Lesson 4: Operational and Strategic Planning and the Nurse Leader’s Role In Health Policy

If you fail to plan, you plan to fail...

As I've chapter 7 it has become clear. Without proper planning more time is going to be spent in achieving few goals. The purpose of planning is to decide in advance what to do and how to do it. It is  purposeful and proactive. There are several different kinds of planning and after reading and reviewing each one, it seems to me that the most beneficial mode of planning is that of proactive planning. Instead of waiting until a problem arises or working to maintain status quot, proactive planning considers the past, present, and future in anticipation of a need or problem. When done properly, planning allows for the best use of resources, whether it be time or money, identification of short and long-term goals, and creation of objectives and the organization to achieve these goals.

Just as personal plans and goals are influenced by our personal values, the values and beliefs of an organization shape it's plans and therefore influence what goals are set. Determining the values and beliefs of an organization begins with defining their purpose, or mission statement; the reason the particular organization exists and what it aims to accomplish. The purpose of the organization as set for by the mission statement gives way to an organizational philosophy that further delineates the values and beliefs that direct the actions of the organization. After an organization has developed a set of values and beliefs by defining it's mission and organizational philosophy goals and objectives for achieving their purpose, as well as policies, procedures and rules that guide the way the goals are achieved.

The role of a nurse leader in planning and formulating policy for the organization they work requires they are creative and innovative in identifying goals and objectives so that policy reflects current practice but also leaves room to grow and incorporate views of the future. Because self-awareness influences the way one views the system of beliefs and values, it is also important that a nurse leader provide support staff with opportunities to grow and increase their self-awareness in their individual positions at the organization.

Another key point to being a successful nurse leader in an organization is to have a value system that is consistent with that of the organization. When individual values and beliefs are not congruent with those of the organization, it may result in confusion and anxiety. This internal struggle creates personal conflict and will ultimately lead to job stress and dissatisfaction and eventually job burnout.

Lesson 3: Ethics Ethical and Legal Responsibilities and the Role of the Nurse Leader as Advocate

Ethics, ethics, and more ethics....Sometimes it feels as though we're beating a dead horse. Professional Standards of Nursing was nothing but 16 weeks of the ANA Professional Code of Ethics. Nursing in Health Systems Policy tackled the ethics (or lack of there of) involved in the making of health policy. And now, here it is again. Ethics in leadership. And you know what? I learned something new. Well, I don't know that I really learned anything new, it's more like I had to think about ethics in a new light.

Ethics, according tot he definition in the book, is "the systematic study of what a person's conduct and actions ought to be with regard to self, other human beings, and the environment; it is the justification of what is right or good and the study of what a person's life and relationships ought to be, not necessarily what they are" (pg 68).  Ethics of a profession arise out of the purpose of that profession. For example, in nursing our goal is to protect life and our code of ethics evolved out of that goal. The point the book brought out is that management is a discipline and not a profession, so the previous rule does not apply. Instead, the ethical obligations of someone in management are tied to the purpose of the organization for which they work, which is tied to the function is aims to fill in society, and is further tied to the societal constraints placed upon it. Further evidence, or tick marks, under the "Why Somer doesn't want to be management" column.  Red tape frustrates me. I have a difficult time understanding the management aspect of nursing that is more concerned with budgets and cost cuts over what is best for a patient. I realize that to receive compensation and reimbursement from insurance companies, certain parameters must be met. I have a difficult time when those preset parameters are not what is in the patients best interest. I disagree, due to my personal ethics, that keeping a patient in the hospital for 3 days, when they are ready to go home on day 2, is right based on the fact that that is what insurance will pay for. This is why I could never be management.

As I thought about myself in a management position, or rather the reasons why you would never find me in a management position (I know. I know. Never say never.) I considered the type of ethical framework that is most congruent with my personal code of ethics. I feel, after considering each option, that I rely on a intuitionist's ethical framework. I feel that each case should be considered case-by-case to determine the goals, duties, and rights related to each individual situation. In my opinion, this ethical framework does not work with the role of a manager in nursing. From what I've learned, management requires more of a utilitarian approach to provide the greatest good for the greatest number of people...while saving the greatest amount of money, if I might add that in there.

So, I learned a lot from this reading...and this was just from Chapter 4. Chapters 5 & 6 had a lot of thought provoking information a well, but quite frankly, I'm just too tired to get into that.

Lesson 2: Successful Leadership and Management

Leadership vs Management. I've actually never given it much thought. I thought it was interesting that the text devoted a chapter to the defining of each. However, after the reading, it does make sense because, although I previously thought of them as interchangeable, they are very different.

Management is an assigned position. It is involved more with formal organization and the title is a source of legitimate power within that organization. Managers direct those who follow them both willing and unwillingly.The manager is the one who accomplish, has the responsibility, and conducts. Managers are held responsible and accountable for the success and failures of the departments and people that they manage.

Leadership is seems as though it is more of a mantle that certain people take on in a given situation, and not necessarily as part of a formal organization. Leaders are people who influence others and have an influence to guide and direct their opinions and actions. To be a leader, one must have willing followers. Leadership can be developed.

Interestingly enough, a good manager is not necessarily a good leader. Nor is a good leader necessarily a good manager.

I don't work with any other nurses at my current job, so I don't have a nurse manager to ask what they expected when they took a management position. I work with, and as part of, an interdisciplinary team at a residential treatment program.

I disagree with the Great Man and Trait theories. I think some personalities may take on the role of a leader more easily than others, however I think anyone can prove to be a leader, depending on the given situation. I also think that those who possess the ability to lead also know when to step back into the roll of follower to support others in the position to lead.

I like the idea of transformational leadership in that it aims to have leaders and followers who are lift each other up to higher planes of motivation and morality. I don't think it would be possible to be a transformational leader 100% of the time.

I think an effective manager needs to possess leadership qualities so that those whom he/she manages want to do so. I also think that a good leader/manager combines parts from each of the different theories of leadership and management until they find what works for them and makes them the best leader or manager they can be in the given situation.

Boooook!

Every time I've gone to get the book for Nursing Leadership, the book store is out of the. I'm told, "We've ordered them, they shipment should be in within 7 days." But, when I go back...it's not there. Until this last time. Last time there was note stuck in the spot where the book should have been.

This book is out of print. 

The next edition will be released February 11

February 11? I mean really! I am not waiting until 1 month into the semester to get the latest and greatest edition of an over priced book that I'll never use again...no offense Sean. But, what to do? It's difficult for even the most experienced craftsman to practice without the necessary books....even if that craft is WITCHCRAFT!

 After throwing open my own set of shutters and calling in vain, I set out to hunt for my book...taking to the web and searching high and low. And then I found it: Half.com! You know what I found there? You're right...I found my book. Not only did I find edition 6, but I found THE FIFTH EDITION FOR $5.00! I put out the call via the internet and it came...rush delivery. Now, the work can really begin.

Location...Location...Location

Have you ever noticed how you can randomly throw a rock in Utah County and hit a nursing student? I'm finding this is definitely not to my advantage. I'm currently trying to find a location to complete my clinical hours for Nursing Leadership and Development...and hopefully complete my Senior Project. However, with all the students out there looking for similar opportunities...pickin's is slim. Because of my current work schedule (10 hour days Monday, Wednesday, Thursday, and Friday) and school schedule (Tuesdays from 8 a.m. to 6 p.m.) I got special permission to follow a house supervisor during graveyard and weekend shifts. Now...if I could just get someone to return my calls.