 (2), 59-69.
Yoder-Wise, P. S. (2011). Leading and Managing in Nursing (5th ed.). St. Louis, MO: Mosby
Elsevier.