N496 Module 1 assignment: leading and managing essay with emotional intelligence reflection, a full sample

The Same Shift, Two Jobs: Leading and Managing as a Charge Nurse in an Outpatient Dialysis Clinic, With an Emotional Intelligence Self-Assessment

Student Name

RN to BSN Program, Aspen University

N496: Nursing Leadership and Management

Instructor Name

Month Day, Year

The Same Shift, Two Jobs: Leading and Managing as a Charge Nurse in an Outpatient Dialysis Clinic, With an Emotional Intelligence Self-Assessment

Nursing students often learn that leaders inspire and managers control, as if the two were different kinds of people. My experience as a charge nurse in an outpatient hemodialysis clinic suggests something different: the same nurse moves between leading and managing many times in one shift, and the skill lies in knowing which one a situation calls for. This essay defines the two roles, compares them through three examples from the clinic, and reflects on what an emotional intelligence self-assessment revealed about my own leadership.

Defining Leadership and Management

The distinction has a long history. Zaleznik (1977) argued that managers and leaders differ in their attitudes toward goals, work, and relationships, with managers seeking order and stability and leaders seeking change and new possibilities. Kotter (1990) framed the difference in terms of functions: management copes with complexity through planning, budgeting, organizing, staffing, controlling, and problem solving, while leadership copes with change through setting direction, aligning people, and motivating and inspiring them. Kotter emphasized that organizations need both, and that strong management without leadership produces stability without adaptation, while strong leadership without management produces change without order.

In nursing, the question matters because leadership style shapes the work environment. A systematic review of 129 studies found that relational leadership styles, such as transformational and resonant leadership, were associated with higher nurse job satisfaction and better work environment outcomes, while task-focused styles were associated with lower satisfaction; the authors concluded that leadership focused only on task completion is insufficient (Cummings et al., 2018). A charge nurse who only manages tasks may keep the schedule running while quietly losing the staff who run it.

Why the Distinction Matters in Dialysis

Outpatient hemodialysis makes the two roles unusually visible. The work is tightly scheduled: each patient's treatment runs about four hours, three times a week, and a delay in one chair ripples through the rest of the day. That structure rewards management. At the same time, dialysis nurses care for the same patients for years, often through depression, missed treatments, transplant evaluations, and decisions about stopping dialysis. Those relationships reward leadership, because the care team must stay engaged and adaptable over a very long horizon.

The staff mix adds another layer. Most direct care in our clinic is delivered by patient care technicians, supervised by a small number of registered nurses. The charge nurse therefore leads a team whose members differ in training, scope, and experience, and who notice different things about patients. A charge nurse who only directs tasks will miss much of what the technicians know; one who only inspires will leave gaps in a schedule that cannot tolerate them. The examples that follow show how both roles appear, often within minutes of each other.

Example One: The Schedule and the New Nurse

Our clinic runs three patient shifts a day, six days a week, with about 16 patients per shift. As charge nurse, I manage the assignment board: matching patient acuity to staff skill, covering call-outs, and making sure every treatment starts on time. This is management in Kotter's sense, organizing and staffing to control complexity, and when it fails, patients wait and treatments are shortened.

During the same shift, a nurse three weeks out of orientation struggled to cannulate a patient's fistula and was visibly shaken after a second miss. Management would have reassigned the patient to an experienced nurse and moved on. Leadership meant taking two minutes to acknowledge the difficulty, cannulating together with her talking through each step, and later asking what she wanted to practice. The reassignment solved the problem for that patient; the coaching invested in the next hundred patients she will cannulate.

Example Two: A New Catheter Care Protocol

When our organization introduced a revised central venous catheter care protocol to reduce bloodstream infections, the management task was clear: train every nurse, audit compliance weekly, and report the results. Those steps are necessary, and without them the protocol would exist only on paper.

Audits alone, however, produced grudging compliance. Several experienced nurses saw the new steps as extra work that slowed turnover between patient shifts. Leading the change meant explaining why the protocol mattered, sharing the clinic's own infection data, inviting the most skeptical senior nurse to identify steps that could be streamlined without losing safety, and recognizing staff publicly when compliance improved. Kotter's leadership functions of setting direction and aligning people describe exactly this work (Kotter, 1990). Within two months, the clinic's compliance scores rose, and the skeptical nurse became the protocol's most effective teacher.

Example Three: A Patient Who Keeps Missing Treatments

One patient had missed four treatments in a month. Clinic policy defines a management response: document each absence, notify the nephrologist, and after a set number of missed treatments, issue a formal warning about possible discharge from the clinic. Following policy protects the clinic and ensures consistency.

Leadership looked at the problem differently. At our team huddle I asked the social worker, dietitian, and patient care technicians what they knew. The technician who connected him most often knew that his ride had been canceled when his daughter changed jobs. The social worker arranged transportation through his insurance, and he missed no treatments the following month. The policy was still followed, but leading the team to look beyond it solved the actual problem.

Emotional Intelligence Self-Assessment

Emotional intelligence, meaning skill at noticing and regulating feelings in oneself and reading them accurately in others, has been described as a core competency in nursing that supports communication, teamwork, and patient-centered care (Raghubir, 2018). Goleman (1998) argued that it distinguishes the most effective leaders and described five components: knowing one's own emotions, governing them, drive, understanding others' feelings, and skill in relationships, which his framework names self-awareness and self-regulation, then motivation, then empathy, and finally social skill. Research in nursing and other fields suggests that emotional intelligence abilities improve communication and conflict resolution and may contribute to patient safety (Codier & Codier, 2017).

On the emotional intelligence test assigned in this module, my scores were highest in empathy and motivation and lowest in self-regulation. The empathy result fits my experience; patients and new nurses often confide in me. The self-regulation result was harder to accept, but it is accurate. When the schedule collapses at 5:30 a.m. because of two call-outs, I become curt, and I have seen technicians avoid asking me questions on those mornings. Those are precisely the moments when a charge nurse most needs to lead, and my frustration makes me retreat into pure management, moving names on the board without speaking to anyone.

The results also clarified how emotional intelligence connects to the rest of this essay. Each of my three examples turned on an emotional moment: a new nurse shaken after a missed cannulation, senior nurses resentful of extra steps, and a patient whose absences looked like noncompliance until someone asked why. Management tools, such as the assignment board, the audit, and the policy, handled the structure of each situation. What moved each situation forward was noticing the emotion underneath and responding to it, which is the practical meaning of empathy and social skill. The self-assessment suggests that I do this well when I am calm and poorly when I am not, which means that my leadership is only as reliable as my self-regulation.

A self-report test has limits. It measures how I see myself rather than how others experience me, and people tend to rate themselves generously on socially desirable traits. For that reason I asked two colleagues, a senior technician and the clinic manager, whether the results matched what they see. Both agreed about empathy; the technician added, kindly, that I am "a different person before 6 a.m." That comment confirmed the score more convincingly than the test did.

What I Will Do Differently

Three changes follow from the assessment. First, on difficult mornings I will take one minute before making the assignment to name the problem aloud to the team, calmly, and ask for ideas, which turns a moment of stress into a moment of shared problem solving. Second, I will ask a trusted colleague to tell me when my tone becomes curt, since self-awareness improves with feedback. Third, I will build on my strengths by formalizing the coaching I already do with new nurses, perhaps as a preceptor, where empathy and motivation are most useful.

Conclusion

Leading and managing are not separate jobs held by different people but two modes that a charge nurse moves between all day. Management keeps treatments on time, protocols in place, and policies consistent; leadership develops staff, builds commitment to change, and draws on the whole team to solve problems policies cannot. The evidence that relational leadership improves the nursing work environment, and the emotional intelligence that makes it possible, gives me a clear direction: to manage well on the hardest mornings without forgetting to lead.

References

Codier, E., & Codier, D. D. (2017). Could emotional intelligence make patients safer? American Journal of Nursing, 117(7), 58-62. https://doi.org/10.1097/01.NAJ.0000520946.39224.db

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19-60. https://doi.org/10.1016/j.ijnurstu.2018.04.016

Goleman, D. (1998). What makes a leader? Harvard Business Review, 76(6), 93-102.

Kotter, J. P. (1990). What leaders really do. Harvard Business Review, 68(3), 103-111.

Raghubir, A. E. (2018). Emotional intelligence in professional nursing practice: A concept review using Rodgers's evolutionary analysis approach. International Journal of Nursing Sciences, 5(2), 126-130. https://doi.org/10.1016/j.ijnss.2018.03.004

Zaleznik, A. (1977). Managers and leaders: Are they different? Harvard Business Review, 55(3), 67-78.