The notion of healthcare has significantly evolved in its semantic paradigm over the last decades. The perception of the job description, however, has been mostly modified in the field of nursing care and management. If previously, the major emphasis was placed on the service quality, nowadays it is the organizational structure of the nursing unit that also matters for the overall healthcare system’s success. Hence, the major responsibility for securing such a variety of indicators as financial management, human resource management, negotiations, conflict resolution, and leadership is to be taken by the nurse manager (Cox, 2019). To obtain a better understanding of the nurse manager’s role in the healthcare paradigm, the practicing nurse manager was interviewed on the subject of her perception of the job description and major challenges in the workplace. In terms of the following paper, the information obtained during the interview will be summarized in order to outline the fundamentals of the nurse manager’s decision-making process.
To begin with, it is of crucial importance to establish the basic elements that make up a nurse manager’s job description caused by both internal and external factors that correlate with the specialist’s responsibility. The internal factors that influence the decision-making process in nurse management include the working relationships within a unit, nurse-patient collaboration, and individual qualities of the staff members. These aspects are tangible in terms of management, as they could be handled on the spot. The external indicators that impact the management process include health policy patterns in the healthcare unit, financing, regulatory requirements, and the unit’s accreditation peculiarities. These factors, on the contrary, cannot be managed individually by the manager, making it his or her responsibility to adjust the unit according to the defined criteria.
To understand how these factors could be handled by a leader, an interview was conducted with a nurse manager who has extensive experience in the aforementioned field. The interviewee has been working in the nurse management segment for the last five years, working in two medical establishments. The interview sample consisted of 15 questions concerning the overall attitude to the nurse management occupation and the ways in which managers tend to deal with external occupational factors. The questions were extended and required a great deal of critical analysis and reflection upon the experience in the management process.
In the course of the discussion, some of the major points of the decision-making process within the nurse management paradigm were established:
- Healthcare policies play one of the most significant roles in terms of nurse management decision-making. According to the respondent, current patterns of organizational structure greatly influence the independence of the nurse managers. Many currently implemented policies limit the scope of responsibility and autonomy managers have. Hence, nurse managers now face the cognitive dissonance between the number of tasks they have to manage and the policy limitations surrounding these opportunities;
- The financial aspect of the healthcare system is directly correlated with the manager’s decision-making skills in urgent situations. As a major part of nurse management, a leader is to take full responsibility for the allocation of the finances within the unit (Moore et al., 2016). However, nowadays, it is a common practice for the local healthcare facilities to significantly cut on expenses dedicated to the unit. Hence, managers have no other option but to learn how to deal with the financial aspect in the most cost-efficient way. According to the respondent’s answer, nurse management required quite extensive quick-thinking skills in order to establish an agile framework of budget planning.
- The sociological aspect of the manager generally plays a more important role in the decision-making process than the external one. Various researchers claim that personal attributes such as stress-resistance, interpersonal skills, and strong professional competence serve as the most valuable in terms of the occupation (Warshawsky, 2018). According to the respondent’s answers, those qualities were, in fact, the catalyst of a successful model of nurse management and leadership. Despite the variety of external factors that influence the material part of the job, overall service satisfaction and success are directly correlated with one’s personal qualities. The major issue here lies in the fact that while the governmentally-based policies on the healthcare system and nursing practice, in particular, are supposed to be tailored according to certain standards, there are many aspects to consider on the local level when adopting a policy. At that stage, nurse managers are to be extremely flexible in terms of decision-making, as they are to take into account all the peculiarities of a workplace.
- Regulatory requirements in healthcare establishments greatly impact how managerial decisions are made. The regulatory requirements could be defined as a series of applicable approvals, licenses, and laws tailored to the healthcare facilities. Taking into account the interview results, it might be outlined that the nurse managers do not consider these restrictions helpful, seeing them as a major obstacle and limitation instead. According to the interviewee’s point of view, the regulatory limitations and standards should not be enforced by the authorities that are not explicitly related to the realities of healthcare. Instead, the decisions are to be made considering the opinion of the vast majority of the practitioners in the field who face challenges every day in the workplace.
Hence, taking into account all the aforementioned factors that were outlined in the course of the interview, it might be concluded that the management in the context of the healthcare system is a complex and somehow flawed mechanism that needs urgent reconsideration. Among all the indicators that influence the patterns of managerial decision-making, the internal and the external factors could be outlined. To realize how crucial the outer aspects are for the nurse manager, an interview with an experienced nursing leader was conducted. Hence, it was established that the very process of decision-making has major dependence on such notions as healthcare policies, regulatory requirements, and financial backing of the segment.
As a result, it became clear that the modern version of the healthcare system hierarchy limits the zone of responsibility for nurse managers. The financial backing and the development of various policies and authority regulations are not efficient in terms of the success rate increasing and overall satisfaction with the job. After examining the results of the interview, one might conclude that today’s regulations deal with the issues on a level satisfying for the governmental initiatives yet extremely irrelevant in the context of their application to real-life decisions in the workplace. Hence, the future implication of the nurse manager’s role in the healthcare setting is to collect empirical data on the possible solutions to the issue.
References
Cox, C. A. (2019). Nurse manager job satisfaction and retention: A home healthcare perspective. Nursing Management, 50(7), 16.
Moore, L. W., Sublett, C., & Leahy, C. (2016). Nurse managers’ insights regarding their role highlight the need for practice changes. Applied nursing research, 30, 98-103.
Warshawsky, N. E. (2018). Promote nurse manager job satisfaction and retention. Am Nurse Today, 13(8), 33-34.