Most healthcare professionals, including nurses, are empowered to some degree by their own professional knowledge and compe- tence. There are a number of ways in which this competence can be enhanced, thereby increasing your own sense of empowerment (Fig. 7–3):
•
Active participation in interdisciplinary team conferences and patient-centered con- ferences on your unit•
Attendance at continuing education offer- ings selected to enhance your expertise•
Attendance at local, regional, and national conferences sponsored by relevant nursing and specialty organizations•
Reading journals and books in your spe- cialty area•
Participating in nursing research projects related to your clinical specialty area•
Discussing with colleagues in nursing and other disciplines how to handle a difficult clinical situation•
Observing the practice of experienced nurses•
Returning to school to earn a bachelor’s and higher degrees in nursingYou can probably think of more ideas, but this list at least gives you an idea of what you can do to enhance your expertise.
The second part of the effort to increase your feeling of empowerment through enhancing expertise is to share the knowledge and experience you have gained with other people. This means not only using your knowledge to improve your own practice but also communicating what you have learned to your colleagues in nursing and in other healthcare professions. It also means letting your supervisors know that you have enhanced your professional competence. You can share your knowledge with your clients, empowering them as well. You may even reach the point at which you have learned more about a particular subject than most nurses have and want to write about it for publication.
Image/Text rights unavailable
Image/Text rights unavailable
CONCLUSION
Although most nurses are employed by health- care organizations, too few have taken the
time to analyze the operation of their employ- ing organizations and the effect it has on their practice. Understanding organizations and the power relationships within them will increase the effectiveness of your leadership.
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INCREASE YOUR EXPERT POWER
Participate in interdisciplinary conferences Attend continuing education offerings Attend professional organization meetings Read books and journals related to your nursing practice
Problem-solve and brainstorm with colleagues Return to school to earn a higher degree
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Figure 7–3• How to increase your expert power.
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S T U D Y Q U E S T I O N S
1. Describe the organizational characteristics of a facility in which you currently have a clinical assignment. Be sure to include the following:
a. The type of organization it is b. The overall climate
c. How the organization is structured
d. The formal and informal goals and processes of the organization
R E F E R E N C E S
Barraclough, R.A., & Stewart, R.A. (1992). Power and control: Social science perspectives. In Richmond, V.P.,
& McCroskey, J.C. (Eds.). Power in the Classroom:
Communication, Control and Concern.Hillsdale, N.J.:
Lawrence Erlbaum.
Bradford, D.L., & Cohen, A.R. (1998). Power Up:
Transforming Organizations through Shared Leadership.New York: John Wiley & Sons.
Fitton, R.A. (1997). Leadership: Quotations from the World’s Greatest Motivators.Boulder, Colo.: Westview Press.
Fralic, M.F. (2000). What is leadership? J Nurs Adm, 30(7/8), 340–341.
Hannigan, T.A. (1998). Managing Tomorrow’s High- Performance Unions. Westport, Conn.: Greenwood Publishing.
Laschinger, H.K.S., Wong, C., McMahon, L., &
Kaufman, C. (1999). Leader behavior impact on staff nurse empowerment, job tension, and work effective- ness. J Nurs Adm, 29(5), 28–39.
Lukes, S. (1986). Power.New York: New York University Press.
Mondros, J.B., & Wilson, S.M. (1994). Organizing for Power and Empowerment. New York: Columbia University Press.
Morgan, A. (1997). Images of Organization.Thousand Oaks, Calif.: Sage.
Morgan, A. (1993). Imaginization: The Art of Creative Management.Newbury Park, Calif.: Sage.
Parker, M., & Gadbois, S. (2000). Building community in the healthcare workplace. J Nurs Adm, 30(9), 426–431.
Perrow, C. (1969). The analysis of goals in complex organizations. In Etzioni, A. (Ed). Readings on Modern Organizations.Englewood Cliffs, N.J.: Prentice-Hall.
Purser, R.E., & Cabana, S. (1999). The Self-Managing Organization. New York: Free Press (Simon &
Schuster).
Rosen, R.H. (1996). Leading People: Transforming Business from the Inside Out. New York: Viking Penguin.
Rudy, E.B., Daly, B.J., Douglas, S., Montenegro, H.D., Song, R., & Dyer, M.A. (1995). Patient outcomes for the chronically critically ill: Special care unit versus intensive care unit. Nurs Res, 44(6), 324–331.
Sabiston, J.A., & Laschinger, H.K.S. (1995). Staff nurse work empowerment and perceived autonomy. J Nurs Adm, 25(9), 42–49.
Senge, P., Kleiner, A., Roberts, C., Ross, R., Roth, G., &
Smith, B. (1999). The Dance of Change.New York:
Currency/Doubleday.
96 ❖ Essentials of Nursing Leadership and Management
C R I T I C A L T H I N K I N G E X E R C I S E
Tanya Washington will finish her associate’s degree nursing program in 6 weeks.
Her preferred clinical area is parent-child nursing, and she hopes to become a pediatric nurse practitioner one day.
Tanya has received two job offers, both from urban hospitals with large pediatric populations. Several of her friends are already employed by these facili- ties, so she asked them for their impressions.
“Central Hospital is a good place to work,” said one friend. “It is a dynam- ic, growing institution, always on the cutting edge of change. Any new idea that seems promising, Central is the first to try it. It’s an exciting place to work.’’
“City Hospital is also a good place to work,” said her other friend, “It is a strong, stable institution where traditions are valued. Any new idea must be care- fully evaluated before it is adapted. It’s been a pleasure to work there.”
1. How would the organizational climate of each hospital affect a new graduate?
2. Which organizational climate do you think would be best for a new gradu- ate, Central’s or City’s?
3. What do you need to know about Tanya before deciding which hospital would be best for her?
4. What else would you like to know about the hospitals?
5. Would your answers differ if Tanya were an experienced nurse?
2. Define power,and describe how power affects the relationships between people of different disciplines (e.g., nursing, medicine, microbiology, administration, finance, social work) in a healthcare organization.
3. Discuss ways in which nurses can become more empowered. How can you use your leadership skills to do this?
Tappen, R.M. (2001). Nursing Leadership and Management: Concepts and Practice (ed. 4).
Philadelphia: F.A. Davis.
Weber, M. (1969). Bureaucratic organization. In Etzioni, A. (Ed.). Readings on Modern Organizations.
Englewood Cliffs, N.J.: Prentice-Hall.
Westrope, R.A., Vaughn, L., Bott, M., & Taunton, R.L.
(1995). Shared governance: From vision to reality.
J Nurs Adm, 25(2), 45–54.
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99
Dealing With Problems and Conflicts
O U T L I N E Conflict
Sources of Conflict Tension Between Groups Increased Workload Multiple Role Demands
Threats to Professional Identity and Territory Threats to Safety and Security
Scarce Resources Cultural Differences Invasion of Personal Space
When Conflict Occurs
Resolving Problems and Conflicts Win, Lose, or Draw?
Resolving a Problem
Negotiating an Agreement Informally Formal Negotiation: Collective Bargaining The Pros and Cons of Collective Bargaining Conclusion
O B J E C T I V E S
After reading this chapter, the student should be able to:
• Identify common sources of conflict in the workplace.
• Guide an individual or small group through the process of problem resolution.
• Participate in informal negotiations.
• Discuss the purposes of collective bargaining.
C H A P T E R 8
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Each of us brings different experi- ences, beliefs, values, and habits with us to work. These differences are a nat- ural part of our being unique individ- uals and members of different segments of our society. Various pressures and demands in the workplace also generate problems and con- flicts among people at work. Any or all of these can interfere with our ability to work together. Consider the following example, which is the first of three used to illustrate how to deal with problems and conflicts.
C a s e 1 :
T e a m A a n d T e a m B Team A has stopped talking to Team B. If several members of Team A are out sick, no one on Team B will help Team A with their work. Likewise, Team A members will not take telephone messages for any- one on Team B. Instead, they ask the per- son to call back later. When members of the two teams pass each other in the hall, they either glare at each other or turn away to avoid eye contact. Arguments erupt when members of the two teams need the same computer terminal or another piece of equipment at the same time.
When a Team A nurse reached for the pulse oximeter at the same moment as a Team B nurse did, the second nurse said,
“You’ve been using that all morning.’’
“I’ve got a lot of patients to monitor,”
was the response.
“Oh, you think you’re the only one with work to do?’’
“We take good care of our patients.’’
“Are you saying we don’t?’’
The nurses fell silent when the nurse manager entered the room.
“Is something the matter?’’ she asked.
Both nurses shook their heads and left quickly.
“I’m not sure what’s going on here,”
the nurse manager thought to herself, “but something’s wrong, and I need to find out what it is right away.”
We will return to this case later when we dis- cuss workplace problems and conflicts, their sources, and how to resolve them.