Learning Exercise 1.11
In the case in Learning Exercise 1.11 in page 27 where I had to assume the role of a newly graduated nurse finishing a 3 month probation period at a first job in acute care nursing (as presented in the book) was a rather complex one because there were a lot of factors and variables involved, some of which were even unique to the situation and not commonly encountered by normal people. Considering all these findings, it would be unwise to solve the problem using a systematic or standards-based problem solving model because as mentioned, the factors and variables were unique to the situation and so the outcomes being promised by the currently available systematic approaches to solve the problem may not yield the same outcomes.
On the other hand, using a decision making style that is based more on intuition can be unreliable because common sense and intuition can often be considered as a good recipe for creating a disaster especially when it comes to nursing practice. There is more to life being a nurse than just being driven and guided by common sense and intuition. For this case, I think a combination of intuition and experience (i.e. systematic way of decision making) would be necessary. The real question however, is how large a portion of the resulting decision making style would be comprised of the systematic way and how large would be comprised of the intuitive way. The safest combination would be a 50-50 one. However, it might be a good idea to try tweaking this partition or combination until the most perfect mixture of being a systematic and intuitive decision maker gets developed.
There are numerous styles and or ways how people make decisions . Often, the type of decision-making style one makes depend on his personality and or approach as a manager regardless whether the organization that the person making the vital decision is related to the nursing and or healthcare field or otherwise. Often the style that a person would most likely use when it comes to decision making depends on the personal characteristics and qualities that that person has. There are different dimensions where people can have differences when it comes to the way they approach decision making. There are people who are more focused on the rational and logical dimension of decision making and there are also those who are more focused on the emotional and social way of doing the same thing. Rarely can one see a person, often a manager (i.e. the decision maker), being able to find and strike the perfect balance between logic and rationality, and emotion and sociality, when it comes to making a decision. The important thing to know at this point is that people take in different inputs differently when it comes to making decisions. A leader of a nursing team who has a low level of tolerance for ambiguity when it comes to making decisions and making things happen, for example, would most likely find (himself) leaning towards the rational and logical dimension of decision making more than the emotional and social one.
Learning Exercise 2.8
There are, in general, four types of decision making styles and these are the autocratic style, democratic style, and the laissez faire style. Each of these decision making styles can be characterized based on their tolerance of ambiguity; their tendency to make impulsive decisions; and the tendency of their decisions to be influenced by the perceptions and ideas of others.
A person who has an autocratic style when it comes to decision making can be characterized by the following qualities: low tolerance for uncertainty and ambiguity, efficiency, logical, and rational when it comes to the way they think. In short, directive decision makers are those who are focused and goal oriented. They tend to focus more on the short term impact of their decisions. Their decision may also change from time to time depending on what the situation calls for. They however, are the ones, who tend to be easily affected by the suggestion and perceptions of others and are in fact more prone to committing decision making mistakes as a result of impulsivity.
Laissez faire types of decision makers are the opposite of the autocratic types. They have a higher level of tolerance for uncertainty and ambiguity because they have a higher level of confidence that the decision they are trying to make is right. They focus more on the facts rather than on the noises (i.e. irrelevant things) that are often present in decision-making situations, hence the term analytic. Unlike autocratic decision makers, laissez faire decision makers let their subordinates have and enjoy a certain level of autonomy .
And lastly, there is the democratic decision makers; these are decision makers who either voluntarily or involuntarily (i.e. subconsciously) practice democracy whenever there are decisions to be made, often regardless whether they are large or small ones. A behavioral decision maker, unlike the other types of decision makers discussed, is one who is open to the suggestions of the other members of the team. They often do it in order to promote teamwork and to encourage everyone in the team or organization to make bigger contributions to the way how the team or organization is being run. Now, when it comes
Considering all these information, I think the best way to solve all the three scenarios being presented in the case would be to become an autocratic decision maker. I think one common problem in all of the three cases is the presence of problematic staff members. In case 1, for example, the staff were forwarding requests they knew were impossible to be granted considering the current situation in the department but they still want the management the grant their request nonetheless. These are situations where an active and more authoritative type of leader and therefore decision maker is necessary. Democracy and even a laissez faire type of leadership and decision making may in fact work well at first but people would tend to become abusive in the long run and such abusive behaviors may later on affect the way how the organization works and functions.
Learning Exercise 3.6
The use of electronic health records is easily becoming one of the hottest trends when it comes to improving nursing and health care quality, productivity, and efficiency. Most hospitals and medical institutions today are starting to migrate from using pen and paper health records to completely paperless ones. Basically, the reason is simple. The developers of electronic health records think that this is the best way to make one of the most important parts of treating a patient, which is documentation, fast, easy, and efficient, from an economic perspective at the very least. Another way to look into this newly established trend in the documentation of patient records is that they were really meant not just to make the process of documenting information about the patients faster so that the hospitals and medical institutions can handle a higher volume of patients but also to improve the quality of health care and services that they, the patients, receive.
All in all, what can be developed would be a situation where everyone wins. The hospital gets to do the one thing that took a lot of its workers’ hours to finish before (i.e. patient documentation) and potentially cut the size of its electronic health record department by a significant percentage because there would not be any need to keep a lot of people in that department because the tasks and responsibilities in their respective job description would already be performed by the new electronic health record servers and computers. The patients, on the other hand, would be able to make sure that they receive a continuous service as far as healthcare is concerned; that they would not have to undergo redundant screening, treatment, and documentation procedures and processes only to encounter similar outcomes (i.e. failures) because electronic health records are meant to be transferrable from one medical institution to another, unless of course the medical institution where the patient got transferred to does not support the use of electronic health records yet.
One of the disadvantages of implementing an electronic health record-based way of keeping and documenting patient records is that they require a lot of changes with the way how things get done in the hospital. For so many years, the hospital staff may have gotten used to using the traditional pen and paper based approach when it comes to record keeping. People are naturally resistive to change; the higher the level of change or the farther from their comfort zone they would be displaced, the higher level of resistance to change would be encountered. This very principle applies to the implementation of a paperless electronic health record system in a hospital or medical institution. Other than this hurdle, however, it is expected that the use of electronic health records in hospitals and medical institutions would have a net positive impact in the nursing and allied medical and healthcare industry by means of improving the efficiency of providing medical and health care and services to patients and promoting the continuity of care, something which is simply not possible with the current traditional pen and paper-based way of keeping patient records and other information.
Cherry, K. (2015). What is Laissez Faire Leadership. The Pros and Cons of the Delegative Leadership Style.
Marquis, B., & Huston, C. (2011). Leadership Roles and Management Functions in Nursing: Theory and Application (Marquis, Leadership Roles and Management Functions in Nursing). LWW; Seventh, North American Edition edition .