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663_Chapter 2_0017-0026.indd 18 9/15/2014 4:37:03 PM /15/2014 4:37:03 PM Process Cyan rocess CyanProcess Magenta rocess MagentaProcess Yellow rocess YellowProcess Black rocess Black chapter 2 ■ Manager 19 professionals. Despite its name, servant leadership applies more to people in supervisory or administrative positions than to people in staff positions. The servant leader–style manager believes that people have value as people, not just as workers (Spears & Lawrence, 2004). The manager is committed to improving the way each employee is treated at work. The attitude is “employee first,” not “manager first.” So the manager sees himself or herself as being there for the employee. Here is an example: Hope Marshall is a relatively new staff nurse at Jefferson County Hospital. When she was invited to be the staff nurse representative on the search committee for a new chief nursing officer, she was very excited about being on a committee with so many managerial and administrative people. As the interviews of candidates began, she focused on what they had to say. All the candidates had impressive résumés and spoke confidently about their accomplishments. Hope was impressed but did not yet prefer one over the other. Then the final candidate spoke to the committee. “My primary job,” he said, “is to make it possible for each nurse to do the very best job he or she can do. I am here to make their work easier, to remove barriers, and to provide them with whatever they need to provide the best patient care possible.” Hope had never heard the term servant leadership, but she knew immediately that this candidate, who articulated the essence of servant leadership, was the one she would support for this important position. Qualities of an Effective Manager Two-thirds of people who leave their jobs say the main reason was an ineffective or incompetent manager (Hunter, 2004). A survey of 3,266 newly licensed nurses found that lack of support from their manager was the nurses’ primary reason for leaving their position, followed by a stressful work environment. Following are some of the indicators of their stressful work environment: ■ 25% reported at least one needle stick in their first year. ■ 39% reported at least one strain or sprain. ■ 62% reported experiencing verbal abuse. ■ 25% reported a shortage of supplies needed to do their work. These results underscore the importance of having effective nurse managers who can create an environment in which new nurses thrive (Kovner, Brewer, Fairchild, et al., 2007). Nurse managers hold pivotal positions in hospitals, nursing homes, and other health-care facilities. They report to the administration of these facilities, coordinate with a myriad of departments (the lab, dietary, pharmacy, and so forth) and care providers (physicians, nurse practitioners, therapists, and so forth), and supervise a staff that provides care around the clock. You can see why their effectiveness has considerable influence on the quality of the care provided under their direction (Trossman, 2011). Consider for a moment the knowledge and skills needed by a nurse manager: ■ Leadership, especially relationship building, teamwork, and mentoring skills ■ Professionalism, including advocacy for nursing staff and support of nursing roles and ethical practice ■ Advanced clinical expertise including quality improvement and evidence-based practice ■ Human resource management expertise including staff development, and performance appraisals ■ Financial management ■ Coordination of patient care, including scheduling, work flow, work assignments, monitoring the quality of care provided, and documentation of that care ( Jones, 2010; Fennimore & Wolf, 2011) The effective nurse manager possesses a combi nation of qualities: leadership, clinical expertise, and business sense. None of these alone is enough; it is the combination that prepares an individual for the complex task of managing a unit or team of healthcare providers. Consider each of these briefly: ■ Leadership. All of the people skills of the leader are essential to the effective manager. ■ Clinical expertise. Without possessing clinical expertise oneself, it is very difficult to help others develop
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