Jackie is a new nurse manager. She

Jackie is a new nurse manager. She had no prior experience in a management position, but she was eager to accept the challenge of managing her own unit. She had been frustrated in her past positions as a staff nurse, staff educator, and nurse coordinator, feeling powerless to make significant change. She had enjoyed great success in these roles leading hospital projects, and she had received rave reviews from her peers and supervisor. When this new nurse manager position became available and the opportunity was offered to her, she jumped at the chance to move to the next level into a real leadership role, though she had no expertise in the specialty of her new unit. She had heard that the staff was a very cohesive team, and she was eager to finally have authority to bring about change and influence. She entered into the nurse manager position very enthusiastic to make immediate changes and with the help of improving staff accessibility and greater utilization of technology when possible. In the first few months, after a brief orientation to the department, Jackie made many changes, such as changing the staff work patterns and scheduling process, quickly filling all vacant positions, eliminating the staff break room, and eliminating routine monthly staff meetings. With each change, Jackie felt great pride and the changes she made, believing the staff would accept and appreciate the value in the changes, and she awaited the subsequent improved outcome. However, in less than six months, half of the new staff she hired had resigned, along with four existing staff members, creating an even greater vacancy rate. Staff call-ins increased by 50%, and the staff felt disconnected, unappreciated, and distrustful of Jackie. Many reported feeling that she was frequently unavailable and did not support them or appreciate their opinions or input. Jackie found that she was very uneasy having direct communication with the staff. She perceived all voiced concerns or complaints as a challenge to her nurse manager skills and authority, and she resisted all suggestions from them. When members of the interdisciplinary team approached her with areas that needed improvement, she felt personally attacked. She realized she had not anticipated how much personal contact the staff seem to require. She was even more unprepared for how much supervision was necessary to monitor care delivery, patient and family satisfaction, and adherence to policy. Yet Jackie was eager for the staff to like her and feel friendly toward her. Do you think if Jackie had experience in this specialty unit, that would have made a difference? How long do you think it is appropriate to wait before making major changes in a department? How important is listening to staff concerns and values first before making changes? Why is having a room for down-time and meetings imperative in a high-stress specialty unit? How important is communication at work? What management or leadership style did Jackie display? If you were her manager, how would you empower and equip her to become more successful at this position?

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