Additional Learning Exercises and Applications
DISPLAY 11.5 General Guidelines for Resumé Preparation
1. Schools have voiced concerns that transition-to-practice programs are taking preceptorship slots that have been historically allocated to prelicensure students. Do you support this reallocation of resources?
2. Should transition-to-practice programs/residencies be a requirement for completion of nursing education?
3. Residencies have historically been a cost hospitals or employers have assumed. Should this cost be shared and why?
4. Would you participate in a school-based transition-to-practice program without an associated stipend if it could help you gain experience? Would you pay to participate?
Resumé Preparation
Despite the best efforts of organizations to help subordinates identify career needs, wants, and opportunities, it is how employees represent themselves that often determines whether desired career opportunities become a reality. Creating a positive image often depends on having well-developed interviewing skills (see Chapter 15) and a well-prepared resumé. “Few documents are more important to your professional career than a resumé, since a high quality resumé is necessary to distinguish yourself from the mass of applicants, and express to the employer what makes you special and why you will succeed” (Resumé 2015, 2015/2016a, para.
1). The resumé is also a screening tool used by employers to select applicants and make promotion decisions;
therefore, maintaining a current, professional resumé is a career-planning necessity for health-care professionals and should not be undertaken lightly.
Resumé Format
Various acceptable styles and formats of resumés exist. However, because the resumé represents the professionalism of the applicant and recruiters use it to summarize an applicant’s qualifications, it must be professionally prepared, make an impression, and quickly capture the reader’s attention. General guidelines for resumé preparation are shown in Display 11.5. A sample resumé is shown in Figure 11.2.
Use high-quality, heavy white, or off-white paper to print the resumé.
Consider adding a splash of color to your black-and-white resumé to make it “pop” out from your competition but do not go overboard (Slack, n.d.). Black and another color is good enough. Use the color on your headings and keep your bullet points black.
Include a cover letter (whether by mail or e-mail), addressed to a specific individual when possible, to introduce yourself, briefly highlight key points of the resumé, and make a positive first impression.
Do include a professional objective or goal statement specific to your desired job.
Make sure only to list people who know you well for quite some time like 3 years as your list of referees (Resumé 2015, 2015/2016b). You should also inform the referees that you have listed them in your resumé as your referees so that when they are contacted, they do not start wondering who the person they are being asked about is.
Integrating Leadership Roles and Management Functions in Career Planning and Development
It is clear that appropriate career management should foster positive career planning and development, alleviate burnout, reduce attrition, and promote productivity. Management functions in career planning and development include disseminating career information and posting job openings. The manager should have a well-developed, planned system for career development for all employees; this system should include long- term coaching, the appropriate use of transfers, and how promotions are to be handled. These policies should be fair and communicated effectively to all employees.
With the integration of leadership, managers become more aware of how their own values shape personal career decisions. In addition, the leader-manager shows genuine interest in the career development of all employees. Career planning is encouraged, and potential leaders are identified and developed. Present leaders are rewarded when they see those, whom they have helped to develop, advance in their careers and in turn develop leadership and management skills in others.
Effective managers recognize that in all career decisions, the employee must decide when he or she is ready to pursue promotions, return to school, or take on greater responsibility. Leaders are aware that every person perceives success differently. Although career development programs benefit all employees and the
organization, there is an added bonus for the professional nurse. When professional nurses have the
opportunity to experience a well-planned career development program, a greater viability for and increased commitment to the profession are often evident.
KEY CONCEPT
There are many outcomes of a career development program that justify its implementation.
Career job sequencing should assist the manager in career management.
Career development programs consist of a set of personal responsibilities called career planning and a set of management responsibilities called career management.
Employees often need to be encouraged to make more formalized long-term career plans.
Career planning should include, at minimum, a commitment to the use of evidence-based practice, learning new skills or bettering practice through the use of role models and mentors, staying aware of and being involved in professional issues, and furthering one’s education.
Designing career paths is an important part of organizational career management.
Managers should plan specific interventions that promote growth and development in each of their subordinates.
Most individuals progress through normal and predictable career stages. Shirey (2009) describes these stages as promise, momentum, and harvest.
Benner (2013) suggests that in the transition from novice to expert, nurses develop skills and an understanding of patient care over time through a sound educational base as well as a multitude of experiences. Thus, the new nurse moves from reliance on past abstract principles to the use of past concrete experience and changes his or her perception of situations to whole parts rather than separate pieces.
Career coaching involves helping others to identify professional goals and career options and designing a career plan to achieve those goals. This coaching should be both short and long term.
Competency assessment and goal setting in career planning should help the employee identify how to exceed the minimum levels of competency required by federal, state, or organizational standards.
Professional specialty certification is one way that an employee can demonstrate advanced achievement of competencies.
To be successful, management development must be planned and supported by top-level management. This type of planned program is called succession planning.
If appropriate management attitudes and insight are goals of a management development program, social learning techniques need to be part of the teaching strategies used.
Multiple types of transition-to-practice programs exist, but all are focused on helping nursing students bridge from school into employment.
Maintaining a current, professional resumé is a career-planning necessity for the health-care professional and should not be undertaken lightly.
Cover letters (whether by mail or e-mail) should always be used when submitting a resumé.
Their purpose is to introduce the applicant, briefly highlight key points of the resumé, and make a positive first impression.
All nurses should maintain a professional portfolio (a collection of materials that document a nurse’s competencies and illustrate the expertise of the nurse) to reflect their professional growth over their career.
Additional Learning Exercises and Applications
LEARNING EXERCISE
11.7
Developing a Realistic 20-Year Career Plan
D
evelop a 20-year career plan, taking into account the constraints of family responsibilities such as marriage, children, and aging parents. Have your career plan critiqued to determine whether it is feasible and whether the timelines and goals are realistic.LEARNING EXERCISE
11.8
Listing Policies Relating to Reimbursement of Educational Expenses for Career Advancement
Y
ou have been appointed to a committee of staff nurses in your home health agency to assist in developing a set of policies regarding the reimbursement of employee expenses for educational or career advancement. Employees have suggested that support for educational advancement is not appropriated uniformly and no criteria exist to determine who should be eligible.A S S I G N M E N T:
Develop a list of five to seven policies regarding who and what should be eligible for educational expenses for career advancement. Be able to justify your criteria and policies.
LEARNING EXERCISE
11.9
Preparing a Resumé
T
he medical center where you have applied for a position has requested that you submit a resumé along with your application. Prepare a professional resumé using your actual experience and education. You may use any style and format that you desire. The resumé will be critiqued on its professional appearance and appropriateness of included content.LEARNING EXERCISE
11.10
Constructing a Management Development Program
Y
ou are serving on an ad hoc committee to construct a management development program. Your organization has requested that the charge nurses work with staff development and plan a 1-week training and education program that would be required of all new charge nurses before their appointment. Because the organization will be bearing the cost of the program (i.e., paying for the educators and employee time), you are required to select appropriate content and educational methods that will not exceed 40 hours, including actual orientation time by a charge nurse.A S S I G N M E N T:
Develop and write up such a plan and share it with the class. Your plan should depict hours, content, and educational methods.
LEARNING EXERCISE
11.11
Career Mapping
C
areer planning is often made easier when a career map is created to assist in developing a long-term master plan. Use the career guide shown in Figure 11.3, along with the individual responsibilities for career development outlined in Table 11.1, to assist with developing the personal plan described in Learning Exercise 11.7.LEARNING EXERCISE
11.12
The Reluctant Preceptor (Marquis & Huston, 2012)
Y
ou are a new graduate nurse in your first job as a staff nurse on an oncology unit. You have been assigned to orient with Steve, an experienced RN and longtime employee on the unit. This is, however, Steve’s first experience as a preceptor. Steve is an expert clinician, and you marvel at his high-quality assessments and how intuitive his nursing diagnoses seem to be. Steve is a role model for you in terms of the level of clinical skills you hope to achieve.Steve, however, seems to have difficulty teaching in the preceptor role. He accomplishes his work quickly and often, without explanation—even though you are at his side. He also is resistant to allowing you to practice many of the basic skills and tasks you are qualified to do, suggesting instead that you should just watch him do it and learn by shadowing. When you question Steve about this practice, he reassures you that he believes you are competent and that you will be a good nurse but states that he does not yet feel comfortable in “letting you do things on your own.”
You are becoming increasingly frustrated with this style of preceptorship and worry that you are not getting the experience you will need to autonomously function as an RN when your orientation ends in 4 weeks. Yet, you also value the opportunity to work so closely with such a skilled clinician and wonderful
role model.
A S S I G N M E N T:
Determine what you will do. What goals are driving your decision? What are the potential risks and benefits inherent in your plan?
R E F E R E N C E S
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Washington, DC: Author.
Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402–407.
Boyle, D. K., Cramer, E., Potter, C., Gatua, M. W., & Stobinski, J. X. (2014). The relationship between direct-care RN specialty certification and surgical patient outcomes. AORN Journal, 100(5), 511–528.
doi:10.1016/j.aorn.2014.04.018
Boyle, D. K., Cramer, E., Potter, C., & Staggs, V. S. (2015). Longitudinal association of registered nurse national nursing specialty certification and patient falls in acute care hospitals. Nursing Research, 64(4), 291–299. doi:10.1097/NNR.0000000000000107
BusinessDictonary.com. (2016a). Career ladder. Retrieved March 11, 2016, from http://www.businessdictionary.com/definition/career-ladder.html
BusinessDictionary.com. (2016b). Professional. Retrieved March 11, 2016, from http://www.businessdictionary.com/definition/professional.html
Executive Coaching Network. (n.d.). What is executive coaching? Retrieved November 27, 2015, from http://www.execcoachnetwork.com.au/whatis.html
Fitzpatrick, J. J., Campo, T. M., & Gacki-Smith, J. (2014). Emergency care nurses: Certification, empowerment, and work-related variables. Journal Of Emergency Nursing, 40(2), e37–e43.
doi:10.1016/j.jen.2013.01.021
Huston, C. (2008). Preparing nurse leaders for 2020. Journal of Nursing Management, 16(8), 905–911.
Huston, C. J. (2017). Assuring provider competence through licensure, continuing education and certification.
In C. J. Huston (Ed.), Professional issues in nursing: Challenges & opportunities (4th ed., pp. 317–
331). Philadelphia, PA: Wolters Kluwer.
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC:
National Academies Press.
Jones, D., & West, N. (2017). New graduate RN transition to practice programs. In C. Huston (Ed.),
Professional issues in nursing: Challenges and opportunities (4th ed., pp. 233–249). Philadelphia, PA:
Wolters Kluwer.
Marquis, B., & Huston, C. (2012). Leadership and management tools for the new nurse (1st ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.
North Carolina Board of Nursing. (2016). Continuing competence requirements. Retrieved March 10, 2016, from http://www.ncbon.com/dcp/i/licensurelisting-renewalreinstatement-continuing-competence- requirements-submission-of-evidence
Pool, I. A., Poell, R. F., Berings, M. G., & Cate, O. T. (2015). Strategies for continuing professional
development among younger, middle-aged, and older nurses: A biographical approach. International Journal of Nursing Studies, 52(5), 939–950. doi:10.1016/j.ijnurstu.2015.02.004
Raffals, R. (n.d.). What is coaching? Retrieved November 27, 2015, from http://www.awakenthemagic.com/coach/whatis.html
Resumé 2015. (2015/2016a). Cutting-edge resume in 2015-2016. Retrieved March 11, 2016, from http://www.resume2015.com/
Resumé 2015. (2015/2016b). Tips to follow on how to write a resume 2015. Retrieved March 11, 2016, from http://www.resume2015.com/best-resume-writing-tips-2015/
Shirey, M. (2009). Building an extraordinary career in nursing: Promise, momentum, and harvest. Journal of Continuing Education in Nursing, 40(9), 394–402.
Sinclair, P., Bowen, L., & Donkin, B. (2013). Professional nephrology nursing portfolios: Maintaining competence to practice. Renal Society of Australasia Journal, 9(1), 35–40.
Slack, M. (n.d.). 5 Ways to spruce up your resume for 2015. Retrieved March 10, 2016, from http://theundercoverrecruiter.com/spruce-up-resume-new-year/
12
Organizational Structure
. . . The days of the traditional pyramid shaped corporate hierarchy as a viable business model are coming to an end.
—Michael Hugos
. . . in a changing world, organizations must change as surely as individuals must change.
Recent years have seen an increase in organizational “flattening,” the tendency to shrink the organizational structure through the removal of layers of hierarchy.
—Charles R. McConnell
This chapter addresses:
BSN Essential II: Basic organizational and systems leadership for quality care and patient safety BSN Essential VI: Interprofessional communication and collaboration for improving patient health
outcomes
BSN Essential VIII: Professionalism and professional values MSN Essential II: Organizational and systems leadership MSN Essential III: Quality improvement and safety
MSN Essential VII: Interprofessional collaboration for improving patient and population health outcomes
AONE Nurse Executive Competency I: Communication and relationship building AONE Nurse Executive Competency II: Knowledge of the health-care environment AONE Nurse Executive Competency IV: Professionalism
AONE Nurse Executive Competency V: Business skills ANA Standard of Professional Performance 10: Collaboration ANA Standard of Professional Performance 11: Leadership ANA Standard of Professional Performance 14: Quality of practice ANA Standard of Professional Performance 16: Resource utilization ANA Standard of Professional Performance 17: Environmental health QSEN Competency: Teamwork and collaboration
QSEN Competency: Quality improvement QSEN Competency: Safety
The learner will:
describe how the structure of an organization facilitates or impedes communication, flexibility, and job satisfaction
identify characteristics of a bureaucracy as defined by Max Weber
identify line-and-staff relationships, span of control, unity of command, and scalar chains on the organization chart
describe components of the informal organization structure including employee interpersonal relationships, the formation of primary and secondary groups, and group leaders without formal authority
differentiate between first, middle, and top levels of management compare and contrast centralized and decentralized decision making
analyze how position on the organization chart is related to centrality
describe common components of shared governance models and differentiate shared governance from participatory decision making
contrast individual authority, responsibility, and accountability in given scenarios
identify appropriate strategies the leader/manager may take to create a constructive organizational culture
describe characteristics of effective committees and committee members
define “groupthink” and discuss the impact of groupthink on organizational decision making and risk taking
identify symptoms of poorly designed organizations
describe the five model components of Magnet-designated health-care organizations as well as the 14 foundational forces required to achieve Magnet status
provide examples of an organization’s potential stakeholders
Introduction
Unit III provided a background in planning, the first phase of the management process. Organizing follows planning as the second phase of the management process and is explored in this unit. In the organizing phase, relationships are defined, procedures are outlined, equipment is readied, and tasks are assigned. Organizing also involves establishing a formal structure that provides the best possible coordination or use of resources to accomplish unit objectives. This chapter looks at how the structure of an organization facilitates or impedes communication, flexibility, productivity, and job satisfaction. Chapter 13 examines the role of authority and power in organizations and how power may be used to meet individual, unit, and organizational goals.
Chapter 14 looks at how human resources can be organized to accomplish patient care.
Formal and Informal Organizational Structure
Fayol (1949) suggested that an organization is formed when the number of workers is large enough to require a supervisor. Organizations are necessary because they accomplish more work than can be done by individual effort. Because people spend most of their lives in social, personal, and professional organizations, they need to understand how organizations are structured—their formation, methods of communication, channels of authority, and decision-making processes.
Each organization has a formal and an informal organizational structure. “Essentially, in the formal organization, the emphasis is on organizational positions and formal power, whereas in the informal
organization, the focus is on the employees, their relationships, and the informal power that is inherent within those relationships” (Hartzell, 2003–2016, para. 3). In addition, the formal structure is generally highly planned and visible, whereas the informal structure is unplanned and often hidden.
Formal structure, through departmentalization and work division, provides a framework for defining managerial authority, responsibility, and accountability. In a well-defined formal structure, roles and functions are defined and systematically arranged, different people have differing roles, and rank and hierarchy are evident.
Organizational structure refers to the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions.
Informal structure is generally a naturally forming social network of employees. Hartzell (2003–2016) suggests that it is the informal structure that fills in the gaps with connections and relationships that illustrate how employees network with one another to get work done. Because informal structures are typically based on camaraderie, they often result in a more immediate response from individuals, saving people’s time and effort (Schatz, 2016). People also rely on informal structure if the formal structure has stopped being effective, which often happens as an organization grows or changes but does not reevaluate its hierarchy or
work groups (Schatz, 2016).
The informal structure even has its own communication network, known as the grapevine. Hartzell (2003–
2016) suggests that grapevine communication is at the heart of the informal organization; it is the conversations that occur in the break room, down the halls, during the carpool, and in between work that allows the relationships of informal groups to develop. In addition, social media sites (Facebook, Instagram, Snapchat, Twitter, etc.) and electronic communication such as e-mail and text messages are also used to facilitate communication among informal group members.
Although grapevine communication is fast and can facilitate information upward, downward, and horizontally, it is difficult to control or to stop. With little accountability for the message, grapevine communication often becomes a source for rumor or gossip.
The informal structure also has its own leaders. In addition, it also has its own communication channels, often referred to as the grapevine.
People need to be aware that informal authority and lines of communication exist in every group, even when they are never formally acknowledged. The primary emphasis of this chapter, however, is the identification of components of organizational structure, the leadership roles and management functions associated with formal