D155 Task 1 Power Skills Scenario Responses Example

Five Scenarios in a Cardiac Catheterization Lab: Power Skills Applied by a New Nurse Manager, With the First Words, the Next Action and the Expected Result

Student Name

Leavitt School of Health, Western Governors University

D155: Leading with Personal Mastery, Task 1

Course Instructor

Month Day, Year

Five Scenarios in a Cardiac Catheterization Lab: Power Skills Applied by a New Nurse Manager, With the First Words, the Next Action and the Expected Result

Introduction

Power skills are the interpersonal and self-management capacities that let a leader turn knowledge into results with and through other people. This paper applies five of them to scenarios in a composite cardiac catheterization lab at a 300-bed regional hospital. The lab runs three procedure rooms, performs about 3,200 procedures a year and staffs 22 registered nurses, cardiovascular technologists and radiologic technologists, with an on-call team for emergency heart attack cases at night. I am the new nurse manager, promoted from staff nurse in the same lab eight months ago, which means I now lead people who were recently my peers. For each scenario I state my response, including the words I would use, explain why the response fits the power skill, and describe the outcome I would expect.

Scenario 1: Giving, Receiving and Incorporating Feedback

A technologist with fifteen years in the lab stops me after a morning huddle and says, in front of two others, that my new room-turnover checklist is a waste of time and that I changed it without asking anyone who does the work.

Response. My first words would be: "You may be right that I skipped a step. Can we take ten minutes after the first case so you can show me where it slows you down?" In that meeting I would ask him to walk me through a turnover using the checklist, write down each point where it adds time, and ask which items he would keep. I would then bring the revised version to the next huddle and credit him by name.

Rationale. Feedback that arrives in public and with an edge is still information. Stone and Heen (2014) describe the three triggers that make people reject feedback: they think it is wrong, they dislike who is giving it, or it threatens their identity. A former peer who is now my subordinate triggers all three for me. Accepting the meeting without defending the checklist shows staff that criticism of the manager is safe, which is the condition under which teams report problems and learn (Edmondson, 1999).

Expected outcome. A shorter checklist that technologists actually use, a senior technologist who feels heard, and a visible signal to the team that disagreement will be answered with a meeting, not a grudge.

Scenario 2: Adapting to Ambiguity

At 0700 the hospital announces that a regional contrast media shortage means the lab will receive about half its usual weekly supply, with no date for full delivery. Physicians want to know which cases will be canceled. Nobody above me has a policy yet.

Response. I would say at the huddle: "We do not know how long this will last, so we are going to decide one week at a time and review every morning." I would ask the medical director to meet at 0730 to set a temporary rule: emergency and inpatient cases first, then outpatient cases the physicians rank by clinical need, with low-contrast techniques used where the physician judges them safe. I would ask the inventory technologist to post the remaining supply on the whiteboard each morning.

Rationale. Snowden and Boone (2007) distinguish situations where the answer is known from complex situations where it can only emerge through small experiments and close watching. A shortage with no end date is the second kind. Waiting for certainty would leave physicians making conflicting decisions case by case; a short, reviewable rule gives the team structure without pretending to know what cannot yet be known.

Expected outcome. No emergency case delayed for lack of contrast, a daily visible supply count, and physicians who disagree with a decision taking it to the morning review rather than to the scheduler.

Scenario 3: Empathy and Inclusive Collaboration

A newly hired nurse, educated in the Philippines and new to the United States, rarely speaks at huddles. A technologist tells me she seems slow and suggests she is not a good fit.

Response. I would first thank the technologist and ask what specifically she has seen. Then I would meet privately with the new nurse and ask: "What has been hardest about starting here, and what would help?" If, as is common, she explains that in her previous hospital junior staff did not question senior staff or physicians, I would pair her with a preceptor for sedation cases, tell her directly that questions and stop requests are expected here, and invite her by name to give the patient safety check at one huddle each week.

Rationale. Empathy starts with asking rather than assuming, and inclusion means changing the conditions that keep someone quiet rather than judging the silence. A hierarchy norm from another health system can look like slowness or disengagement to colleagues who do not share it. Leaders who make speaking up explicitly safe raise the whole team's willingness to report concerns (Edmondson, 1999).

Expected outcome. A nurse who speaks at huddles within a month, a technologist who sees the problem differently, and a lab where the quietest person has a regular role in the safety check.

Scenario 4: Working Through a Complex Problem

Night on-call response times for emergency heart attack cases have crept up. The lab is meeting its door-to-balloon target, but with less margin than a year ago. Staff say they are exhausted by call; the physicians say the team arrives late; the scheduler says nobody will trade shifts.

Response. I would say at the staff meeting: "Before anyone fixes anything, I want to understand the whole chain from page to table." I would pull three months of call activation times, arrival times and case start times, and sit with two volunteers from each role to map where minutes are lost. I would also count how many call hours each person worked, because the call burden may be uneven.

Rationale. A complex problem has several interacting causes, and a solution aimed at one of them, such as a stricter arrival rule, can make another worse by adding to fatigue. Mapping the process with the people who do it separates delay that comes from travel time, from paging failures and from equipment setup, and it treats exhaustion as data rather than complaint. Sustained overload is a known driver of burnout, and leaders who fix the work rather than exhorting the workers see better engagement (Shanafelt & Noseworthy, 2017).

Expected outcome. A specific cause, for example a slow second page to the radiologic technologist, fixed at its source, and a fairer call schedule based on the hour counts.

Scenario 5: Emotional and Cultural Intelligence

A patient's adult son, speaking loudly in the waiting area, accuses staff of hiding information after his father's procedure runs two hours longer than planned. A charge nurse from a culture where direct confrontation is avoided has stopped going out to update him.

Response. I would go to the son myself and say: "I am the nurse manager. Your father is stable, and I am going to get you a direct update from his physician within fifteen minutes." I would stay with him until the physician arrived. Afterward I would debrief with the charge nurse privately, acknowledge that the conversation was hard, and agree on a plan: for any case running more than an hour late, the circulating nurse gives the family a timed update, so no single person carries the confrontation.

Rationale. Emotional intelligence here means reading the son's anger as fear and answering the fear with a fact and a time. Cultural intelligence means recognizing that the charge nurse's withdrawal is a learned response to conflict, not indifference, and designing a system that does not depend on everyone handling confrontation the same way (Earley & Mosakowski, 2004).

Expected outcome. A calmer family, a physician update within the promised time, and a standard that prevents the same gap on the next long case.

References

Earley, P. C., & Mosakowski, E. (2004). Cultural intelligence. Harvard Business Review, 82(10), 139-146.

Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350-383. https://doi.org/10.2307/2666999

Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings, 92(1), 129-146. https://doi.org/10.1016/j.mayocp.2016.10.004

Snowden, D. J., & Boone, M. E. (2007). A leader's framework for decision making. Harvard Business Review, 85(11), 68-76.

Stone, D., & Heen, S. (2014). Thanks for the feedback: The science and art of receiving feedback well. Viking.