Nurse Leadership Discussions

Cardiac Unit Staff Empowerment

The cardiac unit is an extremely busy department, and most staff members suffer from unrealistic workloads from demanding physicians and patients’ needs. As a result, the staff members are more likely to leave work especially when they feel undervalued or unheard. In particular, Linnen and Rowly (2014) note that clinical nurse managers have been accused of being insensitive to their staff needs, showing less concern for employee well-being, not providing adequate staff training, or clinical advancement. With such a team, it then becomes extremely hard for the nurse leaders to work with them since they are likely to perceive even the slightest instructions as an invasion of their duties and may even read mistrust from their leaders. Therefore, empowering the cardiac unit nurses team is a critical nurse manager function that can significantly boost staff morale, increase productivity, staff retention, and improved patient care, all at minimal costs.

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The realization of this milestone has a threefold approach. Firstly, nurse managers should practice effective leadership towards nurses. As Linnen & Rowley note, a good leader should build trust among those they lead, show empathy, design the desired behavior, and learn how to manage and solve conflicts when they occur. Secondly, management should screen all staff members for their professional traits and psychological disposition to evaluate years of experience and clinical expertise. Nurses should be able to operate within a professional environment, with enough staffing and resources adequacy, mutually respectful nurse-physician relationship, and participation in policymaking and governance. Along with that, it is important to provide the staff members with a supportive working environment. As it is, working in a cardiac unit is a very demanding job, and nurses are more likely to experience burnouts. The nursing leadership should provide an environment where nurses are able to express their frustrations and get emotional and moral support in case of a breakdown.

My Sphere of Control

A nurse manager holds an assigned position within the hierarchy of a hospital management system. The manager has the powers over various processes, make specific decisions, and to carry out certain duties as required by the superior authority. However, a nurse manager is not the same as a nurse leader. As a nurse manager, I have consistently maintained productivity in my unit and has a strong enthusiasm towards achieving organization goals. Moreover, I always make sure to create time from my busy schedule to offer support and mentor the less experienced nurses as a way of promoting the competent nursing practice and quality patient care. Thus, it would be right to say that out of the three empowerment process elements; effective leadership is my sphere of control.

Sources of Power in Cardiac Unit

Even in the best-organized healthcare facilities, it is important to analyze and understand the various sources of power especially in a cardiac unit. In this case, the first source of power is the physicians who are most likely to demand clinical nurse assistance or instruct them on various procedures to be performed on the patient. The other source of power is the nurse manager who is responsible for the whole team in a cardiac unit. Along with that are the patients who are more likely to demand the attention of the nurses in the absence of the physician.

Nurses Powerlessness and Transfer from the Unit

Nursing in a critical care unit such as the cardiac unit is an extremely demanding job, both physically and emotionally. While the physical toll may not be as strong, the emotional toll can have devastating consequences to the individual especially if they are not addressed in time. The critical care nurses are at a risk of experiencing intense stress, develop burnouts, and compassion fatigue as they watch their patients every day (Lombardo & Eyre, 2011). At most, burnouts are due to increased frustration with the work environment, the schedules, and management among other underlying factors. Meanwhile, compassion fatigue is likely to crop up as nurses ability to feel empathy is reduced, as a result of constant pressure from patients in distress. Nurses are also likely to suffer from anger and resentment, feelings of being irritable, anxiety or minimal concentration at work. In return, nurses may end up feeling powerless and possibly request a transfer from the unit to a less demanding one.

Group project

Every year, hundreds if not thousands of cancer patients, travel from home to get the best cancer treatment in hospitals. The activity can place additional emotional and financial burden on the patients, their families, and caregivers during this challenging time. The patients, who come from various geographical areas, sit together and spend time with their counterparts who are also suffering from the chronic disease at the outpatient department, where most of the cancer treatment takes place. Several studies suggest that cancer survivors who experience stronger emotional support adjust easily to the changes cancer brings in their lives, have a more positive outlook towards life, and often have better quality lives (The American Cancer Society Medical and Editorial Content Team, 2014). As a way of easing the cancer burden, I and my five friends believe that we can make a difference in the lives of these people suffering from cancer by spending some quality time with them as they await their turn at the waiting bay. The goal was to offer support to cancer patients who visited the hospital and try to make it a routine visit once every month. This month, we managed to spend two hours with the patients and learned more about how cancer was affecting their everyday lives. From the information we collected, it was easier for use to offer support from a nurse point of view. Ours was to make a difference in the lives of these patients and help them realize they can enjoy life as much if only they change their attitude towards cancer.

Effectiveness of Group Decision Making Process and Barriers

When it comes to decision-making, groups are more effective due to their expansive experiences and larger perspectives from the individuals. Initially, the group was torn between visiting nursing homes to offer support to patients receiving palliative care and giving support to cancer patients at the outpatients’ area. However, more members argued that patients in nursing homes are more likely to receive quality care and support as opposed to cancer patients who visit the hospitals for their treatment. As a group, it was easier to be more creative, which led to decisions that were more effective. Nevertheless, the decision-making process was not without some barriers. As it is, it took us more time discussing each member thoughts about the two alternatives and arriving at a conclusion.

Techniques Utilized in the Group Decision Making Process

In group discussions, some techniques are important for effective decision making. During the process, the group utilized the brainstorming technique, which as Boddy (2012) elaborates, involves a group of around five people sitting together to generate ideas. The major focus is not to evaluate, but to gather ideas. In our case, several ideas were generated, which made it possible to come up with the two proposals about visiting a nursing home and cancer patients.  After the brainstorming session was over, we adopted the nominal group technique, which is more structured. In this technique, Boddy notes, members operate independently and hand out their written ideas to the coordinator who reads out aloud for the others to hear. After this, the ideas were discussed as each member was encouraged to support their idea for clarification purpose and improvement. We then evaluated the ideas according to their merits and demerits and settled on the highest ranked, which was selected to act as a guide to the group objectives.  

Patient Care Delivery System

The patient care delivery system used at my place of work is the Team Nursing patient care delivery system, which is mostly common in the United States. Under the system, a team of nurses works together, to provide maximum quality care to a group of patients (Tiedeman & Lookinland, 2004). The model relies on a team leader, usually a registered nurse and requires effective communication and leadership skills for effective implementation. Nursing environments are complex, but the model prioritizes nurses’ workloads, which is necessary for smooth operations. Besides, the model prevents workplace stress and burnouts, which may have dire consequences on the staff members and the organization.

From a Nurse Manager Point of view

Nevertheless, given a choice, I would implement the relationship-based care delivery system, which first seeks to know the patient as a person, and encourages collaboration between clinicians and patients, while ensuring smooth transitions among care providers. From tested principles, this care delivery system is high effective for all inpatient, outpatient, and ambulatory clinics. The model requires a consistent team of caregivers alongside hospice infrastructure to implement and sustain a medical plan for patients. Physicians, nurses, medical assistants, come together to provide preventive and quality care to patients (“Nursing care delivery system: relationship-based care,” n.d).  One of the major reasons why I would choose this patient delivery care system is because it aligns with the organization goals and values with a collaborative approach to provide excellent outcomes. The other reason is due to its emphasize on the importance of quality care and the relationship it enhances between patients and caregivers. Along with that, the model encourages teamwork, while making individuals responsible for their actions.

From a Patient Point of View

Given a chance as a patient, I would choose the relationship-based patient delivery care system, a model that considers the physical environment and the relationship between caregivers and the patients as the immediate context for the experience. The system provides patients with detailed information about the primary caregiver coordinating their care. Along with that, the system is concerned about delivery of improved patient experience, their emotional safety enhances better communication channels, and allows for earlier identification of transforms in a patient’s condition. Besides the system requires a caregiver to identify the patient’s health needs and tailor an individualized care plan with the aim of improving the condition of the patient.


“Nursing care delivery system: relationship-based care.” (n.d). The UVAHS Professional Nursing Staff Organization. Retrieved from:

Boddy, C. (2012). The Nominal Group Technique: an aid to Brainstorming ideas in research. Qualitative Market Research: an International Journal, 15(1), pp. 6-18.

Linnen, D., & Rowley, A. (2014). Encouraging clinical nurse empowerment. Nursing Management Illinois Then Springhouse-, 45(2), pp. 44-47.

Lombardo, B., & Eyre, C. (2011). Compassion fatigue: a nurse’s primer. Online Journal of Issues in Nursing, 16(1), pp. 3

The American Cancer Society Medical and Editorial Content Team. (2014). Attitudes and Cancer. American Cancer Society. Retrieved from:

Tiedeman, M. E., & Lookinland, S. (2004). Traditional Models of Care Delivery: What Have We Learned?. Journal of Nursing Administration, 34(6), pp. 291-297.

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