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1 Running head: TRANSFORMATIONAL LEADERSHIP BEHAVIOR

Analysis of a Transformational Leader Kaitlyn Baldwin Ferris State University

Analysis of a Transformational Leader Learning the knowledge, skills, and values of nursing leadership in the classroom is also reinforced by preceptors and mentors who model leadership behaviors and skills in practice settings. (Kalb et al., 2012). One such mentor named Gail Westover has presented in the work setting of a registered nurse (RN). Leadership and management style determines the culture in which a nursing unit or health care organization runs. The following paper will analyze Gails management style and describe areas where she has influenced this RNs own leadership behaviors. This paper will also compare the Transformational Leadership (TFL) style to Gails style and state reasons why this style is compatible with nursing performance in the Radiology Department at Munson Medical Center. Qualifications Education Gail holds an Associates Degree in Nursing from NMC I graduated in 1972, before you were born (Westover, 2013). She also continued her education which is important to do as a leader. Effective leaders are continually engaging themselves in lifelong learning. They are service oriented and concerned with the common good (Yoder-Wise, 2011, p. 37). Gail completed a Bachelors Degree in Business Administration from Ferris State University (Westover, 2013). History Gails clinical experience is extensive and includes medical surgical nursing as well as critical care nursing in her background. In the past I was ACLS, PALS, a Certified Emergency Nurse, and now have current certification as Training Center Faculty (TCF) for Northwest

Michigan EMS Education(Westover, 2013). The keys to leadership are to believe in the vision and to enjoy the journey (Yoder-Wise, 2011, p. 45). Gail has had a long and accomplishing career. Gail itemized in an electronic mailing interview with this RN to describe her journey and experience over the years.
1 year Med-Surg / Ortho at MMC, 4 years ER Nursing at Traverse City Osteopathic Hospital, 13 years Emergency Nursing, 2 years as the Manager at Munson Medical Center (MMC), 1 year combination endoscopy, radiology, Human Resources, Diabetes Education experience (MMC), 5 years as Manager of ER and Medical Procedure Room Traverse City Community Hospital, 12 years Manager Urgent Care (MMC), 6 years Manager of Pain Clinic (Worked as Manager of both Urgent Care Pain Clinic for 3 years), 4 years Manager MPR (worked as Manager of both Pain Clinic and MPR for 2 years), 2 years Manager both MPR and Radiology Nursing. I have been a Training Center Facility staff for Northwest Michigan EMS Education for 8 years. I have served on the Med-Surg annual nursing conference planning committee for 10 years (Westover, 2013).

Gail Currently holds the title of Manager over the Medical Procedure Room (MPR) and Radiology nurses. Gail stated her past clinical experience, nursing management experience, reputation and a desire to work with these nursing groups is how she came into her current job title. Actually, Kathleen McManus contacted me in September of 2011 and asked me to pursue the Radiology Nursing position. The small group of nurses had no nursing leader and was floundering as they were the forgotten child in the organization (Westover, 2013). In Gails current position she describes her duties in two categories, patient care and nursing unit obligations. My main job is to insure that patients receive top quality care (Westover, 2013). An effective nursing unit performance is characterized by consistent increase

in patient satisfaction ratings and retention of staff nurses as well as a decrease in hospitalacquired infections and hospitalization days (Casida et. al., 2012). In that regard, my other priority is management of staff and making sure they have what they need to do their jobs with oversight and management of daily operations, resource allocation, problem solving, crisis management, and human resource issues (Westover, 2013). Management Style Mentorship Gail has come to be a mentor for this RN in the Radiology department. A mentor is someone who models behavior, offers advice and criticism, and coaches the novice to develop a personal leadership style (Yoder-Wise, 2011, p. 42). Prior to the interview the RN did not know that Gail is currently a mentor for the MMC Mentor Program and has served as a management resource for the Ambulatory Nursing Council at MMC (Westover, 2013). Mentorship is a twoway street. The mentor must agree to work with the novice leader and must have some interest in the novices future development (Yoder-Wise, 2013, p.42). Gail has demonstrated that she is interested and cares about the development of this RNs leadership skills because she has participated in this interview allowing this RN to analyze her as a leader despite a very busy schedule. It may also be argued that leadership in nursing begins with the nurse educator, and is promoted by nurse leaders across all practice settings where students are engaged in learning (Kalb et. al., 2012). Collaboration Collaboration with the subordinate nurses that work under Gail and also MMCs management leaders that Gail reports to, she has successfully made changes in the Radiology

department so the nursing staff no longer feels like they are the forgotten child. She uses Transformational Leadership (TFL) skills that change how the nurses interact within the unit. Transformational leadership is based on inspirational vision that changes the framework of the organization for employees. Employees are encouraged to transcend their own self-interest (Yoder-Wise, 2011, p. 40). Over the last two years Gail has overseen and helped coordinate moving the radiology nurses into a new department, facilitated a new check-in process for the out patients who are seen in the department for special procedures, and also restructured the staffing and scheduling matrix. This RN has participated in the change and seen the positive outcomes that are resulting. The first key element of the TFL leadership behavior of the nurse manager that has a predictive power on a nursing unit consistency culture is idealized influence (Casida et. al., 2012). If it were not for Gails consistency and influence the department would still be floundering with lack of focus for patient care that embodies MMC core values. During this time of change Gail has collaborated with multiple departments; The departments that I work with on a regular bases include Patient Safety, Patient Liaison, Patient Account, Patient Access, OR, PACU, CPD, Facilities, EVS, Staff Development, Cerner Education, CDS, Logistics, Forms, Human Resources, Infection Prevention, Medical Records, Lab, Corporate Communications, Performance Improvement, and Risk Management. Oh and let's not forget Physicians and hospital administrators (Westover, 2013).

Decision Making and Problem Solving Skills Gail has used strategies to minimize problems and include the staff nurses throughout the transition of the changes that were initiated in the radiology department. The second key element of TFL is the influence of the nurse managers intellectual stimulation behavior on the adaptability culture traitstaff nurses have the likelihood to become flexible and adaptive to external forces that could potentially destabilize the dynamics of the nursing unit (Casida et al., 2012) My management style is participatory. I encourage group problem solving and work hard to get input from departmental staff before making decisions. I lead by example and throughout the years have lived by the motto that I would never expect any staff member to do something that I would not do myself. This has served me well over the years. People who I have worked with have been very loyal and supportive. They have willingly embraced changed, worked together to solve problems, and developed as teams (Westover, 2013). Evidenced-Based Practice Gail incorporates evidenced-based practice as a leader. In the radiology department there have been several changes in practice to improve patient care. The changes have been small but important; an example is changing the documentation forms used so they have all the Centers for Medicare Medicaid Services requirements. Evidenced-based practice is the integration of the best research evidence with clinical expertise and the patients unique values and circumstances in making decisions about the care of individual patients (Straus, Richardson, Glasziou, & Haynes, 2005) (Yoder-Wise, 2012, p. 416). Gail stated in the interview I review professional

organization standards of care. I look for opportunities to change processes based on evolving evidence as presented in professional publications, new findings discussed at meetings, and new practices introduced to the organization (Westover, 2013). Legal and Ethical Considerations All nurses are aware of legal and ethical issues in the care of patients. In a management role the legal issues expand. Gail summarized how she makes legal and ethical considerations in her role as a manager: One always has to be mindful of patient rights. As consumers, patients have increasingly become more knowledgeable over the years. They have high expectations for the quality of care and use of technology. As high care becomes more costly, it is an ongoing challenge to balance and address ethical decisions around end of life and allocation of resources, supplies, equipment and technology. Staff who delivers care must be competent in their skills. All care givers must be aware of signs/symptoms of abuse/neglect in patients of all ages. The organization has multiple resources available to assist with legal and ethical patient care issues such as legal and ethics professionals, medical social workers, and risk management specialists. Human Resources specialists are always available to assist with employment issues (Westover, 2013). Malpractice is always in the back of any nurses mind during their career. Gail focused on staying current in her nursing practice and using good accurate documentation. These types of behaviors have kept her from being involved in any malpractice claims. Documentation is not separate from care but rather an extension of the high quality and quantity of care RNs provide

(Vogel, 2012). It is the documentation that will show that a nurse is practicing within standards of care, and that documentation will save them from legal liability. As a long time manager, I have been involved in cases where law suits were brought against nurses working in my departments. These times are always challenging for the involved nurses. I have sat through hours information gathering, depositions, and legal counsel, serving as a coach and supporter of nurses. Although hospitals may have settled lawsuits out of court, I do not feel that the nurses that have worked in my departments delivered substandard or irresponsible care which resulted in bad outcomes (Westover, 2013). Conclusion The leader and manager Gail Westover uses management strategies that mimic the Transitional Leadership style. She has successfully incorporated the participation of the staff nurses in the radiology department to develop a unit that has grown from floundering to an active and productive component at MMC. Gail uses her reputation to influence and leads by example. Using evidenced-based practice and legal and ethical considerations she is an advocate for patients and staff nurses alike. Health care is changing so rapidly. As a nurse manager, I feel that it is my responsibility to be cost conscious but not at the expense of patient care. Managers are charged with looking for ways to deliver care in less costly ways, cheaper supplies, creative staffing matrices, more efficient processes. I agree that all of these need to be considered however not at the expense of care quality. Manager must bridge the gap between Administration and the patient, serving as a voice for the patients and the employees (Westover, 2013).

References

Casida, J.M., Crane, P.C., Walker T.L., Wargo, L.M. (2012). Elaboration of leadership and culture in high-performing nursing units of hospitals as perceived by staff nurses. Research and Theory for Nursing Practice: An International Journal, 26(4), 241-261. Doi:10.1891/1541-6577.26.4.241 Kalb, K.A., OConner-Von, S.K., Schipper, L.M., Watkins, A.K., Yetter, D.M. (2012). Educating leaders in nursing: faculty perspectives. International Journal of Nursing Education Scholarship, 9(1), 1-13. Doi:10.1515/1548-923X.2215 Vogel, E.T. (2012 winter). Documentation: an ethical consideration. SRNA NewsBulletin, 14(1), 22-23 retrieved from http://0web.ebscohost.com.libcat.ferris.edu/ehost/pdfviewer/pdfviewer?vid=11&sid=a58b8dc75f35-4758-b912-5ede81b964a3%40sessionmgr113&hid=124 Westover, G. (2013, September 28). Re: Interview Questions [Electronic mailing list message]. Retrieved from https://mail.google.com/mail/u/0/#inbox/1416fe9c2eb12a19 Yoder-Wise, P. (2011). Leading and managing in nursing (5th Ed.). St. Louis, MO: Elsevier Mosby.