Week 5: Management of Influence, Power, Conflict, and Decision Making

As the nurse executive at SLMC, you are trying to increase communication and empower decision making among your team members. In the past, it has been difficult for some of the various shift workers to attend scheduled, mandatory meetings that involve Magnet™ designation preparation. Share your specific strategies (examples) for enhancing communication and empowering all members of your team.

Scholarly references to support your response are required.

Week 5: Introduction

Table of Contents

Welcome to Week 5!

This week, we will focus on managing influence, power, and conflict in our role as a nurse leader. Let’s get started.

Course Leader Week 5 Introduction

Hi this is Dr Diana Meeks and I’m the course leader for NR five three one and welcome to the week five webinar our I hope you’re enjoying the course here you’re over the halfway point so keep up the great work so thank you so much for listening to this webinar our this evening and I appreciate it so with regards to weeks four we left off the last time that we met during week three so week four you focused on creating a motivating climate for your team and this also talked about organizational structure and accountability.

 

Other items and criteria that you do you were focusing on was managing performance of your employees and also looking at specific theories that may be helpful to you as a nurse leader so a lot of information week four and week five this week you’re focused on understanding the influence and managing power and conflict and as a nurse leader or a nurse executive that’s you know is a part of your role and that can be challenging sometimes for us and with different different scenarios and and different situations one thing I would say to you that as you deal with a certain situation reflect on that and review what could you have done differently to try to improve for next time or change things slightly It’s a learning process though and again you know there are so many variables and different situations will call for different tactics if you will but you do have a lot of power in your position as a nurse executive a nurse leader so as we’ve gone through the first assignment and you’re getting ready to submit your second assignment that’s why we want to give you flexibility when you do your assignments because you do have that influence that power that leverage if you will.

To do things a certain way because of your power within the organization so we just want to kind of prepare you for that as you get out into there into the real world so your week five assignment to focus is on articulating leadership theories that specifically support your management of power as a nurse executive and you’re going to be comparing and contrasting different influences and how you manage your role in that power were also you’re going to be tying in of course scholarly evidence in your assignment as well so there will be a webinar are as well regarding that specific assignment so please if you have an opportunity to attend the session live and that way there is an opportunity to have some live Q & A.

and discussion with peers and with myself as being the course leader and if you can attend live I encourage you to please review the webinar recording there is some good information there as well and sometimes if you have a question someone else may have the same question and they ask that again please as always if you have any questions please contact your instructor and anything that we can do to help support you as you move through the course we certainly do that we will be doing that so anyway I hope you’re enjoying the course so far again keep up the great work and I look forward to seeing you later on in the session so have a wonderful rest of your day thank you.

Outcomes

2

Synthesize management and leadership theories with her/his strengths in preparing for nursing administrator roles; utilizing critical thinking, communication skills and therapeutic intervention strategies, of the professional role. (PO 3)

Weekly Objectives

  • Examine theories when to assist in communication and decision making skills as a leader.

3

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.
  • Examine theories when to assist in communication and decision making skills as a leader.

4

Apply the use of research in the evaluation of healthcare outcomes; utilizing critical thinking skills, and research strategies. (PO 2)

Weekly Objectives

  • Assess the effect of organizational management through research and evaluation of healthcare outcomes.

Week 5: Reading

  • Points None

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

  • Chapter 13: Understanding Organizational, Political, and Personal Power

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

  • Chapter 15: Messaging and Disseminating Excellence in Leadership and Ethical Implications (Review)

Articles

Formosa, C. (2015). Understanding power and communication relationships in health settings. British Journal of Healthcare Management, 21(9), 420.

Zydziunaite, V., Lepaite, D., Åstedt-Kurki, P., & Suominen, T. (2015). Head nurses’ decision-making when managing ethical dilemmas. Baltic Journal of Management, 10(2), 166. doi:10.1108/BJM-12-2013-0194

Week 5: Lesson

Table of Contents

Management of Influence, Power, and Conflict

Organizational Management

As we begin this week’s lesson, it is important to reflect on the fact that, as the nurse leader within a healthcare organization, you have the ability to influence the organization with the power of your role. In addition, as the leader, you can also be helpful to dissipate any conflict that may also exist and enhance communication. Through effective communications, the decision making process among persons may be less challenging within an organization.

Management of Influence

As the nurse leader within an organization, this role carries great influence from many different aspects, which may include staffing, equipment, supplies, bed space, patient assignments, and so forth. (Roussel, Thomas, & Harris, 2016). The influence of your role as a nurse leader should focus on the organizational purpose and avoid imparting personal influences when making decisions. The American Nurses Association (ANA) (2013) developed a Code of Ethics for Nursing to help guide nurses to incorporate ethics into decision making and keep the focus away from personal influence. With the emergence of more organizations adopting a shared-governance model, nurse leaders must embrace and accept the influence that staff can impart within an organization, hence relinquishing some of your power to the staff.

Management of Power

Power is having the ability to accomplish an intended goal (Marquis & Huston, 2017). Oftentimes, the notion of power can be misunderstood, whereby individuals may fear, mistrust, or worship persons in a power role or position. Historically, women have been viewed as being less powerful; however, this view has changed over time (Marquis & Huston, 2017). For nurse leaders to be effective in their role, some type or source of power is actualized, whether by an informal or formal group. In the section below, various sources of power are identified.

Matching

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Drag each term from the center column to its corresponding definition on the left or right side.

Association with others

Position

The need for information

Personal

Referent

Legitimate

Coercive

Reward

Expert

Charismatic

Informational

Ability to grant favors

Fear

Knowledge and skill

 

As a profession, nurses have increased in overall numbers, as well as their knowledge and skills, which affords the nursing profession an opportunity to have greater influence on various healthcare issues. I encourage all nurses to join their local and national nursing association and consider participating in various meetings and activities that may take place. This is a great way to network and keep up-to-date on current issues in your local and extended areas.

As we discussed previously in the course, a nurse leader can empower their staff members, which can provide several positive benefits for the team and your organization. When staff members are provided learning opportunities and assigned tasks or projects, the leader can assist in nurturing and supporting their team members to achieve the satisfaction from accomplishing these additional responsibilities. As a leader, it can be challenging to give up this power and allow or empower team members to be responsible for a project and follow-up back to the leader. One example is allowing staff members to influence decisions who are part of a shared governance council.

There are various strategies for leaders that can assist with empowering their team to meet set organizational and personal goals. For example, the utilization of committees with regular meetings can be helpful to receive updates on progress and timelines of various projects and provide staff with leadership opportunities. Support by the leader is also needed to allow staff members time away from their unit to attend these meetings.

Management of Conflict

As a nurse leader, conflict may be experienced on a daily basis in a variety of situations or settings. Delegation of tasks may lead to occasional conflict between individuals, depending upon the situation and whom is involved. Conflict may arise due to internal or external discord that results from differences in ideas, values, or feelings between two or more people (Marquis & Huston, 2017). Competition among employees, a lack of resources, restructuring, or poor role delineation can be some reasons for conflict in the work setting. Oftentimes, conflict occurs due to ineffective communication, and depending on how a conflict is handled, it can be viewed in a positive or negative manner. Unit conflict can occur due to several possible causes, with ineffective communication being a frequent reason.

Time to reflect…

Consider how you would handle an outburst at the nurses’ station between two of your team members. How would you proceed? How would you coach these team members?

Listen to these reflective thoughts from the Course Leader:

Hi this is Dr Diana me said it’s time to reflect consider how you would handle an outburst at the nurse’s station between two of your team members how would you proceed how would you coach the team members hopefully this is the scenario that you will never have to encounter however that has happened and certainly may happen the first thing that with regard to if there is an outburst that the nurse’s station you would want to take them away from more of a public setting where patients other disciplines family members may hear or see this to try to take them into if you have a conference room take them into your or your office or the nurse manager of the office and get them away and have them calm down and try to diffuse the situation.

 

Once the team members are calm then hear and listen to each side of their story without making any judgments just let them go ahead and one person share and you know and try to let the other person not interject anything with them to be can share what they want and then let the other ones to be can share what they want and then after that certainly reflect and listen to what they have to say and really hear them and see if there is a way to resolve all of this and come to an agreement hopefully that is the case as professional that we can resolve issues that have occurred.

 

And be able to move forward only if if an outburst a occurs again they are there certainly you know maybe are right out maybe some discipline that needs to occur all. The other thing is how to coach them coach them regarding Again their per professionals or team members that you know we certainly don’t want family members patients other discipline you know.

 

You know kind of airing your dirty laundry so to speak to others and hearing this we don’t want to have it any obvious you know discord on the unit. So I would coach them and coach them on your expectations for your organization and for their particular area if you’re the nurse executive and you see this and certainly their manager there should be involved in these discussions as well and you know have them take the lead on that you may need to involve H.R. and certainly we would not hope that we would have to include security but that certainly would be you know and an option that you would have to you so again hopefully you would never have to encounter this situation but you know something to reflect on as a leader thank you.

For example, if an outburst should occur, the nurse leader must remain calm and avoid becoming defensive. Listening is an important skill for a manager, and one must be aware of their nonverbal and verbal behaviors. Courses or additional training are available if needed to help manage and deal with conflict, whether the conflict be with an employee, patient, family, physician, or other individual. Powerful listening tools, such as asking, mirroring, paraphrasing, and priming, have been found to be helpful to assist with effective listening (Patterson, Grenny, McMillan, & Switzer, 2011).

Conflict may occur between two or more groups of people, departments, or organizations and is termed intergroup conflict. Encouraging interprofessional collaboration is a great way to get to know other departments and encourage communication and support to assist in supporting the overall goal of quality patient care. In addition, an individual may struggle with intrapersonal. Be familiar with resources within your organization to support team members, if needed. Lastly, interpersonal conflict occurs when two or more people have different beliefs, goals, or values and their behavior is perceived to be more than rudeness or incivility, and termed bullying (Marquis & Huston, 2017).

Time to reflect…

At the initial interview is a great time to share expected behavior based upon your expectations and the job position applied for. What information would you share with potential new hires regarding expectations?

Listen to these reflective thoughts from the Course Leader:

Hi this is Dr Diana Meeks and this is our time to reflect at the initial interview this is a great time to share expected behavior based upon your expectations and the job position applied for what information would you share with potential new hires regarding your expectations so again the nurse executive you have certainly direct reports that you would be hiring but then oftentimes you may be called in as a second person to interview or certainly to meet with that depending upon the organising organization.

Often times I will you know meet with someone just to introduce myself and reiterate some of the expectations. So you as an nurse leader can set the tone share various expectations that you have you can share the mission of the organization vision your philosophy and expectations as far as patient safety goals and also as far as positive work environment and things of that nature I think it’s really good during the initial interview or even to again if it’s if you’re just meeting a person to touch base or maybe at the second interview as well it never hurts to reiterate the expectations sometimes individuals interview based upon your expectations they may not be a good fit for the organization even though they’re highly qualified Some individuals may have a you know again a different philosophy a different you know vision of the organization or work ethic or attitude that may not match the difficultly yours and you want to try if you can during the initial interview in the screening process to get the right members on the team who are going to support that So these are.

Just a couple of. Tips and also what’s good to have again some peer review it’s good to have more than one set of eyes to meet with someone in just to get the impression that well so this is Dr Meeks and it’s our time to reflect.

Resolution of any conflict and creating a win-win situation for all parties involved is preferred; however, this may not always be the result. Some common conflict resolution strategies include compromising, competing, cooperating or accommodating, smoothing, avoiding, and collaborating (Marquis & Huston, 2017). A formal negotiation process is an alternative approach to assist in resolving conflict. Preparations for the negotiation process by the nurse leader will need to be completed before, during, and after the process. Please review the following information from the textbook that provides items to consider including for a negotiation process.

 Please view Display 21.4: Before, During, and After the Negotiation. (Marquis & Huston, 2017). Consider which strategies you may find helpful for you as a nurse leader. When would you utilize these strategies?

Communication and Decision Making

Communication and decision making occurs daily within healthcare and in the role of a nurse leader, in either oral or written form. Electronic information technology, such as e-mail, can enhance communication between one or a group of individuals at the same time to ensure all hear the same message. Certain situations necessitate an in-person meeting with individuals or small groups as well, such as an investigation, performance review, or a mentoring or coaching session. Among the models of decision making that exist, the rational model is generally used by nurse leaders since it is objective, logical, and systematic (Roussel, et al., 2016). It is important to review all available information and reflect on any advantages or disadvantages of a situation before a decision is finalized. When weighing future benefits and costs of a decision, it is recommended that the decision be feasible and is aligned with the organization’s goals and objectives. In a cost-benefit analysis of a pending decision, an objective analysis of the quantifiable and qualitative benefits should be reviewed thoroughly.

Once a decision is made, it is imperative that clear, effective communication occurs with the appropriate parties who will be involved and affected by the decision, with appropriate follow-up as necessary. As we discussed previously in the course, in the shared-governance model, the staff typically has an active role in the decision-making process and can influence the outcome. Even within a shared-governance model, there may be some resistance from employees for a variety of reasons. Allowing opportunities to address any questions is helpful for employees to have their concerns heard and acknowledged. This may be accomplished in a large group setting or a more intimate meeting.

Oftentimes, acceptance of a decision can be made smoother through increased, effective communication as early as possible. Utilizing staff as part of any committee work that may be required can aid acceptance and buy-in of a change within the organization. Obtaining consensus of a decision or goal and sharing information early in the decision-making process can be a positive strategy, leading to favorable outcomes in communication and acceptance by the team, in many cases. At times, it may be necessary to have an individual meeting to determine the cause of the resistance. Some employees may be fearful of not being able to adapt to the new change. An open-door policy as a strategy to influence positive communication with employees can be beneficial when clear rules are communicated, such as if permission from another person may be required.

Summary

This week, we explored the management of influence, power, delegation and conflict management within an organization and how communication can influence decision making. Next week, we will focus on team-building approaches.

References

American Nurses Association (2013). About the code. Retrieved from http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/AboutTheCode.htm

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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