Running head: ANALYZING A LEADER INTERVIEW

Analyzing a Leader Interview NURS 440 Constance Chrisman

ANALYZING A LEADER INTERVIEW

Analyzing a Leader Interview To analyze a leader one must first know the definition of a leader. A leader is an individual who works with others to develop a clear vision of the preferred future and to make that vision happen (Yoder-Wise, 2011, p. 37). Just because a leader has a title it doesnt mean they are able to inspire and motivate people to follow or grow. According to Convey (1992) there are eight characteristics that make an individual an effective leader: 1. Engage in lifelong learning 2. Are service-oriented 3. Are concerned with the common good 4. Radiate positive energy 5. Believe in other people 6. Lead balanced lives and see life as an adventure 7. Are synergistic; that is, they see things as greater than the sum of the parts 8. Engage themselves in self-renewal (Yoder-Wise, 2011, p. 38) Eric Nelson is the Director of Surgical Services for Spectrum Health United Hospital and was interviewed November 7, 2013. Nelson is a registered nurse and has been since 2001. Nelson has been in his position for the last two years and was the surgical services manager for four years prior to his current role. When Nelson became a nurse his goal was to become a flight nurse. He began his nursing career in the emergency department (ED) at Metropolitan Hospital in Grand Rapids. He worked in the ED for one year and transitioned to Spectrum Health after hearing he needed two years experience in the intensive care unit (ICU) at

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Spectrum Health before he could qualify as a flight nurse. However, Nelson was unable to obtain a first shift job in the ICU so he took a position in Spectrums surgical department. Nelson discovered a love for the surgical environment, working closely with surgeons, and pharmaceutical representatives. Nelson stated he loved the technology and equipment as he felt it was more guyish. Nelson explained how he enjoys the equipment logistics that comes with surgery and how there is little social interaction between a surgical nurse and their patient. Surgical nursing is more about sterility, infection control, padding body parts, and having the correct equipment for the procedure. These are the aspects of surgical nursing that keeps Nelson surgical services oriented. Education is a primary focus for Nelson. He is currently enrolled at Ferris State University in the registered nurse (RN) to bachelors of science in nursing (BSN) program and is scheduled to graduate in 2014. His future education goals are to obtain his Masters as a certified registered nurse anesthetist (CRNA). He is currently evaluating CRNA programs in this area and online. Professionally, Nelson belongs to the Association of Operative Registered Nurses (AORN) and works closely as a member of the Michigan Health and Hospital Association on keystone surgical process improvements. Personally, Nelson lives in Greenville with his wife of 12 years and their two daughters ages 8 and 10. He is involved in the community as an assistant coach for some of his daughters sporting activities.

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Job Duties As the Director of Surgical Services, Nelson is charged with overseeing three surgical suites, one post anesthesia care unit (PACU), the outpatient care unit, sterile processing, and the outpatient infusion clinic. Additionally, Nelson is charged with department specific organizational goals which include quality measures, finances, patient satisfaction scores, payroll, budget, staffing, and facilitator for staff meetings, educator, data collector, data auditor, service recruitment, and physician engagement. However, Nelsons main job function as the director is caring for patients, their safety, and managing staffing levels to ensure they are consistent with approved full time employee (FTE) levels. As the director of surgical services Nelson reports directly to the chief nursing officer (CNO) who is directly under the chief executive officer (CEO) who reports to the board of trustees. Within the Spectrum Health United Hospital organizational chart Nelson is at the fourth tier along with the other directors. Within the Spectrum Health organizational reporting structure Nelson has 36 direct reports. These staff members include RNs, health unit coordinators (HUC), surgical technologist, and sterile processing staff. Collaboration Role Nelson works with other department leads to discuss, review, and facilitate changes as needed regarding preoperative labs, respiratory for electrocardiogram preoperative planning, diagnostic imaging concerning the equipment used in surgery for fluoroscopy and pre-surgical xrays, just to name a few. Nelson actively works with billing and coding to ensure the patient charges are correct per the services received. Overall, Nelson works with all department leads for services their departments need from surgical services.

ANALYZING A LEADER INTERVIEW

Nelson collaborates with other department leads through scheduled meetings, emails, phone calls, and webinars. Regularly scheduled meetings are utilized for action planning, updates and impromptu meetings are utilized as needs arise with staff or other department leads. The overall purpose of this collaboration is to ensure patients safety and evidence base practice standards are met. Ethical Nelson identified an ethical debate that has been going on for years which pertains to using reprocessed single use instruments. Since the 1980s and the HIV scare hospitals have been using more and more single use surgical instruments. These instruments are made of metal, can easily be broken down, cleaned, sterilized, and reused thus eliminating landfill waste of instruments that are stainless steel and therefore will never rust or breakdown. Companys such as Stryker Solutions take single use surgical instruments and break them down, clean, sterilize and sell them back to hospitals for 40-60% less than the original purchase price. The original manufacturers are screaming this is unethical because hospitals are doing this without getting the consent of the patient allowing them to use reprocessed instruments during their procedures. Additionally, the devices were designed to be thrown away after single use, but sterilizing them for resale to hospitals at discount prices has become a $125 million business in the United States (Medgadget.com, 2005). According to the Massachusetts Hospital Association and the American college of Cardiology, say reuse is safe, and manufacturers can only document a few instances of patients being put at risk (Medgadget.com, 2005). Since 2000, the Food and Drug Administration (FDA) has taken steps to require reprocessing companies meet the same stringent regulations for their products that original-

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device makers do (New York Times, 2010). Nelson states that since the AORN and the FDA support the use of reprocessed surgical instruments as a safe practice his department will continue to use them when able for green health initiatives and fiscal responsibility. Power and Influence Influence is the process of using power. Influence can range from punitive power of coercion to the interactive power of collaboration (Yoder-Wise, 2011, p. 179). Nelson discussed how he approaches problem solving and works to influence others. Nelson approaches problem solving by gathering research information and/or data, reaches out to other department leaders, and obtains the charge nurse and staff input. Nelson believes all of this to be helpful in making well informed decisions. Nelson states he likes to involve his staff as much as possible when considering new initiatives but if some staff does not agree with an initiative it does not mean he still would not move forward with it. Nelson stated you have to weigh the benefits against the deficits. Additionally, Nelson reaches out to the Grand Rapids healthcare affiliates for best practice information. Overall, the final decision is Nelsons and he accepts the good decisions along with the bad. Nelson does well by including his staff, other department leads, and reaching out to other organizations for input when looking at new initiatives. His staff responds well to his perceived power and influence which allows his departments to run efficiently by reducing patient safety errors and promoting teamwork.

ANALYZING A LEADER INTERVIEW

Decision and Problem Solving To understand what decision and problem solving is one first must know the definition of both. Decision making is a purposeful and goal-directed effort that uses a systematic process to choose among options (Yoder-Wise, 2011, p. 99). Problem solving, which includes a decision making step, is focused on trying to solve an immediate problem, which can be viewed as a gap between what is and what should be (Yoder-Wise, 2011, p. 99). Nelson uses his years of surgical nursing experience and observation to help guide him in decision making and problem solving. Nelson has great critical thinking skills which helps him during unplanned events involving patient safety or staffing concern crises. Additionally, he reaches out to his staff for problem solving ideas which helps keep them involved and focused on the department mission. Additionally, Nelson continues his personal growth by furthering his education as well as remains current with AORN evidence based practice research which provides him the knowledge needed to make more informed decisions. Nelson mentors his staff to continue their education by supporting and promoting their future career and educational goals. These aspects keep his staff engaged at work; build a strong and more unified team all of which benefit patient safety and experiences in the services they receive. Management and Resolution The definition of management is an engaged process of guiding others through a set of derived practices and procedures that are evidence-based and known to satisfy pre-established outcomes based on repeated clinical situations (Yoder-Wise, 2011, p. 5). Conflict resolution is not distinct with one universal definition. Conflict carries a negative quality but does not need to

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always be perceived as undesirable. Some studies show that healthy disagreement among health care team members regarding patient care decisions can result in improved trust among team members making for a stronger team (Center for American Nurses, 2009). Nelson describes his management style as a blended style. He states he seeks a lot of input from staff, other department leadership, and his up-line and then blends this with evidence based research. He went on to say if downtown (Spectrum Health Grand Rapids) is doing something it does not necessarily mean it is something that is good to do here. I go with best practice first. Nelson describes best practice as patient safety, staff safety and growth, and the organizations mission with financial responsibility. Nelson does not shy away from conflict when it arises. He takes a calm and neutral approach regardless of whom or what the encounter involves. He looks for opportunities to address conflicts as soon as they arise by identifying preferred outcomes, planning and then proceeding with action(s). If the conflict involves a staff member(s) that is creating a disturbance within the team and therefore does not work as a productive and unified team member then Nelson follows set processes. Nelson will meet with the staff member to enquire into the cause of the conflict and address it based on the underlining information. He provides counseling or coaching as well as educates formal expectations to clarify any staff misunderstanding. Nelson does well to address conflict and provide resolution opportunities in a timely manner. He maintains a positive approach and does well to influence and mentor his staff in how to deal with conflict resolution.

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References Center for American Nurses, (2009). Addressing the 2009 joint commission leadership standards. Retrieved from: centersforamericannurses.org Medgadget.com, (2005). Device makers fight reuse of surgical tools. Retrieved from: medgadget.com New York Times, (2010). In a world of throwaways, making a dent in medical waste. New York, New York. Yoder-Wise, P.S. (2011). Leading and managing in nursing (5th ed.). St. Louis, Missouri: Elsevier Mosby.