Feb 23, 2024 NR 501 Week 6: Impact of Nursing Theory Upon Healthcare Organization
The application of Hildegard Peplau’s theory of interpersonal relations relates to staffing. The staffing of a facility has one of the most significant roles in the operation to function. Nursing staff is usually the largest discipline that is employed and provides the most contact with patients and families. Currently, over 300 nursing staff work under my direction and supervision. There are many factors that affect staffing. A competent staffing coordinator, an adequate nursing schedule program, staffing the units according to needs and acuity, most of all the relation between staff and management. Staffing is also incorporated into healthcare and financial management. Budgeting overtime and allotted use of staffing. The model of nursing schedule that was utilized in my facility was fragmented , inaccurate and confusing. The schedule caused many errors in staffing, over budget costs, poor relationships between the nursing coordinator and the nursing staff. Poor attitude dealing with the staff escalated situations that could have been avoided. A new model of staffing was developed with a six week core schedule with a daily schedule to capture all of the daily changes. Email communication was now in use for any updates and changes to agencies that supply additional staffing, to payroll and administration. A review of the staffing matrix was completed to assess staffing needs without over use and over budgeting. The hypothetical model was incorporated into the current payroll system to financially mange the new system. There has been a performance improvement plan for the scheduling coordinator and communication with the nursing staff has improved. Lees scheduling errors and payroll issues occur. The new model will be reviewed quarterly, to continue to assess the new implementation.
Maria Joao,F. (2015) . Grounded theory in nursing: building a middle range theory in nursing . Journal Biomedical and Biopharmaceutical Research, Vol 12 pp 11-20 (2015), (1), 11.
NR 501 Week 6: Impact of Nursing Theory Upon Healthcare Organization
NR 501 Week 6: Impact of Nursing Theory Upon Healthcare Organization
Nursing theory is significant to the nursing profession since it guides nursing practice. Nursing theories give nurses a framework to guide nursing practice as well as a methodical prescription of action and a sound theoretical base (Quinn & McDonough, 2019). They present the principles that support nursing practice and help produce additional nursing knowledge. It is essential for NPs since nursing theory-guided practice enhances the quality of clinical care since it enables NPs to express the interventions they implement in patient care and their rationale (Younas & Quennell, 2019). Nursing theories help NPs to define their beliefs and values about human health and seek a deep understanding of patient care interventions. Besides, they influence NPs to recognize and evaluate their roles in various patient care settings.
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Nursing theory is important for NPs because NP practice is rooted in critical thinking and understanding the theoretical background. For instance, Roy’s Adaptation theory enables NPs to understand that individuals’ behavior is influenced by an interconnected set of psychological, biological, and social systems. Therefore it informs NP practice as the NP takes action directed towards achieving a state of relative balance in each system (Quinn & McDonough, 2019). This promotes the regularity of function and the ability of every patient to adapt positively to environmental stimuli. Furthermore, nursing theories guide NPs in evaluating patient care and identifying treatment interventions based on the evaluation findings. They also provide NPs with the rationale when making certain patient care decisions. Nevertheless, nurses and NPs should understand that no one nursing theory stands alone as the most appropriate to guide nursing practice (Quinn & McDonough, 2019). Therefore, they need to mostly find a combination of relevant theories for their specific patient populations.
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References
Quinn, B. L., & McDonough, A. (2019). Nursing Theory in Hospital Models of Care. AJN The American Journal of Nursing, 119(12), 11. doi: 10.1097/01.NAJ.0000615708.01269.21
Younas, A., & Quennell, S. (2019). Usefulness of nursing theory-guided practice: an integrative review. Scandinavian Journal of Caring Sciences. doi:10.1111/scs.12670
Peplau’s nursing theory may assist in bringing cohesiveness among the health care team, as through its application, leadership skills might be improved, which could positively impact cohesiveness in the clinical practice. Peplau’s theory of interpersonal relations is an adequate nursing theory that specifically play an excellent role in resolution of administrative problems as well as issues affecting staffing and staff performance when applied by managers and nurse leaders
According to Kumar, Deshmukh, & Adhish (2014) the skills associated with handling self, such as emotional capabilities, time management and active listening are crucial characteristics for the foundation of managing and leadership teams to be able to function in a constructive manner. The implementation of team building exercises play an essential role in accomplishing the goals of the organization. These exercises are of paramount importance when referring and addressing the health care factor in both the clinical as well as public health settings. The main and distinctive quality of a cohesive team is a joint vision towards the achievement of goals.
As a leader, creating and supporting a strong and cohesive team, the nurse will also help the patients take on maximum responsibility for meeting his or her treatment goals, as this will take place in a healthy working environment conducive to productive nursing work. A nurse leader who intends to promote a healthy working environment will take on other roles such as technical expertise and tutor in which this leader makes herself or himself available to the junior nursing staff, providing technical support, also act as a safety agent, environment manager, mediator in any circumstance that mediation is required, administrator and researcher.
According to Kumar, Deshmukh, & Adhish (2014) the team is a cooperative relationship supplementing and supporting each other’s skills, interacting openly and clearly with one another and holding themselves mutually accountable.
According to Hurley, J & Hutchinson, M. (2013) leadership is about relationships. For a nurse leader, it is important to adapt to a leadership style that nurtures healthy relationships intra-professionally and inter-professionally,that is among nurses, nurse leaders and other leaders within the organizations. Applying Peplau’s theory of interpersonal relation can be useful for nurses to adopt in their professional career.
References
Hurley, J & Hutchinson, M. (2013). Setting a course: A critical review of the literature on nurse leadership in Australia. Contemporary Nurse, 43(2), 178–182. Retrieved from https://search-proquest-com.chamberlainuniversity.idm.oclc.org/docview/1698634428/fulltextPDF/EC172494A2C84A47PQ/1?accountid=147674 (Links to an external site.)
Kumar, S., Deshmukh, V., & Adhish, V. (2014). Building and Leading Teams. Indian J Community Med, 39(4), 208-213. doi: 10.4103/0970-0218.143020 (Links to an external site.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215500/ (Links to an external site.)
As healthcare providers we are always tasked with caring for a patient in every aspect. Caring for a patient can already be very tiring and difficult to do. With the addition of unit or organization stress causes people to feel unappreciated or not respected as workers. In regards to Adalaida’s response about the struggles of her work place I feel like that is all too common in nursing. I don’t specifically have a problem with that, but some of my friends who are nurses have had problems with management and other nurses that don’t get addressed in a timely manner if at all. I believe that a theory that could help to develop and engage employees would be the transformational theory. As stated in Hutchinson and Jackson’s article the attributes of a transformational leader are “dynamism, self-confidence, inspiration, emotional intelligence, and symbolism” (2013). Referring back to the difficulties felt and seen in a nursing unit that lacks cohesiveness between management and employees it is almost a unit that needs a very strong leadership person that can come in and put their foot down to stop all the hazing, bullying, and begin to solve staff problems. Strong leaders have to also show that they are willing to put in the time to listen and respond to any issues within the unit. they should start by addressing the most immediate concerns first and the least concerning as they have time to. By coming in with strong footing and helping to address the concerns of the unit can help people to understand how important it is to work as a team and if people do not change their behaviors they should get corrective actions and if that doesn’t work they should be terminated. While being a strong leader doesn’t in any way mean that you are disrespectful to the staff or rude in the way you approach situations, but you present your goals and enthusiasm for creating a healthy helpful environment and try to motivate the staff of the unit to take on those same thoughts and feelings will help to bring everyone together as a team.
References
Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22. doi:10.1111/nin.12006
Concerning the need for a nursing theory of transformational leadership, I do not see the need. The abundance of nursing literature translating the leadership style for use by nursing leadership is likely sufficient. Consolidating the information into a specific nursing theory seems redundant.
Transformational leadership has generally been acknowledged as the most effective leadership style. Unlike the quid-pro-quo style of transactional leaders, transformational leaders encourage followers to create a personalized vision of their role and the future of the organization (Jackson, Hutchinson & Jackson, 2013).
Shared governance would be maximally effective when used in conjunction with a transformational leadership style. The members from each unit that sit on the nursing practice counsel (NPC) can employ transformational leadership styles to encourage nurses on their units to identify deficiencies in practice and develop strategies to combat them. The CNO can act as the ultimate transformational leader in this model, as their approval is required for the development of new NPC bi-laws (Meyers, et al., 2014). Shared governance is a structure of leadership that necessitates follower engagement because leaders are identified throughout the organization and take suggestion from their peers and coworkers.
References
Jackson, D., Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: Towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22.
Myers, M., Parchen, D., Geraci, M., Brenholtz, R., Knisely-Carrigan, D., & Hastings, C. (2013). Using a shared governance structure to evaluate the implementation of a new model of care: The shared experience of a performance improvement committee. The Journal of Nursing Administration, 43(10), 509-516. doi:10.1097/NNA.0b013e3182a3e7ff
I had not read much about Peplau’s Theory of Interpersonal Relations, and I thank you for prompting me to do a bit of research on the theory. It sounds as if a lack of communication between nursing staff and management lead to low employee morale. The integration of communication based on the Theory of Interpersonal Relations could be utilized to help the situation, and your new staffing model sounds comparable.
Peplau’s theory posits three phases of interaction: The orientation phase, the working phase, and the termination phase. The orientation phase, as it relates to staffing levels in the hospital, would be when the management introduces the new model to the nursing staff. It seems that in-person introduction is ideal, although I assume emails and notices may useful if the burden of meetings is too high. During this phase, nursing staff will be able to ask questions, give their input, and possible make suggestions for improvement. When reasonable agreements are made, the working phase begins.
In the working phase, management would employ the new model. Management would keep a close eye on the efficacy of the model, while nursing staff would assess the benefit of the new model to their personal preferences. This phase would include collection of data, including employee opinions of the new model. Data would be synthesized to assess how the current model is functioning.
Eventually the termination phase begins. When enough data has been collected over a sufficient amount of time, and the assessment of the model’s benefits to the organization are concluded, decisions about the future of the model can be made. These may include continuing with the model as is, changing aspects of the model that are not functioning ideally, or perhaps scrapping the model entirely in favor of a different model. During this phase, employee input should be encouraged and considered (Dean & Fain, 2016).
References
Deane, W. H., & Fain, J. A. (2016). Incorporating Peplau’s Theory of Interpersonal Relations to promote holistic communication between older adults and nursing students. Journal of Holistic Nursing, 34(1), 35-41. doi:10.1177/0898010115577975
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