Question

Case 10: The Toxic Leader Marie-Elena Barry Kyle was a BSN-prepared psychiatric nurse with two years of nursing experience under his belt, and was viewed by his peers as being a senior nurse. Currently, he attends a graduate program part-time to earn his MSN, with hopes to be a manager of an inpatient psychiatric unit. Whenever Kyle was on duty he was always in charge of the 12-bed inner city psychiatric unit. He worked on 3 West caring for young adult patients who suffered from developmental disabilities with a codiagnosis of psychiatric conditions such as schizophrenia, autism, or bipolar disease. Every Tuesday and Thursday afternoon, the unit participates in patient care conferences. The purpose of the conference is to discuss patients who represent a challenge for staff or someone who has behaviors that require interdisciplinary collaboration in order to provide a safe and therapeutic milieu. In order to maintain compliance with The Joint Commission, the psychiatrist, nurse manager, pharmacist, psychologist, and representatives of nursing, social work, and recreational therapy are expected to attend. Jackie, the unit manager, is the Chair of the patient care conferences. The psychiatric unit follows a primary care nursing model, and Kyle was the primary nurse for K.C. Kyle reflected that just two days prior to the scheduled care conference, K.C. was verbally threatening to staff and patients. Additionally, he stopped eating and was banging his head on the wall. On the day of the patient care conference, K.C. had physically assaulted another patient. Kyle, having just two years of nursing experience, was having difficulty in managing K.C.’s disturbing behavior. Kyle acknowledged that K.C. was a danger to himself and others, and Kyle was looking for guidance and support from the health care team. Thursday at 2 pm, Kyle entered the conference room, as expected, only to find that he and the recreational therapist were the only staff present. This wasn’t unusual since when Jackie, the unit manager, sporadically attended rounds, she was often late. Ten minutes after the meeting was supposed to start, Jackie passed by the conference room while talking on the phone, and asked the person she was speaking with to hold on for a minute. As she hurriedly walked away, Jackie told Kyle and the recreational therapist the meeting was cancelled and, “Oh, by the way, didn’t you get my e-mail?” Kyle was speechless. He had never received an e-mail from Jackie, and was disappointed as yet another patient care conference went unattended by the management team. In the meantime, Kyle was at a loss on how to positively manage the care for K.C. The unit was getting out of control as K.C. was becoming more aggressive with other patients. On the afternoon of the cancelled meeting, Kyle saw Jackie and asked her for a moment of her time. Jackie stated that she was late for an appointment as she briskly walked towards the door. She asked Kyle to e-mail her so they could set up an appointment for a more convenient time. Immediately, Kyle sent an e-mail to Jackie stating that he was accessible anytime, even on his days off. Days went by and Kyle never received a reply. On Kyle’s next shift, he patiently waited for his unit manager to arrive. He needed to discuss the care of K.C. with her. When Jackie finally arrived at work, she was wearing a too-short sequined dress, large gold hoop earrings, and three-inch heels. As she had barely entered the psychiatric unit, Kyle noticed that she was hanging on Martin’s arm and giggling flirtatiously. Kyle remembered that Martin was complaining earlier that morning that he had scheduled a meeting with Jackie to discuss a staff squabble. To make matters worse, Martin, who was a younger and less senior nurse followed Jackie into her office and closed the door.

Discussion Questions

1. What s going on in the case?

2. what i the nature of this organizational problem?

3.which theory or theorie describe the behavior of the nure manager?

4.How doe Jackie affects the workplace morale?

5.what kind of further actions do you recommend for kyle to manage the safety of his patient and the unit? what kind of data kyle needs to collect?

7. How would you handle this scenario if you were Kyle?

8. Provide your reflections and personal opinions as well as your recommendations for addressing this problem.

Answer 1

• There are many types of leadership. The main three are Autocratic, Democratic and Laissez- Faire leadership. In this scenaria, jackie, the unit manager is following laissez- faire leadership, which means, leader does not care about what staffs are following. It means she is not a good leader
• The best leadership approach is Democratic leadership
• A unit manager should be a role model to others. She should arrive in time. She should arrange training for her suboordinates, if they lack any skill. She should acknowledge other staffs concern. A new nurse always have doubts and concerns related to patient care. It is the duty of nurse manager to help them.
• Nursing is a noble profession. All nurses should maintain a professional relationship only. Do not encourage any personal relationship with staffs or patients outside the care.
• The main important person in a hospital is client only. Clients concern is the priority. If kyle cannot handle the scenario, she can approach to the unit manager. If the unit manager does have any concern towards kyle, he can approach to the main manager. For everything documentation is necessary. If the patient is having trouble himslef and others, it should be written in the nursing notes.
• Kyle can politely tell jackie regarding email that she doesnt receive any email with proof.
• It is the responsibility of kyle to inform the main manager immediately as K.C is harmful to himself and others, and related to jackie with all proofs.