Decision-making is one of the critical parts of any profession, and it is one of the necessary components of professional nursing practice. Making a decision is one of the inevitable roles of any manager, including in the nursing field. A lot of studies have been conducted to determine factors influencing the clinical decision-making process. Clinical skills and experiences are essential factors that determine the effectiveness of decision-making. However, other factors influence decision-making such as health policies, regulatory agencies, and health care financing. Therefore, I interviewed a manager to determine external factors that influence the nurse’s manager decision-making.
Role of Nurse Manager Interviewed and Summary of the Interview
I interviewed my manager who is a Director of Surgical Services in one of the hospitals in the country. As a Director of Surgical services, the manager nurse manager as many roles to play in the hospital. One of its primary roles is to direct surgical services, including the required procedures, the signing of documents, payment process, and providing necessary data and information that are related to surgery. Another role of the manager is to explain any legal requirement and risks that may be involved in surgery while protecting the confidentiality of the patient. Thus, the nursing manager plays an important role in the surgery department because he oversees almost everything to ensure the provision of quality healthcare services.
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The nurse manager was willing to share information about decision-making, especially in the medical profession. The nurse manager concurred during the interview that decision-making is one of the most parts of his job as a manager of one of the critical dockets in the medical field or hospital. Contrary to the perception of many people, the manager opined that decision-making is not an easy process because it is characterized by many constraints and challenges that he must overcome almost every single day. Besides, he stated that decision making is not only influenced by internal or personal factors but also external factors that are always beyond the control of many managers. Although the manager explained that he no longer faces many challenges while making critical decisions because of his experience in the medical field, he was concerned that many medical professionals, including himself, cannot overcome decision-making challenges that are linked to external factors like health policies and regulatory requirements. He further explained that nurse managers could only make effective decisions when they understand the external factors involved, as well as having evidence-based and reliable information before making any decision. The interview was full of insightful information about external factors that influence nurse manager’s decision-making.
Generally, the perception of the manager regarding the impact of health policy on decision-making was positive. According to the manager, health policies have a positive impact on the decision-making process. Specifically, health policies ensure that nurses make accurate and appropriate decisions that can address various health problems and issues that emerge. The manager argues that health policy improves decision-making in any clinical setting because it clearly defines standards and procedures that must be followed to provide various care services. At the same time, based on the manager’s argument, health policies positively influence decisions that are related to practice standards and processes. Therefore, the perception of the impact of health policy on decision-making was positive. However, explained that the health policy could only improve decision-making when it allows flexibility. Thus, strict adherence to the policy may sometimes hinder the effectiveness of decision-making in a clinical setting. The concern, however, can be addressed by formulating flexible health policies that are sensitive to different situations.
Like health policy, the manager maintained that the main role of regulatory agencies is to ensure that medical professionals make appropriate decisions that are aimed at improving the quality of care. According to the interviewee, it is the responsibility of regulatory agencies to ensure that all decisions address the needs of patients. Hence, the agencies help in making the right decision. However, he was concerned that some regulatory agencies create uncertainties that may negatively affect decision-making. Regulatory agencies make nurses to focus a lot on the regulations, which may adversely affect information procession process. The manager, therefore, had a mixed perception of the impact of regulatory agencies on decision-making.
The manager perceived health care financing as one of the external factors that have the greatest impact on decision-making. Any decision that is made by a medical professional is linked to the financial aspects of care. For instance, the decision on any surgical procedure is linked to the ability of the patient to pay. He argued that sometimes surgery experts are forced to change their decision when they realize that the procedure is too expensive and cannot be paid by the client. As a result, they have to choose cheaper alternatives. Therefore, he believes that financial aspect limits decision-making. Managers may not make effective decisions when they face financial constraints.
Analysis of the Interview
The information provided by the interviewee confirms that some external factors influence decision-making in a clinical setting. Apart from internal factors, other external factors such as policies, regulations, and financial constraint affect decisions that are made by managers as they try to accomplish their roles and responsibilities. It is true that health policies improve decision-making in a clinical setting because it provides guidelines, standards, and procedures that must be followed by health professionals. At the same time, according to Wu et al. (2016), apart from defining standards and procedures, health policy is important in clinical decision-making because it provides a guideline on the relationship between health professionals and patients, including other stakeholders like patient’s family. Thus, the policies ensure that decisions made by the nurse manager’s addresses the interests of all stakeholders while improving the quality of care.
Besides, as explained by the interviewee, regulatory agencies help in improving decision-making, but they may also affect the effectiveness of decisions. Based on the findings of a study by Burtscher and Meyer (2014) regulations enhance decision-making as they assist in information framing and focusing, which are required for a person to make a rational decision. Focusing on regulations improved the quality of decisions. However, Burtscher and Meyer (2014) further argue that paying too much attention to the requirements of regulatory agencies may hamper the effectiveness of decisions because it does not give room for flexibility. Hence, it is true that regulatory agencies have both negative and positive impact on decision-making. Also, the argument by the manager that health care financing has the greatest impact on decision making is supported by Nguyen, Gallery, and Newton (2016) who opine that people always consider financial risks before making any critical decision. As a result, financial constraints or challenges limit decisions that are made by nurse managers.
References
Burtscher, M. J., & Meyer, B. (2014). Promoting good decisions: How regulatory focus affects group information processing and decision-making. Group Processes & Intergroup Relations , 17 (5), 663-681.
Nguyen, L., Gallery, G., & Newton, C. (2016). The influence of financial risk tolerance on investment decision-making in a financial advice context. Australasian Accounting, Business and Finance Journal , 10 (3), 3-22.
Wu, M., Yang, J., Liu, L., & Ye, B. (2016). An Investigation of Factors Influencing Nurses’ Clinical Decision-Making Skills. Western Journal of nursing research , 38 (8), 974-991.
