Change in Nurses’ Management Practices in Hospital

Nurse leadership practices in hospital should change 

Nurses play a significant role in the hospital environment. In the hospitals, nurses have a variety of functions which they play to support the patients or assist other medical professionals directly. Nurses plan and carry out nurse care to help patients stabilize, they monitor patients and records they conditions, and they also give and monitor medications and also educate the patients. Moreover, some nurses are in charge of the hospital as administrators. Despite these important role nurse plays in the hospital, they still find themselves misplaced or given little opportunities in management positions. Nurses are only associated with patents’ wards and patients monitoring even though one of their role in the hospital especially those with administrative skills is to represent their colleagues in the management of the hospital (Warshawsky et al., 2102). Currently, nurses are given the opportunity to manage clinics and small hospitals or nursing homes. This is a role nurse have played well since they have both the clinical and administrative knowledge. However, not many nurses who have all these skills are given a chance in the management role. There still exists stigmatization on the role of a nurse as manager. They are still not trusted by big hospitals as managers. This notion should change. The nurse who qualifies for administrative practices should be given the opportunity to represent their fellow nurses in hospital boards. Those with leadership capability should be allowed to practices administrative role to address the issue of nurses and that of the entire hospitals. They should be given an opportunity like any other medical practitioners to be in charge of the big hospitals without discrimination as long as they are qualified to do so. This will enhance their motivation and general representation in the hospital management to address their position in hospitals which for many years have been jeopardized in the hospital. 

Why nurse leadership practices should change 

Nurse position in the hospital has been compromised in many circumstances in hospitals. Nurses are often misunderstood and their role tied to hospitals wards or to monitor patients in hospitals. However, hospital nurse often has many unsolved challenges since those who are in administrative position are always unable to understand their role or what they undergo in their position. In the years 2014, the Center for Disease Control (CDC) ranked nurse as the most stressed medical practitioners in the hospital. The stress comes as a result of the number of patient nurses handle. It is an undeniable fact that nurses treat many patients and the nurse-patient ratio in the most hospital is unquestionably low. For this reason, they need somebody who has the experience as a nurse to be their representative on the board of directors to air out their voices for them to be handled well (Negussie & Demissie, 2013). They need a voice in leadership with inclusive participation in administrative leadership in big hospitals to address the unsolved challenges they face in their daily and stressful occupation. This can only be imaginable if they are given more chances and in the management role and practices in the hospitals and the representation in the governing council. 

Roles of Stakeholders in the current management 

The leadership practice in the hospital is a conglomeration of different individuals with both clinical and management skills in the hospital. At the top of the management table is the hospital governing body or the board of directors or the governing body. These are groups of individual who are in this position through appointment for a term of four to five years by their community, management, and the clinical experience. Examples, in this case, are the CEO, the financial officers, and the administrators who are task with the day to day smooth running of the hospital. It is the board that is responsible for all the activities within the hospital and accountable for all privileges and mistakes as well as challenges facing the entire staff in the hospital. For the change to take place, the board of director must have a meeting to ensure that the change is planned for and strategies to manage change to avoid its resistance are hatched. It is the CNO who will be tasked with informing the nurse about change. The administrators will notify all entire hospital about anticipated change. The finance officers will have to reallocate any budgets in case of a new position to be created for a nurse. The CEO will stamp the last decision of change. 

Others within the leadership role in the big hospital are the chief medical officers (CMOs) overseas departmental duties, the chief operating officers (COOs), and the chief financial officers (CFOs) and lastly the Chief Nursing Officers (CNOs) who oversees the functions of the nurse. All these personals have shared vision in the hospital environment. They manage the duties of the hospital with the aim of influencing the staff to ensure that through the staff at their disposal, the hospital achieves the goals. 

In the nursing department, they often have leaders they depend on within the hospital which recognizes their potential leadership capabilities. The chief nurse officers (CNO) always have others nurse leaders who help them ensure that nurse are somehow represented in the hospital leadership. They are inclusive of director of a nurse who manages administrative and clinical areas such as emergency care, surgery, and others. Each of the director’s work in association with nurse managers tasked with overseeing unit’s daily operation. Within each unit of the nurse; there are those who are in charges of different activities such as shift, team leaders, and many others. ALL these nurses’ leaders will be the change agents. They will have to influence their fellow nurse and other friends from different departments to accept the change. Their cooperation in this change will have a massive impact on its outcome. 

Evidence Critique Table: 

Evidence summary of the peer reviewed scholar article 

The peer-reviewed article listed in the table comprehensively analyses the management practices of the nurse in a hospital. The articles have used different methods of presenting their information. However, the information is still aired by all the authors in one voice and with one objective which is to allow the nurse or give nurse chance in the management post and accommodated more of them in the post to have them well represented in the hospital. 

The article all claims that nurse has been subjected as subordinates to fellow colleagues such as doctors in the hospital. According to Kath et al., (2103), this subordination has subjected nurse to a lot of stress since their issues are not well addressed leading to a lot of work, too many patients and others which accumulate subject them to stress. For this reason, the five articles have presented empirical evidence, reviews and case studies as well as the narratives of the history of the nurse to act as a proof of the need of nursing staff thorough inclusion in hospital leadership. 

The documents have recorded data which indicates that in the history of nurse along the lines of their professional, they have faced challenges which have been solved only to quarter due to insignificant representation. For instance, Kind et al., (2012) and Kath et al .,(2013) presents the recent data from Center for Disease Control which indicate that in the entire hospital environment, the nurse is the most stressed workers in the healthcare institution. Overall, the reviewed journals have a good and depth strength in explaining the reasons why nurses practices in the hospital management need to change for the better. 

Model, explanation, and use in the change management 

Changing the management practices among the nurse in the hospital is not chicken feeds. It needs a change model to act as a blueprint for the change direction. Therefore, in this case, the Lewin's change model can be essential. The Lewin's model very useful where there is needs to change the status quo. For instance, in the hospital, the management positions is always known to dominated by the big wigs such the doctors and other medical personnel. To change this status quo, it needs a model which has a strategy on ways in which the organization can freeze to eliminate the status quo first, then communicate the change properly during the time of the confusion then freezing for people settle to settle. For this reason, this model is the recipe for this change. 

Application of the model 

Firstly, unfreeze the organization structure. In this case, we will determine the need for change. This will be inclusive of the survey of the understanding of management issues among the staff. Understand why nurse needs to be in such position of leadership. Secondly, we will ensure that existing powerful leaders are consulted for their support. Then lastly, is to create the need for change in the hospital, for instance, a statement which ties objective and goals of the change to all individual in the hospital on the role of nurse in meeting the objectives (Kath et al., 2013). 

The second point is to implement the change which is inclusive of proper communication of change in positions or creation of new posts for nurses, the benefits of the change to nurse and entire organization, dispel rumors by giving clarification of the befits of the change and last empower actions where employees opportunities for involvement during the change is necessary. 

The last phase is to freeze. This is inclusive of anchoring the nurse in the culture of management and the entire organization. 

Barriers and ethical implications 

One barrier is change resistances from the individuals in positions where they will feel threaten by the change. Secondly, there is fear of unknown from others staff which may lead to change resistance and many others. One ethical consideration, in this case, is the principle of autonomy. Each individual involved during the change process should be allowed to air their views and make a decision without influence. 

References 

Kath, L. M., Stichler, J. F., & Ehrhart, M. G. (2012). Moderators of the negative outcomes of nurse manager stress. Journal of Nursing Administration , 42 (4), 215-221. 

Kath, L. M., Stichler, J. F., Ehrhart, M. G., & Sievers, A. (2013). Predictors of nurse manager stress: a dominance analysis of potential work environment stressors. International journal of nursing studies , 50 (11), 1474-1480. 

Kind, A. J., Jensen, L., Barczi, S., Bridges, A., Kordahl, R., Smith, M. A., & Asthana, S. (2012). Low-cost transitional care with nurse managers making mostly phone contact with patients cut rehospitalization at a VA hospital. Health Affairs , 31 (12), 2659-2668. 

Negussie, N., & Demissie, A. (2013). Relationship between leadership styles of Nurese managers and nurses’ job satisfaction in Jimma University Specialized Hospital. Ethiopian journal of health sciences , 23 (1), 50-58. 

Warshawsky, N. E., Havens, D. S., & Knafl, G. (2012). The influence of interpersonal relationships on nurse managers' work engagement and proactive work behavior. The Journal of nursing administration , 42 (9), 418.