Ginny Rogers NUR Unit 3

Ginny Rogers NUR “One person can make a difference And every person must try” - John F. Kennedy

Ginny Rogers NUR Delegation Delegation as defined by the National Council of State Boards of Nursing Delegation involves the transfer of care to a competent individual with authority to do a selected nursing task in situations. If the nurse delegates to a nursing assistant, the nursing assistant is responsible for performing the task: however, the nurse retains responsibility and accountability for the total nursing care of the client.

Ginny Rogers NUR Delegation Starts at the top includes: participation in organizational task forces and committees assignment of duties to complete tasks can empower staff provides an effective mechanism for training

Ginny Rogers NUR Determination of the task, procedure, or function that is to be delegated Available staff Assessment of clients needs Assessment of the potential delegatee’s competency Consideration of the level of supervision available and determination of the level and method of supervision required to assure safe performance Avoidance of delegating practice- pervasive functions of assessment, evaluation, and nursing judgment

Ginny Rogers NUR Barriers To Delegation I can do better myself Lack of ability to direct others Lack of confidence in others Loss of control Aversion to taking risks Fear of criticism Person is already overworked Lack of self-confidence

Ginny Rogers NUR DELEGATING RESPONSIBLY KNOW JOB DESCRIPTION KNOW DELEGATES STRENGTHS, WEAKNESSES, MOTIVATION & PREFERENCES KNOW THE PATIENTS BASED ON NS CARE PLAN USE PROFESSIONAL JUDGMENT CONTINUE SUPERVISION, FEEDBACK

Ginny Rogers NUR Special Situations in Delegation You are the manager over your friend You are manager over older employees Subordinates won’t do what you ask them to do You don’t know the answer to the question You are compared to the previous manger Jealousy Resentment competition

Ginny Rogers NUR Team Building Groups vs. Teams Phases of Group and Team development Team Building Characteristics of Teams/Groups Roles Communication Managing

Ginny Rogers NUR Motivation Theorists Maslow Herzberg Maintenance (dissatisfies) factors do not relate to the content of the job Motivation factors – job itself People seek different degrees of the above two factors “if you want to motivate the worker, don’t put in another water fountain, provide a bigger share of the job itself”

Ginny Rogers NUR HERZBERG’S MOTIVATORS ACHIEVEMENT RECOGNITION WORK ITSELF RESPONSIBILITY ADVANCEMENT POSSIBILITY FOR GROWTH COMPANY POLICY STATUS

Ginny Rogers NUR MOST PEOPLE WOULD RATHER BE DIRECTED THAN ASSUME RESPONSIBILITY FOR CREATIVE PROBLEM SOLVING MOTIVATED BY REWARDS AND PUNISHMENTS MUST BE DIRECTED NEED CLOSE SUPERVISION McGREGOR THEORY X

Ginny Rogers NUR MOST EMPLOYEES LIKE AND ENJOY WORK ARE SELF-DIRECTED SEEK RESPONSIBILITY ARE IMAGINATIVE AND CREATIVE NEED ONLY GENERAL SUPERVISION ARE ENCOURAGED TO PARTICIPATE IN PROBLEM SOLVING McGREGOR THEORY Y

Ginny Rogers NUR Micro- vs. Macromotivaiton Micromotivation-known also as type A motivation and focuses on getting work done Macromotivation – known also as type B motivation and incorporates outside factors that influence performance Organizations today have shifted toward type B considerations

Ginny Rogers NUR Intentional Model of Motivation Intentionally inviting level based on Optimism Respect Trust Intentionality Intentionally disinviting level Dissuades Discourages Defeats Destroys

Ginny Rogers NUR Change The more complex an organization is, the greater the rate of change. Health Care facilities are among the most complex types of organizations. The rate of change within health care facilities is very quick

Ginny Rogers NUR KURT LEWIN THEORY OF CHANGE DRIVING FORCES (MOVE TOWARDS CHANGE) RESTRAINING FORCES (PUSH AGAINST CHANGE) When making changes, examine all driving and restraining forces Attempt to reduce the restraining forces

Ginny Rogers NUR Resistance to Change Recognizing the worker’s needs based on Maslow Acknowledging both active and passive resistance Strategies to lower resistance: Dissemination of information Disconfirmation of currently held beliefs Provision of psychological safety Command

Ginny Rogers NUR Stages Of Change UNFREEZING - CHANGE THE STATUS QUO - POWERFUL NEED TO CHANGE OUTLINE THE PLAN - PILOT THE CHANGE REFREEZING - NEW PLAN BECOMES THE STATUS QUO

Ginny Rogers NUR Planned Change Empiric evidence of need Aims at improving the system Incorporates others Provides reeducation

Ginny Rogers NUR Radical Intervention Change Positive consequences – wards off or manages a crisis Negative consequences – used as a show of force: dependent people “hang on” creative, highly competent people leave

Ginny Rogers NUR Response to Change Drive toward change when there: Are explanations Is input Are acknowledged concerns Are small doses Is help available Are benefits that are understood

Ginny Rogers NUR Resistance toward change when there : Is mystery Is secrecy Is change as punishment Are pressures Is poor planning Is an ignoring of human nature

Ginny Rogers NUR Assumptions underlying Performance Appraisal Process 1. Immediate superior is the most promising rater 2. Everyone needs to know how he/she is doing 3. The process provides information not available in any other way 4. The process can and will improve performance 5. Evaluations have enough validity to justify use of the results

Ginny Rogers NUR PERFORMANCE APPRAISAL CHOOSE THE TOOL RATING TOOL CHECKLIST MBO PEER REVIEW PLAN COMMUNICATE

Ginny Rogers NUR The performance appraisal interview Prepare feedback Establish improvement-oriented climate Key behaviors Improving accuracy

Ginny Rogers NUR Elements in the PA Tool Philosophy – beliefs about health, clients, how population is served Mission - primary responsibilities, environment, expectations Objectives – how it will carry out it’s mission

Ginny Rogers NUR PROGRESSIVE DISCIPLINE INFORMAL REPRIMAND 2. FORMAL REPRIMAND 3. SUSPENSION FROM WORK 4. INVOLUNTARY TERMINATION OR DISMISSAL

Ginny Rogers NUR