FOR KIM WOODS

Analysis model

Kelley Hageman

Capella University

Introduction

Nurses are bestowed professional authority that covers their powers to maintain autonomous operation that establishes their political and intellectual impact within the healthcare organization (Ghaderi, & Kafcheh, 2016). The authority demands and attracts respect from peers, other medical practitioners, patients and the community at large. Therefore, the nursing services must maintain their distinctive format to maximize productivity because the authority establishes a high responsibility for visibility, quality care and confidence (Ghaderi, & Kafcheh, 2016). The assumption in granting authority is the ability of the nurses to operate at high levels of competence from professional training. Over the years, the parted boundaries associated with the nurses’ professional authority have been blurred between the senior nurses and the nurse administration. There has to be a clear understanding of the fact that the authority granted to nurses is confined in leadership and effective interaction with the nursing administration staff. The nursing administration staff members represent managers that are biased towards administrative aspects of nursing as opposed to actual nursing with regards to patient care. The blurred line in administration arises from the mistake most employers make through offering practicing nurses managerial roles rather than leadership roles. It is the duty of human resource managers to identify the roles that promote leadership to assign to the senior nurses rather than provide the roles that demand managerial application. Therefore, unclear nursing authority prevails in most healthcare facilities a fact that is detrimental to productivity based on the resultant conflicts of interests. There is a need to reverse the situation thus develop workable solutions. The PDSA Cycle is the best model applicable in resolving the identified boundaries problem.

The blurred line occurs because people cannot differentiate between leadership and management. In basic terms, leadership has people follow an individual while management has the employees work for the individual (Grohar-Murray, DiCroce, & Langan, 2016). Therefore, leadership is about bringing the best out of people and influencing their performance towards specific goals or objectives in the long run such as improving the quality of care and reducing the turnover rate of employees. Management is concerned with control, procedures and day to day running of the organization with goals such as minimizing costs and ensuring the workforce is not negligent in their operations. It is true a leader can also be a manager but it takes time and clear understanding of the difference to satisfy the polarized demands of the two roles (Grohar-Murray, DiCroce, & Langan, 2016). That is why not every senior nurse qualifies to be a manager, but they naturally gain leadership skills out of experience and years of interaction with peers at different levels of nursing.

PDSA Cycle

The acronym version has four stages including; planning, doing, studying and acting phases. However, before any of the stages are implemented, there are three PDSA Cycle questions that must be answered satisfactorily to put the situation in the right context for application. The questions include (Lanter, Wolff, Johnson, Ercolano, Kilmer, & Provost, 2015);

· What is being pursued or accomplished?

· How will the team determine change as an agent of success or improvement?

· What changes made will result into improvement?

Planning phase involves utilization of instruments such as evidence-based unit standards and the pain-management flow sheet to establish potential assessment, management, evaluation and documentation of the results (Donnelly, & Kirk, 2015). Doing is the execution phase after planning is completed and involves collection of information and related data to establish a resource for effective problem solving. The studying phase includes the analysis of the information and documentation prepared during the doing-phase. This is where the information is synthesized to establish findings that are relevant in resolving the issue at hand. Acting involves implementation of the new process that is a revision of the planning stage backed by verified findings for improved efficiency and accuracy.

PSDA Cycle Application

The situation of concern is the blurred boundaries between the nurse administration and senior nurses. The assumption the most experienced and excellent senior nurses make the most effective leaders or managers, is not absolutely true. Despite this knowledge, the employers continue involving the senior nurses in administrative roles. Extreme situations involve the senior nurses being asked to take up managerial roles yet burdened to retain their nursing responsibilities (Donnelly, & Kirk, 2015). Therefore, conflict of interest leads to indecisiveness, confusion and inefficiency leading to poor productivity. Therefore, the PSDA application will apply to reinstate the clear boundaries.

· What is being pursued or accomplished? Clear authority boundaries.

· How will the team determine change as an agent of success or improvement? Success is achieved through the improved employee engagement, realized job satisfaction and sustained employee motivation.

· What changes made will result into improvement? There will be no direct engagement of nurses into managerial or administrative roles. All non-administrative employees (nurses) needed for managerial roles must be taken through theoretical and practical assessments to justify their qualification for effectiveness in management (Stanley, 2006). This will avoid the common mistake of taking strong leadership to represent excellent managerial skills. Once engaged administratively, the nurses must not be allowed to retain their practical clinical responsibilities but can act at advisory roles. Only emergency shortages should allow the nurse-administrators to supplement the small numbers of employees. A clear separation of these roles and establishing policies on when administrators can take part in active nursing helps to remind people that leadership is different from management. Therefore, the nurses will understand when their colleague is addressing or acting as a manager, and when she is acting as a leader.

· Planning: List all administrative roles susceptible to multi-role application such as verification of check-in time or overtime calculation and documentation. Put in place all recording instrumentation used to monitor the nurses’ activity.

· Doing: Provide simple training sessions that create awareness separating leadership from administration. Clarity of the functions should assist the nurses chosen for administrative roles appreciate on the appropriate interaction system as well as the employers from mixing the roles. Leadership allows multi-role playing buy management is administrative. Record decisions made by the nurse-administrators.

· Study: An analysis of the nurses in terms of performance is the main action that considers the decisions made in the doing phase. The results can be tabulated to reflect

historical trends in performance of senior nurses before and after being engaged in administrative roles. Further analysis involves the impact of the senior nurse to peers.

· Action: Freeze all nurse-administrative members from operation as active nurses. This should require recruitment of extra nurses to cover the gap under pressures of under-staffing. Train the admin-nurses on administrative roles after which they must excel on prepared assessment tests.

Focus Methodology

This system starts with the problem statement and drawing participants based on their active contribution to the problem. However, unlike the PDSA model, an articulate solution is already determined before the team of executors is asked to implement the provided solution. The change needed is communicated in advance since little or no chance of change is allowed after implementation. Therefore, the proposed solution hinges on the review of related literature and performance in other institutions with regards to similar problems. Therefore, the Focus Methodology allows the implementers to integrate the PDSA model in various stages of this method before it is implemented. Focus methodology narrows attention to the exact problem with little room to handle any collateral issues.

Six Interventions

Clear coding and separation of roles: Increased focus and quality of work that provides maximum satisfaction to the nurse.

Reinstate autonomy of duty execution: empowering the nurses to develop or maintain a sense of purpose should increase the professional engagement and enhance employee morale from intrinsic motivation.

Align people to roles: Assessment of capacity to multi-task should boost the confidence of the nurses and the constant review or re-assessment of their performance acts as a reminder that promotes the appreciation of their roles.

Enhance credibility through professional training and certification: This procedure creates a vivid separation of duties and allows the nurses to operate effectively on multi-tasking roles from the conscious and subconscious appreciation of their credentials.

Communicate change management: communication provides room for feedback thus adjustments to the model can be timely and relevant for maximum productivity. The employees feel valued and therefore own the process to the end.

Inspiration sessions: These arrangements communicate failure in a positive manner that allows employees to connect with their weaknesses thus increasing acceptability of the change initiatives.

References

Donnelly, P., & Kirk, P. (2015). Use the PDSA model for effective change management. Education for Primary Care, 26(4), 279-281.

Ghaderi, N., & Kafcheh, P. (2016). A study on sources of conflict from the perspective of staff and managers of hospitals of Sanandaj city. International Journal of Humanities and Cultural Studies (IJHCS)​ ISSN 2356-5926, 1401-1408.

Grohar-Murray, M. E., DiCroce, H. R., & Langan, J. C. (2016). Leadership and management in nursing. Pearson.

Lanter, P. L., Wolff, K. B., Johnson, L. C., Ercolano, E. M., Kilmer, J. R., & Provost, L. (2015). Change IS possible: Reducing high-risk drinking using a collaborative improvement model. Journal of American College Health, 63(5), 330-336.

Stanley, D. (2006). Role conflict: leaders and managers: David Stanley reviews the literature, and discusses his own research, on the difference between leadership and management. Nursing Management, 13(5), 31-37.