Nursing Leadership & Management Past Paper PDF

NURSING LEADERSHIP & MANAGEMENT WEEK 7 | Staffing | By: JK & Cheska Staffing and overall health care facility “Employee selection is so crucial that nothing performance else — not leadership, not t...

NURSING LEADERSHIP & MANAGEMENT WEEK 7 | Staffing | By: JK & Cheska Staffing and overall health care facility “Employee selection is so crucial that nothing performance else — not leadership, not team building, not Recruits, Selects, Places, Indoctrinates training, not pay incentives, not total quality Personnel management — can overcome poor hiring ○ To accomplish goals and objectives, decisions”. (Gerald Graham) the leader manager indoctrinates ○ Effective employee selection is personnel. foundational – because it ensures ○ Indoctrinate means to teach a person that the right individuals who are or group to accept a set of beliefs and capable and aligned with critically organization's values and goals are Promotes Personnel Development brought on board so this supports the ○ Staffing promotes personnel success of all other organizational development. We should promote it by efforts. investing staff learning and ○ The statement emphasizes the critical development offers numerous both importance of making good hiring employees and organizations. decisions as it suggests that no The process of determining and providing matter how strong other aspects of an the acceptable number and mix of nursing organization are such as leadership, in personnel building training, pay incentives or ○ To produce a desired level of care to quality management, these elements meet the patient’s demands. cannot compensate for the negative impact of poor hiring choices. Steps of Staffing Responsibilities A healthcare manager should be sensitive 1. Determining the number and types of to the importance of the following factors: personnel needed ○ Physical Resources - These are the We need to determine the types of technology, space, building, medical personnel to fulfill the philosophy, meet equipment or strategic positioning of the fiscal planning responsibilities and station, bench and doors carry out the chosen patient care ○ Financial Resources - In order to be delivery system selected by the able to operate efficiently and organization sufficiently well to promote success. Fiscal planning means “it’s the ○ Human Resources - During the last continuous process which involves several decades, the value and decision or choices about alternative potential for the development of a third ways of using available resources with element, the human resources, gain the aim of achieving particular goals.” new recognition. 2. Recruit, interview, select and assign 3rd Phase of the Management Process personnel based on establish job ○ Staffing is the third phase of the description management process following 3. Use organizational resources for induction planning and organizing and orientation ○ Staffing and nursing is a critical - Induction means education and process that ensures that there is an training adequate number of nurses with 4. Employee is socialized to organizational appropriate skills to provide safe, values efficient and high quality careers to - We need to ascertain that each patients. employee has adequately socialized ○ Effective staffing plays a vital role in organizational values and unit norms. patient outcomes, staff satisfaction 1 | MIDTERMS NCMB419  - He / she should know the mission, Nursing Shortage vision, goals, objectives, the core This is one of the problems today. values, and others What are the reasons? Probably nurse 5. Develop a program of staff education burn-out, career and family location, the aging - We will assist the employees with the workforce. meeting of goals of the organization - There are lectures of nurse managers What happens when there is a Nursing Shortage? discussion of specialization by Patient safety: The patient safety is physician and then assigned staff to compromised if there is a nursing shortage attend the conventions and there is a Diminishes hospital’s capacity to treat “TNA” or training needs assessment patients: Some of the wards are still closed, 6. Use creative and flexible scheduling some of the hospitals due to nursing shortage. - Use creative and flexible scheduling Contributes to emergency department based on patient care needs to overcrowding: Sometimes there are 7 beds increase productivity and retention so versus 2 nurses and 1 doctor. the schedules are adjusted depending Reduce number of staffed beds: Sometimes on necessities. there is a closure of nursing units Cancellation of elective surgeries: Due to Definition of Terms decreased OR nurses and there are no Retention - Happens when the organization is available on calls. able to create a work environment that makes Discontinuation of services: Thus, the staff want to stay. diversion of emergency department patients to Selection - process of choosing from among other facilities applicants the best qualified individuals for a particular job or possession. How a Manager should respond to Shortages? Interviewing - It’s the foundation of selecting Budget Constraints: Nurse managers need people. It is a verbal interaction between to consider budget allowance for staffing as individuals, it can be structured or approved and mandated. unstructured. Type of patient care management used: Placement - is assigning an employee the 1. Primary: This is his/her first contact position and unit within the manager’s fear of with the patient. There is the authority. day-to-day health care, usually the Introduction - we have two types of patients go here are undiagnosed and introduction. the practitioner is a general ○ Orientation practitioner and community health - Corporate values providers. - Rules and regulations 2. Secondary: This includes a treatment ○ Job Description - Summary of for illness hospital or in outpatient primary duties in a complete fashion. clinic includes “tests, and care for - General statement duties: certain conditions” Performs administrative work 3. Tertiary: Specialized consultative in planning, coordinating and healthcare, referrals from primary, directing the nursing service. secondary healthcare and advanced - Supervision Received: medical treatment. Works under general direction Education and knowledge level of staff to of the hospital administrator. be recruited: If you are a nurse manager, you - Supervision Exercised: need to know: do you need an ICU nurse? OR Supervises assigned nurse? Head nurse? What kind of personnel as a significant part specialization? of duties Socialization - confirm means forced to learn Recruitment new values, skills, attitudes and social rules. Is the process of actively seeking out or attracting applicants for existing positions 2 | MIDTERMS NCMB419  ○ Although at any given time in someone therefore, it will be assigned to the organization, they may have adequate nurse managers. supply of registered nurses to meet - So these are the head nurses, the the demand. nurse, the nursing supervisors, chief ○ Historical data supports the idea that nurse where they have the capability recruitment should be an ongoing to assess the nurse applicant of their process. Because sometimes the qualifications. nurse resigns, or goes AWOL. - The Chief nurse usually do the ○ So recruitment is a process of actively interview. seeking out or attracting applicants for 3. Decentralization is important: The nurse existing positions. manager should come with this kind of Goals and Objectives = Quality Employees decision The organization’s ability to meet its goals and 4. Comes with the great responsibility: When objectives is directly related to the quality of its interviewing for selection, so when it is employees. assigned to the nursing department to have an ○ So when you seek employees, seek efficient recruitment outcome, a great quality. No amount of good leadership responsibility shall reflect to the department if can replace a bad employee. with a negative selection outcome. Recruitment Methods Retention 1. Employee Recommendations: If you tell a Begins with how much the organization does very close friend that there’s a vacant position or does not value the staff and you added the institution offers benefits ○ Recruitment however, is not the key to and other employee privileges. adequate staffing. Retention is. 2. Word of mouth: When you ask someone in Happens when the organization is able to your company a co-worker or you tell them that create a work environment that makes staff there are vacant positions available and want to stay needed immediately, then that is a word of mouth. Nurse Turnover 3. Advertisements: This includes your social It is a concern in staffing that managers have media, newspaper and post things. to consider. Nurse turnover has a positive 4. Fliers effect and negative effect. 5. Placement Services Some turnover is normally in fact desirable because in few organizations with fresh ideas The Recruiter this reduces the probability of grouping. - If you are Recruiter, you should possess all of In which all the people in the organization the following and technically assigned to the share similar thoughts, processes, values and human resource personnel or human resource goals. And they tend to stick with what they department. believe — groupthink. 1. Should know the needs of the ○ Groupthink: Is a phenomenon where organization: What do they lack? Do people tend to confirm with the group they need ward nurses or do they decisions to avoid feeling outcast, need special nurses with leading to errors in decision making. specialization? Expensive: Nurse turnover is expensive, 2. Can represent the institution costly at the expense of the HR, that is the 3. Can relate well to people negative effect of nurse turnover. Costly: It’s costly to recruit, orient and train The Nurse Recruiter new nurses because it will utilize resources. 1. Separate entity: Or individual depending on Human resource expenses for advertising and the capability of the institution to hire such interviewing. position Overtime of existing staff: Once there’s a 2. Assigned to Nurse Managers: If the turnover of existing staff, most probably will management considers the cause to hire undergo overtime with pay. The middle 3 | MIDTERMS NCMB419  managers have the greatest impact in lots of absences, those who don’t have addressing these concerns. therapeutic communication, lazy and Loss Revenues: According to Research, those who have malingering. Hospitals can lose 5.2 million dollars to 8.1 9. Minimize paperwork million dollars annually from the nurse - We should minimize the paperwork. turnover. These are the loss revenues. Now paperwork is one of the barriers Increased Nurse — Patient Ratio: When implementing this patient interaction. there is an increased nurse patient ratio, the Paperwork stands to minimize the nurse will be experiencing burnout, there is interaction where it plays a vital less safe nursing care and decreased quality function in the patient’s recovery and nursing care. health promotion 10. Limiting the use of mandatory overtime Creating Cultures of Retention in Organizations - If you have limited time to rest then 1. Providing leadership and management you will feel burned out. training: The commission recommends that, “Leaders don’t create followers, they create Nursing Managers play a pivotal role in the more leaders.” – According to Tom Peters. retention of nurses. (Antony, Standing, & Glick, 2. Delegating authority to nurse managers, 2005) and staff nurses: Delegating authority to - If you become a nurse manager, you are others to make decisions regarding patient essential, you have a critical role in retention of care resource deployment. nurses so do not be the cause of conflict and 3. Nurse Autonomy: It’s the ability to act problems. according to one’s knowledge and judgment. It’s also one of empowering our nurses. Interview 4. Greater control over practice: So the It is the foundation for selecting people for learner’s ability to provide safe and competent positions. care and nurses personal preferences should be considered in making assignments. Structured Interview 5. Nurse participation in organizational policy Requires greater planning decisions: Shared governance so nurse now Questions are prepared in advance has voices in the first place and they are the ○ Address specific job requirements ones who have those bedside cares all the ○ Skills and qualities immediate concerns are handled by the ○ Applicant’s experience nurses. ○ Willingness & motivation to perform 6. Good nurse — physician relationship: the job must be determined. - Address issues and concerns: by Utilized for critical positions addressing immediately nurse, ○ Positions that are critical and physician issues and concerns organization when there is careful - Improve communication: improve selection like manager operating communication between the two officers. examples, and up the escort on the situation background, assessment and Unstructured Interview recommendation Requires little planning - The interviewer - Impossible if nurse is incompetent: does more than talking because a doctor might get angry if Questions are not prepared in advance - the nurse is incompetent Tell me about yourself. What is your greatest 7. Setting staffing levels strength? - Skill appropriate to patient acuteness Not so critical job positions - Like the staff - You need to assign nurse according to nurse their specialization or their capacity 8. Adopting zero tolerance policies for Selection abusive behaviors Is the process of choosing from among - Do not tolerate negative attitudes, applicants the best qualified individuals for a those who are late, those who have particular job or position 4 | MIDTERMS NCMB419  ○ Selection happens after applications ○ Leader is able to assign new were completed and interviews have employees opposition within his/her been completed sphere of authority where the Verifying the applicant’s qualifications employee will have a reasonable Checking his or her work history chance for success. “It’s heck a lot easier to hire the right people to Interest of specialization begin with than to fix them later” ○ You need to address the individual’s interest of specialization. The Final Selection ○ It’s possible for one person to fit in well 1. Notification about the applicants’ decision with an established group or as - Once the final selection is within, the another equally person will not just manager is responsible for the closure because of wrong placement, so this of the pre-employment. person might fail. - You need to follow up with the ○ So if there is new staff, let them applicants as well as possible, understand they know the policy on thanking them for the applications and the entry area. informing them when they can expect them to be notified about the decision. Indoctrination 2. A timely written notice to those Adjustment of an employee to the applications that are eliminated. organization - Candidates that offer the position ○ As a management function, this refers should receive a timely written notice to plan guided adjustment of an of their elimination. employee to the organization and work - So whenever it is appropriate of being environment. hired should be given reasons “why Establish favorable employee attitudes they were not hired” which is probably ○ The denotes a much broader because of insufficient education or approach the process of employment work experience or whether your adjustment then either induction application will be held for possible orientation it seeks to establish later employment or if they should favorable employee attitudes towards reapply in the future. organization unit or department 3. Informing of the benefits compensation and Continues until the employee has been placement socialized to the norms and values of the - So to avoid misunderstandings later work group. regarding what employees think that they were promised by the nurse Phase of Indoctrination recruiter or the interviewer. A. Induction 4. Informing of the pre-employment The first phase of indoctrination procedures General information about the - Applicants who accept the job offers organization should be informed as to Developed by the personnel pre-employment procedures such as department or human resource physical examinations, and supplied department with the data report to work. ○ There is a much broader 5. Confirm in writing the intention to accept approach to the process of the position employment adjustment than - Applicants who are offered positions either induction orientation as should be requested to confirm in it seeks to establish a writing intention to accept a position. favorable employee towards the organization unit or Placement department. Assigning an employee to a position and Signed by new employees unit within the manager’s sphere of A reference authority B. Orientation 5 | MIDTERMS NCMB419  The second phase of indoctrination 1. Training: seminars and training, these More specific for the position are structured programs designed to ○ 1st day - personnel develop the specific skills or department knowledge and this can be hands-on - You have a tour and online or classroom based. you will talk to the 2. Education: This can be formal or HRD. informal. If we are comparing training ○ 2nd day - staff development and education, education is more department. formal and broader in scope. - There is a fire safety, 3. Coaching accident prevention, 4. Team building and others. ○ 3rd day - specific Training department Organized method of ensuring that people - You will go to your have knowledge and skills respective unit. ○ Simulation C. Socialization ○ OJT The Third phase of indoctrination ○ Lectures Acquires the technical skills ○ The process by which the Why Training and Education are neglected? person requires technical skills 1. Institutional barriers - the availability of in his/her society. venue Knowledge of the kinds of behavior 2. Load of work ○ The kinds of behavior that are 3. Readiness of the staff to learn understood and accepted in 4. Motivation of learning that society 5. Time - due to schedule Attitudes and values that make 6. Manager’s initiative conformity ○ Make conformity with social Assisting Staff Development Needs rules and personally The assessment or the training needs meaningful and even assessment (TNA) gratifying. ○ Should be done before the managers Role model or Leadership role develop training and educational ○ Role management functions to programs create an effective staff for ○ They must identify and assess first them to be effective as you the need for staff development are as a nurse manager, you through the following activities. have to lead by. 1. Performance review - Example: You need to 2. Peer evaluation be a role model, 3. Self-administered checklists preceptor and mentor. ○ Role Model: Worthy of Staffing Needs and Scheduling Policies imitation Staff managers must assert the adequate ○ Preceptor: Provides numbers and appropriate mix of person knowledge, emotional support, available to meet daily unit needs and clarification of role organizational roles. expectations 1. Ascertain adequate numbers of nurses ○ Mentor: Assist the protege in 2. Have an appropriate mix of personnel attaining expert status. Who is responsible in meeting Staffing Needs? Staff Development First level and middle level managers - To improve the staff’s knowledge and level and ○ Some organizations uses clerks and capabilities. computers to assist with staffing but players and computers may not 6 | MIDTERMS NCMB419  ensure the concern on appropriate possible, unit manager should mixing of staff. avoid close relationship with the supervisor and staff and if Scheduling this can’t be avoided, the Centralized Chief nurse may give ○ Advantages: instruction that may the two of - Fairer to all employees them will work in a different (because there’s no request) unit or department. - Frees the middle-manager of Cyclical the burden (Because the Chief ○ Allows long-term knowledge of future nurse is on the top level.) work schedules ○ Disadvantages: - In cyclical staffing this allows - Centralized scheduling does long-term knowledge of future not provide as much flexibility work schedules because a set for the worker nor it can staffing pattern is repeated. account well to the workers ○ Made by personnel in a central office. desire and special needs. Decentralized (Unity manager is Centralized: one person usually the chief nurse. Or responsible) schedule the staff nurses ○ Unit manager is often responsible for covering all scheduled staff absences, Decentralized: arranged by a particular unit of the reducing staff during periods of high supervisor patient chances, preparing monthly unit schedules, preparing holiday and Cyclical: Covers a designated number of weeks that is called a cycle length. vacation schedules ○ Advantages: - Understands the unit and RA 5901 “The forty-hour week law” staff intimately: This lead to Employees will work for 40 hrs/week: increased likelihood that some According to RA 5901, otherwise known as the staffing decisions will be made “The forty-hour week law”. Employees will - Able to take personal work for 40 hrs/week - 8 hours per 5 days. scheduling requests 1. For hospital with 100-bed capacity or - Decrease nurse attrition: more This will lead to increased 2. Community population of at least 1 autonomy and flexibility. This million helps the employees maintain However, a nurse will render 48 hrs/wk with a work-life balance and can only 1 off-duty a week if: help employers improve 1. Hospitals with less than 100-bed productivity and efficiency of capacity their business 2. Communities with less than 1 million ○ Disadvantages: population - Staff will be treated unequally: These care the Civil Service Commission Memorandum Circular rest of employees will be No. Series of 1996 treated inconsistently. So Government employees are granted 3 days scheduling can be treated which may be spent for: unfairly due to managers, 1. Birthday personal issues with other 2. Weddings staff. 3. Anniversaries - Unit manager may be 4. Funerals (mourning) viewed as granting rewards: 5. Relocation This could be used by the unit 6. Enrolment/graduation leave manager for rewards and 7. Hospitalization punishments. So as much as 8. Accident leaves 7 | MIDTERMS NCMB419 Total Number of Working Hours and Non-Working ○ So the case manager is the nurse, Days and Hours of Nursing Personnel Per Year he/she collaborates with the physician In working 48 hours to 40 hours, they are the and the other healthcare providers same with vacation leave, sick, leave, legal ○ There is a interdisciplinary approach holidays, special holidays, special privileges. used While they differ on the off-duties(RA 5901), ○ Entire episode of illness is the focus and continuing education program they are the same. Patient Classification Systems The total non-working days per year for 48 Group patients according to specific hours per week is 152 while 100 on working 40 characteristics that measure acuity of illness. hours per week Categories: So the total working days, they also differ ○ Category 1 - Self care: requires 1–2 those who work 48 hours a week have total hours of nursing care/day. working days of 213 while those who work 40 ○ Category 2 - Minimal care: Requires hours per week they have total working days of 3–4 hours of nursing care/day. 265. ○ Category 3 - Intermediate care: requires 5–6 hours of nursing care/day. (The client is dependent on the nurse). ○ Category 4 - Modified intensive care: Requires 7–8 hours of nursing care/day. ○ Category 5 - Intensive care: Requires 10–14 hours of nursing care/day. Making Patient Assignments Patient needs Nursing Care Delivery Systems Available staff Case Method: total patient care is provided by Job description one nurse on each shift Scope of practice for licensed nurses Functional Nursing: Personnel of different Scope of functions skill levels are used according to the complexity of the patient care needs. National League for Nurses Formula for Staffing ○ Task oriented ABO x NCH ÷ No. of Working Hours = ○ Team members under the supervision Nursing Service Personnel for 24 Hours of Head Nurse (RN) ○ ABO - Average Bed Occupancy Team Nursing: Care is provided through team ○ NCH - Nursing Care Hours effort achievement of goals through group action Primary Nursing: RNs give total patient care Standard Values for NCH to 4–6 patients and have 24-hour Medical - 3.4 responsibility. Surgical - 3.4 ○ Advantages: Mixed Medical & Surgical - 3.5 - Accountability OB - 3.0 - Continuity of care Pedia - 4.6 - Number of errors reduced Nursery - 2.8 (lesser px) - Shorter hospital stay Standard Value % of Professional to ○ Disadvantages: Non-Professional - Nurse’s talents are confined Case Management: The nurse work across Area Professional Non-Professional agencies Medical, 60 40 8 | MIDTERMS NCMB419  2. Available staff Surgical, Gen-Ward, 3. Job description OB 4. Scope of practice for licensed nurses 5. Scope of functions Pedia 70 30 Example: Nursery 55 45 % Distribution per Shift ICU 80 20 ○ Morning = 45% ○ Afternoon = 37% ○ Night = 18% Constant Values Staffing for and OB Ward: 30 Beds Units NCH / Patient / Pro. to 30 x 3.0 ÷ 8 = 11 nursing personnel for 24 DAY Non-Pro. Ratio hours % of professionals to non-professionals Gen-Med 3.5 60:40 ○ Professionals: 11 x 0.6 = 7 ○ Non-professionals: 11 x 0.4 = 4 Medical 3.4 60:40 ○ 30 = Bed capacity Surgical 3.4 60:40 ○ 3.0 = Nursing care hours (obstetric) ○ Divide of number of hours which is 8 OB 3.0 60:40 hours per day ○ Answer: 11 percent personnel for 24 Pedia 4.6 70:30 hours Nursery 2.8 55:45 - To look for the percentage of professional to ER / ICU / RR 6.0 70:30 non-professional ratio so in OB we have 60:40 ratio ICU 6.0 80:20 - Professionals: 11 multiplied by 0.6 is = 7 General ward you have 3.5 and the ratio of - Non-Professionals: 11 professional to non-professional is 60:40 multiplied by 0.4 = 4 So general medicine, medical, surgical, and - Therefore, there is 7 nurses obstetrics have the same professional to and 4 nursing aid. non-professional ratio. Staffing for and OB Ward: 30 Beds - Example: 60 percent would be nurses Distribution per Shift while 40 would be the nursing aids. - So in medical and surgical we have Time Professionals Non-professional the same NCH per patient per day. - In obstetrics we have 3.0 AM 7 x 0.45 = 3 4 x 0.45 = 2 - In pediatrics 4.6. So there are higher PM 7 x 0.37 = 3 4 x 0.37 = 1 professionals than the non-professional. Night 7 x 0.18 = 1 4 x 0.18 = 1 - In pathologic nursery 2.8 so the prof to After dividing 60:40 or ratio of professional to non-prof is 55:45 non-professional we will now move onto the - In ER/ICU or RR 6.0 just like in the distribution per shift. Critical Care unit. But the professional 7 X 0.45 (during morning, we have 45%, then to non-professional ratio of the ER, in afternoon we have 37%, and at evening we ICU and RR is 7:30. have 18% - While in the Critical Care Unit the ratio The nurses having their shift on morning is 3 is 80:20 so there should be 80% and in the afternoon it’s 3 and at night only 1. nurses and 20% nursing aid. Then the nursing aids that we’ll have there due in the morning is 2, in the afternoon is 1, and at Making Patient Assignments night is 1. Assignments are based on: 1. Patient needs 9 | MIDTERMS NCMB419 When computing for the nursing personnel, one should ensure that there is sufficient staff to cover for: 1. All shifts 2. Off-duties 3. Holidays 4. Leaves 5. Absences 6. Time for the staff development (training and seminars) To compute for relievers needed, the following should be considered: 1. Average number of leaves taken each year = 15 Vacation Leave =10 Sick Leave = 5 2. Holidays = 12 3. Special privileges = 3 4. Continuing Education Program for Professionals = 3 Total Average = 33 To determine the Relievers needed: 33 (average number of days an employee is absent) 213 or 265 (number of working days / year that each employee serves) = 0.15 (15%) for persons who work 40 hrs/wk = 0.12 (12%) for persons who work 48 hrs/wk 10 | MIDTERMS NCMB419 NURSING LEADERSHIP & MANAGEMENT WEEK 8 | Directing, Add Org Communication | By: JK & Cheska Directing must create a work environment in 4th phase of the management process which both organizational and coordinating or activating individual can be met. ○ Coordinating: because managers ○ While the worker is achieving personal have to conduct coordination with goals, the organizational goals are other managers and departments. also met. Thus, effective motivation is ○ Activating people: Initially see needed as provided by the leader whether planning stage is effective so manager. that necessary adjustments shall be Workers are being motivated primarily by made as early as possible & economic factors eventually meeting the goals and ○ Workers are being motivated primarily objectives by economic factors. “Doing – phase” - Doing phase of the management process regardless of the Intrinsic Motivation nomenclature. It requires leadership and Engage in a behavior because it is personally management skills to accomplish a task. rewarding, not for an external reward Managers direct - Managers direct the work To achieve interest, intrinsic motivation it is of the subordinates; Managers tend to say do directly related to a person’s level of aspiration. this to those assigned. Components: Extrinsic Motivation ○ Motivation Behavior is driven by external rewards such as ○ Communication money, fame, grades, and praise ○ Managing conflict It is enhanced by the job environment or ○ Negotiating external rewards. ○ Delegation The reward occurs after the task has been ○ Components completed, but it is unrealistic for the ○ Collaboration organization to assume that all their ○ Impact of collective bargaining and employees are intrinsically motivated. ○ employment laws on management Maslow Hierarchy of Needs Motivation Because of Maslow's work the hierarchy of Force within the individual that influences needs manager's began to realize that people and directs the behavior of others are complex beings. So not solely economic ○ Motivation comes within a person. The animals that they have may motivate them. managers cannot directly motivate ○ Self Actualization - self fulfillment, subordinates achievement of one’s full capacity Humanistic managers ○ Esteem - self respect, self evaluation, ○ Employees are seen not merely as regard by other economic assets valued primarily for ○ Love/Belonging - affectionate their productivity but as people with relationship with others complex needs and a desire for ○ Safety - free from danger, deprivation, meaningful and varied daily tasks. threat ○ Humanistic managers can have ○ Physiological - 02, H20, sex, food, management support, collegial sleep influence, interaction of personalities in the work group and have a synergistic B.F. Skinner effect on motivation. Behavior that is rewarded will be repeated Personal and organizational goals are met Behavior that is punished is extinguished ○ Motivation is personal and ○ The idea that behavior is determined organizational. The leader manager by its consequences. Through 11 | MIDTERMS NCMB419  reinforcement or punishments which Gellerman make it more or likely that behavior will Stretching - Assigning tasks that are more occur again. difficult than what the person is used to doing Participation - Actively draw employee into Frederick Herzberg decisions affecting their work Employees can be motivated by the work itself and that there is an internal or personal need Motivation Climate to meet organizational goals Employees are an organization’s most Motivators / Satisfiers: achievements, valuable asset recognition, possibility for growth, work itself, Noticing employee contribution may lead to responsibility increased organizational retention Hygiene / Maintenance factors: supervision, Organization must be cognizant of the need to job security, working conditions, remuneration, offer incentives at a level where employees interpersonal relations, company policies value them Recognize employee’s values Vroom Significant association of employees sense of Employees expectations about their accomplishment, equality, being imaginative, environment or a certain event will influence helpful, self-controlled with work satisfaction their behavior (Prothero, Marshall, Fosbinder, Hendrix, ○ Victor Vroom developed the 2000) expectancy model that assumes Consider the manner in which first-line behavior results from conscious manager communicates with employees choices among alternatives whose ○ Because it affects the staff attitude purpose is to maximize pleasure and towards organization for he or she has minimize pain. more influence over employees than ○ Vroom realized that performance is any other level manager. based on individual factors such as Positive Reinforcement - “The personality skills, knowledge and communication skills you showed today as an abilities. advocate for Mr. Cruz were excellent. I think ○ How do we apply this model? you made a significant difference in his care.” Aligned company policies and ○ “We often forget that the only way to management, so if you are the achieve our goals is through the manager you should put your trust in people who work with us” (Kerfoot, persons capabilities 2001) Shared governance, empowerment, McClelland participative management can have a direct Achievement - To achieve something impact on motivation ○ Actively focus on improvement and Finding joy at work is a shared responsibility transform ideas to into action and then ○ Connections: Based on relationships, take risk when necessary it is a primary joy, source of joy and Affiliation - Prefer to being a part of a group occurs in colleagues, patients and ○ People in this group tend to adhere to families. the norms of the culture in the ○ Love of work: The joy found in one’s workplace and typically do not change work even though there is a little the norms of the workplace for fear of remuneration. rejection. ○ Achievement: Accomplishment the Power - Enhance self; esteem and reputation positive work outcomes can bring joy ○ The power that can be gained as a so personal assessment of result of specific action. So the desires achievement is also important than within the person to hold control and external rewards. authority over another person and ○ Recognition: Appreciation, patience, influence and change their decision in gratitude, significant others accordance with his own needs or appreciation and appreciation from desires. colleagues. 12 | MIDTERMS NCMB419  The attitude and energy level of managers ○ Internal Climate: Internal climate, so directly affect the attitude and productivity of the values, the feelings, the their employees. temperament and the stress it is ○ Managers should be internally controlled. motivated before they can motivate ○ External Climate: Weather others. As the saying goes, you can’t conditions, temperature, timing, pour on an empty cup. organizational climate, status, power, ○ Lee (2000) states that, “motivation, authority so external climate can’t be mentoring, and empowerment aren’t controlled. just management jargon: they should If you are the sender, you should determine be resources you use everyday” what receivers see and hear ○ Effective communication requires that Communication the sender determine what is receiver Forms the core of management activities seen and hear, you will not leave the and cuts across all phases of the receiver that understanding you are management process conveying ○ Core is the central and most important part and is needed in all phases Variables Affecting Organization Communication Must be systematic, have continuity, and be Formal organizational structure fully integrated into the organizational People at lower level structure Characteristics of large organization ○ Organizational communication is a Spatial Distance: If there is a large management function, it must be organization, there is a spatial distance from systematic happy continuity and be the higher management down to the lower fully integrated in the organizational rank and file employee. structure encouraging and exchange Subgroups: Because we have different value of views and ideas systems and identify allegiance to their own The most critical leadership skills members it is possible that they resolve to ○ The majority of managerial different translations of the messages. communication time is spent speaking Relationships: We have different systems of and listening. It is clear that in a relationships. Work authority status, prestige, relationship role, in a leadership role friendship structures, influences, one must have excellent interpersonal communication in an organization skills. Constant flux: Constant state of change Necessary for continuity and productivity regarding locations, relationships and ○ The leader is responsible for authority, gender is also considered to be a developing a cohesive team to meet factor since men and women communicate in organizational goals. To do this, use language differently, status in power, male leaders must articulate issues and doctors and administrators against female concerns. So workers will not become administrators. confused about priorities. Complex exchange of thoughts, ideas and Communication Strategies information 1. Assess organizational communication - so ○ What happens? However when the who communicates with whom? Is there timely thoughts, ideas and information communication? Does communication concur exchange do not have the same with formal lines of authority? Are there meaning for both sender and receiver. conflicts or disagreements modes of ○ What if the message is not congruent? communications to be used 2. Recognize who will be affected by Communication Process decisions that are made - so you should We have the sender you have the message it consider formal and informal networks. can be written, non-verbal and verbal then you - Formal communication networks have the receiver. follow the formal line of authority. Sender: 13 | MIDTERMS NCMB419  - Informal communication networks Communication Modes occur between people of same and Written communication: In general, the more different levels but does not represent direct communication. This will be clear the authority and responsibility more people to be involved in filtering the 3. Seek for feedback - whether their message communication the greater chance of distortion was accurately received or misrepresentation. In written communication 4. Ensure that the message is understood - by this allows for documentation. Therefore, we verifying or clarifying. should write clearly. 5. Utilize multiple communication methods - Face-to-face communication: Oral so documentation is an effective method since communication downward in upward formal it indicates time, place and receipt of and informal line of authority and not information by the discipline necessarily with authority. So meeting with 6. Continually communicate with peers and formal presentations are examples subordinates and provide necessary of this. information only - so that subordinates will Nonverbal communication: These are our not be overwhelmed that may lead to not being body language. The facial expressions, body understood. movements, and gestures the emotional component of the message and danger of Channels of Communication misinterpretation Downward Communication - Traditional line Telephone communication: It has become an of communication important tool of communication but does have ○ It is a traditional line of communication limits as an effective communication device. from the superior user to the subordinate. So it helps coordinate Face To Face Communication activities at different level Oral communication downward and upward, Upward Communication: A means of formal and informal. motivation Line of authority and not necessarily with ○ A means of motivation because the authority nurse manager is subordinate to the higher management makes the Non-Verbal Communication decision for a greater segment than Body language, facial expression, body the lower segment management. movement and gestures. Horizontal Communication: Personnel of the Emotional component of the message and same level danger of misinterpretation. ○ So lateral communication horizontal communication is the communication Telephone Communication between personnel at the same level. An important tool of communication but does Diagonal Communication: Not of the same have limits as an effective communication level device. ○ Not of the same level so this occurs between individuals or departments Written Communication that are not of the same level and Used most often - in large organizations and tends to be less formal. the changes in policy the procedures events The Grapevine: Most informal method of are usually announced in writing. communication co-existing with formal Job descriptions, appraisals, memos channels A learned skill that improves with practice ○ So it moves fast and is often distorted Reflects managerial abilities fragmentary and incomplete subject to ○ It should be written clearly and error and distortion. professionally and use simple and ○ It is misrepresented because there is understandable language. no formal line of communication. ○ So in written communication, we have the formal business letter. 14 | MIDTERMS NCMB419 Formal Business Letter then internal departmental so that is 1. Know what you want to say external communication. 2. Put people into your writing: About the To inform, instruct, recommend, document subject, discuss it in terms of the people 1. Make the main point at the beginning affected by it. It avoids words such as 2. Essential information only administration, authorization and 3. Should be written simply implementation because they are abstract and 4. Use headings impersonal. 3. Use action words: Action verbs has a Interpersonal Communication stronger impact Interpersonal communication in a multicultural 4. Write plainly: Use familiar, specific, and workplace, so managers must have sensitivity concrete words because it is more easily and leadership skills to communicate in today’s understood and thus is more apt to the reader. multicultural workplace. Because it is impossible for the individual 5. Use few words as possible: Find one good manager to communicate face-to-face with way to make a point and trust that your reader each member in the large organization. So will understand it. managers must develop interpersonal 6. Use simple, direct sentences: Keep communication skills. sentences less than 20 words and include only 1. Non-verbal communication one idea in each. Make positive statements 2. Verbal that clearly delineate your positions on an 3. Listening skills issue. Tell pertinent or relevant facts first. 7. Give the reader direction: Be consistent in Non-Verbal Clues the tone of message to establish clear point of “What you do speaks so loudly that I cannot view. hear what you say” Ralph Waldo Emerson. 8. Arrange the material logically: A logical Action speaks louder than words. presentation of facts increases the reliability Generally, if verbal and non-verbal messages that the reader attributes to the writer. So the are incongruent the receiver will believe the material may be organized deductively non-verbal message. Because non-verbal inductively by order of importance from familiar behavior can be frequently misinterpreted so to the unfamiliar in chronological order by receivers must validate perception with center close relationship or by physical location. Space 9. Use paragraphs to lead readers: So a ○ The space between the speaker and paragraph should not exceed eight to ten the receiver influences what is (8-10) lines in a memo or five or six lines in a communicated letter ○ Distance implies lack of trust or 10. Connect your thoughts: To do this you must warmth add enough details. Use repetition to tie - make people threatened or thoughts together and select transitional words intimidated to tell the reader when you are moving to a ○ Distance increase power and status: new thought. - so on the part of the manager 11. Be clear: Be certain that your pronouns are talks with the employee across clearly defined. “I, may, be, they, you, she, he, or opposite the desk and like it, yours, himself, ourselves, my that, these, to the manager who sits those,us, who, whom” beside the employee when 12. Express similar thoughts in similar ways: having discussion. This will increase the continuity of the Environment message. ○ Proper venue makes it more formal Generally taken seriously: Memos - So communication that takes Distributed internally within the organization place in the superior's office ○ So communication in large makes it more formal and organizations requires tremendous, generally taken seriously then interdepartmental that is internal and which occurs in a cafeteria. 15 | MIDTERMS NCMB419  Appearance Tone, volume & inflection: Always convey ○ Defines the impact of dress and confidence and clarity Speaking rapidly appearance on role perception and Speaking in a monotone voice: So speaking power rapidly implies nervousness and speaking a - Much is communicated by our monotone voice implies disinterest. Monotone claw thing hairstyles, meaning unchanging voice tone, flat and cosmetics and attractiveness. boring. So the goal is to always convey So dressing has an impact on confidence and clarity. dress and appearance and role perception and power. Verbal Communication - However care should be Assertive communication exercised to establish stress ○ Allows people to express themselves policies that incorporate both in a direct, honest, and appropriate cultural and gender related ways sensitivities. ○ Do not infringe on another person’s Eye contact rights ○ Associated with sincerity - It recognizes our rights while ○ Invites interaction still respecting the rights of ○ Breaking eye contact others even if you don’t agree. ○ One of the key components of - It allows us to take effective body language responsibility for ourselves Posture and our actions without ○ If you slouch, shuffle, or stoop judging or blaming other - You’re sending measures that people you are indifferent ○ “I” statements ○ If you wave your arms, clear your - A person’s position is throat a lot, or pull your hair or expressed clearly and firmly earlobes using I statements. Having or - You may come across as showing a confident but not insincere and unnatural arrogant and forceful ○ If you sit or stand with crossed or personality folded arms, or with your hands inside ○ Congruent verbal and nonverbal your pockets message - You appear protective, - It should be consistent with. defensive and unwelcoming So if you want to ○ Sender should face the receiver, stand communicate, you should be or sit appropriately close and with firm but polite. head erect, leans toward the receiver Passive communication - A message is increased if the ○ Avoid expressing their opinions or sender faces the receiver feelings The person is in silence stands reset appropriately although he or she may feel strongly closed and with the hand erect about the issue so leans toward the receiver. - So they protect their right and Gestures: Can emphasize or distract the identify and meet their needs message: So movement that is too gesturing and passive individuals do not can be distracting. So use of touch is one respond overtly to hurtful or gesture that often sends message anger-inducing situations Facial expression: Effective communication ○ The person is in silence although he or needs a facial expression that agrees with your she may feel strongly about the issue. message Aggressive communication Timing: Hesitation often diminishes the effect ○ People express themselves in a direct of your statement and may imply and often hostile manner that infringes untruthfulness another person’s rights 16 | MIDTERMS NCMB419  - Infringes meaning tresspasses Restate the message by using assertive so it is a method of expressing language needs and desires that doesn’t ○ Rephrase the aggressor’s language to take into account the welfare diffuse the emotion “You” rather “I” of others. - Part of racing helps the ○ Winning at all costs aggressor focus more on the - Aggressive communicators cognitive part of the message. want to win at all costs. The manager might use ○ Demonstrates self-excellence restating by changing “I” “You” - But a harmful communication message to an “I” message. style and can end up So we need to focus on the worsening societal or social aggressor's feelings and anxiety by making others view points. you are more harshly Question Passive – Aggressive communication ○ Put the behavior in the form of a ○ Is an aggressive message presented question by helping the other person in a passive way become aware of an unwarranted - It is a style in which individuals reaction appear passive on the surface - So when the aggressor uses but really acting out anger in a non-verbal clues to be subtle or behind the scenes aggressive, the assertive way. behavior can put this behavior ○ Feigns withdrawal in an effort to in the form of a question as an manipulate the situation effective means of helping other person become aware of Assertive Vs. Aggressive an unwarranted reaction. There is a misconception that assertiveness is synonymous to aggressiveness even when Strategies to Promote Effective Verbal faced with someone else’s aggression the Communication assertive communicator does not become 1. Use proper titles of respect: Do not call a aggressive. person by his or her first name until given So when under attack by an aggressive person permission to do so. “Ms, Mr, Ma’am. Sir” an assertive person can do several things. 2. Be aware of subtle linguistic messages: Be Reflect aware that it may convey bias or inequality. ○ Helps the aggressor to evaluate 3. Avoid derogatory remarks: Avoid all slang, whether the intensity of his or her prerogative words or derogatory terms when feelings is appropriate to the specific referring to persons from particular ethnicity, situation or event race or religious groups like “Black, Islam, So when under attack by an aggressive Muslims”. person, an assertive person can do this. 4. Do not compare their employment Point out the implicit assumptions opportunities and conditions to people in ○ Listening closely and letting the their country of origin: Avoid making remarks aggressor know that you have heard to staff that they should consider themselves him or her fortunate to be employed by the organization. - In these situations, managers Discrimination based on the country of origin, might repeat major points or unfair, and unfavorable treatment of individuals identify key assumptions to based on their origin because they are from a show that they are following particular part of the world. So harassment, the employee’s line of language discrimination accent discrimination reasoning, “I understand you may occur. but you have to give feedback 5. Avoid phrases that will suggest inferiority and address the issue and offensive to others: Avoid using phrases immediately. such as culturally disadvantaged, socially economically disadvantaged and culturally 17 | MIDTERMS NCMB419  deprived. Also avoid using the term as they Conflict issues: So conflict issues and rebel suggest inferiority and may be offensive against demands imposed by the leader arise. non-white as it implies that white is normative standard. Norming Stage 6. Consider uniqueness and individuality: Do The consensus evolves as group cohesion not expect a staff member to know or get along develops. So members interact with others and well with all other staff members of the same refer to the forces that push group members ethnicity. Although they share the same closer together. ethnicity, their uniqueness as individuals Group cohesion creates diversity of interactions, values, Conflict and resistance are overcome experiences and beliefs. Performing Stage Listening Skills Interpersonal structure focuses on task and The active process of listening is vital for its completion: So in performing the work interpersonal communication effectiveness actually gets done. ○ So researchers have shown that most Roles become flexible and functional: people here are actually retain only a Employees work in different functions or can small amount of information given to be deployed purposely to various functions them. with different rules and responsibilities. It is Should be approached as an opportunity to accomplished by making the employees learn appreciation for a cultural perspective of multi-skilled so they can perform various types the organization Kerfoot, 1998 of tasks whenever required and that is ○ You should consider the opportunity flexibility. that might lead to a more effective Energies are directed to task performance: management approach and managers So one goal, one direction one objective we will have the opportunity to improve need to meet them all themselves in handling different kinds of people. Task Roles of Groups A leader who actively listens gives genuine Initiator: Proposes or suggests group goals or time and attention to the sender redefines the problem “pasimuno” ○ So simply, they give importance to Information Seeker: Searches for the factual subordinates. Sometimes it is more basis for the group’s work “marites” effective to listen to them rather than Information Giver: Offers an opinion of what telling them what to do. the group’s view of pertinent values should be “jollibee (bida-bida)” Group Communication Opinion Seeker: Seeks opinion that clarify or Forming Stage reflect the value of other member’s Identification of boundaries of suggestions “segurista” interpersonal behaviors: So people are Elaborator: Gives examples or extends introduced first into the work group process of meanings of suggestions given and how they meeting each other is called forming stage. could work Establish dependency relationships with Coordinator: Clarifies and coordinates ideas, leaders and co-members: It is the essence of suggestions, and activities of the group teamwork “I’ll work with you, you work with Orienter: Summarizes decisions and actions; me”. “Not for you, not to work for you”. identifies and questions departures from Determine what is acceptable behavior: If predetermined goals not identified, they can measure conflict with Evaluator: Questions group accomplishments others boundaries. and compares them to a standard Energizer: Stimulates and prods the group to Storming Stage act and raises the level of its actions Stage where there is much competition and Procedural Technician: Facilitates group attempts at the establishment of individual action by arranging the environment identities. Recorder: Records the group’s activities and Members polarized into subgroups accomplishments 18 | MIDTERMS NCMB419 Group-Building & Maintenance Roles Use of internet as an information source Encourager: Accepts and praises all and communication tool contributions, viewpoints and ideas - Being connected to the healthcare Harmonizer: Resolves conflict system through the internet of things. Compromiser: Yields his or her position in a conflict situation Confidentiality Gatekeeper: Promotes open communication Identiality Standard Setter: Evaluates standards Nurses have a duty to maintain confidential Group Commenter: Provides feedback to the information. Revealed to them by their group patients. So there is an ethical duty as well. Follower: Accepts group ideas This confidentiality can be breached legally only when one provider share information Individual Roles of Group Member about a patient. Aggressor: Expresses disapproval of other’s Computerization was seen as the most values or feelings serious threat to medical privacy. It is even Blocker: Expresses negative points of view more difficult as a result of increased electronic and resurrects dead issue communication. And so computerization was Recognition Seeker: Works to focus positive seen as more serious to medical privacy. attention to himself or herself RA 10173 Data Privacy Act of 2012. So this Self-Confessor: Uses the group setting as a protects the individuals from an authorized forum for personal expression processing of personal information that is Playboy: Remains uninvolved and private, not publicly available and identifiable. demonstrates cynicism, nonchalance, or horseplay Managing Conflict Dominator: Attempts to control and Conflict manipulate the group The internal or external discord between 2 or Help Seeker: Uses expressions of personal more people insecurity, confusion or self – deprecation to It is an expected outcome manipulate sympathy from members Differences in professional values Special Interest Pleader: Cloaks personal Competition among professionals prejudices or biases by ostensibly speaking for Scarce resources others Restructuring Poorly defined role expectations The Impact of Technology on Communication Recognize it in its early stages and actively Collaborative practice will involve a community intervene of electronically connected practitioners providing a richer and more scientific History of Conflict Management foundation for practice Richards, 2001 Avoided at all costs - They can promote patient-centered Ignored, denied and dealt immediately and healthcare, improve quality of care and harshly educate health professionals and Could be avoided if employees were taught the patients. The use of ICTS or one right way to do things information communication technology Could be avoided if employees were taught the binder can have impact on practice one right way to do things May help to balance the constraints being Accepted passively and perceived as normal placed on other patient-care resources and expected - The materials, personnel, facilities, Could be avoided if employees were taught the and anything else that can be used for one right way to do things providing health care are being Accepted passively and perceived as normal stabilized with regard to patients and expected location and resources. Managers resolve it rather than prevent it Offers new ways to pull information Necessity and actively encouraged to promote together and fulfill its potential as a nursing to produce organizational growth resource 19 | MIDTERMS NCMB419  Too little conflict results in organizational stasis Manifest Conflict Too much conflict reduces the organization’s Overt conflict effectiveness and eventually immobilizes Action is taken employee Many individuals are uncomfortable with or The responsibility for determining and creating reluctant to address conflict an appropriate level of conflict on the individual ○ fear of retaliation unit often falls to the manager ○ fear of ridicule Avoidance and suppression is non – ○ fear of alienating others do not have productive the right to speak up past negative Confront and manage experiences Categories of Conflic