Question

Hillary Hockenberry has been a nurse for 4 years in a long-term care facility. Recently, the position of unit manager has become available and she is considering applying for it. Peers have encouraged her to consider doing so and have commented, “You are a born leader and manager and will do really well in the position.” Hillary Hockenberry is no asking herself the following questions:

Am I ready for a position like this?

What management skills will I need to be a good unit manager?

What are the rewards and challenges to a management position?

She seeks input from both the former unit manager, who is now the assistant director of nursing (ADON), who she views as a mentor, as well as the preceptor who she originally worked with as a new graduate.

The preceptor states, “You’ve got good management skills – they are often inherent in what every nurse does in management the care of patient.” Discuss what the preceptor means by this statement.

The ADON states, “The biggest challenge of management is juggling the needs of patients with the needs of the organization.” What does the ADON mean by this statement in light of the economic climate and the nursing labor mean?

Hillary accepts the position, and 6 months into her role as unit manager she was asked to follow up on survey results indicating insufficient staffing to help feed patients at mealtimes, especially the breakfast meal. The majority of residents on the unit need assistance with feeding, from setting up trays to needing to be fed. On the 30-bed unit, the ratio of staff to residents is 1:10 inclusive of licensed and unlicensed personnel. Meals are encouraged to be taken in the dining room, but traditionally, the majority of residents in this unit eat in their rooms. A strategy must be implemented to ensure that feeding/nutritional needs are met for the unit’s residents.

One staff member says, “You’ve got the power to change this so do it.” Looking at the sources of power, who should Hillary respond to this statement?

It is decided that a new dining process will be implemented throughout the facility. All residents will be transported to the dining room for all meals unless contraindicated by health status. Residents/families are in support of this strategy, as it appears it will both ensure that residents are fed and encourage socialization of all residents, regardless of their cognitive level of functioning. All staff will be present in the dining room to assist with meal/feeding needs.

Identify possible factors that will cause resistance to change and implementation of this strategy.

How will Hillary, as the unit manager, evaluate the integration of the change

Answer 1

#. By the statement - You’ve got good management skills – they are often inherent in what every nurse does in management the care of patient" ,the preceptor wants to say that the management skills which are required by a nurse to deal with the patient and other healthcare situations like management of blue code etc are inbuilt in her . She has got these skills from inherent.

#. By the statement -" The biggest challenge of management is juggling the needs of patients with the needs of the organization" ADON wants to say that the main task of the nurse is to manage between the needs of the patients and organisations . She has to consider the needs of both and tackle the situation with our causing deficit in any of the groups .

#. Hillary should use her power and should either request to increase the number of staffs or implement a new feeding process to dealt with this issue.

#. Factors that act as resistance to this change and implementation of new strategy are :-

- complicated health condition of the patients

- staffs those are not ready to change

- patient attendent wants to serve feed themselves

- cultural and religious beliefs among patients

#. Hillary can evaluate the integration of the change by evaluating the nutritional status of the patients and also by having a feedback session by using a questionnaire.