As the clinical director of 24 employees, you have been asked to explain to staff members why they are not getting a raise this year, even though they have been working short-handed for many months and patient satisfaction scores have never been higher. Because you believe yourself to be a transformational leader, you will approach this problem by:

Choice A reason: A functional structure is an organizational design that groups employees by their similar skills and expertise. While it involves clear roles and responsibilities, it does not necessarily imply that the majority of decisions are made by senior administrators.

Choice B reason: Transformational leadership is a style of leadership where the leader works with teams to identify needed change, creating a vision to guide the change through inspiration. This does not specifically describe an organization with clear rules and procedures.

Choice C reason: A matrix service line is a type of management system that combines a traditional departmental structure with a project-based structure. This choice does not fit the description of an organization primarily governed by strict rules and senior administrator decisions.

Choice D reason: This is the correct answer because a bureaucratic organization is characterized by formal procedures and protocols, a clear hierarchy, and decision-making authority typically residing with senior administrators. This structure is designed to ensure efficiency and consistency in operations.

Choice A reason: Advocating for the patient means the nurse manager is acting on behalf of the patient's interests, especially when the patient is unable to do so. This includes ensuring the patient receives necessary medical care regardless of their ability to pay.

Choice B reason: Empowering the patient typically involves educating and enabling them to make informed decisions about their own care. While important, it does not directly relate to the nurse manager's actions in this scenario.

Choice C reason: Avoiding litigation may be a secondary benefit of advocating for the patient, but it is not the primary intention described in this scenario. The focus is on patient care, not legal consequences.

Choice D reason: Supporting the clinical pathway involves following established protocols for patient care. While the nurse manager's actions may align with the clinical pathway, the term does not capture the advocacy aspect of ensuring treatment for a patient who cannot pay.