The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation.

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Nursing Care Models Worksheet Guidelines

Resource must be used: Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care (3rd ed.). Boston, MA: Pearson. Pg 111-116

Purpose

The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.

Course Outcomes

Completion of this assignment enables the student to meet the following course outcomes.

CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)

CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)

CO4: Apply concepts of leadership and team coordination to promote the achievement of safe and quality outcomes of care for diverse populations. (PO4)

CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO7)

CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)

CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)

Due Dates

Submit by Sunday, 11:59 p.m. MT, end of Week 5.

Points 

This assignment is worth 200 points.

Directions : Use this form to complete the Week 5 Nursing Care Models Assignment: Nursing Care Models Worksheet (Links to an external site.)Links to an external site.

1. Read your text, Finkelman (2016), pp- 111-116.

2. You are required to complete the assignment using the template.

3. Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.

4. Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model

5. Review and summarize one scholarly resource (not your textbook) related to the nursing care model you observed in the practice setting.

6. Review and summarize one scholarly resource (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.

7. Discuss a different nursing care model from step #3, and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.

8. Summarize this experience/assignment and what you learned about the two nursing care models.

9. Submit your completed worksheet no later than 11:59 p.m. MT on Sunday by the end of Week 5.

**Academic Integrity Reminder**

College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Please see the grading criteria and rubrics on this page.

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Theories in Leadership

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Theories in Leadership

Theories in Leadership Case Study 1

approx 30 min

The study described in the Research Perspective (Hauck, Winsett, & Kuric, 2012) was about the introduction of evidence-based practice for a hospital. Rogers’s theory of diffusion of innovation served as the theoretical framework for that study. However, other theoretical perspectives are present. Based on situational-contingency theory, describe factors that the nurse researcher, as the leader of the implementation team, would need to consider. Consider the following:

Question 1

What considerations come into play that are outside of the group targeted for the change initiative? Are there any external stakeholders? What are the internal factors that would drive or limit change from being successful?

Question 2

How do people behave individually and in groups when it comes to adopting a practice-based change? Is there a difference between individual and group behaviors? If so, why does this occur?

 

Question 3

What should the nurse leader do to plan for and address potentially negative attitudes of staff regarding the implementation of evidence-based practice? How should the nurse leader use nurses with positive attitudes toward the implementation of evidence-based practice?

Question 4

How can previous interactions with the nurse leader impact the success or failure of implementing evidence-based practice?

Question 5

What are the resource requirements? What are the regulatory requirement

Influence and Diplomacy Case Study 2

approx 30 min

Ryan graduated from his BSN program about 18 months ago and has been working on a surgical unit in a large Magnet™ hospital. He belongs to his state nurses association and the Academy of Medical-Surgical Nurses (AMSN).

He recently moved to another town for graduate school and took a job in a small community hospital. The new chief nursing officer is trying to create a shared governance structure. The nursing staff seems disinterested in participating in such a governance structure. Some of them complain that they do not want to “think” about nursing beyond what they have to do at the bedside.

Ryan served on the practice council at the hospital where he worked after graduation. The nurses he works with now are discouraging him from volunteering to serve on one of the new councils being formed to implement shared governance. He is frustrated by his colleagues’ lack of interest in participating in decision making about nursing care. He wonders if this is the right place for him to work while in his graduate program. Although this hospital is closely affiliated with the school of nursing where he is a graduate student, the nurses on his unit openly challenge the wisdom of his decision to pursue a graduate degree.

Question 1

What resources should Ryan use to gain support for his desire to participate in the new shared governance structure?

Question 2

If Ryan wants to test the job market to find a position in a more positive nursing work environment, what resources can he use?

Question 3

Ryan has been subjected to a lot of questions and negative comments by some of the senior staff nurses about his graduate studies. They tend to negate the importance of advancing one’s nursing education. How can he redirect their comments?

Evolution of the Nurse Leader Case Study-3

approx 30 min

Margaret Compton, RN, is 52 years old and recently widowed. Her husband died a week after traumatic injuries from a serious fall on a hiking expedition.

Margaret has been out of the work force for 23 years, electing to stay at home and take care of her three children while her husband worked. Her youngest is in his third year of college, and Margaret has realized that she needs to return to the workforce.

During her husband’s hospitalization, Margaret realized that she missed nursing and eagerly looks forward to returning to active practice. She kept her license active all these years, but during her husband’s hospitalization, Margaret saw that much has changed since she left her last nursing position.

Question 1

What specific challenges does Margaret face in returning to the nursing workforce after 23 years?

Question 2

What has changed in health care that will make her work different now?

Question 3

What do you think is the same in nursing over time?

 

Professional Standards for Nursing Leadership Case Study 4

approx 30 min

You are the nurse manager of a busy operating room in a large metropolitan hospital, serving both adult and pediatric clients. A case is scheduled involving a child who will have a hip arthroplasty. The surgical technician usually scheduled for the pediatric cases is unavailable to assist with this case, so you schedule a surgical technician who has assisted with multiple hip arthroplasties but has never performed one on a younger child. After the procedure, the child has permanent damage to his sciatic nerve, and his parents have filed a lawsuit against the surgical technician, you as the nurse manager, and the hospital.

Question 1

How do you suspect that the court will react to such a case?

Question 2

What would their findings likely be in such an instance and why?

Question 3

What could you have done to prevent this outcome?

Professional Standards for Nursing Leadership Case Study 5

approx 30 min

Joe Rodriquez, 19, presents to the hospital Emergency Department with a diagnosis of West Nile virus. He has a fever of 102° F, chills, and generalized aching in all his muscles. He reports that he was recently hiking in a wooded portion of the state and was bitten repeatedly by mosquitoes, despite the fact that he used an insect repellent. He and his parents are informed about this condition, including the need for immediate hospitalization and the treatment plan. Joe refuses to be hospitalized, stating that he will follow all medical recommendations at home. He asks to be assigned a home healthcare nurse to assist with his medical treatment. His parents are totally torn between honoring their son’s wishes and forcing the admission of their son, so that he can receive the needed medical and nursing care.

Question 1

You are the nurse manager for the emergency department, and staff members approach you about this patient. How would you begin to resolve this dilemma?

Question 2

What type of direction would you give staff members to allow them to come to a satisfactory conclusion?

Question 3

How does the Code of Ethics for Nurses (ANA, 2001) provide guidance in reaching needed decisions?

The post Theories in Leadership appeared first on Infinite Essays.

Factors That Influence the Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in Emergency Department Nurses Stacie Hunsaker, MSN, CPEN, CEN1, Hsiu-Chin Chen, PhD, RN, EdD2, Dale Maughan, PhD, RN3, & Sondra Heaston, MS, NP-C, CEN, CNE4

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HEALTH POLICY AND SYSTEMS

Factors That Influence the Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in Emergency Department Nurses Stacie Hunsaker, MSN, CPEN, CEN1, Hsiu-Chin Chen, PhD, RN, EdD2, Dale Maughan, PhD, RN3, & Sondra Heaston, MS, NP-C, CEN, CNE4

1 Iota Iota, Assistant Teaching Professor, Brigham Young University College of Nursing, Provo, UT, USA 2 Professor, Department of Nursing, Utah Valley University, Orem, UT, USA 3Chair, Department of Nursing, Utah Valley University, Orem, UT, USA 4 Iota Iota, Associate Teaching Professor, Brigham Young University College of Nursing, Provo, UT, USA

Key words Compassion fatigue, compassion satisfaction,

burnout, emergency nurses

Correspondence Ms. Stacie Hunsaker, Assistant Teaching

Professor, Brigham Young University College

of Nursing, Provo, UT 84602. E-mail:

Stacie-hunsaker@byu.edu

Accepted: October 20, 2014

doi: 10.1111/jnu.12122

Abstract

Purpose: The purpose of this study was twofold: (a) to determine the preva- lence of compassion satisfaction, compassion fatigue, and burnout in emer- gency department nurses throughout the United States and (b) to examine which demographic and work-related components affect the development of compassion satisfaction, compassion fatigue, and burnout in this nursing specialty. Design and Methods: This was a nonexperimental, descriptive, and pre- dictive study using a self-administered survey. Survey packets including a demographic questionnaire and the Professional Quality of Life Scale version 5 (ProQOL 5) were mailed to 1,000 selected emergency nurses throughout the United States. The ProQOL 5 scale was used to measure the prevalence of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses. Multiple regression using stepwise solution was employed to determine which variables of demographics and work-related characteris- tics predicted the prevalence of compassion satisfaction, compassion fatigue, and burnout. The α level was set at .05 for statistical significance. Findings: The results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satis- faction among this group of emergency department nurses. The low level of manager support was a significant predictor of higher levels of burnout and compassion fatigue among emergency department nurses, while a high level of manager support contributed to a higher level of compassion satisfaction. Conclusions: The results may serve to help distinguish elements in emer- gency department nurses’ work and life that are related to compassion satis- faction and may identify factors associated with higher levels of compassion fatigue and burnout. Clinical Relevance: Improving recognition and awareness of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses may prevent emotional exhaustion and help identify interventions that will help nurses remain empathetic and compassionate professionals.

The profession of emergency nursing is physically and emotionally demanding. Complex patient loads, long shifts, demanding physicians, a fast-paced environ- ment, and working in an emotionally and physically

challenging area can cause stress for emergency de- partment (ED) nurses (Healy & Tyrrell, 2011; Hooper, Craig, Janvrin, Wetsel, & Reimels, 2010; Von Rueden et al., 2010). Compassion fatigue (CF) and burnout are

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conditions that can become overwhelming burdens on nurses and can cause physical, mental, and emotional health difficulties (Potter, 2006). CF is a negative conse- quence of working with traumatized individuals (Figley, 1995). Moreover, CF has been described as emotional, physical, and spiritual exhaustion from witnessing and absorbing the problems and suffering of others (Peery, 2010; Sabo, 2011). Equally as troubling is burnout, which differs from CF in that it is associated with feelings of hopelessness and apathy and creates an inability to perform one’s job duties effectively (Stamm, 2010). Burnout manifests similarly to CF, but is not typically linked to empathy. Instead, it is a gradual worsening of feelings of frustration with career responsibilities (Maslach, Jackson, & Leiter, 1996). Both CF and burnout may cause a nurse to become ineffective, depressed, apathetic, and detached (Boyle, 2011). Long-term results of both CF and burnout include low morale in the workplace, absenteeism, nurse turnover, and apathy (Jones & Gates, 2007; Portnoy, 2011). All of these consequences have a negative impact on patient care. Moreover, high levels of nurse burnout are linked to patient dissatisfaction (Vahey, Aiken, Sloane, Clarke, & Vargas, 2004). Consequently, it is imperative that CF and burnout be recognized and addressed. By studying the impact of CF and burnout on ED nurses, researchers may bring to the attention of managers, healthcare leaders, and nurses themselves the reality of this phenomenon and aid in the comprehension of its negative influence.

Additionally, the complexity of patient care is climbing, resources are decreasing, and insurance reimbursement is being linked to patient satisfaction (Medicare, 2013). It is more important now, perhaps more than at any other time in health care, to understand the prevalence and predictors of CF and burnout, but also compassion satisfaction (CS), in ED nurses. By understanding factors that influence both positive and negative aspects of nurses’ work, perhaps levels of awareness will be raised and nurses may maintain caring relationships and posi- tive attitudes. Moreover, few studies were conducted to explore factors that influence the prevalence of CF and burnout on ED nurses (Dominguez-Gomez & Rutledge, 2009; Hooper et al., 2010). Thus, the purpose of this study was to determine the prevalence of CS, CF, and burnout in ED nurses throughout the United States and to determine which demographic and work-related components affect the development of CS, CF, and burnout in this nursing specialty.

Based on the purpose of the study, the research ques- tions were: (a) What is the prevalence of CS, CF, and burnout among ED nurses? (b) What demographic char- acteristics such as age and gender are associated with the prevalence of CS, CF, and burnout among ED nurses?

(c) What work-related characteristics such as educational level, years in nursing, shift length, years worked in the ED, hours worked per week, and having adequate man- ager support are significantly associated with the preva- lence of CS, CF, and burnout among ED nurses? And (d) To what extent do the variables of demographics and work-related characteristics predict the prevalence of developing CS, CF, and burnout among ED nurses, respectively?

Literature Review

The term compassion fatigue was first introduced by Joinson in 1992. She described CF as nurses losing their ability to nurture. CF has been defined as the negative consequences of working with a significant number of traumatized individuals in combination with a strong, personal, empathic orientation. Figley (1995), a noted early researcher on CF, commented that those who are in a caring profession have an enormous capacity for feeling and expressing empathy and tend to be more at risk for CF. Humans, by nature, are wired for empathy, and therefore, caregiving can take a toll both emotionally and physically (Flarity, 2011).The stress resulting from helping a traumatized or suffering person may result in CF, which develops as a self-protection measure (Figley, 1995).

While CF is caused by empathy, burnout is associ- ated with environmental factors such as high patient acuity, overcrowding, and problems with administration (Flarity, Gentry, & Mesnikoff, 2013). Burnout is a con- dition often associated with feelings of hopelessness and inability to perform job duties effectively (Stamm, 2010). Burnout and CF are often linked and closely mimic one another. CF is often described as a type of burnout (Portnoy, 2011). A principal difference between burnout and CF is that burnout typically exhibits a gradual onset while CF may occur suddenly. Although measur- ing negative aspects of a nurse’s job is important, it is equally valuable to determine what makes a nurse feel happy. CS is the positive aspect of helping others. It is the satisfaction achieved with one’s work by helping others and being able to do one’s job well (Stamm, 2010). Many nurses chose their profession specifically to help others.

CF and burnout may have severe professional conse- quences in addition to affecting a nurse’s personal well- being. CF and burnout affect nurse retention, patient safety, and patient satisfaction (Burtson & Stichler, 2010; Potter et al., 2010). Hospitals are expected not only to provide positive outcomes for patients, but make them happy while providing quality care. A relatively new per- formance measure for hospitals is patient satisfaction.

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Compassion Fatigue, Satisfaction, and Burnout Hunsaker et al.

Since 2007, the passage of health reform legislation has increased focus on the importance of the patient experi- ence (McHugh, Kutney-Lee, Cimiotti, Sloane, & Aiken, 2011). Therefore, Medicare reimbursements to hospitals are now partially based on patient satisfaction measure- ments. Thirty percent of the incentive payments provided by Medicare to hospitals is based on approval scores of satisfaction (Medicare, 2013).

Nurses who are experiencing CF and burnout are too exhausted to provide levels of care that help patients feel satisfied (Boyle, 2011; McHugh et al., 2011). As aforementioned, CS is the positive aspect of helping oth- ers (Stamm, 2010). Many nurses choose this profession because they experience fulfillment in helping others. Thus, understanding the factors that contribute to CF and burnout may help ED nurses maintain their ability to experience work fulfillment and contribute to patient satisfaction.

Empirical Studies Related to the Study Problem

The need to identify the level of CF in ED nurses was clear throughout the literature review. The conclu- sions in most research reviewed portrayed high levels of CF in healthcare workers and indicated the need for further research regarding CF and burnout among ED nurses. To the researchers’ knowledge, there have been only two quantitative studies precisely targeting CF in ED nurses (Dominguez-Gomez & Rutledge, 2009; Hooper et al., 2010). Both studies had a limitation of a small sam- ple size and studied CF in ED nurses in two specific ge- ographical locations: a hospital in the Southeast United States, and three hospitals in California, respectively.

Hooper et al. (2010) compared levels of CS, CF, and burnout among ED, intensive care unit, oncology, and nephrology nurses. The Professional Quality of Life (ProQOL) scale was used to examine a difference in the level of CF and burnout in nurses working in these different specialty units. Although this exploratory, cross-sectional study did not show a significantly statis- tical difference in CF levels of the nurses among those specialty units, it did attest that ED nurses were at risk for less CS compared to the other types of nurses. This study also revealed a greater risk for burnout in ED nurses and a greater risk for CF in oncology nurses.

Dominguez-Gomez and Rutledge’s (2009) study fo- cused on measuring the level of CF in ED nurses us- ing the Secondary Traumatic Stress tool. It was the first quantitative exploration of CF in ED nurses. The find- ings of the study demonstrated high levels of CF among the ED nurse respondents. High levels of CF in nurses may affect patient care and contribute to burnout. The study suggested further research aims at increasing the

awareness of this phenomenon, as well as a recommen- dation for managers and organizations to be more aware of the problems of CF and burnout and to support nurses, and, when appropriate, urge them to seek counseling (Dominguez-Gomez & Rutledge, 2009).

Understandably, EDs are often considered to be a stressful work environment. Multiple studies have re- vealed that workplace violence, death or resuscitations of patients, caring for trauma victims, and stressful events that occur frequently in this setting contribute to in- creased stress in ED workers (Healy & Tyrrell, 2011; Von Rueden et al., 2010). ED nurses must deal with unpre- dictable events, which may include death, violence, and overcrowding. However, little evidence has emerged to identify factors that are associated with ED nurses’ de- mographics and work-related characteristics contributing to their CF, CS, and burnout levels. Identifying factors that may predict CF and burnout, as well as recognizing factors that improve satisfaction at work, may be useful in retaining ED nurses and developing strategies to sup- port them to provide excellent care without compromis- ing their own health and happiness.

Conceptual Framework

A number of theoretical frameworks were applied to guide studies related to CS, CF, and burnout, such as Maslow’s theory of hierarchy of needs and Watson’s the- ory of human caring (Burtson & Stichler, 2010). A most significant theoretical model developed by Figley (2002) was the stress-process framework. This model was de- veloped based on factors that contribute to CF. Figley discovered that CF develops as a result of a caregiver’s exposure to his or her patients’ experiences joined with his or her natural empathy. Later on, Stamm (2010) ap- plied the CS-CF model to the development of the Pro- QOL scale. The CS-CF model illustrates a theoretical path analysis of positive outcomes (CS) and negative outcomes (CF) of helping those who have experienced traumatic stress.

Based on Stamm’s (2010) theoretical path analysis di- agram, a conceptual framework related to CS, CF, and burnout among ED nurses was developed to guide this study. The researchers believe that individual and orga- nizational characteristics may contribute to and have an influence on the development of CS, CF, and burnout. Several variables were identified according to literature reviews. The demographic independent variables were age and gender. The work-related independent variables were level of education, years in profession, hours of work per week, length of shift, years as an ED nurse, and manager support. The dependent variables included CS, CF, and burnout.

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Hunsaker et al. Compassion Fatigue, Satisfaction, and Burnout

Methods

Sample and Population

This cross-sectional study used a nonexperimental, descriptive, and predictive design. The target population for this study was registered nurses (RNs) who worked in EDs throughout the United States. The inclusion criteria for participation were: (a) work at least 8 hr per week in the ED, (b) interact directly with ED patients at least 8 hr per week, and (c) have at least 1 year of experience in the ED. The rationale for including a minimum of at least 1 year of experience in the ED and working at least 8 hr per week was the consideration of having experience and ex- posure frequently enough to traumatic events that con- tribute to the development of CF and burnout. According to a list of ED nurse members with mailing addresses throughout the United States provided by the Emergency Nurses Association (ENA), a purposive sampling was used to recruit the total 1,000 ED nurses in this study.

Data Collection Procedure

Approval from the institutional review board of the university was obtained prior to any data collection. The survey packet, including a letter of explanation, an informed consent letter, a copy of the demographic ques- tionnaire, and a copy of the ProQOL version 5 (ProQOL 5) scale, was mailed to each potential participant. The participants returned the surveys to the researchers in a provided self-addressed stamped envelope. In order to maximize the response rate, two follow-up postcard reminders were sent to all 1,000 potential participants at 2-week and 6-week intervals, respectively, from the original survey mailing date. The researchers took every precaution possible to protect the anonymity and privacy of the individuals. The survey was answered anonymously and kept confidential in reporting the results of the study by removing identifying information. To protect confidentiality, all data were numerically coded and accessible only by the researchers.

Instrumentation

The survey used in this study included the ProQOL 5 scale and a set of demographic questions developed by the researchers. The demographic questions included in- formation about the ED nurses’ education level, years in nursing profession, typical shift length, age, etc. The ProQOL is a 30-item self-report survey that includes three subscales: CS, CF, and burnout (Figley & Stamm, 1996). Testing for convergent and discriminant validity have demonstrated that each scale measures different constructs (Stamm, 2010). Each subscale is distinct, and the results of each subscale cannot be combined to give

a single significant score. Stamm (2010) reported psy- chometric properties with an α reliability ranging from .84 to .90 on the three subscales. The interscale correla- tions showed 2% shared variance (r = −.23; co-σ = 5%; N = 1,187) with CF and 5% shared variance (r = −0.14; co-σ = 2%; N = 1,187) with burnout. Each subscale has 10 question items and uses a 5-point Likert scale scoring from 1 = never to 5 = very often (Stamm, 2010). Stamm (2010) has previously established the construct validity and reliability of the ProQOL. The scores of the ProQOL for each subscale were totaled using Stamm’s validated levels: a CS score of 22 or less denotes low levels of CS, a score of 23–41 indicates average levels, and 42 and above suggests high levels of CS. For CF and burnout, a score of 22 or less indicates low levels, 23–41 indicates average levels, and a score of 42 and higher reveals high levels of CF and burnout.

The ProQOL tool was first developed in 1995 and has been used, revised, and updated over time. The ProQOL 5 was used to examine the prevalence of CS, CF, and burnout among ED nurses in this study. Cronbach’s α co- efficients of internal consistency reliability of the ProQOL 5 for this study were .96 for the total scale, .92 for the CS subscale, .79 for the CF subscale, and .82 for the burnout subscale.

Data Analysis

All of the data were entered into and analyzed by the Statistical Package for the Social Science (SPSS) for Win- dows, version 21.0 (SPSS Inc., Chicago, IL, USA). Item means, standard deviations, medians, and percentages of the descriptive statistics were computed for the level of CS, CF, and burnout. A series of Pearson r correlation, t test, and one-way analysis of variance (ANOVA) were used to examine the associations between demograph- ics, work-related characteristics, and the level of CS, CF, and burnout. The α level was set at .05 for statistical significance.

Multiple regression was employed to determine which variables of demographics and work-related character- istics contributed to the variation of the level of CS, CF, and burnout. Using seven selected independent variables to run a multiple regression, this study needed a minimum sample size of 153 subjects to achieve 95% power and a medium effect size (.15) at α = .05.

Results

Demographic Characteristics

Of the 1,000 surveys mailed to ED nurses nation- wide, 284 were returned, representing a 28% response rate. Because six participants worked fewer than 8 hr

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Compassion Fatigue, Satisfaction, and Burnout Hunsaker et al.

per week, their results were removed from data analysis, leaving the total sample number at 278. The participants of the study were primarily women (n = 243, 87.4%), White (n = 248, 89.2%), and married (n = 190, 68.3%). The mean age was 44 years (SD = 11.47; range = 24–74 years). Years working as a nurse ranged from 1 to 48 (M = 17.58; SD = 12.67). The mean length of years working in the ED was 13.01 (SD = 9.89; range = 1–40). The partici- pants’ educational background varied from diploma (n = 86, 30.9%) to MSN/doctoral degree (n = 55, 19.8%), with the largest number holding a bachelor’s degree (n = 137, 49.3%). Most of the participants worked 12-hr shifts (n = 213, 77.2%).

Prevalence of CS, CF, and Burnout

Research question 1 was “What is the prevalence of CS, CF, and burnout among ED nurses?” Descriptive statistics were used to calculate means, standard deviations, and percentages for CS, CF, and burnout. The mean scores for the level of CS, CF, and burnout among ED nurses were 39.77 (SD = 6.32), 21.57 (SD = 5.44), and 23.66 (SD = 5.87), respectively. According to Stamm’s (2010) inter- pretation, 56.8% of the ED nurses fell into the average level of CS (score of 23–41), 65.9% of the ED nurses were in the low level of CF (score of 22 or less), and 54.1% of the ED nurses were in the average level of burnout (score of 23–41).

Associations Between Demographics, CS, CF, and Burnout

Research question 2 was “What demographic charac- teristics such as age and gender are associated with the prevalence of CS, CF, and burnout among ED nurses?” The Pearson r correlation and t test were used to ex- amine the prevalence of CS, CF, and burnout related to the demographic variables of age and gender. The results showed that the older the nurse was at the time of taking the survey, the higher the level of CS (r = .260, p = .001). The younger the nurse was at the time of taking the sur- vey, the higher the burnout score (r = −.191, p = .002) and the CF score (r = −.134, p = .027). While compar- ing the difference in the level of CS, CF, and burnout be- tween male and female nurses, no statistical significance was found.

Associations Between Work-Related Characteristics, CS, CF, and Burnout

The Pearson r correlation, t test, and one-way ANOVA were used to answer research question 3, “What work-related characteristics such as educational level,

years in nursing, shift length, years worked in the ED, hours worked per week, and having adequate manager support are significantly associated with the prevalence of CS, CF, and burnout among ED nurses?” Scheffe post- hoc comparisons were used to compare if significant dif- ferences were found in the groups. It was discovered that the CS level among nurses who held graduate and doctor- ate degrees was higher than among nurses with diploma or ADN and BSN degrees (F = 5.48, p = .005). More- over, those who had master’s or doctorate degrees had significantly lower burnout levels than did nurses who held the other degrees (F = 4.92, p = .008). No signifi- cant differences in CF between educational backgrounds were identified in this study.

The relationship between years as a nurse, years as a nurse working in the ED, average hours worked per week, and level of CS, CF, and burnout was computed us- ing Pearson’s bivariate correlations, respectively. The re- sult indicated that the more years a nurse has practiced, the higher the level of CS (r = .269, p = .001) and the lower the level of burnout (r = −.182, p = .003). There was no statistically significant relationship between years that a nurse has practiced and CF level. Additionally, the more years that nurses worked in the ED, the higher the level of CS (r = .264, p = .001) and the lower the level of burnout (r = −.183, p = .003) they had. There was no significant relationship between years a nurse worked in the ED and level of CF. Also, no significant relationships between average hours that ED nurses worked per week and level of CS, CF, and burnout were identified.

While comparing the difference in the level of CS, CF, and burnout between length of shifts and the support of managers, respectively, t tests were computed to find that nurses who worked 8- to 10-hr shifts had a higher level of CS (t = 2.47, p = .014) and a lower level of burnout (t = −3.34, p = .001) than did nurses who worked 12-hr and “other” shifts, respectively. No significant dif- ference in CF was found between nurses who worked 8- to 10-hr shifts and those who worked 12-hr and other shifts. Regarding the support received from the manager, nurses who perceived receiving support from the man- ager had a higher level of CS (t = 3.99, p = .001) and a lower level of CF (t = −2.89, p = .005) and burnout (t = −5.64, p = .001).

Factors for Predicting the Level of CS, CF, and Burnout

In order to identify which significant variables of demographics and work-related characteristics can predict the level of CS, CF, and burnout, multiple regression was employed for research question 4. Seven significant variables of demographics and work-related

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Hunsaker et al. Compassion Fatigue, Satisfaction, and Burnout

Table 1. Summary of Multiple Regression for Predicting the Compassion Satisfaction, Compassion Fatigue, and Burnout in Emergency Department nurses (N =237)

Dependent variable/ Adjusted R Standardized

Blocka variable entered R2 square change F coefficient β t

Compassion satisfaction

1 Age .040 .044 .239 3.90∗∗

2 Manager support .122 .085 17.36∗∗ .292 4.77∗∗

Compassion fatigue

1 Age .006 .011 −.126 −1.96 2 Manager support .055 .053 7.76∗∗ −.230 −3.59∗∗

Burnout

1 Age .013 .017 −.166 −2.74∗ 2 Manager support .148 .138 21.26∗∗ −.373 −6.15∗∗

a Stepwise solution was used. ∗p< .05; ∗∗p < .01.

characteristics identified from research questions 2 and 3 were entered into the regression equation using the stepwise solution. As shown in Table 1, age (β = .239, p < .01) and manager support (β = .292, p < .01) signif- icantly and positively predicted the level of CS, whereas only manager support (β = −.230, p < .01) significantly and negatively predicted the level of CF. In addition, age (β = −.166, p < .05) and manager support (β = −.373, p < .01) significantly and negatively predicted the level of burnout. Apparently, manager support was the major predictor contributing to the level of CS (8.5%, adjusted R2 = .122, F = 17.36, p < .01), CF (5.3%, adjusted R2 = .055, F = 7.76, p < .01), and burnout (13.8%, adjusted R2 = .148, F = 21.26, p < .01).

Discussion

Level of CS, CF, and Burnout

In this study, the results indicated a low to average level of CF and burnout among ED nurses, which is not consistent with the results of the two previous stud- ies (Dominguez-Gomez & Rutledge, 2009; Hooper et al., 2010) related to ED nurses who perceived significantly higher levels of these two negative aspects. Due to this study’s participants being members of the ED professional organization, perhaps they were more involved and in- vested in their careers than the non-ENA counterparts.

Compassion satisfaction occurs when the care provider feels a sense of connection with his or her patients and feels a sense of achievement in his or her work (Stamm et al., 2010). The positive aspect of caring for others and providing support for those in need may outweigh the difficulties of the job. Although the CS level among ED nurses was average in this study, the possible reason might be that this group’s nurses were more senior and encompassed a more confident outlook of CS toward the

positive aspects of nursing. Low levels of CS are a known factor in nursing turnover in the ED (Sawatzky & Enns, 2012). Not only should the nursing profession pursue the likely causes of CF, but it must further investigate the factors that contribute to CS in ED nurses.

Demographic-Related Characteristics and CS, CF, and Burnout

CF is less prevalent with increasing age and working experience (Hill & Stephens, 2003). Correspondingly, this current study demonstrated that older nurses had higher CS scores, as well as lower CF and burnout levels. Specific challenges are present for new, younger nurses. Not only are they inexperienced and challenged to learn new in- formation daily, but they must also maintain their stride in a busy work environment where speed and skill are critical. The ED leadership and experienced senior nurses must provide a supportive and collaborative environment for newer nurses. Perhaps a formal mentoring program would be helpful to pair a new ED nurse with a more established nurse.

Work-Related Characteristics and CS, CF, and Burnout

Crucial factors that surfaced in this study as significant elements in ED nurses who exhibited higher CS levels and lower burnout levels included increased years in the profession, more years in the ED, a higher level of edu- cational background, shorter shift length, and adequate manager support at work. The above-mentioned findings are consistent with previous research in which the influ- ence of a positive work environment and more working experience leads to more satisfied nurses (Friedrich, Prasun, Henderson, & Taft, 2011; Hoar, 2011; Li, Early,

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Compassion Fatigue, Satisfaction, and Burnout Hunsaker et al.

Mahrer, Klaristenfeld, & Gold, 2014; Torangeau, Cum- mings, Cranley, Ferron, & Harvey, 2010). The more attentive and involved ED managers are, the higher the CS scores of their nurses. Healthy, happy work environments that include manager support, shared decision making, and recognizing nurses’ contributions to practice are precisely associated with increased nurse retention, reduced staff turnover, and increased job satisfaction (American Organization of Nurse Executives, 2003; Leiter & Laschinger, 2006).

Factors for Predicting the Level of CS, CF, and Burnout

This study identified specific demographic and work- related characteristics that influence a nurse’s level of happiness and satisfaction, as well as CF and burnout at work. A critical modifiable feature related to predict the level of CS, CF, and burnout was manager support. While influences such as age are not changeable, the nursing leaders might acknowledge that younger nurses may be at risk for developing burnout and CF at work.

A key concern is that EDs are becoming increasingly busier and more stressful. Between 1997 and 2007, total annual visits to U.S. EDs increased from an estimated 94.9 million to an estimated 116.8 million (Tang, Stein, Hsia, Maselli, & Gonzales, 2010). According to the Agency for Healthcare Research and Quality, ED visits in the United States are outpacing the growth of the general popula- tion. In 2011, there were more than 131 million total ED visits in the United States (Weiss, Wier, Stocks, & Blan- chard, 2014). Certainly, these statistics are going to make an ED nurse’s job more challenging. The prevalence of CF and burnout will most likely continue to grow unless further strategies and solutions are made available to de- crease the severity. Compassion fatigue and burnout may have severe professional consequences, such as affecting the ability to care for others (Boyle, 2011; Sabo, 2011; Wisniewski, 2011) and affecting nurse retention, patient safety, and patient satisfaction (Burtson & Stichler, 2010; Hooper et al., 2010; Potter et al., 2010).

A positive, supportive manager is more likely to have nurses who have high levels of CS, as well as lower levels of burnout. Nurse leaders must become cognizant of nurses who are at higher risk for CF and burnout and have a positive relationship with them in order to appropriately counsel and communicate with them. These leaders are crucial in the successful development of strong, positive, professional practice environments (Laposa, Alden, & Fullerton, 2003). By building a sup- portive environment, perhaps the early recognition of CF and burnout in ED nurses and providing adequate

manager support may aid in the retention of knowledge- able, caring, experienced nurses.

Limitations and Recommendations

One limitation of this study was a small sample size with a low response rate. To reach more subjects, a mailed survey was utilized. However, out of 1,000 sur- veys mailed to ENA members, only 284 were returned. A disadvantage of a mailed survey is that prospective subjects may not feel the topic is pertinent to them and they may not participate. Another shortcoming of send- ing the survey to ENA members is that the results may not be generalizable to all ED nurses. Not all ED nurses belong to this professional organization; involvement and membership is voluntary. A second limitation is that the prevalence of CS, CF, and burnout was measured at a single point in time, and it is possible that an individ- ual’s assessment of his or her perceptions changes over time due to individual work-related conditions (Stamm, 2010). Moreover, ED nurses’ perceptions of CS, CF, and burnout are subjective, and their perceptions may be affected by variables that were not examined in this study.

Further research could lead to the development of pro- grams that help ED nurses manage the strain of caring for difficult patients. Additional exploration may be directed toward examining coping strategies that may prevent the development of CF and burnout. Future research con- centrating on a more detailed view of the finding that older and more experienced nurses had higher levels of CS would be very beneficial for the nursing profession. It may be possible that more experienced nurses could be the key in assisting newer, younger nurses to find strate- gies that can improve their quality of life at work and perhaps prevent burnout and CF.

Conclusions

Overall results of this study revealed average to low levels of CF and burnout and average to high levels of CS among this group of ED nurses. Demographic and work- related characteristics, such as age, educational back- ground, and years as a nurse, influenced the prevalence of CS, CF, and burnout among ED nurses. A key predic- tor, manager support, predicted the CS, CF, and burnout in this study. An increased awareness of CF and burnout may aid in improved ED nurse job satisfaction, and there- fore, increased quality patient care. It is imperative that the nursing profession address support, strategies, and so- lutions that may facilitate a higher level of work satisfac- tion among ED nurses.

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Clinical Resources � Professional quality of life information, including

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proqol.org � Information for caregivers: www.compassion-

fatigue.org � Information and articles for post-traumatic

stress syndrome survivors and their caregivers: www.giftfromwithin.org

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The post Factors That Influence the Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in Emergency Department Nurses Stacie Hunsaker, MSN, CPEN, CEN1, Hsiu-Chin Chen, PhD, RN, EdD2, Dale Maughan, PhD, RN3, & Sondra Heaston, MS, NP-C, CEN, CNE4 appeared first on Infinite Essays.

Interprof Org & Sys Leadership

/in /by

NURS – 6053N: Interprof Org & Sys Leadership

DISCUSSION #1

Organizational Foundations

As you strive to grow in your leadership skills and abilities, you will find that the context in which you work influences your motivation and areas of focus. In a similar vein, your commitment to developing professionally can contribute toward organizational effectiveness.

To that end, it is critical to recognize the importance of organizational culture and climate. In particular, through this week’s Learning Resources, you may consider several questions: How do an organization’s mission, vision, and values relate to its culture? What is the difference between culture and climate? Moreover, how are culture and climate manifested within the organization?

For this Discussion, you explore the culture and climate of your current organization or one with which you are familiar. You also consider decisions and day-to-day practices and the way they relate to the organization’s mission, vision, and values.

 

To prepare:

· Review the information related to planning and decision making in health care organizations presented in the textbook, Leadership Roles and Management Functions in Nursing: Theory and Application. Consider how planning and decision making relate to an organization’s mission, vision, and values, as well as its culture and its climate.

· Familiarize yourself with the mission, vision, and values of your organization or one with which you are familiar. Consider how the statements and actions of leaders and others within the organization support or demonstrate the organizational mission, vision, and values. In addition, note any apparent discrepancies between word and deed. Think about how this translates into expectations for direct service providers. Note any data or artifacts that seem to indicate whether behaviors within the organization are congruent with its mission, vision, and values.

· Begin to examine and reflect on the culture and climate of the organization. How do culture and climate differ?

· Why is it important for you, as a master’s-prepared nurse leader, to be cognizant of these matters?

 

Post a description of your selected organization’s mission, vision, and values. Describe relevant data, or artifacts, words, and actions of leaders and others in the organization that support, or perhaps appear to contradict the organization’s mission, vision, and values statement. In addition, discuss the organization’s culture and its climate, differentiating between the two. Explain why examining these matters is significant to your role as a nurse leader.

 

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 1, “Decision Making, Problem Solving, Critical Thinking, and Clinical Reasoning: Requisites for Successful Leadership and Management”

 

Chapter 1 provides information relevant to this week’s Discussion and serves as a foundation for topics explored in future weeks of the course. The authors note that decision making, problem solving, critical thinking, and critical reasoning are integral to both leadership and management and beneficial as one examines leadership and management issues. As you read this chapter, focus primarily on the “Decision Making in Organizations” section.

 

· Chapter 7, “Organizational Planning”

 

This chapter introduces planning and highlights some of the trends that are likely to impact health care organizations now and in the future. It also addresses vision and mission statements, which are essential for guiding planning and decision making in health care settings.

 

· Chapter 12, “Organizational Structure”

 

This chapter addresses organizational culture.

 

Business Dictionary.com. (2013) Organizational culture: Definition. Retrieved from http://www.businessdictionary.com/definition/organizational-culture.html

 

Nelson, W. A., & Gardent, P. B. (2011). Organizational values statements. Healthcare Executive, 26(2), 56–59.

Retrieved from the Walden Library databases.

 

This article focuses on the impact that organizational values statements have on an organization’s mission. For employees to follow value statements, leaders must effectively model those values day in and day out.

Plath, D. (2013). Organizational processes supporting evidence-based practice. Administration in Social Work, 37(2), 171–188. doi:10.1080/03643107.2012.672946

Retrieved from the Walden Library databases.

Rai, G. S. (2013). Job satisfaction among long-term care staff: Bureaucracy isn’t always bad. Administration in Social Work, 37(1), 90–99. doi:10.1080/03643107.2012.657750

Retrieved from the Walden Library databases.

 

Watkins, M. (2013, May). What is organizational culture? Retrieved from https://hbr.org/2013/05/what-is-organizational-culture

 

This site offers several descriptions of organizational culture. These perspectives provide the kind of holistic, nuanced view of organizational culture that is needed by leaders in order to truly understand their organizations—and to have any hope of changing them for the better.

 

Online Assessments

Note:  Results from the following assessment are required for the course.

 

Keirsey Temperament Sorter (KTS-II). (n.d.). Retrieved from http://www.keirsey.com/

 

Please complete the online assessment and receive a free mini report. Additionally, more extensive reports are available for purchase and are optional. You should complete the Keirsey Temperament Sorter assessment early in the course so you will be prepared to discuss the results in Week 9.

 

Required Media

 

Laureate Education (Producer). (2012e). Foundations of an organization and organizational assessment. Baltimore, MD: Author.

 

In this week’s media presentation, experts from a diverse group of health care organizations share insights on how an organization’s mission, vision, and values influence its daily practices.

 

Laureate Education (Producer). (2012c). Factors that influence organizational cultures: Coastal Medical Associates, Salisbury, MA. Baltimore, MD: Author.

Laureate Education (Producer). (2012d). Factors that influence organizational cultures: Huntington Hospital, Pasadena, CA. Baltimore, MD: Author.

Optional Resources

You may find the following online assessments useful as you proceed through the course:

 

Appraisal 360. (n.d.). Retrieved from http://www.appraisal360.co.uk/

 

HumanMetrics. (n.d.). Jung Typology Test. Retrieved from http://www.humanmetrics.com/cgi-win/jtypes2.asp

 

Leadership-Tools.com. (2012). 360 degree feedback leadership tool. Retrieved from http://www.leadership-tools.com/360-degree-feedback-leadership.html

 

Union Rescue Mission. (Executive Producer). (2012). Stories from Skid Row [Video file]. Retrieved from http://urm.org/solution/stories-from-skid-row/

 

DISCUSSION # 2

Transitioning From Closed to Open Systems

How do effective nurse leaders and others approach problem solving and decision making in organizations? As suggested in this week’s Learning Resources, systems theory provides a valuable way to assess situations and prepare to address problems.

For this week’s Discussion, you identify an issue or process that could be improved and apply knowledge and strategies related to systems theory.

 

To prepare:

· Review the information presented in this week’s Learning Resources on systems theory and the difference between open and closed systems.

· Reflect on the practices and processes with which you are familiar in your organization. Identify one problematic issue or process that could be improved.

· Consider the problem from a closed-system perspective. Then think about how the issue or process you selected could be addressed by viewing it from an open-system perspective. How would the transition from a closed- to an open-system view help you and others to address the problem and improve outcomes?

 

Post a description of the problem that you identified in your selected organization. Explain the problem from a closed-system perspective. Then, describe how the problem could be addressed by viewing it from an open-system perspective, and explain how this modification would help you and others improve health care outcomes.

 

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Review Chapter 7, “Organizational Planning”

 

See especially Figure 7.1.

 

· Chapter 8, “Planned Change”

 

· Organizational Change Associated With Nonlinear Dynamics

 

Read this section of Chapter 8 on planned change. Consider the role of leaders in effectively managing planned change.

 

· Chapter 12, “Organizational Structure”

 

· “Organizational Culture”

 

There are many structures organizations take, and these structures influence how the organization functions. This chapter discusses many different organizational structures and provides insights into how these structures influence the change process, as well as leadership and management.

 

Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Improving the safety and quality of patient care by recognizing and improving the systems in which we work. Retrieved from http://www.ahrq.gov/downloads/pub/advances2/vol2/Advances-Johnson_90.pdf

 

This article addresses the importance of systems-based practice (SBP) in health care workplaces. The authors state that SBP knowledge is one of six core competencies that physicians have to know in order to provide safe and proper care for their patients.

 

Manley, K., O’Keefe, H., Jackson, C., Pearce, J., & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: Organisational transformation using practice development methodology. FoNS 2014 International Practice Development Journal 4-(1).

Retrieved from the Walden Library databases.

Meyer, R. M., & O’Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828–2838.

Retrieved from the Walden Library databases.

 

In this article, the authors examine the effects of nursing services delivery theory in large-scale organizations. Among other benefits, this theory supports multilevel phenomena and cross-level studies, and it can guide future research and the management of nursing services.

Optional Resources

 

Glennister, D. (2011, July). Towards a general systems theory of nursing: A literature review. Paper presented at the 55th Annual Meeting of the International Society for the System Sciences, Hull, United Kingdom. Retrieved from http://journals.isss.org/index.php/proceedings55th/article/viewFile/1717/569

 

Hayajneh, Y. (2007). Management for health care professionals series: Systems & systems theory. Retrieved from http://www.hayajneh.org/a/readings/Systems-Theory.pdf

 

 

DISCUSSION # 3

Organizational Structures and Leadership

In most health care settings, it is unlikely that you would hear the terms “ad hoc” or “matrix” as you walk down the hallway. Although it is helpful for any organization to delineate pathways of responsibility and authority in an organizational chart, the lived experience of these structures is most apparent through the inquiries and behaviors people share everyday.

In your own workplace, you may find yourself wondering, who should I turn to when I have a practice dilemma? or Where can I go to learn more about this issue? These questions speak to the intricacies of formal and informal organizational structure and leadership.

 

To prepare:

· Review the information presented in Chapter 12 of the course text. Focus on the information about formal versus informal structure as well as the types of organizational structures.

· Consider the overall structure or hierarchy of your organization or one with which you are familiar. Which organizational structure best describes your organization—line (or bureaucratic), ad hoc, matrix, service line, or flat? Note: It is possible to have a combination of structures in one organization. Is decision making centralized or decentralized in this organization?

· What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and informal leadership.

· Reflect on how decisions are made within a specific department or unit. Which stakeholders provide input or influence the decision-making process? Assess this in terms of formal and informal leadership.

· To support your analysis, consider your own experiences and investigate these matters by speaking with others at the organization and reviewing available documents. Be sure to consider how the concepts of formal and informal structure and leadership relate to one another and are demonstrated in the organization and in the particular department or unit.

Post a depiction of your organization’s formal structure, indicating whether it is best described as line, ad hoc, matrix, service line, flat, or a combination. Describe how decisions are made within the organization and within one department or unit in particular, noting relevant attributes of centralized/decentralized decision making. Explain the influence of formal and informal leadership on decision making within this department or unit.

 

Learning Resources

 

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 2, “Classical Views of Leadership and Management”

 

The information introduced through this chapter relates to this week’s Discussion, and will also be referred to in future weeks of the course.

 

· Chapter 3, “Twenty-First Century Thinking About Leadership and Management”

 

This chapter examines new thinking about leadership and management and how this may influence the future of nursing.

 

· Review Chapter 12, “Organizational Structure”

Allmark, P., Baxter, S., Goyder, E., Guillaume, L. & Crofton-Martin, G. (2013), Assessing the health benefits of advice services: Using research evidence and logic model methods to explore complex pathways. Health & Social Care in the Community, 21, 59–68. doi:10.1111/j.1365-2524.2012.01087.x

 

This manuscript examines causal pathways between the provision of advice services and improvements in health. It may also be useful to commissioners and practitioners in making decisions regarding development and commissioning of advice services.

Downey, M., Parslow, S., & Smart, M. (2011). The hidden treasure in nursing leadership: Informal leaders. Journal of Nursing Management, 19(4), 517–521.

Retrieved from the Walden Library databases.

 

Informal leaders can have a strong impact in the workplace. This article explores the value informal leaders can provide.

Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., & Charns, M. P. (2014). Leadership for evidence-based practice: strategic and functional behaviors for institutionalizing EBP. Worldviews on Evidence-Based Nursing, 11(4), 219–226. doi:10.1111/wvn.12044

Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2012a). Diverse organizational structures. Baltimore, MD: Author.

 

DISCUSSION # 4

Critiquing a Change Effort

As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.

To prepare:

· Review Chapters 7 and 8 in the course text. Focus on the strategies for planning and implementing change in an organization, as well as the roles of nurses, managers, and other health care professionals throughout this process.

· Reflect on a specific change that has recently occurred in your organization or one in which you have worked previously. What was the catalyst or purpose of the change?

· How did the change affect your job and responsibilities?

· Consider the results of the change and whether or not the intended outcomes have been achieved.

· Was the change managed skillfully? Why or why not? How might the process have been improved?

By Day 3

Post a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. Explain the rationale for the change, and whether or not the intended outcomes have been met. Assess the management of the change, and propose suggestions for how the process could have been improved.

 

Learning Resources

 

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Review Chapter 7, “Strategic and Operational Planning”

· Chapter 8, “Planned Change”

 

This chapter explores methods for facilitating change and the theoretical underpinnings of implementing effective change

McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P. Brown, C.,  Baumgart, A.,  Nyström, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change. Quality Management in Health Care, 23(4), 254–267 doi: 10.1097/QMH.0b013e31828bc37d

 

An international group of investigators explored the issues of organizational culture and Quality Improvement (QI) in different health care contexts and settings. The aim of the research was to examine if a core set of organizational cultural attributes are associated with successful QI systems.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management – UK, 20(1), 32–37. doi: 10.7748/nm2013.04.20.1.32.e1013

Retrieved from the Walden Library databases.

Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration, 43(2), 69–72. doi:10.1097/NNA.0b013e31827f20a9

Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2012g). Organizational dynamics: Planned change and project planning. Baltimore, MD: Author.

Optional Resources

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 9, “Time Management”

Batras, D., Duff, C., & Smith, B. J. (2014). Organizational change theory: implications for health promotion practice. Health Promotion International, Retrieved from MEDLINE with Full Text, EBSCOhost

 

This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners.

 

 

 

DISCUSSION # 5

Groups

The dynamic and increasingly complex world of health care often requires nurses to work collaboratively on interprofessional teams. In the group environment, individuals with unique skills and expertise come together to focus on a common goal; however, groups must become cohesive before they can become effective.

Your experiences working with groups—whether you perceive them as positive, negative, or neutral—can be used to facilitate insight and development. Health care, with its focus on interprofessional teamwork and collaboration, offers ample opportunities and an imperative for continuous learning.

For this Discussion, you focus on strategies for facilitating the group process.

 

To prepare:

· Review the information in this week’s Learning Resources regarding the stages of group formation, problematic roles individuals play in groups, and strategies for facilitating and maintaining positive group collaboration. In particular, review Learning Exercise 19.14 of the course text.

· Reflect on various groups with which you have been or are currently involved. Select one specific group to analyze for the purposes of this Discussion. Identify the purpose or task that the group is or was meant to perform.

· Consider the four stages of group formation (forming, storming, norming, and performing). How would you describe the progression between stages? Is there a stage in which you believe your group is or was “stuck”?

· Consider the task or group-building role you normally play in a group setting. How could you apply the information from the Learning Resources to improve your group participation and facilitation, as well as the functioning of the group as a whole?

· In addition, think about which individuals within your group (including yourself) may fall into problematic roles such as the Dominator, the Aggressor, or the Blocker. How have you and your group members addressed the enactment of these roles and its impact on interactions? With information from the Learning Resources in mind, what strategies would you apply now or going forward?

 

Post a description of a group with which you have been or are currently involved. Assess where the group is in terms of the four stages of group formation. If you are reflecting on a past experience, explain if your group moved through all four stages. Describe the task or group-building role you typically play, or played, in this group. Then, explain what strategies you, as a leader, can apply to better facilitate the group process and address any problematic individual roles in the group.

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 19 “Organizational, Interpersonal, and Group Communication”

 

Chapter 19 covers many aspects of the communication process, including group communication. As you read this chapter, focus on the stages of group development (forming, storming, norming, performing) and group dynamics (group task roles, group building and maintenance roles, problematic roles). Consider how you can apply these concepts as you engage in group work.

Adams, S. L., & Anantatmula, V. (2010). Social and behavioral influences on team process. Project Management Journal, 41(4), 89–98.

Retrieved from the Walden Library databases.

 

In this article, the authors report on the effects of individual behaviors on project teams and provide a model that identifies the progress of social and behavioral development. For each stage, the authors provide recommendations for managing team members.

Chun, J. S., & Choi, J. N. (2014). Members’ needs, intragroup conflict, and group performance. The Journal Of Applied Psychology, 99(3), 437–450. doi:10.1037/a0036363

 

This study theorizes and empirically investigates the relationships among the psychological needs of group members, intragroup conflict, and group performance.

Haynes, J., & Strickler, J. (2014). TeamSTEPPS makes strides for better communication. Nursing,44(1), 62–63. doi:10.1097/01.NURSE.0000438725.66087.89

 

Teamwork and communication are the focus of this article and include the use of the TeamStepps model for Quality Improvement.

Hogg, M. A., Van Knippenberg, D., & Rast, D. E., III. (2012). Intergroup leadership in organizations: Leading across group and organizational boundaries. Academy of Management Review, 37(2), 232–255.

Retrieved from the Walden Library databases.

 

The authors of this article introduce a theory on intergroup leadership that is based on social theory and intergroup relations. This theory purports that intergroup performance relies on a leader’s capacity to create intergroup relational identities.

Kaufman, B. (2012). Anatomy of dysfunctional working relationships. Business Strategy Series, 13(2), 102–106.

Retrieved from the Walden Library databases.

 

Kaufman examines the impact of dysfunctional working relationships in an organization. She provides managers with tips that will allow them to identify early warning signs of dysfunctional behavior and to minimize its effects in the workplace.

 

Mind Tools. (2012). Forming, storming, norming and performing: Helping new teams perform effectively, quickly. Retrieved from http://www.mindtools.com/pages/article/newLDR_86.htm

 

This web article discusses stages of team development and provides strategies for moving through the early stages effectively.

 

Mind Tools. (2009). Team charters. Retrieved from http://www.mindtools.com/pages/article/newTMM_95.htm

 

This web page features helpful information about team charters. Before you begin work on the Week 7 Assignment, you may find it helpful to create a charter that can guide your group’s work together.

 

Ortega, A., Sánchez-Manzanares, M., Gil, F., & Rico, R. (2013). Enhancing team learning in nursing teams through beliefs about interpersonal context. Journal Of Advanced Nursing, 69(1), 102–111. doi:10.1111/j.1365-2648.2012.05996.x

 

This article examines the relationship between team-level learning and performance in nursing teams, and the role of beliefs about the interpersonal context in this relationship.

 

Table Group. (n.d.). Retrieved July 24, 2012, from http://www.tablegroup.com/

 

Patrick Lencioni is recognized worldwide for his work on teams. Under the Patrick Lencioni link, download and read articles related to addressing team dysfunctions.

 

Optional Resources

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 16, “Socializing and Educating Staff for Team Building in a Learning Organization”

 

DISCUSSION # 6

Power Dynamics

Bring to mind a nurse whose words, behaviors, or reputation convey power. What is it about this individual that suggests power? How does your perception of this person relate to your view of yourself as a nurse leader and the image you associate with nursing?

Learning Resources

 

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 13, “Organizational, Political, and Personal Power”

 

Chapter 13 delves into different types of power. As you read, consider how you see power demonstrated within your own organization.

Leach, L. S., & McFarland, P. (2014). Assessing the professional development needs of experienced nurse executive leaders. Journal of Nursing Administration, 44(1), 51–62.

Retrieved from the Walden Library databases.

 

McMurry, T. B. (2011). The image of male nurses and nursing leadership mobility. Nursing Forum, 46(1), 22–28.

 

This article discusses the underrepresentation of males in nursing and the advantages and difficulties faced by men in the nursing profession.

 

Rao, A. (2012). The contemporary construction of nurse empowerment. Journal of Nursing Scholarship, 44(4), 396–402.

Retrieved from the Walden Library databases.

Spence Laschinger, H. K., & Fida, R. (2014). New nurses burnout and workplace wellbeing: The influence of authentic leadership and psychological capital. Burnout Research. 1(1), 19–28.

Retrieved from the Walden Library databases.

Tost, L. P. (2015). When, why, and how do powerholders “feel the power”? Examining the links between structural and psychological power and reviving the connection between power and responsibility. Research in organizational behavior, 35, 29–56.

Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2012h). Personal power plan. Baltimore, MD: Author.

 

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