Coping with Hostility
Hostility and overt aggression have been identified as factors that have a significant influence on the delivery of clinical care (Gournay 2001) and on the recruitment and retention of staff (Jackson,... Clare & Mannix 2002). Such hostility is not restricted to interactions with patients and their families; it also occurs in interactions between staff members.
All managers rely on information to make decisions. It is therefore essential that nurse managers understand how to use information effectively. In the past, nurses have tended to see technology as de...humanising and counterproductive to the art and science of nursing (Ammenwerth et al. 2003).However, those now entering the nursing profession have been educated with computers and are aware of the possibilities that the Internet and other computer information systems can provide. Attitudes have shifted within the modern nursing workforce (Richards 2001). There is now a move to a requirement of having computers at the place care is provided through hand-held devices (Erdley 2006). Not only is this point-of-care technology seen as providing safer care but also saves time, allowing nurses to spend more time providing nursing care (Smith et al. 2005).
A budget is a formalised planning tool used by management to compare expected revenues with expected expenses for the year (Finkler & Kovner2000). The objective of budgeting is to maximise organisatio...nal resources to meet short-term and long-term goals (Marquis & Huston 2003). A budget is therefore a written financial plan that aims to control resources (Huber 2000).
This chapter outlines how changing health-care environments impact on roster design, defines rostering objectives and outlines the key elements required to achieve these objectives. It also introduces... a range of methodologies and outlines their relative advantagesand disadvantages gives a practical example of how to measure the number of labour hoursper patient day a roster pattern will absorbs, estimates associated costs and describes the purpose and process of roster re-engineering.
Recruiting and Retaining Staff
The current global shortage of nurses has created a highly competitive market in the recruitment of nurses. Health services are competing with each other to recruit suitably qualified nurses and the h...ealth industry as a whole is trying to attract school and university students to undertake nursing studies. This competitive environment has ensured that a critical component of the work of nurse managers is the recruitment and retention of nursing staff.
Working With Job Descriptions
Job descriptions play a vital role in the success of organisational performance. The term job description has been largely replaced by position description (Dessler et al. 2004). Both provide a clear ...written template of roles and expected performance for both an organisation and for individual employees. At the recruitment phase, a job or position description gives the prospective employee an opportunity for self-assessment suitability. In a sense this represents the commencement of the culling phase of selection. Throughout the period of employment the job description serves as an ongoing framework for performance evaluation, as well as for position review and for position redesign. When an employee leaves the organisation, the job description can be further reviewed and refined to assist the organisation in achieving its goals.
Writing Policies and Procedures
In coming to grips with any topic, the first task is to define the key terms—in this case policy. Within this context, there are two sorts of policy: public policy and organisational policy. The act...ivities listed below clearly refer to government functions, hence the term ‘public’; indeed, public policy is allabout how public resources are used and the expected outcomes from theallocation of resources. However, the principles behind each of these points can be adapted to policy areas of health services; that is, ‘organisational’ policy. The umbrella term of policy describes a number of organisational activities(Hogwood & Gunn 1984), including: a label for field of activity; an expression of general purpose or desired state of affairs; specific proposals; decisions of government; formal authorisation; programs; output; outcome; theory or model; and process.
Maximising the Quality Factor
Quality in health care has been defined as ‘doing the right thing, the first time, in the right way, and at the right time’ (NSW Health 2002). Consumers of health care expect that the services pro...vided will be safe, effective, appropriate, consumer-focused, accessible and efficient. The challenge for providers of health care is to monitor and improve systems continuously to satisfy these expectations.
Occupational Health and Safety
The nature of nursing means that every day many nurses are injured or become ill as a result of work. Causes include physical violence, ergonomic hazards (such as manual handling), exposure to infecti...ous diseases (airborne, blood borne and direct contact), fatigue (due to physically and mentally demanding work), work organisation and shift work, radiation (ionising and non-ionising), handling toxic drugs and exposure to chemicals.
Managing risk is an overarching aspect of the nurse manager’s role. In providing clinical services, the nurse manager’s paramount concern must be to ensure the health and safety of patients and st...aff. This chapter teaches nurse managers about how to manage risks proactively by assessing what can possibly go wrong, developing a plan to manage these risks, act on this plan, harness the efforts of the team and then recognise the improvements.
Managing performance is a vital management tool if nurse managers are to inspire, motivate and lead their teams to clinical excellence. Performance management includes the evaluation of an individual'...s work practice, the review of goals, the setting of new objectives and career planning.
Dealing with Unhelpful Nurses
It is not an easy task to manage workers in health-care settings. High levels of stress caused by unsociable working hours together with the emotionally, physically and intellectually draining nature ...of clinical-care delivery contribute to ‘unhelpful’ behaviour.
Counseling Your Staff
When a staff member comes to a nurse manager for counselling, that staff member expects to take part in a confidential, professional interview through which he or she hopes to feel better and receive ...help in solving problems (Geldard & Geldard 2001). Counselling staff involves skilled intervention, confidentiality and, most importantly, the ability to help staff members find a solution to their problems. Counselling is not a pleasant chat between friends; rather, it is a structured attempt to provide help in a problem situation.
Making Meetings Work
Meetings are critical elements in the management of health-care facilities but for a busy nurse manager they can be a liability if not managed well. These gatherings can be held in various settings an...d be formal or informal; however, if they are to create value for the organisation, meetings must have key elements and outcomes of defining issues of importance, resolving problems and making decisions.
Working with Other Disciplines
Delivery of health care is a collaborative effort, and each person has a valuable contribution to make. Although many important aspects of care are not specific to any particular discipline—for exam...ple, those that involve the basic principles of positive human interaction—other aspects are determined by the specific expertise and requirements of various disciplinary or occupational groups.
Leading, Motivating, and Enthusing
A new nurse manager is often plunged into an unfamiliar leadership role, as well as having many other challenging responsibilities. They will find themselves on an acute learning curve: adapting to ne...w policies and procedures, observing occupational health-and-safety rules and becoming aware of abstract legal responsibilities.
There are many areas in contemporary nursing that involve far-reaching ethical issues—such as informed consent, substitute decision-making, effective use of health-care resources, moral distress of ...staff, and conflict between staff and patient’s family members. This chapter examines some common ethical issues that nursing managers face, the notion of a moral community and ways to combat moral distress among staff.
Working Relationships and Promotion
Becoming a nurse manager is a recognised career path for nurses. It is a demanding role that requires a wide array of professional skills and leadership qualities to effectively manage resources and p...ersonnel in a dynamic clinical environment. A nurse manager is also involved in clinical supervision and clinical governance, areas that directly affect staff morale and the quality of care provided in the clinical environment.
The Nurse Manager
The new nurse manager is handed the keys to the office, given a new name-tag and title and begins the first day on the job with a raft of ideas ready to implement. Feelings of excitement and enthusias...m, however, can very quickly dissipate because a new manager is often unprepared to face the barrage of unfamiliar day-to-day organisational problems, which have the potential to distract from their strategic vision.
eChapter End Matter
This chapter contains the index to the Ausmed chapter series Nurse Managers: A Guide to Practice - 2nd Edition. In addition to this useful reference, a glossary of key terms included in the series is ...included and a post-series test that readers may find useful to check their knowledge.