Running head: MANAGER INTERVIEW 1

Manager Interview and Analysis

Melissa Bisel and Tessa Grewe
Ferris State University







MANAGER INTERVIEW 2
Manager Interview and Analysis
There are various opportunities available for nurses. One career option is to obtain the
role of a nurse manager. According to Yoder-Wise (2014), nurse managers must possess the
same qualities as a leader such as knowledge, integrity, ambition, judgment, courage, stigma, and
communication skills (p. 22). The purpose of this paper is to analyze the role of a nurse manager
and/or leader and understand how different positions affect patient outcomes. The manager
interviewed is part of the Resource Center at Spectrum Health Butterworth. As a manager of the
resource center, the responsibilities are not like a typical unit manager because they are
accountable for employees and resources throughout the hospital, not direct patient care.
An interview with Audra Nelson-Arnett, manager at Spectrum Health Butterworth
Resource Center was conducted on March 10, 2014. Nelson-Arnett has worked at Spectrum
Health since 2001 and has had various roles. She first started off as a nursing assistant and then
became a nurse on 2 South, which is Orthopedics/Neurology. Being a nurse manager was the
next step in her career in which she specialized in trauma. Nelson-Arnett found that her passion
was in leadership and management; therefore, she took the manager position at the Resource
Center. Nelson-Arnett currently has her bachelors degree in nursing or BSN and is working on
her Masters degree in leadership and organization management.
Job Description and Duties
Nelson-Arnett has many job duties as a manager of the Resource Center. She is
accountable for over 250 employees and has eleven hospital supervisors to help her with
employee tasks. She states that her main job duties include hiring, interviewing, corrective
action, performance evaluations, and accountability of staff. When discussing accountability of
staff she discussed specifically being responsible for certifying employees are competent in
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providing direct patient care. For example, employees are required to complete annual
competencies. If these competencies are not completed, it is her responsibility to take corrective
action and prohibit the employee from working. This ensures that they stay updated on new
information and skills. Nelson-Arnett is not only responsible for staff working at Spectrum
Health Butterworth she is also accountable for travel staff for areas such as the operating room,
neonatal intensive care unit, and pediatric intensive care unit.
When looking at the organizational chart, Audra Nelson-Arnett works directly under the
director of clinical operations, Terri Popa. Popa works directly under the CEO. There are lot of
staff that report to Nelson-Arnett which include hospital supervisors, nurses (unit based and new
grad float pool), nursing assistants, unit secretaries, and resource administrative staff.
Collaboration
According to the Online Journal in Nursing (2005), collaboration is defined as the most
important aspect of teamwork (p. 1). As a resource manager, Nelson-Arnett communicates with
other nurse managers, nurses, nursing assistants, directors, respiratory, patient transport, and
even environmental services. It is imperative that she collaborates with everyone to achieve
goals. For example, in order for her new staff to become trained, she must work with the
manager of the unit along with the nurse that is training to evaluate the new hire.
Nelson-Arnett is part of a committee called Shared Leadership, which takes place once a
month where employees of all departments get together to throw out ideas to improve quality
and patient safety. There is also a nurse manager council twice a month where nurse managers
collaborate to discuss issues, processes, and events. Team Butterworth is an additional meeting
that Nelson-Arnett attends where quality improvements and safety issues are looked at to
enhance the culture at Spectrum Health. It is required that one person from each department
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attends this meeting. As a resource center manager, collaborating with each department creates
safe and competent patient care and allows for quality improvement.
Legal and Ethical Issues
In addition to their leadership responsibilities, nurse managers must have a solid
understanding of current legal trends as they relate to patient care and staff. Nelson-Arnett
brought up a situation that she had just dealt with that could have resulted in a legal issue. One of
her ICU nurses was labeling lab tubes and did not look at the slips before she placed them on the
tubes. That nurse ended up sending down the patients blood with the wrong patient information
on it. Luckily, the other nurse got a call from lab stating that her patient had a critical lab value.
The nurse immediately knew something was wrong and was able to fix the mistake. This
incident did not affect the patient or the organization in any way because the error was caught
before any action was taken. This situation also brings up an ethical issue regarding patient
notification. Due to the fact that the patient was not affected by this mistake, the patient was not
notified of this mix up. According to Wolf and Hughes (2014), there is voluntary and mandatory
reporting. Mandatory reporting is when an error occurs that hurts or kills the patient (p.337). Due
to the fact that this was a near miss event, the mistake did not have to be reported to the patient.
Yoder-Wise (2014) states that nurse managers should thoroughly investigate allegation,
discuss the situation and ways to prevent it, and follow up with the employee (p.78). This near
miss mistake forced Nelson-Arnett to provide the employee with a verbal warning due to
negligence of sending the wrong patients blood to the lab. She states that even though it was a
little mistake it could have resulted in a safety event. The verbal warning is a consequence that
will hopefully prevent the employee from making this mistake a second time.
Power and Influence
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According to Yoder-Wise (2014), influence is the process of using power (p. 181).
Power and influence are two things that are important for processes to run smoothly. According
to Lankshear, Kerr, Lschinger, Heather & Wong (2013) influence tactics can be used to help
with rational persuasion, inspirational appeals, consultation, collaboration, and the use of
pressure (p.351). Using influence can help with more appropriate and effective behavior on the
unit. Nelson-Arnett explained that she used influence and power to change the environment at
Spectrum Health Butterworth. When she first started as the resource manager she was the only
person in charge of the resource employees. By persuading management to implement hospital
supervisors she was able to make employees happier and provide them with more resources.
There are many key factors that contribute to Nelson-Arnetts powerful image along with
her ability to influence others. The first concept results from her knowledge and skills. As a
manager, nurse, and continued leadership education, she is looked up to for advice and ways to
make improvements in the hospital. Another concept is position power. As noticed from the
organizational chart, Nelson-Arnett is a leader in the organization which gives her power. The
last concept is connection power which is gained by the association of people. As a resource
manager connections are crucial. Since she collaborates with a variety of people she is able to
influence others.
Decision Making and Problem Solving
As a resource nurse manager Nelson-Arnett is asked to take on a lot of responsibilities to
meet a growing number of organizational priorities. She is expected to identify problems and
design and implement innovations that will help Spectrum Health achieve targeted patient care
outcomes while increasing efficiency and holding down costs. According to Effken, Verran,
Logue, and Hsu (2010) there are various generic tools to help nurse managers make effective
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decisions such as brainstorming, root cause analysis, fishbone diagrams, decision trees,
mathematical models, and consequences tables (p. 2). Nelson-Arnett explained that when she
makes decisions she uses her education, previous experience, root cause analysis, and
brainstorming to achieve a goal.
According to Yoder-Wise (2014), decision making is a focused and goal-directed effort
that uses a systemic process to decide among opportunities that may or may not help solve a
problem (p.105). Nelson-Arnett explained that there is a lack of resources for individuals that
need psychiatric services but do not necessarily have a medical need. Recognizing this problem,
Nelson-Arnett implemented a process at Spectrum Health to ensure that when individuals are
going through a psychological crisis methods are in place to keep them safe. TelePsych is a new
program in Grand Rapids that offers help to individuals that may be depressed or suicidal. In
order to implement this program Nelson-Arnett used a democratic approach and went to the
nurse managers council which helped support this initiative. Throughout this process, Nelson
Arnett has collaborated with many individuals to decide on quality processes throughout the
hospital.
Conflict Resolution
According to Johansen (2012) effective resolution and management of a conflict
requires clear communication and a level of understanding of the perceived areas of
disagreement (p. 50). There are many different ways to manage conflict which include
avoiding, accommodating, competing, compromising, and collaborating. Nelson-Arnett does not
exactly fit any of those conflict management styles. After doing some research we learned about
carefronting. According to Kupperschmidt(2006), this style takes a different approach to
managing conflict then the previous types. Carefronting is a method of communication that
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entails caring enough about ones self, ones goals, and others to confront conflict courageously
in a self-asserting, responsible manner (p. 20). This style of conflict management maintains
effective, productive working relationships.
Audra Nelson-Arnett stated that when there is conflict she always goes right to the source
and most of the time it is effective. If that does not work she brings the issue to her manager,
Terri Popa, or discusses it with another nurse manager. An example she discussed stemmed from
the employee that applied the wrong labels for the blood draws. Nelson-Arnett stated that she
had previous discussions with this employee regarding performance and after this incident she
had to decide what action to take. Nelson-Arnetts first step was to discuss the employees
performance directly with the individual to find out what was going on. After talking with the
employee Nelson-Arnett still was unsure about the appropriate action to take so she brought the
case to other nurse managers. After receiving input from other managers she then directly took
the information to the director of nursing. With input from each source, Nelson-Arnett was then
able to look at the whole picture and feel confident about her situation. As evidenced through the
interview, Nelson-Arnett is an advocate for her staff and discusses important issues with caring
and effective conversations.
Reflection
Nelson-Arnett is a good example of an effective manager and leader. She is passionate
about her job and works hard to make a difference at Spectrum Health Butterworth. Certain
qualities that she possesses include: respect for staff members and colleagues, effective decision
making, and manages conflict in a professional caring manner. Interviewing a manager was a
great experience to get a better idea of what a manager does and certain traits that a good leader
possesses.
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References
Effken, J., Verran, J., Logue, M., & Hsu, Y. (2010). Nurse managers' decisions: Fast and
favoring remediation. Journal Nursing Administration, 40(4), 188-195.
Gardner, D. (2005). Ten lessons in collaboration. OJIN: The Online Journal of Issues in Nursing,
10(1), 1.
Hughes, R., & Wolf, Z. (2008). Chapter 35: Error Reporting and Disclosure. Patient safety and
quality: an evidence-based handbook for nurses (Vol. 2 ed., pp. 333-335). Rockville,
MD: Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human
Services.
Johansen, M. (2012). Keeping the peace: conflict management. Nursing Management, 1, 50-54.
Kupperschmidt, B. (2006). Carefronting: caring enough to confront. The Oklahoma Nursing,
51(2), 22-23.
Lankshear, S., Kerr, M. S., Lschinger, S., Heather, K., & Wong, C. A. (2013). Professional
practice leadership roles: The role of organizational power and personal influence in
creating a professional practice environment for nurses. Health Care Management
Review, 38(4), 349-360.
Nelson-Arnett, A. (2014, March 5). Personal Interview.
Wise, P. S. (2014). Leading and managing in nursing (5th ed.). St. Louis, Mo.: Elsevier Mosby.