Interviewing a Nurse in a Leadership Role. Kerri Souter. Ferris State University

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1 Running Head: INTERVIEWING A NURSE IN A LEADERSHIP ROLE 1 Interviewing a Nurse in a Leadership Role Kerri Souter Ferris State University

2 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 2 Abstract For the purpose of this assignment I interviewed Todd Knight RN, BSN, MSN, and presented questions regarding the challenges of his profession. Todd is currently the director of Invasive Procedures at Holland Hospital. In the past he was a manager of the Intensive Care and Telemetry units. The areas we discussed included: legal and ethical issues, cultural diversity of staff, patients and peers, use of power and influence, problem solving skills, and dealing with conflict. I examined the director s effect on his staff s performance, morale and, most importantly, the patient care delivered in his departments.

3 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 3 Interviewing a Nurse in a Leadership Role Introduction and Background Information On June 23, 2011, I interviewed Todd Knight RN, BSN, MSN. Todd was given a list of my questions in advance and decided to answer the questions primarily from a manager s role rather than a director s role. Todd received his Associates Degree in Nursing (ADN) in 1985, Bachelors Degree in Nursing (BSN) in 2007 and just completed his Masters Degree in Nursing (MSN) from Ferris State University in According to Yoder-Wise (2011), Effective leaders are continually engaging themselves in lifelong learning (p.37). Todd has been an RN for twenty six years and has been employed at Holland Hospital since Throughout his career he has worked in various places as a staff nurse including: a general practitioner s office, oncology department, emergency room, telemetry unit, and in the catheterization laboratory. He has been in management and nursing administration for the past ten years. Todd managed the intensive care unit/ telemetry unit for five years, and is currently the Director of Invasive Procedures for the Cardiovascular Services and Interventional Radiology. Question: What are the benefits of advanced degrees in nursing? Right off the bat Todd asked me how school was going, and we talked about the benefits of completing a BSN. I explained how this has been a very sensitive subject for me during the process of advancing my degree, because I did not believe completing my BSN would make me better at my job as a floor nurse. Todd explained how it took him twenty two years to get his BSN and that until then no one could have convinced him having a BSN would have made any difference in his duties as a bedside nurse. Todd said, The bar of nursing has been raised. We

4 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 4 can no longer just be task doers, we have to take part and be engaged players, or we will not evolve (personal communication, June 23, 2011). Todd continued by explaining nursing hierarchy to me in this way, Bedside nurses are efficient at thinking of the next immediate task that has to be accomplished. A charge nurse has to think about things in a weekly perspective. A manager has to think about what is occurring over the next several months. A director has to think about what will be taking place over the next five years, and the Vice President/Chief Officer (VP/ CEO) has to think about what will be happening in the next five to ten years (personal communication, June 23, 2011). I believe Todd was promoting the advancement of nursing as a profession, which he does on a daily basis at Holland Hospital. According to Kerfoot (2007), Nursing cannot grow stronger unless we can recruit and sustain a cadre of engaged, spirited, and involved leaders who believe in the future and can plot a course to excellence (p.47). Question: Please tell me about your professional background? Todd provided me with a list of his hospital, state, and national committees, task forces, and association memberships. He is an active member in six West Michigan Nursing Organizations. He is also a faculty member of the American College of Cardiovascular Nursing (ACCN), a task force participant for Michigan: Mission Lifeline- State Task force collaborated by the American Heart Association (AHA) for best treatment options for ST-elevation myocardial infarction (STEMI) in state of Michigan, committee member with writing tasks for MONE Advocacy Committee in Lansing, committee member of Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) STEMI Registry Committee in Ann Arbor, chair for the

5 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 5 Alliance for Health; Nursing Council (West Michigan Nurse Advisory Council (WMNAC) , president of the West Michigan Central Chapter Michigan Organization of Nurse Executives (WCMONE) , and is on the planning committee for Michigan Chapter Annual Conference and National Conference attendance for American College of Cardiology Cardiac Care Associates (CCA). Todd also facilitates several committees at Holland Hospital including: Order Sets, Universal Profile, Cardiology Product Line, and Percutaneous Coronary Intervention (PCI). He is an active member of his community, serving on the board of the Animal Shelter of Allegan County. He is a member of West Shore Aware. West Shore Aware is a philanthropic organization of gay men and women living in Saugatuck/Douglas and the greater west lakeshore community. The organization is dedicated to increasing the positive influence and public awareness of the contribution that gay men and women make to the community in which they belong (Retrieved from Todd serves on an Advocacy Committee in which he is involved with legislations that are coming to vote or being prepared, and has taught AIDS awareness to 7 th and 8 th graders. According to Yoder-Wise (2011), nurses who serve on elected or appointed boards and councils bring a unique perspective Leadership in this case is casting a vision of a healthy, thriving community (p.49). Todd is passionate about continuing his and everyone else s education and promotes involvement with professionals in various organizations. He is a dedicated leader in his community. Todd is enthusiastic about his involvement in the community and freely shares new ideas with his staff.

6 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 6 Question: What is one of the biggest challenges being a manager/ leader? Todd responded, Trying to balance the demands and requirements from executive administration and staff needs to ultimately produce optimal client outcomes and internal/ external satisfaction (personal communication, June 23, 2011). Yoder-Wise (2011) states, The nurse manager who meets the day-to-day management challenges must be able to balance three sources of demand: upper management requests, consumer demands, and staff needs (p.59). Todd realizes nursing is a rapidly changing field and his methods of leadership must continue to change with the needs of Holland Hospital. His leadership style is supported by his experience, education, integrity and ability to embrace change. Question: What is the most rewarding part about being a manager/ leader? Todd responded, Contributing to individuals growth in the nursing field, seeing changes and innovating nursing through challenges of reform, shortage, new technology and over all changes in the workplace (personal communications, June 23, 2011). Leaders are accountable for facilitating change that contributes to the vision and mission of the organization (Yoder-Wise, 2011, p. 340). Anderson & Manno (2010) suggest that attitude and energy level of managers directly affect the attitude and productivity of their

7 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 7 employees (p.182). Todd continually pushes education as a method as keeping himself and his staff current on new techniques and procedures. Todd leads by example. He is a great communicator and his upbeat manner is contagious. Question: What different process do you use to deal effectively with cultural diversity (staff/ peers, and clients/ patients)? Todd responded, One must listen; truly listen to understand differences and perceptions. Take the time to learn about featured traditions or different nationalities, genders, and generations (personal communication, June 23, 2011). Cultural diversity is nothing more than we make it, we are all human, have the same basic needs, and finding that common thread or ground makes for quicker understanding (personal communications, June 23, 2011). Unless we understand the differences, we cannot come together and make decisions that are in the best interest of the patient (Yoder-Wise, 2011, p.165). Holland, Michigan, has always been known as straight laced Dutch white community. Thank goodness perceptions and mindsets are changing. It is a breath of fresh air to have Todd employed at Holland Hospital. He values diversity, and is a proud gay member of his community. Todd s management style is supported by how he understands, relates to, and shows respect to everyone. Question: Can you think of any difficult legal or ethical issue that you have managed or are currently managing? Todd stated, In nursing we are met with ethical challenges all the time and to always keep in mind the bioethical notions of autonomy, beneficence, nonmaleficence, and judicial

8 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 8 considerations forefront not bias or opinion (personal communications, June 23, 2011). I can think of an example where a client s family pressed to use all medical tools to sustain life on a terminal client who was obviously suffering adding weeks and months to this individual s life. It was torture to what I would have done for myself or any of my family, but I needed to look at their autonomy to make that decision no matter my position or opinion (personal communication, June 23, 2011). Eight principals the nurse manager should consider when making ethical decisions are autonomy, beneficence, nonmaleficence, veracity, justice, paternalism, fidelity, and respect for others (Yoder Wise, 2011, p.89). Todd treats patients and employees with respect and demands the same of his staff. Because of talented directors like Todd and many others, Holland Hospital has Magnet Status. It was named one of the nation s top 100 hospitals (six years in a row), was named one of the 100 best places to work in healthcare, and the list goes on. Question: How do you use power and influence in your current position? Todd stated, I do not think power is a word I like to use, more of leading by example to influence and knowing that without titles or labels we can get more done. Roles are defined by job description, but each role contributes to outcomes. Using teamwork and holistic approaches to goals is more my style to influence in my current position (personal communications, June 23, 2011).

9 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 9 According to Feather (2008), It is important for leaders to have the ability to recognize emotions within one's self and to express those feelings to others. This enables the leader to use their positive emotions to influence others and facilitate the vision of the organization through job performance (p.381). Todd is polite but demands high performance of his employees and his fellow coworkers. Todd leads by example, and his door is always open. Hospital employees respect his opinion and often seek his advice. Todd s success is evident by how quickly he has advanced in his career at Holland Hospital. Question: What type of decision making process and problem resolving process do you use? Todd responded by saying, being in a leadership position, this is vital. I use a common sense, obvious approach to problem solving and leading. Listen, ignore titles, do not look backward, enjoy change, anticipate options, and be aware of healthcare perspectives at all levels (in your own hospital, regional, state and nationally). Have a good current reference library in your mind (or one on file) to be self- educated on trends and happenings (personal communication, June 23, 2011). According to Yoder-Wise (2011), Developing expertise expands one s power among nursing colleagues, other professional colleagues, and patients. A high level of expertise can make one nearly indispensable within an organization (p.186). Todd expertise and experience is essential to Holland Hospital and the departments he oversees. Todd s management approach is supported by his education, credibility, and the way he sets clear expectations.

10 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 10 Question: How do you deal with conflict? Todd replied, Conflict is everywhere, go with the obvious. I identify the conflict to a focus point, take one thing at a time, listen to both sides, be a facilitator, offer suggestions, allow the opportunity for the conflict to resolve itself, and always demand accountability (personal communication, June 23, 2011). He then brought up what he called one of his favorite concepts of emotional intelligence (EI). He explained it like this, we are all people, we deal with people, and we have to be in tune with ourselves to be able to understand others (personal communication, June 23, 2011). Yoder-Wise (2011) refers to EI as, possessing social skills, interpersonal competence, psychological maturity, and emotional awareness that help people harmonize to increase their value in the workplace emotionally intelligent nurses are credible as leaders, managers, and followers because they possess awareness of patient, family, and organizational needs, have the ability to collaborate, show insight to others, and commit to self-growth (p.7) Todd is a great communicator, honest, and upfront. He expects and requires his employees to be the same. He holds everyone accountable for their actions and this is vital to our organization. Question; have you been a participant or interpreter of any research projects? What was your role in the project? What was your interpretation? And what outcomes will affect the organization? With a big grin, Todd responded with, Yes! Many! Todd continued to explain that recently a group from West Michigan looked at how to bridge the gap between education and

11 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 11 practice, and what is perceived from stakeholders as qualities in new graduate RNs. Todd was the second investigator, and his role included setting up the study, formatting a tool to gather data, and leading focus groups. Compared to a national study published by the Nursing Executive Center Advisory Board in 2008, we have many similarities of what the services environment wants in new graduate RNs and what schools are teaching to prepare them for their role. Some prioritization detail of what is needed more over others were a little different such as comforts and competence in discharge teaching or how new grads related themselves high on Clinical Reasoning, but educators did not. This data will help not only in our hospital, but other regional institutions in focusing of curriculum priorities in academia and orientation processes and educations offerings in hospitals (personal communications, June 23, 2011). According to Nieswiadomy (2008), The importance of nursing research cannot be stressed enough. Some goals for conducting research are to promote evidence-based nursing practice, ensure credibility of the nursing profession, provide accountability for nursing practice, and document the cost effectiveness of nursing care (p.8). Research is vital to the advancement of nursing as a profession. Todd s willingness to participate in research shows his dedication to nursing. Conclusion During the process of interviewing Todd Knight and researching information on Emotional Intelligence and Effective Leadership, I learned a lot about leadership and what makes a good leader. According to Sims (2009),

12 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 12 The qualities of effective leadership include but are not limited to the following: knowledgeable in their area of expertise, willing to share their knowledge, will to collaborate with others, have conviction of beliefs, goal oriented, have excellent communication skills, are lifelong learners, take responsibility for their actions, as well as those of their staff/ employees/ followers, trustworthy, create a healthy work environment, foster an environment in which staff feel free to interact and contribute, visionary and able to share that vision, have self-awareness, have a good working relationship with staff, create a sense of community, have good listening skills, have a positive attitude, have the ability to make hard choices, take advantage of teachable moments, credible, see challenges/ not problems, flexible, assist others to develop their practice, act as a mentor, recognize the strengths of others, and recognize their own strengths and weaknesses. (p.272) I believe Todd is an excellent example of a great director and his leadership approach is supported by many of these qualities. He is a passionate leader, director, teacher, and takes pride in nursing as a profession. He enjoys his job, his staff, and the patients. With every question I asked, I could see the joy in his face as he shared his experiences and his desire to empower others. He is a great role model. His credentials and knowledge are remarkable, and his way of explaining information is impeccable and easy to understand. His office is lined with resources and references. Education is his passion. He is constantly learning and encourages others to continue their education. Holland Hospital is fortunate to have him on their team. Interviewing Todd was an eye opening experience, left a lasting impression, and gave me a new perspective on higher education.

13 INTERVIEWING A NURSE IN A LEADERSHIP ROLE 13 Resources: Anderson, B. J., & Manno, M. (2010, April). Listening to Nurse Leaders: Using National Database of Nursing Quality Indicators Data to Study Excellence in Nursing Leadership. The Journal of Nursing Administration, 40(4), Feather, R. (2008). Emotional Intelligence in Relation to Nursing Leadership: Does it Matter? Journal of Nursing Management, 17, doi: /j x Kerfoot, K. (2007). Staff Engagement: It Starts With the Leader. Nursing Economics, 25(1), Retrieved June 1, 2011, from Pub Med. Nieswiadomy, Rose M. (2008) Foundations of Nursing Research. Fifth Ed. New Jersey: Pearson Education, Inc., 8-9. Print. Sims, J. M. (2009). Styles and Qualities of Effective Leaders. Dimensions of Critical Care Nursing, 28(6), Retrieved June 1, 2011, from Pub Med. West Shore AWARE information Retrieved from: Yoder-Wise, P. S. (2011). Leading and Managing in Nursing (Fifth ed.). Elsevier Inc.

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