Analyzing a Nurse in a Leader Role
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Tonya Thompson
Analyzing a Leader
Ferris State University
Analyzing a Leader
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Introduction
Leadership is an important concept for an organization to be successful. “Great leaders
have been responsible for helping society move forward and for articulating and accomplishing
one vision after another throughout time” (Yoder-Wise, 2011, p. 37). This paper is to examine
the leadership role of my manager of the Greenville office for West Michigan Heart (WMH).
Effective nursing leaders are able to continue taking direction from physicians and senior leaders
which was the normal way for nurse’s to manage, and now work in collaboration with physicians
and other management members to bring out the success of an organization.
Kim Ritz, RN, manager of the Greenville office for West Michigan Heart, moved into her
role in 2010. To provide a review of Kim’s nursing career, Kim earned her Registered Nurse
degree from Montcalm Community College in 1988. Fresh out of college, Kim started her
nursing career working in the intensive care unit (ICU) at Ionia County Medical hospital for
three years and transferred to house supervisor until 1993. Kim worked for the Ionia Prison from
1993-1995. In 1995, Kim began her nursing journey in the cardiology field. She started out
working in the Catheterization Lab and later was recruited by a cardiologist, in 1997, to work at
Grand River Cardiology. This is where she began her management experience. Kim states she
had multiple duties at this office of being a clinical nurse and manager, plus carrying out
administration work. Due to being overworked and high stress levels, Kim chose to change
nursing fields in 2007. She started working closer to home in the local Emergency Department.
In 2010, an opportunity opened up for Kim to work in a cardiology office in her hometown. This
is where Kim started her journey with West Michigan Heart.
Kim has experience working with cardiac patients in critical states and familiarity
working with arterial lines, swan catheters, and floating transvenous pacemakers. She states she
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often worked single-handedly with a cardiologist while he was performing advanced procedures.
One particular memory she holds dear is working in the ICU while the cardiologist was floating
swan catheters by way of wave form. With today’s technology, these types of procedures just
wouldn’t be allowed.
Organization Mission
West Michigan Heart is a large organization that offers leading cardiovascular care. The
company’s mission statement is “to improve the health status of the people in our community by
providing quality, compassionate, accessible and cost-effective care that is nationally recognized
for excellence”. West Michigan Heart is currently in an integration process with a large medical
organization, Spectrum Health. With this integration, Kim has new responsibilities to learn as
WMH switches over to new protocols and practices.
Job Duties
As manager, Kim “provides leadership to clinical and clerical staff and assists the clinic
management oversight of clinical activities” (WMH, 2011). There are two registered nurses
(RN) that work in the Greenville office, including Kim. Many of the nursing duties are shared.
It’s important to know Kim works as a clinical nurse as well as managing the office. Kim
“assumes 24-hour accountability for managing, supervising, and coordinating the operational and
financial effectiveness and efficiency of the nursing services/ units of the hospital” (Spectrum
Health, 2010). Kim makes sure there is adequate staff each day to provide cardiac stress testing
and that the appropriate tests are ordered for each patient. With the help of co-workers, she is
responsible for stocking adequate equipment and medications. With the cardiologists of WMH
evaluating their patients in the same office, it is a responsibility of Kim to make sure the
providers have everything they need to take care of their patients. “Key responsibilities include
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unit based goal setting, program development, fiscal management, resource allocation, standards
of care, policy and procedure development” and handling complaints of patients, staff, and
providers (Spectrum Health, 2010). Another important job for Kim is the point of service that
WMH offers for patients on Coumadin, as well as phone triaging- answering patients questions
and prescription refills.
Chain of Command
Kim reports to the WMH operational director, Michelle Doctor whom reports to the Vice
President, Patrice Villemure. Kim tries to take care of issues on her own matters concerning the
Greenville office, but still needs to follow the chain of command and seek assistance. With the
integration, there will more communication with her peers from Spectrum Health. The
Greenville office is now located inside Spectrum Health United hospital so new rules and
regulations have to be followed. “Change, whether proactively initiated at the point of change or
imposed from external sources, affects people, technology, and systems” (Yoder-Wise, 2011, p.
332). In order to meet the requests of the cardiologists, Kim has to involve administration from
the hospital for that to happen. An example would be the physicians wanting chart holders
outside their doors. The holders that were used in the old office didn’t have Spectrum Health’s
approval so new ones had to be ordered. The computer system that WMH uses didn’t interface
with Spectrum Health’s system so collaboration with Information Systems (IT) staff was
necessary. Kim collaborates with directors from the lab and other departments to make sure the
appropriate cardiac tests are ordered and required labs are done before the test can proceed.
Communication usually occurs via email or phone. She has to put in a request for a meeting
time via a scheduling program, which is how most communication amongst managers transpires.
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All actions/decisions that would have impact on the hospital have to be approved by Spectrum
Health administration. This requires email communication with the appropriate staff.
Analyzing an Ethical Issue
Now that WMH performs all testing at Spectrum Health United hospital (outpatient and
inpatient), an ethical issue of not performing tests on West Michigan Cardiology (WMC) patients
has to be dealt with. It is very important with all tests being performed, to ask the patient if they
have an established cardiologist. Established patients of WMC will have their test performed by
WMH but be read by WMC. There have been issues where patients didn’t state they were
established with WMC and WMH physicians read the test. These mistakes can cause
unpleasantness between the two groups. Kim has had to call one of the physicians from WMC
after receiving a complaint to assure them WMH will make every conscious effort to make sure
we do not let it happen again. She reassured them WMH will make a conscious effort to
communicate with their entity. “Effective communication between businesses and their
employees requires a two-way flow of information. Business leaders need to not only convey
messages; they need to also receive messages from employees to best understand their
perspectives and areas of concern” (Richards).
Description of Power
The Greenville office made some changes with its recent move to the hospital. The
testing capability increased requiring more staff to do the job. WMH put in a request for two
computers to be placed in each testing room so the two programs that are used can be
simultaneously be worked on during each test. Spectrum Health decided that one computer was
only necessary for each room, not knowing what exactly how tests are performed. Kim
collaborated with staff and show proof with statistics why two computers would save money and
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time each day. “Effective decision making is not merely a matter of decision quality but also of
ensuring that the decision will have the necessary support and commitment for its effective
implementation” (Vroom, 2010).
Analysis of Problem-solving
With an increase of testing capabilities for WMH, the scheduling template had to be
adjusted after moving to the hospital. The entity has to be able to add tests for inpatients as
necessary. This was difficult to plan for the unknown of how many patients would need to be
tested each week. After a few weeks of operation in the hospital, the schedule template had to be
reopened to block certain times each day for inpatient testing. If there are no inpatients, then
there is money loss where an out-patient test could have been performed. In collaboration with
management from WMH and Spectrum Health, the testing availability had to be made.
Resolution of Conflict
To have a positive operation, staff must work as a team to make it successful. Recently a
physician was creating a hostile environment which is truly unacceptable. “Verbal abuse
significantly impacts the workplace by decreasing morale, increasing job dissatisfaction, and
creating hostile work climate” (Oweis & Diabat, 2005). Kim investigated the situation by
interviewing the parties involved. Kim first spoke with the physician and he apologized. After
recurring events of creating a hostile environment, Kim had to seek assistance from the
operational director for WMH. “Verbal abuse negates a caring organizational culture and
threatens the organization itself by higher turnover rates, increased lawsuits, decreased
productivity, increased errors, and overall decreased quality of care” (Oweis & Diabat, 2005).
The provider involved made the decision with Vice President of WMH to remove himself from
the Greenville office and slow down his patient load to reduce his stress load.
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References
Oweis, A., & Diabat, K. M. (2005). Jordanian nurses perception of physicians' verbal abuse:
findings from a questionnaire survey. International Journal of Nursing Studies, 42, 881888.
Richards, L. (n.d.). Chron. In Ways to Improve Communication Within a Business. From
http://smallbusiness.chron.com/ways-improve-communication-within-business2840.html
Spectrum Health. (2010, October). Job Descriptions.
Vroom, V. H. (2003). Educating managers for decision making and leadership. Emerald
Management Decision, 41(10). Doi:10.1108/00251740310509490
West Michigan Heart. 2011. Job Description Summary.