Facility’s Organizational Chart Review

Organizational Structures in Nursing

In this writing assignment, you will complete a paper addressing an issue from the perspective of the nurse manager on a unit.

Step 1 Review your unit’s and/or facility’s organizational chart.
You have been promoted to nurse manager of your unit. You realize that to function effectively, you must have a better understanding of your organization’s structure and, specifically, the chain of command.

Find and analyze the organizational chart of the healthcare organization you are currently working for or for one that you have encountered in your nursing experience.

Step 2 In a two-page (500-word) paper, address the following points:

  • Give a brief description of the organization of the healthcare structure used in your facility.
  • Describe the chain of command used in your organization and identify the people you report to and those who report to you.
  • Consider the following and discuss how the chain of command is used to implement change.
    • Based on the organization chart, what leadership structure is used in the organization—hierarchical or flat?  How does this affect implementing change?
    • Does this organization use a shared governance model for nursing?
    • When nurses have an idea for changing a process and they make a decision as a group, where do they go with their suggestions? (the director? the unit manager?)

They go to the unit assistant manager

  • Explain why understanding this information is important to your success.

Write your paper using APA format. Cite all sources in APA format.

Title: Organizational Structures in Nursing: A Nurse Manager’s Perspective


As a newly appointed nurse manager, understanding the organizational structure of the healthcare facility is imperative for effective leadership and decision-making. This paper aims to analyze the organizational structure, chain of command, leadership style, and decision-making processes within the healthcare organization I currently work for.

Description of the Organizational Structure:

The healthcare facility I am affiliated with follows a hierarchical organizational structure. This structure comprises multiple levels of management, including executives, directors, managers, supervisors, and frontline staff. Each level has distinct roles and responsibilities contributing to the overall functioning of the organization.

Chain of Command:

In this hierarchical structure, my position as a nurse manager places me in a middle-management role. I report directly to the director of nursing or nursing administration. Additionally, I oversee the nursing staff on my unit, including registered nurses, licensed practical nurses, and nursing assistants. They report directly to me, forming the immediate chain of command within the unit.

Implementing Change through the Chain of Command:

The hierarchical leadership structure can both facilitate and hinder the implementation of change within the organization. While clear lines of authority enable efficient communication and decision-making, bureaucratic processes may slow down the implementation of innovative ideas. As a nurse manager, I play a crucial role in bridging the gap between upper management and frontline staff, facilitating the smooth execution of change initiatives.

Shared Governance Model for Nursing:

Our organization utilizes a shared governance model for nursing, empowering frontline staff to participate in decision-making processes. This model fosters collaboration, transparency, and accountability among nurses at all levels. Through shared governance committees, nurses have the opportunity to voice their concerns, propose ideas for improvement, and contribute to policy development.

Decision-Making Process for Process Improvement:

When nurses have suggestions for changing a process, they typically bring their ideas to the unit assistant manager. As a frontline leader, the assistant manager serves as a liaison between staff nurses and higher management. They evaluate the feasibility of proposed changes, provide guidance and support, and escalate significant issues to the nurse manager or director as needed.

Importance of Understanding Organizational Structure:

Understanding the organizational structure, chain of command, and decision-making processes is essential for my success as a nurse manager. It enables me to navigate the complexities of the healthcare system, communicate effectively with stakeholders at all levels, and lead my team towards achieving organizational goals. By leveraging this knowledge, I can promote a culture of collaboration, innovation, and excellence in patient care.


In conclusion, a comprehensive understanding of the organizational structure and leadership dynamics within the healthcare facility is crucial for nurse managers. By analyzing the chain of command, leadership style, and decision-making processes, nurse managers can effectively implement change, promote shared governance, and drive positive outcomes for both staff and patients.

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