Insights gained through interviewing Chief Nurse Executive I had the distinct to spend some time with a busy,

yet personable nurse who was willing to take time out of her day to speak with me in order to enlighten me on a side of the healthcare organization that I didnt know. I have worked at this outpatient clinic for 16 months as a nurse supervisor in one of five clinical areas. Although all clinics perform similar functions, they each are run independently. Her function is to ensure that each remain within Joint Commission standards, nursing management is in place and report to her, and safety concerns are addressed. She is a member of the Board of Directors and brings nursing issues as far as staffing and patient care to the board members and she is also a part of the hiring process. These are just of few of the many responsibilities that the Senior Nurse Executive holds. She expressed how important it was to be available to her nurses and also continue to maintain a finger on he pulse of an ever changing profession as far as educational opportunities, research, and promotion boards for her active duty nurses. You may not know it, but you are a mentor and a role model. It is imperative to be a juggler of responsibilities and be an excellent time manager in the position that she holds. I am a nurse manager and template manager, I sometimes have difficulties with the many taskings at hand. Her philosophy is to have the right personnel in the right positions and hold them accountable. She also states that empowering her personnel and not micromanaging is a strong trait that she possesses. The guidance and wisdom displayed by the Senior Nurse Executive was astounding. She had experience in many areas and seemed to thoroughly enjoy the impact her position allowed her to do. These are a few of the insights gained from the interview.

Specific knowledge and skills The ability to work with the different department heads throughout this course increased my knowledge in the roles of many aspects of patient care. The specific departments are all intertwined and connected in an effort to assist the patient. I was also able to learn how other areas of the clinic performed and what impact they had on each other. Being an effective manager and leader requires effective communication and networking with other areas within your facility as well as outside your facility.

Expectations and Career Goals As stated earlier, it is imperative that one must be able to ascertain what the organizations function is and be able to understand its mission and determine whether it is being accomplished. According to an article by Patrick & Laschinger, Middle managers who worked in hospitals with greater than four hierarchical levels perceived they had less access to senior managers which resulted in a sense of isolation, and that decisions were being made without their involvement that were of major concerns to nursing. (p. 2). We, as nurses, have a powerful role in ensuring this is occurring, either through policy changing, or reinforcement of certain policies, or the educating of others. My awareness during this course has heightened my sensitivity to being able to step outside of my comfort zone. I am a nurse manager and by personality, I am a peacemaker. I do not like conflict and I have a difficult time with switching my leadership styles. But I know that not all people respond the same to the same leadership. Pursing and eventually obtaining my Masters in Nursing in management and leadership will afford me the opportunity to continue my passion for nursing, but at a

level that I am able to make an impact for others. Not just nurses, but other professionals. Working in different areas of the clinic has proven to be a great asset. Observing how others lead and manage has given me insight. I understand that one must now work in a vacuum, but must be interactive in other forums. Managers need to be involved in committees and decision making, staffing, teaching, and coaching. They must be creative, innovative, and depending on what your organization requires, you must stay proficient and competent in clinical skills. Some managers allow this to go by the wayside, but with the staffing shortage, being well-rounded will help ease through a transition period of staffing shortage. There are numerous resources for managers to utilize. In this complex and challenging times of healthcare, I believe the best managers use them. One of those resources is the American Organization of Nurse Executives (AONE). In brief, AONE believes nurse leaders at all levels should be competent in communication and relationship-building, knowledge of the health care environment, leadership, professionalism and business skills. (Thompson, Navarra, & Antonson, 2005 p.331).

References: Allison, P. & Laschinger, H. K. (2006). The effect of structural empowerment and perceived organizational support on middle level nurse managers role satisfaction. Journal of Nursing Management 14. (1) pp. 13-22. Thompson, P. A., Navarra, M. B., & Antonson, N. (2005). Patient safety: The four domains of nursing leadership. Nursing Economic$. 23 (6) pp. 331-333.