NRS

FACULTY OF HEALTH SCIENCE

BACHELOR (HONS) OF NURSING HS220
LEADERSHIP AND MANAGEMENT IN NURSING (NRS 516) Title: The Options Available for a Nurse Manager to Success Implements Change
Name: Siti Khatijah binti Derasah Matrix Number: 2007267562 Name of Lecture: Prof Madya Dr. Faridah binti Hashim Date of Submission: 20th August 2010

Submitted in partial fulfillment the requirement of the course NRS516: Leadership and Management in Nursing

TABLE OF CONTENT No Contents Page

Acknowledgement

Introduction

The options that available to implement success changes 3.1 Power coercive strategies 3.2 Empirical rational model 3.3 Normative - reeducative strategies 3.4 Characteristic of a Nurse Manager as Change Agent 3.5 Communicating Effectively 3.6 Employees Attitude and Perception 3.7 Continuos Improvement, Working Environment and Motivations 3.8 Effective managing of staffing, scheduling and budgetting 3.9 Effective Time Management

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Conclusion

References

10

1) ACKNOWLEDGEMENT First, I would like to make expression of gratitude to God because I have success to finish this an assignment. Besides that, I would like to give appreciation to our lecture NRS516: Leadership and Management in Nursing lecture Prof Madya Dr Hajjah Faridah binti Hashim in assisting me in finishing this assignment. Because of her teaching, coaching and advising I make serious efforts in finishing this assignment. Thank you very much for all guide that has given. Also to my parent, I would to say thank you because of their support from the side of money and encouragement give me by giving spirit to finish this assignment. Lastly to my entire friend, thank a lot for giving me an idea to done this assignment.

2) INTRODUCTION Nurse Manager sometimes is called head manager whose is responsible for clinical and administrative functions of a particular unit. Nurse Manager plays vital roles in maintaining order at a hospital and in improving staff morale. Nurse Manager also acts as middle person between staff and management. Besides that, a nurse manager is one who works to bring changes. In order to implement successful changes nurse manager must consider all option that available to make the result of change must benefit nurses and patient. To implement changes a nurse manager requires time, effort and energy. According to Sullivan & Decker (2009) change is the process of making something different from what it was. Change is a continually unfolding process rather than event. A change often produces anxiety and fear, because of that, the nurse manager should understand and anticipate this reaction to change. The change process is included assessment, planning, implementation and evaluation. Assessment is a process to identify the problem or opportunity, collect data and analyze data. Planning is a target system for the change, while implementation is a method to change individual or groups. The evaluation is the process to evaluate the effectiveness and stabilize the change. In order to implement changes there are options available to implement success changes such as power- coercive strategies, empirical- rational model, normative- reeducative strategies, characteristics of change agents, communicating effectively, employees attitude and perception, continuos improvement, working environment and motivations, effective managing of staffing, scheduling and budgetting and effective time management.

3) THE OPTIONS THAT AVAILABLE TO IMPLEMENT SUCCESS CHANGES

3.1 Power coercive strategies

These options are base on the application of power by legitimate authority, economic sanction or political influence. The nurse manager used power plays to diminish or demolish their opponents. Power is the potential ability to influences (Blanchard, & Johnson, 2007). Power is a potential to achieve a goal. The nurse manager will use power to increases ability for the changes. Power coercive strategies are useful when much resistance is anticipated, time is short and the change is critical in the organizational such as the drastic changes of staffs behavior in preventing infection transmitted are needed in Intensive Care Unit due to increasing number of patient infected by infections . 3.2 Empirical rational model The empirical rational model of change strategies used the knowledge as an option in making changes. According to Sullivan E.J and Decker P.J the assumptions of this model is people are rational and will follow their rational self-interest if that self-interest is clear to them. Therefore, it is assuming that the changed agent who has knowledge has the expert power to persuade people to accept a rationally justified change that will benefit them. The flow of influences is moves from those who know to those who do not know. The peoples either accept or reject the idea or changes based on merits and consequences of the ideas. The empirical- rational strategies are effective when little resistance introduced. For example, other staff would accept introduction of new technology that is easy to used, save nursing time and improves quality of care. From the research, cost effective technology can implemented by using this strategies. By the way, ward manager are able to persuade the changes of staffs behaviors in the ward. The most common method used to change individuals perceptions, attitudes and values is information giving (Katz & Kahn, 1978). The changes of individuals perceptions, attitudes and values are depend on the information giving, so the nurse manager are able to used their knowledge in giving the right information in influences the staff nurse change.

3.3 Normative - reeducative strategies These normative reeducative strategies are using norms and values as options for changes. In this mode, the power for changes is not authority or knowledge, but it required skill in interpersonal relationships. The change agent does not use coercion or nonreciprocal influences but collaboration. Besides that, information and rational argument only are insufficient strategies to change peoples pattern of action; therefore, the change agent must focus on noncognitive determinants of behaviors as well. Normative- reeducative strategies are suitable to the creative problem solving needed in nursing and health care. According to Sullivan E.J and Decker P.J the example of changes amenable to the normative reeducative approach including changing from a traditional nursing system to self-governance or initiating a home follow up services for hospitalized. These change strategies are effective in reducing resistance and stimulating personal and organizational creativity

3.4 Characteristic of a Nurse Manager as Change Agent The characteristic and qualities of nurse manager must focus on experiences, success, being respected, leadership skills and management competencies. In other words individuals who have a positive attitude about work and seize opportunities to get involves in new directions to make changes. For example, the nurse managers are willing to spend their time in correcting problems, and they deliberately chosen to be a positive, optimistic and enthusiastic. The attitudes of the nurse manager play roles in the process of making changes. The process of making changes is including assessment, planning, implementing and evaluation. The nurse manager are responsible to develop plan for action which includes a description and rationales of changes, objectives of changes and a projected timetables for each stage of implementation. Because of systematic and make a serious afford produces an effective changes. A nurse manager who is dedicated to the practice of nursing serves as a good example to the staff. The nurse manager must strive to stay current in the field and tries to improve their skills at their own expense, volunteers at a nonprofit organization or does other things that show commitment, they will acquire more skills that will make them more effective in implement changes.

Besides that ability to govern critical thinking, problem solving and decisions making skill also options for making effective changes. Critical thinking is a higher level cognitive process that includes creativity, problem solving and decision-making. The changes making that govern by critical thinking, problem solving and decision-making skills will producing the most effective changes. That is because the changes that has make are requiring examine underlying assumptions about current evidences, interpreting information and evaluating the arguments presented to reach a new and exciting conclusion for changes.

3.5 Communicating Effectively A nurse manager needs communication skills to success collaborate with physician partners and hospital management. The nurse manager must clearly disseminate information to their staff in order to avoid confusion and gossip. The nurse manager must be good listeners in order to effective communicate the appropriate response to issues facing staff. According to research from the interviews conducted, we found that effective communication played a significant role in ensuring a successful. This in turn impacted on employees productivity.nCommunication was important amongst managers to employees, and also in employee to employee relationships. Most of the interviewed employees concurred that listening skills, as part of effective communication, is one of the key competencies that a manager ought to possess at all times. Before, during and after the implementation of change, managers should listen to employees opinions and understand their perspective and feelings on the imposed changes. This would further help managers to introduce future organizational change. Communications skill also plays roles in successfully implement the changes. That is because successful manager are able to persuades others and support others in changes. As we know, to changes the staff need supported from the managers. Therefore, it is important for the nurse manager has an effective communication skill to implement effective changes. For example, in giving instruction for changes to the staff the nurse manager need to develop messages strategy that help improve effective responses from others. The nurse manager need to get positive attention to avoids factors that interfere with effective listening and the instruction must be clear which is must be precise. To make sure the receiver are understand the nurse manager need to verify through feedback or response of receiver. For example if the staff nurse in the ward are understand and effectively changes, the staff manager are able to gather feedback and continuously assess the effectiveness of changes.

3.6 Employees Attitude and Perception

In order to make change successful nurse managers should be alert at all times to staff reaction to change. If staff do not cooperate with nurse managers and do not collaborate with collegues, clients service delivery will deteriorate. Furthermore,when staff resist change,

conflict may occur amongst colleguess and nurse managers. As a result, staff do not concentrated withtheir work and the implementation of change are failed.This may further result in the resignation of staff. Nurse Managers must understand staff acceptance and willingness to apply and support change in order toprevent both poor clients service and the resignation of employees.Because of that nurse managers should provide encouragement and stimulation for their staff to maintain and enhance clients service performance.

3.7 Continuos Improvement, Working Environment and Motivations

Continuos improvement, working environment and motivations are the options that will contributed to success implemented of changes. That is because, pleasant workplace will promote staff happy and continuos improvement toward the changes that have implement making the staff becomes likes with the changes. The staff also would be able to establish and maintain harmonious working relationship with collegues and contribute to keeping the

changes. Nurse managers should always maintain a pleasant workplace for staff to keep them motivated because a stressful environment will negatively impact the changes that have made.

3.8 Effective managing of staffing, scheduling and budgetting

Staffing and scheduling is an important responsibility of nurse manager. In order to successfully implement the changes in clients quality care received, nurse manager need to effectively managed staffing and scheduling the staff. The goal of staffing are to provides the appropriate numbers and mix of nursing staff (nursing care hours) to provides effective and efficients nursing care. The nurse mangers need to determines the number of staff needed and then examine workload patterns for the designated units, department or clinic. To encourage the effectives changes in clients quality care services, nurse manager need to flexible and creative staffing and scheduling, they need to taking care the problems of the staff. The scheduling are made up according to willlingness of the staff. So, by this way there are no resistances in changes.

Budgeting is the process of planning and controlling future operations by comparing actual result with planned expectations. Nurse manager are responsible in budgeting, the budgeting process allows manager to visibly identify resources problems early and to adjust them to changing situations. In order to provides best quality clients care the organizations resources must be well managed.

3.9 Effective Time Management

The ability to manage people with different concept of time involves patience and knowledge of time management. Effective manager need to evaluate time constrain, develop and implement methods that conserves and uses time effectively. Effective time management also act as options for the nurse manager to implement the successfully changes. Effective time management will promote decreasing in time wasting in order to implement effective changes to the staff.

4) CONCLUSION In organization, there is need continuting changes that will provides more efficient, effectives product and services. To implement successfully changes, it required the collabarotion among all sector of organization, manager, staff and client. Before the change occurs it seems important for managers to have thorough analysis of the implementation of organizational change to be able to determine to what extent the change is beneficial to organization, staff, clients, and performance. Since nurse manager play roles in making the changes, the nurse manager need to consider all the need of the clients, staff and organization in maintaining order at hospital and improves the quality of work. The options that available to implements successful changes including the charactheristic, cognitive thinking, actions, perceptions, motivation and effectively management of communicating, staffing, scheduling and budgeting. The nurse manager is responsible for the quality, cost-effectiveness and safety of patient care on unit. In order to do this, they needs to recruit professional nurses, engage them in decision-making about their daily practice and monitor patient outcomes. All these options are available toward the succesfully in implementing the changes. A nurse manager has a strong foundation in clinical practice, excellent people skills, commendable negotiating abilities, sound fiscal strategies and a great sense of humor as an agent of changes.

5) REFERENCESS

Marquis, B. L., & Huston, C. J. (2000). Leadership Roles and Management Functions in Nursing. Philadelphia: Lippincott Williams & Wilkins.

Sullivan, E. J., & Decker, P. J. (2009). Effective Leadership and management in nursing. New Jersey: Pearson Prentice Hall.

Yoder-Wise, P. S. (2003). Leading and Managing in Nursing. Philadelphia: Elsevier Mosby.

Grohar- Murray M.E & DiCroce H.R (2003). Leadership and Management in Nursing. New Jersey: Pearson Education.