Running head: ANALYZING A NURSE IN A LEADER ROLE
Analyzing a Nurse in a Leader Role
Stephanie Gulledge
Ferris State University
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ANALYZING A NURSE IN A LEADER ROLE
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Analyzing a Nurse in a Leader Role
This paper examines a nurse in a leader role. “A leader is an individual who works with
others to develop a clear vision of the preferred future and to make that vision happen” (YoderWise, 2011, p. 37). A strong leader is necessary for the success of any business and a hospital is
no exception. Leadership qualities inspire others to perform to their utmost potential and
advance the success of the organization. This paper is an evaluation of a nurse in a leader role
and how the leadership position effects the organization, employees, and ultimately the patients.
The nurse I interviewed for this paper is Mary-Anne Ponti, RN, MSN, MBA, CNAA-BC,
FACHE, and Chief Operating Officer (COO), at McLaren Northern Michigan Hospital in
Petoskey, Michigan.
Ponti received a Bachelor’s degree in Nursing in 1980 from the University of Vermont
and started as a staff nurse on the neurosurgery floor at Duke University Medical Center in North
Carolina until relocating to Massachusetts. Ponti’s move to Berkshire Medical Center in
Massachusetts presented her with an opportunity to move into Critical Care nursing where she
remained for two years until her family relocated to New York. Ponti continued as a Critical
Care staff nurse at Saint Francis Hospital in Poughkeepsie, New York where after two years was
promoted to a senior staff nurse based on the recommendation of her manager. She explained
that this promotion to a senior staff nurse was a life-changing point in her career. It was her
manager who had noticed Ponti’s ability to lead others, suggested her for advancement, and
continued to serve as a mentor to Ponti as she advanced within the organization (M. Ponti,
personal communication, February 11, 2013).
Ponti’s past positions have included Patient Care Coordinator, Director of Discharge
Planning, Director of Patient Care, Administrative Director of Clinical Services, Vice President
(VP) of Nursing and Patient Care Services, VP of Nursing and Division Leader, VP and Chief
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Nurse Executive, and her current position of COO. In 2007 she accepted a position at Northern
Michigan Hospital which is now part of the McLaren Health System (M. Ponti, personal
communication, February 11, 2013).
Role Responsibilities
As the COO, Ponti reports directly to the President and Chief Executive Officer of
McLaren Northern Michigan. The organizational chart lists 18 areas in the hospital that report
directly to the COO. Some of these areas include the employed physicians of the hospital,
laboratory, pharmacy, cardiac catheterization lab, radiation therapy, clinical drug research,
community free clinic, spiritual care, nurse practitioners, and physician assistants. Her
responsibilities include short and long-term clinical, financial, and operational goals and
objectives. She is also responsible for the clinical and physician practice operations and the
organization’s operational policies, objectives, and initiatives. Ponti is also responsible for the
delivery of quality, safe patient care, and service and fiscal stewardship of the organization.
“Basically I am responsible for the overall success of hospital operations” (M. Ponti, personal
communication, February 11, 2013).
In addition to her responsibilities at McLaren Northern Michigan, Ponti sits on the Board
of Directors, Region 5 for the American Organization of Nurse Executives (AONE), the
Regional Policy Board, Region 5 of the American Hospital Association, and the American
College of Healthcare Executives (ACHE) editorial board. She serves on the Nursing Advisory
Boards for both Lake Superior State University and North Central Michigan College and the
Regional Trauma Network Board of Directors for Region 7 (M. Ponti, personal communication,
February 11, 2013).
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Collaboration Role
When the topic of collaboration was brought up Ponti pulled out a packet of information
from the AONE on Nurse Executive Competencies and stated she refers to this often. She feels
so strongly about these standards that she used them as the framework for her research article
Transforming from Leadership Development to Succession Management. Ponti discussed the
importance of collaboration in health care and how communication is a large part of building
trust and good working relationships with colleagues, peers, physicians, community leaders, and
legislators (AONE, 2011, p. 4). Good communication is important in health care due to the everevolving environment. No matter what Ponti is involved in she never loses sight of the purpose
for her work, the patients’ best interest. By keeping this focus she believes the best decisions
will be made (M. Ponti, personal communication, February 11, 2013).
Ponti stated that early on in her career she learned the importance of communication and
value of teamwork. This concept has helped Ponti surround herself with capable staff members,
allowing her to delegate tasks by utilizing committees. This becomes very important because
Ponti believes in the adage that “there is no I in team” (M. Ponti, personal communication,
February 11, 2013). According to Ponti & Devet (2012), communication and relationship
building “create an environment that allows other team members to succeed” (p. 13). McLaren
uses Joanne Duffy’s Quality Caring Theory as the basis for nursing practice. This theory states
that even with the top leadership team, “value must be placed on human relationships such that
staff members learn that it is a foremost priority” (Duffy, 2005, p. 5). Ponti practices this belief.
Legal and Ethical Issues
As the COO, Ponti is responsible for the organization’s operational policies. One policy
recently revised at McLaren Northern Michigan was as a result of employee drug diversion of
controlled substances. According to Buzzeo & Neal (2013), “hospitals have become significant
ANALYZING A NURSE IN A LEADER ROLE
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sources to divert and abuse prescription drugs and controlled substances” (p. 3). Employees who
divert drugs negatively affect the organization, the employees, and patients. “Healthcare and
nursing leaders have a responsibility to ensure security systems are in place to prevent diversion
and protect patients” (Tanga, 2011, p. 14).
Ponti was instrumental in implementing an upgrade to all hospital Pyxis drug dispensing
machines to include fingerprint access for the removal of drugs after a nurse confessed to
stealing passwords and gaining unauthorized access to Fentanyl for his personal use. “Nurses
who divert medications are a liability to the organization as a result of theft and patient safety
issues” (Tanga, 2011, p. 16). This upgrade helped deter diversion by eliminating the use of
passwords to gain access to controlled substances which results in a safer environment for
patients and colleagues (M. Ponti, personal communication, February 11, 2013).
Power and Influence
Ponti’s initial position at McLaren was the VP/Chief Nurse Executive role. The quest for
American Nurses Credentialing Center (ANCC) Magnet recognition was one of her professional
goals. To prepare the hospital for the Magnet journey Ponti used her strong belief in the
transformational leadership model and redesigned the nursing shared governance structure. This
is an example of how Ponti formulated teams and instilled autonomy in others to create change
within the organization. “Transformational leaders convey a strong sense of advocacy,
influence, and support on behalf of all staff and patients in a healthcare organization” (Wolf,
2012, p. 310). “The transformational leadership process also requires evidence that all levels of
nurses are involved in decision making and that leaders engage and involve the entire
organization” (Luzinski, 2012, p. 543). In 2011 with Ponti leading the journey, the hospital
achieved ANCC Magnet Designation following union decertification and a four year long
nurses’ strike (M. Ponti, personal communication, February 11, 2013). Magnet recognition
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designates organizational and nursing excellence and focuses on delivering quality patient care
(Yoder-Wise, 2011, p. 31). According to Duffy (2005), “nursing has a responsibility to cocreate
caring relationships with members of the healthcare team in order to foster cohesive teams for
effective caregiving” (p. 5).
Decision-Making and Problem-Solving
Ponti noticed the inefficiency in the hospital’s succession planning when there was no
internal candidate to fill the vacant chief nurse executive position created as a result of her
promotion to COO. She has been involved with helping solve the problem of an aging
workforce especially within the top levels of the organization. “Succession planning and
management takes time and needs to begin now so current executives can retire knowing that
future leaders are fully prepared” (Ponti, 2009, p. 125). Previously the hospital had focused on
leadership development but now realizes the need to plan ahead and groom internal candidates
for future job vacancies within the organization. Ponti has reinforced the need for succession
planning to be a top priority and is now a key driver in the organizational strategic plan (Ponti,
2009, p.126). Ponti remains a strong believer in identifying top talent within the organization
and the coaching and mentoring of these employees along with providing opportunities for skill
development (Ponti, 2009, p.141). Employees feel valued when they know the organization
supports their opportunities for advancement. When employees feel valued this enhances the
loyalty they feel toward the organization and positively influences the care they provide to
patients (M. Ponti, personal communication, February 11, 2013).
Management and Resolution of Conflict
In order to keep communication lines open between the colleagues and the upper
management of the hospital Ponti developed “Mornings with Mary-Anne” which are marketed as
an opportunity to sit, have a cup of coffee and address any concerns or rumors or talk about
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anything on your mind. These sessions are scheduled every two weeks and are located on
different units in order to reach more people. “Frequency of interactions with other team
members, talking with them and sharing thoughts, ideas, and experiences-these activities support
teamwork” (Yoder-Wise, 2011, p. 359). Addressing employee concerns early may help prevent
the development of larger problems later. Open communication fosters an environment where
employees feel they can ask questions or voice concerns and makes employees feel valued as
part of a team. Although Ponti has an open door policy, her current position keeps her schedule
full on most days but employees are always encouraged to email her and she strives to reply to
everyone the same day. In addition to “Mornings with Mary-Anne” she also rounds on the units
within the hospital on both day and night shifts to promote visibility and accessibility of the
management team (M. Ponti, personal communication, February 11, 2013). This supports
Duffy’s Quality-Caring Model “care providers and administrators must first learn how to think
differently about interacting with patients and with each other interacting with an intent to know,
or understand another, is risky because the hurried environment of acute care does not reward
human interaction” (Duffy, 2005, p. 5).
Conclusion
“Management and leadership skills in the nurse executive are essential. The ability to
balance the day-to-day operating knowledge with the ability to lead a nursing service
organization into the future is a winning combination” (Yoder-Wise, 2011, p. 47). When Ponti’s
nursing career began 33 years ago she never thought she would be the COO of a hospital. Now
she aspires to one day be the president and CEO and feels she has aligned herself for the
possibility. Ponti feels the most successful hospitals have a President and CEO with clinical
background. It is the clinical background that allows the patient focus to remain first and
ANALYZING A NURSE IN A LEADER ROLE
foremost which after all is the purpose of the hospital’s existence (M. Ponti, personal
communication, February 11, 2013).
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References
American Organization of Nurse Executives (AONE). (2011). The AONE nurse executive
competencies. Retrieved from
http://www.aone.org/resources/leadership%20tools/PDFs/AONE_NEC.pdf
Buzzeo, R. & Neal, M. (2013). Hospital drug diversion and abuse-creating an effective
surveillance and prevention program. Retrieved from
http://crm.cegedim.com/DOCS_whitepaper/compliance/hospital_drug_diversion_whitepa
per.pdf
Duffy, J.R. (2005). Implementing the Quality-Caring Model in acute care. Journal of Nursing
Administration, 35(1), 4-6. Retrieved from
http://www.nursingcenter.com/pdf.asp?AID=539833
Luzinski, C. (2012). Transformational leadership and navigating change. Journal of Nursing
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