Example of case study on leadership and management

Powerlessness

One of the issues that create powerlessness is role conflict. Role conflict emanates from the different roles a nurse has to fulfill. A nurse has an official role, which she has to fulfill to meet the expectations set by the institution. Communication of roles is via the normal administrative channels. Additionally, the nurse has to fulfill the expectations of the colleagues and peers. Thirdly, a nurse has to fulfill self-expectations from the basic personal understanding of what a nurse is required to do. These entire roles may themselves introduce role conflict, which contribute to the reduction in motivation among the nurses. If the nurse feels that lack of appreciation from the administration for the work done, morale goes down and this causes powerlessness.
The type of workload that a nurse is involved in may also be a major cause of powerlessness. According to Kornhaber and Wilson (2011), nurses may experience powerlessness in situations where they are dealing with pain management, difficult treatment options and death of patients. These situations result in development of stressful conditions, which may cause burnouts among the nurses. Powerlessness may also be caused by increased level of competition among nurses especially in cases where one has to prove himself or herself among his or her peers. Additionally, when there is lack of trust, the working environment becomes a hostile one and people tend to feel neglected. A low quality of teamwork is likely to develop following an increase in conflicts and dissatisfaction (Estryn-Béhar and Van der Heijden, 2012). Managers may also neglect their subordinates who will often feel undervalued or not needed in the organization. These situations will ultimately make the nurse to feel powerless hence resorting to quitting or changing jobs because of poor job satisfaction.

Sources of Power

Various sources can be found in this nursing situation. As a nurse manager, Nancy exhibits several sources of power. One of these powers is legitimate power. According to Mason, Leavitt and Chaffee (2013) legitimate power is normally derived from an organizational position, which Nancy seems to hold. Additionally, Nancy seems to have expert power by the virtue of her being a nurse. Expert power and legitimate power are the two common sources of power in this scenario. It is important to note that lack of application of other sources of power such as reward power, referent power and information power seem to be highly neglected. A situation where nurse feel powerless may be caused by the lack of trust and respect among coworkers, as discussed above. This situation clearly indicates that the lack of respect is an indication of the lack of referent power.
How might Nancy encourage the staff to become empowered?
Nancy may encourage the staff by providing emotional support. Emotional support can be in the form of praise. As a manager, Nancy needs to ensure that the nurses feel appreciated for the work they do. Additionally Nancy can empower the nurses by being a good role model. By maintaining a high standard of care and professionalism, Nancy may stand a chance of influencing the attitude and behavior of the nurses (Carling and Duffy, 2013). Furthermore, increased socialization with the nurses ensures that the nurses develop a team spirit attitude in their work. By making the nurses feel that they are part of a team, Nancy can ensure the enhancement of cooperation among the nurses who may be in a better position to express their feelings and thoughts and may contribute suggestions on how to improve their performance. Nancy may also include the nurses in the development of a flexible working schedule. This makes the nurse to feel appreciated as a part of the organization.
What information should you obtain from the staff on your unit prior to attending the meeting?
One of the most common information to obtain would be the level of patient care in the facility. It is important to know the extent of patient care prior to establishing the issues that may be causing the reduction in the delivery of quality of care. Further, information on the amount of work that an individual nurse handles will also be significant. Other factors that need to be established because of the long shift hours include injuries associated with fatigue, cases of any patient’s deaths, presence of diagnostic errors. Normally, fatigue risks in nurses increases when the nurses work for shifts, which exceed more than 12 hours (Frankel, 2009). Furthermore, the cost implications of the shift hours need to be also taken into account. The staff can also provide information on how they manage or balance their personal homes based on the current working shifts and provide information on any detrimental effects associated with the shift hours.
What other information would you gather about returning to 8-hour shifts prior to attending the meeting?
Additional information concerning the return to 8-hour shifts may include how these shifts will affect the level of service delivery to the patients. Additionally, proposed working schedules from the nurses’ point of view would also be significant. It would also be important to establish how interruptions and disturbances affect the nurse’s ability to perform. It is also important to collect information from the nurses on possible suggestions, which may be used to make the shift work tolerable.
How will you assist your team members in understanding the role of shared governance in bringing about policy change?
It will be important to explain and to remind the team members of the continued challenges that the nursing profession is currently facing. There are many financial constraints. Furthermore, reinforcing the importance of addressing the issue of patient safety would be a top priority in trying to convince the team members why it would be beneficial to move to the 8-hour shifts. Apart from the normal benefits of reducing fatigue among nurses because of a reduction in working hours, it would be crucial to explain to the team members how nurses can use the extra time to increase and progress the nursing careers in terms of education. Further, it will be important to ensure that members acknowledge and appreciate how resources both financial and human can be effectively applied in the decision making process. Finally, it would be helpful to inform the team members of some of the significant benefits that may develop from application of shared governance. Some of these benefits include improving quality of care, increasing and developing a proactive learning environment, enhancing multi-professional collaboration and increasing the nursing staff level of job satisfaction. This would ensure that nurses are empowered to perform effectively
References
Carlin, A., & Duffy, K. (2013). Newly qualified staff’s perceptions of senior charge nurse roles. Nursing Management – UK, 20(7), 24-30.
Estryn-Béhar, M., & Van der Heijden, B. M. (2012). Effects of extended work shifts on employee fatigue, health, satisfaction, work/family balance, and patient safety. Work, 414283-4290.
Frankel, A. (2009). The essential guide for patient safety officers. Oakbrook Terrace, IL: Joint Commission Resources [and] Institute for Healthcare Improvement.
Kornhaber, R., & Wilson, A. (2011). Enduring feelings of powerlessness as a burns nurse: A descriptive phenomenological inquiry. Contemporary Nurse: A Journal for the Australian Nursing Profession, 39(2), 172-179.
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2014). Policy and politics in nursing and health care.