Ginny Rogers NUR211 2003

Unit 3

Ginny Rogers NUR211 2003

“One person can make a difference

And every person must try”

- John F. Kennedy

Ginny Rogers NUR211 2003

Delegation

Delegation as defined by the National Council of State Boards of Nursing

Delegation involves the transfer of care to a competent individual with authority to do a selected nursing task in situations. If the nurse delegates to a nursing assistant, the nursing assistant is responsible for performing the task: however, the nurse retains responsibility and accountability for the total nursing care of the client.

Ginny Rogers NUR211 2003

Delegation

Starts at the topincludes:participation in organizational task forces and committeesassignment of duties to complete taskscan empower staffprovides an effective mechanism for training

Ginny Rogers NUR211 2003

Determination of the task, procedure, or function that is to be delegatedAvailable staffAssessment of clients needsAssessment of the potential delegatee’s competencyConsideration of the level of supervision available and determination of the level and method of supervision required to assure safe performanceAvoidance of delegating practice-pervasive functions of assessment , evaluation, and nursing judgment

Ginny Rogers NUR211 2003

Barriers To Delegation

I can do better myself

Lack of ability to direct others

Lack of confidence in others

Loss of control

Aversion to taking risks

Fear of criticism

Person is already overworked

Lack of self-confidence

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DELEGATING RESPONSIBLY

KNOW JOB DESCRIPTION

KNOW DELEGATES STRENGTHS, WEAKNESSES, MOTIVATION & PREFERENCES

KNOW THE PATIENTS BASED ON NS CARE PLAN

USE PROFESSIONAL JUDGMENT

CONTINUE SUPERVISION, FEEDBACK

Ginny Rogers NUR211 2003

Special Situations in Delegation

You are the manager over your friendYou are manager over older employeesSubordinates won’t do what you ask them to doYou don’t know the answer to the questionYou are compared to the previous mangerJealousyResentmentcompetition

Ginny Rogers NUR211 2003

Team Building

Groups vs. Teams

Phases of Group and Team development

Team Building

Characteristics of Teams/Groups

Roles

Communication

Managing

Ginny Rogers NUR211 2003

Motivation

TheoristsMaslowHerzberg

Maintenance (dissatisfies) factors do not relate to the content of the job

Motivation factors – job itselfPeople seek different degrees of the above two

factors “if you want to motivate the worker, don’t put in

another water fountain, provide a bigger share of the job itself”

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HERZBERG’S MOTIVATORS

ACHIEVEMENTRECOGNITIONWORK ITSELFRESPONSIBILITYADVANCEMENTPOSSIBILITY FOR GROWTH COMPANY POLICYSTATUS

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MOST PEOPLE WOULD RATHER BE DIRECTED THAN ASSUME RESPONSIBILITY FOR CREATIVE PROBLEM SOLVING

MOTIVATED BY REWARDS AND PUNISHMENTS

MUST BE DIRECTED

NEED CLOSE SUPERVISION

McGREGOR THEORY X

Ginny Rogers NUR211 2003

MOST EMPLOYEES LIKE AND ENJOY WORK

ARE SELF-DIRECTED

SEEK RESPONSIBILITY

ARE IMAGINATIVE AND CREATIVE

NEED ONLY GENERAL SUPERVISION

ARE ENCOURAGED TO PARTICIPATE IN PROBLEM SOLVING

McGREGOR THEORY Y

Ginny Rogers NUR211 2003

Micro- vs. Macromotivaiton

Micromotivation-known also as type A motivation and focuses on getting work doneMacromotivation – known also as type B motivation and incorporates outside factors that influence performanceOrganizations today have shifted toward type B considerations

Ginny Rogers NUR211 2003

Intentional Model of Motivation

Intentionally inviting level based on Optimism Respect Trust Intentionality

Intentionally disinviting level Dissuades Discourages Defeats Destroys

Ginny Rogers NUR211 2003

ChangeThe more complex an organization is, the

greater the rate of change.Health Care facilities are among the most

complex types of organizations.The rate of change within health care facilities is

very quick

Ginny Rogers NUR211 2003

KURT LEWINTHEORY OF CHANGE

DRIVING FORCES (MOVE TOWARDS CHANGE)

RESTRAINING FORCES (PUSH AGAINST CHANGE)

When making changes, examine all driving and restraining forces

Attempt to reduce the restraining forces

Ginny Rogers NUR211 2003

Resistance to Change

Recognizing the worker’s needs based on MaslowAcknowledging both active and passive resistanceStrategies to lower resistance:Dissemination of informationDisconfirmation of currently held beliefsProvision of psychological safetyCommand

Ginny Rogers NUR211 2003

Stages Of Change

UNFREEZING - CHANGE THE STATUS QUO - POWERFUL NEED TO CHANGE

OUTLINE THE PLAN - PILOT THE CHANGE

REFREEZING - NEW PLAN BECOMES THE STATUS QUO

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Planned Change

Empiric evidence of need

Aims at improving the system

Incorporates others

Provides reeducation

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Radical Intervention Change

Positive consequences – wards off or manages a crisis

Negative consequences – used as a show of force: dependent people “hang on” creative , highly competent people

leave

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Response to Change

Drive toward change when there:Are explanations Is inputAre acknowledged concernsAre small doses Is help availableAre benefits that are understood

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Resistance toward change when there :

Is mystery

Is secrecy

Is change as punishment

Are pressures

Is poor planning

Is an ignoring of human nature

Ginny Rogers NUR211 2003

Assumptions underlying Performance Appraisal

Process1. Immediate superior is the most promising

rater2. Everyone needs to know how he/she is

doing3. The process provides information not

available in any other way4. The process can and will improve

performance5. Evaluations have enough validity to justify

use of the results

Ginny Rogers NUR211 2003

PERFORMANCE APPRAISAL

CHOOSE THE TOOLRATING TOOLCHECKLISTMBOPEER REVIEW

PLAN

COMMUNICATE

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The performance appraisal interview

Prepare feedback

Establish improvement-oriented climate

Key behaviors

Improving accuracy

Ginny Rogers NUR211 2003

Elements in the PA Tool

Philosophy – beliefs about health, clients, how population is served

Mission - primary responsibilities, environment, expectations

Objectives – how it will carry out it’s mission

Ginny Rogers NUR211 2003

PROGRESSIVE DISCIPLINE

INFORMAL REPRIMAND

2. FORMAL REPRIMAND

3. SUSPENSION FROM WORK

4. INVOLUNTARY TERMINATION OR DISMISSAL

Ginny Rogers NUR211 2003