Nurse Leader Interview

Nurse Leader Interview

Stacey J. Davis

University of Phoenix

NUR/ 587

Charlotte Cooper

March 24, 2014

Nurse Leader Interview

        The Chief Nursing Officer (CNO) at my current hospital has been a nurse for 25 years, her leadership in nursing started about 17 years ago where she became a manager of a nursing unit.  She has since evolved her leadership skills and became our CNO of our hospital last year.  As a nurse leader our CNO needs to be able to respond to an ever-changing healthcare environment, including organizational expectations and changes to local and national policy (Middleton, n.d.).  I would consider this CNO a mentor, she is a teacher, supporter, coach, facilitator, assessor, and role model to our nursing team.  She is also a democratic leader, she is a leader that encourages open communication and team participation in decisions.  She delegates and gives responsibility, accountability, and feedback regarding their performances.  Our CNO also believes that building relationships are important while focusing on quality improvement of systems and processes.  She believes there should be processes written out for everything we do for the patient.  Then we have something to follow as a guide in the future.  

Leadership Style

        As stated, our CNO is a democratic leader, in her prior position, in Nevada she was the Director of Nursing over the Emergency Room department.  The difference in her style of leadership as CNO is the approach.  As before she was over a department and had to only worry about the Emergency room and the processes in that department.  As she became CNO she realized that she needed to look at things differently.  Now she was over a system and had to look at system approaches in the hospital.  This has been a challenge for her, as she has to control her attempt of taking control of the nursing departments when they are having issues instead of leaving the current manager to deal with the issues and process of the department.  

Challenges

        Some of the challenges that our CNO discussed with me is surviving all the changes that are happening in healthcare today.  One of the biggest challenges for her is understanding all the changes that are happening with Medicare and Medicaid.  Understanding the caps with government reimbursements, and providing healthcare services to an aging population that relies on Medicare for their healthcare needs (Weil, 2007).  The other challenge that she mentioned was the trials and tribulations of keeping the doors open to the hospital, it’s been a learning experience for all of us to open the doors to a brand new hospital last year.  But with that we are learning how to develop processes from the ground up.  With the rapidly changing healthcare system, regulations and guidelines have been changing.  As healthcare providers must comply with federal and state laws, they have to operate a complex regulatory environment in which federal health care laws intersect, and often overlap with, a variety of state-specific legislation, including state health regulations, insurance laws, antitrust laws, consumer protection laws, and other statutes (Weil, 2007).  As a new CNO learning to maintain and help implement the regulatory processes within the hospital has been challenging over these past six months, we have had Florida Agency for Health Care Administration (AHCA), and within the next six months we should have our Joint Commission inspection.

Informal Versus Formal Power

As we discussed informal and formal power within our organization she felt that her management skills are built on informal power, her definition of informal power is transparent and how imperative it is to be successful as a team and collaborate with each other’s to meet at one common goal.  She then turned the question on me, I explained that I believe that informal power is when the manager isn’t necessarily your manager but the person with the most influence.  In my department, it could be a surgical tech that has years of experience and has influence over the other team.  As formal power would be a typical organizational chart that lists ranks and positions within the organization.  The chart shows lines of authority and outlines the formal power structure of the company.  I felt the description she described of informal leadership or power was a democratic leader.  When discussing the differences of informal and formal power, she decided that she is a little of both.  As our organization has a formal organizational chart and has lines to who is in direct reports to who in the leadership.  On the other hand, we have informal power within our organization.  We have opportunities within our organization to have power at all levels to suggest and make changes within our organization.  We have a group of selected individuals that their department managers felt could be informal leaders.  This group is called “Circle of Champions.” This group gets together twice a month and takes ideas within their department and presents them to the peers in the “Circle of Champions” then these individuals can voice their changes and make help make our work environment better for patients and team.