Nurse Managers have the responsibility of supervising the nursing staff within a hospital or clinical environment. They have to oversee patients' care, take part in managerial decision-making, set time schedules, and engage in the coordination of meetings (Yen et al., 2016). The nurse care manager focused on her role in the provision of interdisciplinary leadership, clinical practices, and staff development in several areas of nursing services. The nurse manager uses participative management to conduct the planning, innovating, coordinating, directing, and evaluating patient services to ensure that the nursing standards are properly maintained across the health organization. This may include dealing with staffing issues and hiring staff every month.
Based on the interview, one of the main roles identified was nurses' leadership and supervisory roles within the facility. This leadership means that for the other nursing staff, the nurse manager provides direction on any form of change to be implemented and how services can be enhanced. The nurse manager is also expected to have constant communication and interactions with the patients. This constant communication and interactions with patients are necessary to identify any deficiencies in the quality of services they receive and their resultant satisfaction. Hence, the nurse manager's primary role is to ensure that the satisfaction of patients is maximized through the provision of high-quality and efficient services.
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A nurse manager is also expected to act as a mentor to the nursing staff. As already stated, a majority of the duties and responsibilities of a nurse manager are concerned with leading different nursing staff sections to ensure that proper services are provided. While conducting these leadership activities, nurse managers are also expected to act as mentors to other nursing employees (Yen et al., 2016). This is done by encouraging professional development and providing opportunities to other nurses to supervise and lead different nursing staff aspects. In this way, not only is the quality of services promoted, but the employees are also motivated to conduct their duties better.
Lastly, nurse managers are also responsible for making financial decisions and budgeting concerning the nursing unit that they lead (Jones et al., 2018). The nursing manager stated that one of her duties within this role was to ensure that staffing costs remained within the budget limits. This included monitoring all staff members with overtime as members of the nursing staff are not allowed to take on overtime without permission from the executive staff. On the other hand, when in a staffing crisis, the nurse manager can also pay employees overtime to maintain safe patient ratios. The nurse manager is also responsible for making financial decisions concerned with repairs that have to be conducted in the unit or any additional resources that may be warranted.
Due to the different roles that the nurse manager has, there was a demonstrated need for the ability to draw on knowledge from a variety of areas. Some of these areas included proper knowledge and information concerning clinical practice guidelines, standards, and best practices, healthcare evaluation and proper outcome measures. This knowledge is essential to ensure that the nurse manager is able to use the best strategies available to measure the needs of the patients while properly structuring the nursing workload (Kirwan et al., 2018). This knowledge is also necessary to highlight ways in which the nurses' performance can be enhanced and what systems would be most efficient for the safety of patients.
Impact of Health Policy on Decision
There were several factors that were identified as having an impact on decision making in health policy. These factors can be divided into internal factors and external factors. Internal factors are aspects concerned with the organizational environment that is considered before the nurse manager makes a decision concerning the health policy. One of the main internal factors is the associated capability and knowledge of existing nursing employees. The nursing manager evaluates whether the nursing staff have the capabilities to act according to the protocols set within the policy. The second internal factor to be considered is the impact that the policy will have on patient outcomes.
On the other hand, external factors are features outside the organization that affect the decision to be made. The main external factor for the nurse manager was the allocation of necessary resources by the hospital management to the nursing unit. Another external factor is the level of collaboration that exists with other nursing managers. These external factors are a considerable consideration before the implementation of health policy. The nurse manager then assesses these factors to identify what decision should be made concerning the new policy.
Impact of Regulatory Agencies on Decision Making
As concerning regulatory agencies, the nursing manager's decisions mainly concern, ensuring existing practices and activities meet the standards of these regulatory agencies (Kirwan et al., 2018). The guidelines provided by regulatory agencies affect the type of decisions that the nurse manager makes. For example, when the joint commission is expected to visit the facility, there are several decisions that the nurse manager is expected to make in their role. Some of these decisions, including identifying whether all the practices and qualifications of the nursing staff, are effectively updated. This included assessing whether the nursing licenses of the employees involved and the annual education requirements that nurses are expected to have are up-to-date. This is essential as the nurse manager's failure to make the appropriate decisions may result in the loss of accreditation.
Regulatory agencies also affect decisions concerning the education of nurses and the design of hospital processes. An example of this can be seen through the management of CLABSI and CAUTI infections within the facility. According to the guidelines provided, when these infections occur, the nurse manager is expected to investigate how these infections occur. Through these investigations, the nurse manager can then use the information obtained to make better decisions on the improvement of protocols and processes while also educating the nurses involved.
Impact of Health Care Financing on Decision
Healthcare financing has a considerable influence on the decisions that a nurse manager has to make. This form of financing mainly affects decisions such as the nursing unit's staffing, the inclusion of additional resources, and the incorporation of best practices within the staff (Jones et al., 2018). For example, the nurse manager is responsible for making decisions concerning the nursing staff and overtime. The nurse manager has to set nursing schedules based on existing financing. Overtime can only be allowed if financial resources are available. If the financial resources are not available, the nurse manager has to monitor the schedule to ensure that no overtime is included.
Healthcare financing also influences the use of additional resources to improve the quality of services. To make a decision concerning whether more resources should be integrated into the unit, the nurse manager has to make a consideration of the existing budget. For example, before the addition of an extra Omni cell for the peritoneal dialysis patients, the nurse had to wait for budget approval. The nurse manager also had to ensure that after this additional resource had been financed, the associated inventory of supplies was managed by the provided budget.
References
Jones, C., Finkler, S. A., Kovner, C. T., & Mose, J. (2018). Financial Management for Nurse Managers and Executives-E-Book . Elsevier Health Sciences.
Kirwan, M., Riklikienė, O., Rengel Diáz, C., Fuster Linares, M. D. P., & Cordeiro, R. A. C. (2018). Patient safety minimising missed care: best practice guidelines for nursing care managers. In 22nd international philosophy of nursing conference" Missed care, care left undone: Organisation ethics and the appropriate use of the nursing resource": August 23-25, 2018, Galway, Ireland: book of abstracts/International philosophy of nursing society (IPONS). Galway: International philosophy of nursing society (IPONS), 2018 .
Yen, M., Trede, F., & Patterson, C. (2016). Learning in the workplace: the role of Nurse Managers. Australian Health Review , 40 (3), 286-291.
