1. ROSTERING AND EMPOWERMENT
AN OVERVIEW

2. EMPOWERMENT “Responsible autonomy”, or “Freedom within a framework”
In an empowered situation staff exert greater control over problem-solving and decision-making, while managers exert influence rather than control.

3. Three Fallacies About Empowerment
Quick-Fix Fallacy: unwillingness to accept that sustained effort is needed to bring about “people” change
“Single-Bullet Solution” Fallacy: a panacea to resolve all problems (!)
Top-Down Fallacy: an oversimplistic assumption that hierarchy can “cascade” change throughout the organisation.

4. Managers’ Responses To Empowerment
Positive:
welcome greater staff involvement
compliment staff effort
create opportunities
offer issues for questioning.
Negative:
threatened by perceived challenges
criticise staff “failures”
build restrictions
enforce the rules.

5. Managers’ Responses To Empowerment
Positive:
Open, shared information
Coaching and support
Negative:
Secrecy and telling on a “need to know” basis
Tightly-defined roles and tasks.

6. Centralised Rostering
Familiar, efficient, big picture
Senior nurse management are accountable
Decisions made remote from the patient
Dis-empowering of staff (and of CNMs)
Stops development
Gives the illusion of control – can be used unethically.

7. Ward-Based Rostering Requires development of CNMs
CNM role moves away from 100% patient care
More sensitive to rapid change and patient needs
Staff involvement
CNM becomes accountable.

8. Team-Based Self Rostering
Agreed staffing guidelines and staff mix form the framework
Staff very involved in the process - negotiate with each other, developmental and adult
Staff become accountable
Manager still has ultimate accountability.