You are the supervisor of a surgical services department in a nonunion hospital. The staff on your unit have become increasingly frustrated with hospital policies regarding staffing ratios, on-call pay, and verbal medical orders but feel they have limited opportunities to provide feedback to change the current system. You would like to explore the possibility […]
| You are the supervisor of a surgical services department in a nonunion hospital. The staff on your unit have become increasingly frustrated with hospital policies regarding staffing ratios, on-call pay, and verbal medical orders but feel they have limited opportunities to provide feedback to change the current system. You would like to explore the possibility of moving toward a shared governance model of decision-making to resolve the issue and others like it but are not quite sure where to start. |
Review Learning Exercise 12.6 - Problem Solving: Working Toward Shared Governance (located in Chapter 12 of the textbook)
Answer the following questions:
Your paper should be:
An organization’s line of command and decision structure is determined by its system. In centralized decision-making, the decisions are made by the top management, whereas in the decentralization system, the responsibility is diffused, and the decisions are solved at the lowest managerial level (Marquis & Huston, 2009). One of the decentralized system methods includes participatory management, which implies that the other members with a vested interest in the matter at hand are allowed to participate in decision-making, although there is an ultimate authority in control. Participatory management has paved the way for the existence of shared governance, which refers to an organization design that makes nurses an integral part of the decision-making system, with them being responsible for the implementation of nursing-related decisions. Arguably, it provides responsibility and accountability to the nursing practice (Marquis & Huston, 2009). Although shared governance is one of the best ways to revamp the old bureaucratic methods, the benefits can only be accrued through correct implementation: by delving into the logistics involved, identifying supervisory roles, and resolving employee concerns.
The first step I will take toward implementing the shared governance model involves initiating a discussion around the topic. Consequently, it includes informing and creating a dialogue among all departments involved in key decision-making. Additionally, all partners playing a major role in patient care-delivery planning need to be actively involved in the implementation team (Grady, 2009). I should involve everyone willing to commit themselves and enough members to accomplish the task in the committee. Another factor that I should consider includes gender and cultural diversity. Arguably, these factors need to be addressed early and included in the discussion. Finally, one of the best ways I can help determine whether an organization is ready to adopt shared governance is through their willingness to support participatory management policies.
One of the major influences on the adoption and preference of a certain model in an organization is external stakeholders since their vested interest in an organization depends on the gains accrued from such change. In this regard, the stakeholders will support the effort. According to my analysis, the shared governance will bestow many benefits to the external stakeholders, including the unions getting better working conditions for workers and better insurance terms as the “people on the ground” make decisions beneficial to their well-being, among others. Additionally, according to Marquis and Huston (2009), a professional organization such as the American Academy of Nursing has even introduced “magnet status” programs to recognize organizations that have made such efforts.
In my experience, the organization’s culture also determines the outlook of its members by creating a value system that is hard to dispel. The structure that constitutes the cultural environment in the workplace will determine whether I will consider it more or less friendly relating to implementing policies that will adopt the change. If the culture is constructive and progressive, the adoption of shared governance will be simpler. The alternative is rigid and entrenches cultural and subcultural patterns (Marquis& Huston, 2009). Arguably, in the latter case, I will develop priorities and norms that encourage shared culture by transforming the existing one through giving leadership direction and management assessment.
To make the project successful, I have to introduce certain mechanisms. First, the nursing council needs to be all-inclusive, drawing representatives from leadership, the other existing councils, the quality department, and professional development fields in order to establish the coordinating council. The members I choose must be committed to dedicating their energy and time. One of the ways that will make the project successful is by ensuring that the committee has enough members to accomplish the task though not so many as to hinder its progress. Additionally, I should establish well-defined agendas with assignments that are given clearly, concisely, and timely (Marquis & Huston, 2009). Finally, in identifying and resolving employee concerns, my role as a supervisor in the shared governance model involves constructive representation of their grievances toward the council while aiding in the policy change and implementation process.
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application. Philadelphia, PA: Lippincott Williams & Wilkins.
Porter-OGrady, T. (2009). Interdisciplinary shared governance integrating practice, transforming health care. Sudbury, MA: Jones and Bartlett.
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