During the first week in October it was my privilege to spend four (4) hours with my nurse manager/supervisor in the pediatric ward of the hospital I work. The four hours were spent one day during 2 o’clock in the afternoon to 6.p.m. Mrs. V.P is an advance nurse specialized in pediatrics and happens to be nurse manager for the pediatric unit in that hospital. The unit comprises of pediatrics medical, pediatric surgical and a separate unit where children with infected diseases are isolated during the active course of the disease.
The daily census for these three units amounts to an average of 10 children each. Staffing is through one registered nurse (RN) per unit for each shift; two, Licensed Registered Nurses (LPNs); two Certified Nursing Assistants (CNAs) and one patient care technician (PCT). Mrs.V.P was promoted area supervisor pediatric unit of this hospital after completing training specializing in pediatrics five years ago. Prior to this promotion she gave exemplary services as associate pediatric area supervisor for three years in the hospital she now serves as unit/areas manager.
With regards to management styles observed there were many elements in Mrs. V.P. character worthy of emulation. In my opinion she is neither totally authoritarian nor democratic, but wisely blends the two in achieving cooperation from her staff. There are two types of authoritative management styles practiced in the modern world currently. One is exploitative whereby managers use threats to achieve goals the other is benevolent in which motivation to function according to rules is based on punishment and rewards system (Modaff, Butler & DeWine, 2008).
When practicing democratic management a supervisor/ manager is open encouraging employees’ participation in decision-making process. There is no single decision making by administration and employees compelled to follow (Minier, 2001). Mrs. V.K’s astute management blending autocratic with democratic was demonstrated when an incident occurred on the surgical pediatric unit. She was notified via the telephone. The doctor reporting the indecent tried making the registered nurse on duty responsible for incorrect medication recording and administration.
She used authority to defend the rights of her staff by reiterating the protocol though which such complaints must be addressed. Then asked that evidence supportive of all accusations pertaining to the incident be brought to her office. Almost immediately both doctor and registered nurse were engaged in a meeting with her for about an hour (Terry, 2003).
No decisions were made regarding who was to be blame. Her approach was that it is not a blaming game, but rather a question of patient safety for which every member of the health care team is accountable even she as a manager. Therefore, the resolution entailed tendering an incident report, which will be investigated for possible future system adjustments (Choi, (2007). In my opinion that was a magnificent resolution to the incident, incorporating authority with democracy.
The management process which was observed seemed in alignment with organizational goals and projected patient outcomes. Much of the data retrieved pertaining to planning; organizing, staffing, directing and controlling were obtained from interviewing Mrs. V.P.
Planning was undertaken through daily allocation of duties based on staffing requirements. Weekly meetings were held with unit heads/registered nurses to verify staffing needs and plan, who will head each shift along with supporting LPNs, CNAs and PCTs. Off duties are requested and discussed with staff in endorsing their agreement with the assigned shifts and days off.
Organizing clinical areas to ensure that pediatric patients’ safety during hospitalizations was mandatory. Children are very active and could fall or enter into difficult circumstances if left unsupervised. Even though many of them are hospitalized only the very weak ones tend to remain in bed all the time. Therefore, organizing for safety is essential in all the units. Doors are not locked, but a security in placed on each floor and doors have alarms in case a child tries to get out. The alarms have a central focus alert system.
Staffing is very important since children require more supervision than adults. With an average census of 10 children per unit/ floor the staffing distribution per shift seems adequate. Very serious cases are transferred to the intensive care unit.
Directing is from behind and not authoritatively announcing who is in charge. Every nurse/ health care provider is in charge of the duties required to perform on that particular shift. Mrs. V. P. explained that she visits the units once per shift and leaves supportive management to registered nurses who report to her at eh end of the day.
Controlling seems not to be a part of Mrs. V.P character. This does not mean that she is fare laissez-faire allowing anything to happen on the units, but she gives opportunities all senior staff/ registered nurses opportunities to take control of events on their shift and report any discrepancies.
Choi, S. (2007). Democratic Leadership: The Lessons of Exemplary Models for Democratic Governance. The International Journal of Leaderships Studies. 2( 3), 243-262
Minier, J. (2001). Is democracy a normal good? Evidence from democratic movements. Southern Economic Journal, 67(4), 996-1008.
Modaff, D. Butler, J., & DeWine, S. (2008). Organizational Communication: Foundations, Challenges, and Misunderstandings (3rd ed) Glenview: Pearson Education
Terry, L. (2003). Leadership of public bureaucracies: The administrator as conservator (2nd ed.). Armonk, NY: M. E. Sharpe.