Running head: ANALYZING NURSE MANAGER

Analyzing a Nurse Manager

Aubry Hire and Megan Moore
Ferris State University

ANALYZING NURSE MANAGER

Analyzing a Nurse Manager

Nurse Managers are a vital role in operation of each unit; a nurse manager demonstrates
leadership qualities, while attaining nursing skills and expertise (Yoder-Wise, 2010). The nurse
manager ensures all staff (registered nurses, nurse techs, and secretaries) provide safe and quality
care to the patients. This paper discusses the importance of a nurse manager, which includes
quality and safety measures related to patient care, and the effects of implementing evidencebased research on staffing. This paper discusses the interview, conducted with a nurse manager,
regarding the managerial role and the effect on the unit; also the American Organization of Nurse
Executives (AONE) competencies (2005) will be analyzed versus the managers organization.
Amanda Bourdon, RN, BSN, is the current nurse manager for Spectrum Health
Butterworths Orthopedic Progressive Unit (2 South). Bourdon started by volunteering time at
Butterworth, while a senior in high school. After high school, Bourdon attended college at
Grand Valley State University (GVSU), where she obtained a nursing degree; she worked as a
Nurse Technician while attending college, to help aid in patient care experience. After
graduation, Bourdon worked as a RN, on 2 south, and then become a charge nurse; charge nurse
helped her develop further communication skills and organizational skills, which led her to the
managerial position.
Job Description
Bourdon describes being a nurse manager as the control center of the unit; she works
45-50 hours at the hospital and about 10 hours at home a week, with that being said, she is on
call at all hours of the day in case of a medical emergency. Staff and patients are the two main
duties she attends to. Bourdon states her main responsibilities are implementing changes, 24hour accountability, retaining staff, and finances. Bourdon assures that monthly staff meetings,

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attending financial meetings and allowing a night-shift supervisor, meet her responsibilities as
the manager.
The organizational structure is a key source to determine the differences between job
descriptions, their authority and assist the flow of communication. The organizational chart
further explains chain of command and demonstrates specific job roles. Bourdon manages the
nurses, techs, and secretaries; she reports to the nursing director, who then reports to the Chief
Nurse Executive, when necessary.
Communication and Relationship-Building
The AONE has established seven key areas for communication and relationship-building.
These include: effective communication, relationship management, influencing behaviors,
diversity, shared decision-making, community involvement, and medical/staff relationships.
Described in more depth are influencing behaviors and relationship management.
Influencing Behaviors and Relationship Management
Bourdon maintains communication by Developing, communicating and monitoring
behavior expectations, (AONE, 2005) with peer accountability. This includes reporting any
issues to the manager. This helps encourage all nurses to assist with policy/procedure changes;
Bourdon also uses rewarding techniques to help encourage change, such as offering chocolate or
candles. Maintaining relationships with staff is important to Bourdon; she offers to assist the
nurses on a daily basis, which builds rapport between her and the nurses. Bourdon also attends
to call lights if she is on the floor, working. Bourdon likes to help my staff in any way
possible. In addition, to build the relationships, she facilitates a monthly team dinner. This
allows all staff to get to know one another outside of work.
Knowledge of the Health Care Environment

ANALYZING NURSE MANAGER

Some of the aspects AONE (2005) focuses on are clinical practice knowledge, delivery
models, healthcare economics, health care policy, evidence-based practice, and patient safety.
This ensures a safe and well-versed environment for patient care.
Evidence-Based Practice and Patient Safety
Bourdon strongly encourages all nurses to practice based upon evidence. One program
initiated is the Falls protocol. This ensures that a gait belt, walker, and an assist are used to
take a patient to the bathroom; also a bed/chair alarm is to be initiated when patients are alone.
This has exponentially reduced the amount of patient falls. Bourdon believes in peer
accountability to confirm all nurses are taking part. Bourdon also implemented that when a bed
alarm goes off all available personnel run to the room. These protocols help ensure patient safety
Leadership
The AONE (2005) has established five areas of focus when describing a leader. They are
foundational thinking skills, personal journey disciplines, systems thinking, succession planning,
and change management. Personal journey disciplines and change management will be
described in more depth below.
Personal Journey Disciplines
Bourdon has demonstrated the value of lifelong learning through ones own example,
(AONE, 2005) by starting here career as a volunteer in high school. She then got certified to
become a nurse aid. Bourdon went to GVSU and received her Bachelor of Science in Nursing.
Managing 2 South is contingent on Bourdon going back to school to get a masters degree.
Tanaka, Taketomi, Yonemitsu, and Kawamoto (2014) state that there is a, strong relationship
between education preparation and nursing professionalism, demonstrating how important
education is in nurse managing. She is an example of continuing education that her staff can

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look to. Continuing education will help the organization to have the most educated and
innovative leaders.
Change Management
The nurses of 2 South approached Bourdon about initiating a new program that would
help the nurses to describe the side effects of some of the common medications that are
commonly used on the floor. Bourdon worked with the nurse educator and the pharmacy to
create medication cue cards. They are now hanging in each patient room for the nurses to utilize.
Bourdon worked to create something that would be useful to the nurses and to the patients. The
patients receive accurate information on their medications, and that will enhance the entire
hospital stay for that person.
Professionalism
The AONE (2005) has six areas that define a professional nurse. These areas are
personal and professional accountability, career planning, ethics, evidence-based clinical and
management practice, advocacy, and active membership in professional organizations. Personal
and professional accountability and ethics are discussed below.
Personal and Professional Accountability
Bourdon has created an accountability policy on 2 South. If a patient has a fall the staff
must call the manager, even if the manager is not currently on the floor. Bourdon will then
discuss the situation with the staff member(s) to see if any of the 25 fall protocols were not
followed in this instance. This creates accountability of the staff for patient safety. Yoder-Wise
(p. 66, 2011) states that, holding others accountableare inherent behaviors in the role of a
manager. Increased patient safety will help to increase overall patient satisfaction for the
hospital and fewer complications from staying in a hospital.

ANALYZING NURSE MANAGER

Ethics
On 2 South, Bourdon has had some nurses come to her with tough ethical issues. One
issue that nurses come to her with is instances where the patient is receiving end of life care, but
the family doesnt want to let go to their loved one. Bourdon shared that they once had a patient
who was there for over 100 days and coded three times. Each time the staff revived the patient
because of family wishes. Bourdon indicated that there were many care conferences with that
family, and eventually they made the patient do not resuscitate. Bourdon shared that this was
difficult for her staff, and she told them to empathize with both the patient and the family. It is
important to have high ethical standards, as this will help patients, and it will help the hospital to
build a good reputation.
Business Skills
ANOE lists five areas in which nurse managers incorporate into business skills. They are
financial management, human resource management, strategic management, marketing, and
information management and technology.
Human Resource Management
Bourdon accomplishes many human resource tasks in her position as a nurse manager.
She does the hiring and the termination for the floor. She states that there must be two managers
present for all terminations. Bourdon also indicated the importance of crucial conversations.
These are conversations, sometimes difficult conversations, which provide feedback to
individual staff members. One example of a topic for these conversations is about how to have a
conversation with peers. Bourdon also specified that Spectrum Health has a three strike policy.
This means that in one year if you get three strikes, these can be anything against policy from
parking to attendance, then you will get terminated.

ANALYZING NURSE MANAGER

Information Management and Technology

Information technology can help healthcare providers acquire, manage, analyze, and
disseminate both information and knowledge, (Yoder-Wise, p.190, 2011). Technology is an
essential part of the health care world. Bourdon uses the computer in a multitude of ways to help
keep the unit running smoothly. She also recognizes the shortcomings of technology, and will
have conversations with her staff to keep current on the floors inner workings. Bourdon uses
information gleaned from technology to better analyze new policies on the unit. One example is
call lights; in April a no pass rule was established and the average time for call lights to be
answered went from five minutes to 90 seconds. Bourdons use of technology helped the
patients to receive the desired care in a more timely fashion. Institutional ratings will continue to
improve as the patients receive care in a faster manner.
Conclusion
An interview with Bourdon was analyzed using the AONE standards, as well as
discussion patient and organizational effects. The job description is elaborated upon, with an
emphasis on education. Bourdon uses communication effectively with her staff and her patients.
A knowledge of health care environment is essential, and Bourdon has proved that she excels in
this area. Change management and personal journey disciplines are a big part of leadership that
Bourdon has exhibited as a nurse manager. Professionalism is a learned habit that Bourdon has
showed she is capable of handling. Lastly, business skills were discussed and Bourdon has a
firm grasp on the intricacies of running a unit. To be a successful nurse manager, one must
exemplify the qualities of communication, health care environment, leadership, professionalism,
and business skills.

ANALYZING NURSE MANAGER

References
Tanaka, M., Taketomi, K., Yonemitsu, Y., & Kawamoto, R. (2014, October 30). Professional
behaviors and factors contributing to nursing professionalism among nurse
managers. Journal of Nursing Management. doi:10.1111/jonm.12264
The American Organization of Nurse Executives. (2005). The AONE Nurse Executive
Competencies. In AONE: The Voice of Nursing Leadership.
Yoder-Wise, P. S. (2011). Leading and Managing in Nursing (5th ed.). St. Louis, MO: Mosby
Elsevier.