Week 4: Theory Utilization in Management

In the last week, five of your direct-report nurse managers have stopped by your office, frustrated and angry. Their comments included, “I used to love my job, but now I am tired of working with incompetent people,” “I am sick of having to call for supplies that should be automatically stocked on my unit,” and “Working here is no longer fun.” Using motivational theory, discuss your strategies, as the nurse executive, for creating a motivating climate and atmosphere that supports a more positive work environment and that could be implemented fairly quickly.

Scholarly references to support your response are required.


As the nurse executive, discuss your vision that you would like to implement for the organizational structure at SLMC. Share your rationale. How would you incorporate aspects of the person-centred nursing framework into your vision?

Scholarly references to support your response are required.

Week 4: Introduction

Table of Contents

Welcome to Week 4!

The focus for this week is on organizational theories; specifically, motivational theories and their impact within the organization. Consider what motivates you and how others may be motivated in a variety of intrinsic and extrinsic ways. Let’s get started.



Evaluate organizational theories in relation to healthcare administration utilizing critical thinking and collaborative therapeutic intervention strategies of the professional role. (PO5)

Weekly Objectives

  • Evaluate motivational theories that may be utilized for your healthcare facility in your role as a nurse leader.
  • Determine which motivational theory to utilize for your healthcare facility in your role as a nurse leader.


Compare and contrast the effect of organizational structures, e.g. organizational charts, standards, philosophy, procedures, and culture on work processes and organizational and patient outcomes; utilizing critical thinking, communication skills and therapeutic intervention strategies of the professional role. (PO 8)

Weekly Objectives

  • Discuss the impact of theories within the organization related to organizational structures.

Week 4: Reading

  • DueAug 5 by 11:59pm
  • PointsNone

Marquis, B. L. & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application. (9th ed.). Philadelphia: Lippincott Williams & Wilkins.

  • Chapter 18: Creating a Motivating Climate

Roussel, L., Thomas, P., & Harris, J. (2016). Management and leadership for nurse administrators. (7th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 6: Organizational Structure and Accountabilty (Review)
  • Chapter 10: Managing Performance


Jones-Schenk, J. (2017). Fostering personal power during change. Journal of Continuing Education in Nursing, 48(8), 343-344. doi:10.3928/00220124-20170712-03

Moradi, T., Mehraban, M. A., & Moeini, M. (2017). Comparison of the perceptions of managers and nursing staff toward performance appraisal. Iranian Journal of Nursing & Midwifery Research, 22(2), 128-134. doi:10.4103/ijnmr.IJNMR_142_15

Week 4: Lesson

Table of Contents

Theory Utilization in Management

The Impact of Theories Within the Organization

As we begin this week’s lesson, it is important to reflect upon how theories may impact management and the organization. We will begin with an overview of select theories related to aspects of management. Previously in the course, we touched on organizational theory and how theory can influence an organization. This week, we will explore this concept in more depth.

Organizational structure can involve various responsibilities and activities being organized into workable units, which can delineate communication and lines of authority. Theories can assist leaders in organizational structuring and organizing various aspects, such as group and work assignments, coordination of activities, and may also influence the mission and philosophy of an organization. There are key principles involved in shaping organization structures, which include policies, coordination, delegation, the chain and unity of command, bureaucracy, line and staff, and span of control and specialization (Roussel, Thomas, & Harris, 2016).

As a nurse leader, it is important your team members all receive necessary information and consistent role expectations. When this does not occur, employees can experience role conflict, ineffective communication, and have ineffective performance and job dissatisfaction (Roussel, et al., 2016). This information process is initiated with employees during the interview process. Initial and ongoing education and incentives can assist with reinforcing one’s role expectations. When role theory is used effectively, there is typically a positive correlation in work quality.

As mentioned previously, there are variations in organizational structure and organizational charts depending on the nature of the structure, with advantages and disadvantages of each. Last week, we discussed shared governance as a participatory-management approach. New organizational structures or models may be developed to focus on a specific need.

Time to reflect…

Does your current or previous organization have an organizational chart? Please review the chart and reflect if it is clear and understandable to you and the employees? What would you change or add to this chart to enhance communication and role expectations?

Listen to these reflective thoughts from our Course Leader:

Hi this is Dr Diana Meeks and this our time to reflect does your current or your previous organization have an organizational chart if so and if you’re not sure if you have won it please contact your nurse executive and review that chart and reflect if it is clear and understandable to you and if it’s understandable in clear to other employees so after doing that I’d like you to reflect on what would you change or add to this chart to enhance communication and role expansion and it could be a learning experience at different organizations the organizational chart can look a little bit different and some organizations can be detailed and state the individual name and their role and the reporting lines and other can be very vague and ambiguous the one item to reflect on as well that when you do it a little exercise is to find out who is responsible for updating the organizational chart what I have found is that it can be difficult to keep it up to date especially if there is a lot of turnover and so you may want to designate someone or you know do you have the best way is to keep it updated and where it’s all the located within the organization for managers and also for others to the interim where we need to know this is our time to reflect Thank you.

The Association of Nurse Executives (AONE) developed the AONE nurse leader patient-safety-model to support an environment of safety and high-quality care utilizing leadership (Roussel, 2016). Patient safety is a priority focus for most agencies throughout the country. The development of the organizational climate and culture is a reflection of the organization personality. In some instances, for example, an organization that may wish to pursue Magnet designation may need to change their organizational climate to achieve the desired outcome. Patient safety and quality are key items involved in Magnet designation criteria. In some organizations, there may be a need to attain a more positive organizational climate. There are several activities nurse leaders can encourage and support to promote and help achieve a positive climate for their organization. A few examples include promoting teamwork, role modeling the expected and desired performance behavior related to roles, and developing the mission, philosophy, vision, and organizational goals with input from the staff (Roussel, et al., 2016).

As the nurse leader, monitoring the effectiveness of your organization is beneficial to determine if adjustments in various organizational aspects need to be incorporated. Some indicators to monitor your organizational effectiveness may include: patient and family satisfaction regarding care, staff and management satisfaction, community relationships, and organizational health (Roussel, et. al., 2016).

Team building is one way to develop a cohesive environment for your staff and is an example of participatory management. This group cohesiveness can assist with committee or group work and projects, ensuring quality patient care outcomes, and goal achievement for the team. We will discuss team building in more depth later in the course.

Time to reflect…

What factors do you feel, as the nurse leader, that you could implement to motivate your team and a positive work environment?

Listen to these reflective thoughts from our Course Leader:

Hi this is Dr Dianna Meeks and this is our time to reflect what factors do you feel as the nurse leader that you could implement to motivate your team and have a positive work environment Now this may vary depending upon the organization depending upon the unit and depending upon the mix of your team that you have working in a the if it carry up as a nurse leader over time you’ll get to know what motivates your employees or certainly take the time to get to know what motivates your employees what’s important to them some individuals are motivated by money some by just a simple thank you some want a formal recognition others don’t really you know want recognition maybe a note or or maybe just say hey you’re doing a great job so it’s it’s good to see what works for your team and your employees and you certainly want to develop a positive and a healthy work environment.


You know it’s setting the example of modeling that as an Nurse leader is a very important but certainly if there’s any negativity that you hear try to you know find out what is the cause of that and talk to that person and figure out what’s going on you know sometimes there may be a situation that can be difficult to resolve but listening to the employee would be the first step as to what’s going on and then seen you know if it’s possible to resolve an issue Often times unfortunately as a nurse leader one of the things we don’t like to do is to terminate employees so there have been times where there’s been a negative you know employee and they’ve really.


Spread like a virus through the unit where they’ve just been very negative very negative to others and that correctly bred in a very negative work environment for everyone so we certainly do not want. That to be the case you know be aware of that and try to see if the employee can be.


You know kind of redirected if you will and with some support and whatnot but occasionally unfortunately that that employee just cannot you know check kind of change their behavior and we have to let them go but we try not to do that as the first line if possible but certainly talk to H.R. review policies but again set the tone and model and share expectations and that can be also written into job descriptions and discussed performance evaluations in shared and team meetings and various town halls that you have so this is our time to reflect Thank you.

he nurse leader has the overall responsibility to ensure a motivational work climate is established for employees. See below for additional information related to creating a motivating work climate for your team.


View Display 18.1 in Marquis & Huston (2017)—Leadership Roles and Management Functions Associated with Creating a Motivating Work Climate. Take time to reflect on roles and functions you may engage to enhance motivation for your team.

After monitoring the effectiveness of your organization, you may determine some restructuring is needed in one or several aspects to promote a more motivating work climate for your team. Before making any changes within the organization, a careful evaluation and strategic plan are prudent to help ensure a positive change related to organizational restructuring. Soliciting input from your team can be very helpful to ensure they have buy-in to any changes and are engaged in the process. Ongoing follow up and monitoring is recommended to ensure a change is embraced and maintained after implementation.

Motivational Theory

There are several theories related to motivation. Different persons can be motivated by different factors, and what motivates an individual may vary depending upon the influences at that particular time in their life.


“Motivation is the force within the individual that influences or directs behavior” (Marquis & Huston, 2017)

Motivation may be of an intrinsic nature, such as within the person, or extrinsic nature, which is related to the work that has been completed.

As we discussed above, the nurse leader takes the lead for ensuring the organizational environment has a motivating climate for employees. In the work setting, motivation can also be part of an employee’s job position. Generally, if an employee has high job satisfaction, their productivity is high (Roussel, 2016). In positions where an employee may do the same task or routine every shift, expanding the employee’s role or rotating to a different area can help reduce boredom and maintain motivation. As mentioned, some persons are intrinsically motivated, and others are extrinsically motivated by external rewards or their job environment (Marquis & Huston, 2017). The notion of motivation has been studied by researchers in different aspects to try to gain a better understanding of the concept.

Time to reflect…

How does each employee like to be recognized? What are some ways you could try to motivate an employee, whether intrinsic or extrinsic?

Listen to these reflective thoughts from the Course Leader:

Hi this is Dr Diana Meeks and this is our time to reflect how does each employee like to be recognized what are some ways you could try to motivate your employee whether it be intrinsic or X. trinsic and an earlier time to reflect I alluded to this a little bit as well that over time you get to know your direct reports you get to know you are an employee your team members as to what motivates.


Some individual that it’s financial that incentivize them to. To to work to be motivated to do various things and to really engage. For other individuals that may be more of just a simple thank you have maybe a formal you know announcement and things of that nature to find out what works to them it could also be you know outside that they’re want to provide for their family that they’re doing that and that’s what gets them up every morning and get them in so get to know your team and find out what worked for them how this is our time to reflect Thank you.

Last week, we discussed the Magnet model; within this model, adding higher levels of responsibility to a role, for example, participating on the shared governance council, can add more value to their role, motivate them, and a higher commitment to the organization. The annual review process is a great time for nurse leaders to discuss and set specific goals for their employees. Generally, a challenging goal that the employee embraces can enhance their motivation. Many organizations that utilize the Magnet model also include a clinical ladders program, whereby the nurse can set specific goals and be motivated for a change in status, which also typically translates into a monetary increase. There is an incentive for the nurse to continue to be motivated and keep this new monetary increment; as well, expanded opportunities or positions can be available as you move up the clinical ladder. Different facilities may designate a similar program with a different name. The benefits of this program are actualized by the employee, the organization, and ultimately, the patient and quality care.

To create and sustain a motivating climate for employees can be challenging at times, as different employees have different aspects of what motivates them. The organizational climate and culture can influence the external motivation or morale of an employee. It is prudent for the nurse leader to get to know your employees and be aware of what motivates each employee. Sometimes, a simple “Thank you” or telling an employee “You did a great job today” can be extremely motivating and rewarding as positive reinforcement for an employee. Some strategies may work for your team, and some may not. As a nurse leader, over time, you will get to know what motivates your employees and develop or sustain a motivating climate.



This week, we explored some select aspects of theories that may impact management and the organization; specifically motivation of an employee. Next week, we will focus on managing influence, power, and conflict in your role as a nurse leader.


Marquis, B. L. & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application. (9th ed.).  Philadelphia: Lippincott Williams & Wilkins.

Roussel, L., Thomas, P., & Harris, J. (2016). Management and leadership for nurse administrators. (7th ed.). Burlington, MA: Jones & Bartlett Learning.


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