A formal structure is a framework which outlines management power, duty, as well as accountability by way of departmentalization and work division (Marquis and Houston, 2015). This description completely depicts the organization I work in. I execute my nursing duties in the organization’s critical access emergency department (ED). The ED has a medical floor with five ED beds. Also, the ED offers physical therapy, respiratory therapy, lab services, as well as x-ray. There is a clear chain of command in the organization, and as such, it categorizes as a line structure (Laureate, 2012a). The lower of the structure’s classification entails a staff nurse, charge nurse, and assistant charge manager. The chain continues with the nurse manager, director, and the administrator. On top of the line are the Chief Nursing Officer and the Chief Executive Officer.
Decisions in the Organization
The hospital’s decisions are derivatives of decentralized decision making; that is, there exists a committee elected to handle every issue independently. For instance, there is a committee for handling decision concerning employee satisfaction, patient access, as well as ED throughput among others. As such, making the organization’s decisions are done at the issue’s level. Nevertheless, there is always utilization of the chain of command, and if there someone bypasses a link in the command, the outcome is facing disciplinary action(s).
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Decisions in the Emergency Department
In health care organizations, it is the role of the manager to organize, allocate, as well as coordinate duties to the staff for the realization of the department’s objectives and the organization as a whole. The ED’s has a centralized decision-making structure. The ED’s manager is the overall decision maker in the department. However, each nurse has other duties exclusive of patient care provision allocated to them by the manager. The duties include chart auditing, benchmark indicators’ as well as productivity tracking among others. Despite the decision-making structure being centralized, the department has informal leadership. I can describe our ED as full of camaraderie. There is no restriction of chatting in the hallways and break-room even during the organization working time. We co-exist like a small family in the department with very little secrets because of the open lines of communication. As such, every person works hard to ensure the department runs smoothly, and the manager considers every individual’s opinion before making a decision. In the end, due to developing and empowering of nurses by managers, the performance, effectiveness, and environmental culture in the department is positively impacted ( Downey, Parslow, and Smart, 2011 )
References
Downey, M., Parslow, S., & Smart, M. (2011). The hidden treasure in nursing leadership: Informal leaders. Journal of Nursing Management, 19(4), 517–521
Laureate Education (Producer). (2012a). Diverse organizational structures. Baltimore, MD: Author.
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
