Running head: A DAY IN THE LIFE OF A CVICU NURSE 1

A Day in the Life of a CVICU Nurse Manager

Jennifer Barnett
Leadership and Management Professional Nursing-NUR 4827C
June 29, 2014
University of South Florida


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The leadership and management skills found among any nursing unit are crucial to the
functionality and productiveness of that unit. Without these two components, patient care is
compromised and cohesiveness of the staff will falter. It is important that all floors and units
have a charge nurse or nurse manager on duty, so that staff nurses and patient care technicians
have a go to person in times of need, as well as someone who is there to enforce the rules,
regulations, and goals of the organization. But, just because someone is in a management
position, does not automatically make them a good leader. According to Sadeghi and Pihie
(2012), effective leaders require good relationships with their followers because they enhance
well-being and work performance. When there is a mutual respect between managers and their
staff, the unit as a whole is more successful in achieving their goals.
To experience first-hand what a day in the life of a nurse manager is like, my class was
assigned to complete clinical leadership hours. I chose to follow a nurse manager from the
CVICU. Mrs. L responded promptly to my request and we quickly scheduled a date for me to
follow her. Upon arrival to the CVICU, I noticed it was a small unit only consisting of 6 beds.
This unit was unlike any I had previously been on, for it was much smaller and newer looking
compared to other units in the same hospital. The nurse manager arrived shortly thereafter, and
she immediately made me feel comfortable. We first went to see the type of patients on the unit
and which nurses were assigned to each patient. I did recognize the fact that Mrs. L only
acknowledged one of the nurses even though others were close by. We then headed into her
office where she first and foremost offered me a piece of chocolate candy. She went on to
explain that we would be going to a bed board meeting in a half an hour and before that she
would be working on payroll. I noticed as I sat down in her office that it seemed unorganized.
There were papers lying all around and many pieces of trash yet to be thrown away. Even with
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the disorganization, she did not seem to have a difficult time finding whatever papers she needed
in the moment. Mrs. L then went on to speak with me about how she does the payroll and a little
about the program she uses for it. Before we knew it, it was time to head to the bed board
meeting.
Bed board is a meeting where twice a day, in the morning and afternoon, the nurse
managers from each unit get together to discuss patient loads and staffing. Each nurse would
explain how many beds they had available, how many discharges, new admissions that were
coming in, as well as how many nurses and techs where on staff for the units. I found it
interesting to be involved in a meeting I have only heard about but never had the chance to
experience. After only about fifteen minutes, the meeting was over and we headed back to the
unit to continue payroll. Mrs. L told me while she was working on payroll that I could ask her
any questions I may have. I first asked what challenges she faces as a nurse manger. Her
response included matching nurses skill sets with the acuity levels of the patients, having the
right number of nurses and techs for the ever fluctuating patient loads, and steering nurses
through changes in administration. This particular hospital has been bought out three different
times in the last year alone, which has caused there to be frustration and some difficulties among
the staff in the unit. I then asked how she communicates changes to her unit and she said she
utilizes staff huddles, and when she cant be there physically to communicate changes, for
instance during night shift, she hangs important information up in the bathrooms and in the
employee lounge. It was then time to go to a barcode scanning implementation follow-up
meeting.
Barcode scanning for medication administration has been newly implemented at this
hospital. Throughout the meeting, the nurse managers and pharmacists went over any problems
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or concerns they have been having with the new technology and ways the problems may be able
to be fixed or adjusted. It was a quick meeting, but it was fascinating to watch everyone
brainstorm and work together to come up with ways to solve the problems being faced by the
staff. Lunch was our next stop. At lunch I asked Mrs. L how she implements evidence-based
practice on her unit. Mrs. L went on to explain that this happens in many ways such as through
grand rounds, care plans, performance improvement meetings, policies, procedures, and
protocols, and standards of practice meetings. As soon as we arrived back at the unit, Mrs. L
called a staff huddle to relay some of the important information we learned at the barcode
scanning meeting. All the members of the staff seemed focused and attentive while Mrs. L was
speaking. Afterwards, she let them all ask any questions or express any concerns they had with
the information she had just provided for them. There seemed to be a mutual respect amongst
the staff and Mrs. L that I could see while witnessing their interaction with one another. The rest
of the day was spent looking at core measures, incident reports, and attending the second bed
board meeting.
Mrs. L, to me, is a good example of a transactional leader. Sadeghi and Pihie (2012)
state, transactional leaders direct followers to achieve established goals by explaining role and
task requirements (p. 188). Through the use of staff huddles, Mrs. L is able to direct her staff,
ensure they are all on the same page, and manage a change taking place on her unit. She also
displayed transactional leadership when handling an incident report on one of her nurses. The
report was written by a patient care tech from another floor who was stating that this particular
nurse had been rude to her during a patient transport. Mrs. L told me that this was the second
time an incident report had been written about this nurse. She said that he is a great nurse and
does not understand why this bad behavior is continuing after she had a discussion with him
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about the similar situation before. Mrs. L says she is a big believer in positive and negative
reinforcement because she sees real change with that strategy. When her staff is working hard
and receives compliments from patients, she says she always praises them and makes sure they
know that they are appreciated. But, on the other hand, when situations like this arise, she
calmly but assertively gives the employee a warning and takes away a day on their schedule or
does not honor a request off. Doucet, Poitras, Chenevert (2009) state transactional leaders
motivate their employees by using positive and negative reinforcement, depending on the
employees conduct and performance. These types of leaders help their employees to identify
what must be done to accomplish and achieve desired results such as better quality output and
reduced cost of production ( Sadeghi & Pihie, 2012).
A leader can be found among anyone, anywhere. It takes superior interpersonal skills for
someone to become a leader who has influence over others in order to help them attain a specific
goal. A manager is someone who has been hired to be accountable for their employees and must
focus on accomplishing the goals of the establishment they work for. Managers have roles and
responsibilities that can range from evaluating outcomes, finances, staffing, planning,
coordinating, solving problems, and many more. When managers possess leadership styles that
empower their employees, more productive and efficient work is executed. According to Regan
and Rodriguez (2011), nurses who feel empowered in their role express confidence and
successful nurse managers who can empower their staff serve an important role in creating a
healthy and safe work environment. Regan and Rodriguez (2011) state that a workforce is
more likely sustainable when staff nurses trust and respect their direct managers.
From my experience following Mrs. L in the CVICU, I learned about the many hats a
nurse manager has to wear and the different attributes one must possess to be successful and
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well-liked amongst their staff. Like many jobs, it is difficult to juggle all of the responsibilities
required while ensuring productivity, safety, and a happy work environment. I am thankful to
have had the opportunity to see what a day in the life of a CVICU nurse manager is like, and be
exposed to a true transactional leader.



















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References
Doucet, O., Poitras, J., Chenevert, D. (2009). The impacts of leadership on workplace conflicts.
International Journal of Conflict Management, 20, 340-354.
Regan, L., Rodriguez, L. (2011). Nurse empowerment from a middle-management perspective:
Nurse managers and assistant nurse managers workplace empowerment views. The
Permanente Journal, 15, 101-107.
Sadeghi, A., Pihie, Z. (2012). Transformational leadership and its predictive effects on leadership
effectiveness. International Journal of Business and Social Science, 3, 186-197.