I think overall this class has helped me have the potential become a more well-balanced nurse manager. Looking at management from different angles that I had not thought of before such as the importance of being a motivator and strategic planning has helped broaden my outlook. I definitely still need to work on strategic and financial planning and budgeting as well. This has been the first class that I’ve had where I have actually felt that group work was helpful. Not only did I learn a lot from my peers but I also learned how important it is to learn from your employees and those around you in the workplace. Open lines of communication can really improve management skills. I think the interviews that were done were also helpful in teaching me how to be a better manager. Even though they did not take place in healthcare, there are many management skills and ideas that can easily transfer over. The most important thing I learned I think is how to better analyze myself before I can manage employees. Understanding my own traits and what I can work on or continue to improve on will always help me to advance as a manager.
Although the legal side of healthcare has never been a passion of mine, its very important to understand how to help reduce risk and keep patients and employees safe. Unfortunately, risk is a normal part of healthcare no matter how good we as practitioners are. Its essential to have protocol in place for when emergencies or accidents arise. Its also important to have every day protocol in place and enforced to help reduce the risk of these emergencies occurring. As a manager it is our job to make sure policies are being followed and updated. We need to encourage employees to relay opinions on how we can improve safety and make sure incident reports are being put in. This helps the unit as a whole improve. We also need to make sure that the work environment remains a blame free but also stress on the importance of personal responsibility and what this can mean for our own health and our own licenses. Safety is number one when it comes to risk management. Proper documentation is a huge part of safety. It keeps employees accountable and also helps ensure proper protocol is being followed. If there is one thing I have learned to manage risk as a manager on a unit it is the importance of documentation.
This week was about motivating employees. My experience only comes from personal work experience and thinking about jobs that I have had that I enjoyed going to work for. For me, I think the best motivator is having a positive and safe work environment. I don’t know of any employees that enjoy going into work and feeling unsafe physically or emotionally or enjoy negativity and conflict. Its easy to say that I will motivate my employees through positivity and hopefully they will enjoy being at work but what that actually looks like will vary from company to company. That could be through incentive programs or paid team meetings or employee recognition etc. I was able to get some great ideas from our team discussion post this week. There were ideas that I have experienced and appreciated as an employee and then there were things that I thought I wish we could test at my work right now! Overall, I think most importantly is that employees feel heard and valued. Team motivation is extremely effective but will not work if an individual isn’t motivated to be at work. Thats why I think focus should be on ensuring that the individual employee feels valued and then overall office morale will inevitably increase and the work flow improve.
Conflict can be an everyday part of life and can happen frequently in the workplace. Clashing ideas and attitudes will always be present because not every person will think the same things or in the same way. Knowing how to manage conflict is the first step in preparing for it. This week I have seen some great skills and some less effective ones in managing conflict. Knowing the difference between aggressive and assertive communication is important in deciding how to go about resolving conflict. Assertive communication is confident and calm but aggressive is rash and demanding. Everyone desired to be heard and have their needs met. Compromise is key when resolving conflict. Its also ok to be vulnerable as well. Confidence can come from vulnerability. The Guardian movie showed us that sharing experiences and allowing for vulnerability can help resolve inner and outer conflict. Trusting others and resolving issues from a team perspective can help bolster relationships and skirt conflict in the future. I think one of the best ways I learned how to resolve conflict this week was through a relational approach. The relationships come first, listening comes first, and exploring resolutions together is a priority. In the workplace, I think this is always a possibility, even if all the steps aren’t taken, its important to always make sure you’re listening first and then talking.
I learned this week that there are a lot of factors that go into strategic planning. Times are definitely changing and companies need to keep up with those changes. Marketing is a huge part of that. Our world is so digital these days that without marketing there is no way to be ahead for the future. Planning is also about anticipating possible changes in the future. Without anticipating all possibilities, a company cannot be as adaptable and planning is is essential to be able to adapt to the changing market. In our strategic planning assignment there are a lot of factors that go into the future of a large company, marketing, education, funding, personnel, building, and maintenance are just a portion of what goes into strategic planning. Without thinking of each possibility within any of those factors, I think a company can head for failure. Strategic planning is best done with a multitude of ideas and takes a committee in my opinion. I would never want to strategically plan without the input and ideas of others. As for an old and new school of thought for planning I think the new school thought is really dependent on marketing. The focus shouldn’t be financial gain, it should be based on staying relevant.
I thought the readings for this week were helpful in not only understanding how necessary it is to change and adapt in the healthcare setting and in life but how to begin to manage those changes. It’s one thing to have the attitude of “change happens,” expect it and learn to anticipate it for yourself, but its more difficult to help others you manage have that same attitude. There are many people who are understandably resistant to change and I also can be resistant at times. Change can be difficult but its essential for personal and company growth and stability. Without change we can’t grow as people or as a healthcare system. The world is constantly evolving and finding the best ways to manage workflow, decrease wasted time, increase profitability and marketability, and better serve our patients to maximize their health and experience is essentially the most important when it comes to succeeding in the healthcare industry. I have noticed even within the short time I have been with my company that better health outcomes come about when the company focuses on changing to fit the patient’s needs. Its not only essential to anticipate and adapt to changes that will and should happen but its important to monitor for the need to make changes. I think sometimes we just let change happen to us instead and then adapt as needed but as managers we need to constantly be searching to make changes. Taking inventory of our workers patients needs is just one example of beginning to facilitate change. We cannot make necessary changes on our own though either, all staff needs to be on board and I think Koppler’s model of change is a great way to begin the process and ensure that the changes are implemented properly and that they are lasting:
- Increase urgency
- Build the guiding team
- Get the vision right
- Communicate for buy-in
- Empower action
- Create short-term wins
- Don’t let up
- Make change stick
I interviewed Chris who is in charge of budgeting for club and high school boys and girls soccer at Black Hills Soccer club. Chris likes to manage budgets for his teams and usually does so alone. He sometimes has his assistant to ordering and inventory to make budgeting easier. He does not have a special degree for his job but he did study finance in college although he never majored in it. The hardest part about budgeting is trying to raise enough money to allot for budgeting. Club teams are a little easier because there are set fees to be on the team and a lot of parents like to be involved in fund raising. High school budgeting is more difficult because fund raising is essential because any money that isn’t raised through fundraising comes from donations and not from the school budget. Some sports teams are luckier than others and some years are better than other and has a greater budget to work with. Chris looks over the budget “pretty frequently” just to make sure there are no surprise dips in the budget. He tries not to make changes to the budget unless absolutely necessary. He tries to maximize whatever money comes in and tries to plan for upcoming expenditures throughout the year. He really attempts to have a budget set a year in advance and has been doing this long enough where he is able to plan that far ahead. There is really no leeway in the budgets and if it is over, then it will be over for the following year and that means less equipment or less travel or cheaper jerseys, whatever needs to be done to save money so there isn’t so much of a hole for the following year. The first area he looks to make cuts is coaches’ gifts or equipment. He tries not to consistently go over the budget but it’s very difficult to plan travel expenses. The bill usually comes at the end of the season and change in gas prices, bus breakdown, emergencies, or change in how long a tournament will be are just some examples of factors that are not as easily planned for. The hardest area to cut a budget according to Chris is the equipment. Equipment is an easy way to make sure a player has a good experience or gets the proper and best training he/she can have but that adds up quickly and it’s easy to get carried away. Overall, a hospital setting is similar because you want the best for the patients and staff but not all factors can be planned for and there needs to be wiggle room in case unplanned expenses arise.
This week I learned a lot about the direction of my career future. Although there are numerous avenues I can take it’s important to recognize and plan for the basic timeframe that each of these avenues can offer. Nursing is moving toward higher education standards and getting a nurse practitioner degree is requiring an advanced doctorate or even phd. As I get further along and more comfortable in my career I need to start thinking about timing and cost associated with getting an advanced degree. Some programs can take you from a BSN-DNP within 3 years but thats at full time, and likely you are not working full time during the program. Financially this could be difficult depending on the family situation. During our group discussion I got to see some other paths that my classmates are interested in and we each have different ideas or things that we need in order to make it work for us. I think for my time frame and financial situation in life it might be a good idea to continue looking into joining the military. It has been on my horizons for 2+ years now and my husband has been very supportive of the possibility. I still have time to decide and need to first complete my BSN but I have the career plan mapped out and it can be adjusted as necessary. For my career goals I feel like this is the best plan. We also discussed staffing this week and what seems to be the best way to go about staffing. I think its such a personal preference as to what works best and every staff member has individual needs. I prefer M-F 8-4, which is what I do. It allows me time with my family and it shortens my day because I tend to get fatigued and feel useless during 12 hour shifts and the recovery time is not enough for me. Others like to have days off in between and I think that can be very useful. I think the best way to staff a unit is to have worker involvement by allowing them to voice preference and applying preference fairly each week. It really depends on unit needs at the time but I think overall, workers are able to get a good amount of preference to their work schedule and managers should do the best they can to fulfill it fairly.
I think this week has been one of my favorites in the learning material. I think it’s so important to be involved in the evolving field of nursing and to learn about where nursing is headed in the future. As a nurse I definitely want to be a part of reaching the goals and mandates set by my fellow nurses and those in legislature. I can be involved in the promising future of nursing. Just by continuing on in my bachelors I am a part of the nursing future. This allows me to train and perform at my highest potential and capabilities within my licensure. We want to have nurses being utilized as full partners in a value based health care system where primary care and prevention is forefront and interdisciplinary care is normalized. It’s fun to see the changes already taking place in healthcare since I’ve entered the field. It’s also interesting for me to see the differences between healthcare by state. I like that the scope of nursing practice is starting to become more uniform. I had a yearly training meeting at my job last week and we were able to really learn the ever evolving nursing scope of practice. There were things that I didn’t even realize I was allowed to perform. And then there were things that I realized I was doing that were technically out of my scope of practice but I learned them from my managers and I figured it was ok. It’s important that we always are educating ourselves as nurses, not just for quality and safety measures, but because patients deserve the best care possible and that can’t happen if we don’t grow in our knowledge and with the changing field of medicine.
This week was a bit tough for me because I don’t quite understand budgeting thoroughly. I only know how to budget for my own family and have never budgeted for a company before. For me, I need to be shown how to do things sometimes before understanding it myself. Our budgeting assignment was difficult because I was unclear on how and what I would be allowed to cut. After discussing with my group, and seeing how they cut the budget for the med-surg floor it made much more sense to me. I was trying to figure out the yearly budget and thinking too far ahead instead of dealing with what was available monthly to me. I tend to do that with a lot of aspects in my life. I can see a lot of the bigger picture and can envision the end but I don’t do as well with the details leading up to that and taking things piece by piece. I definitely need to practice budgeting. I would hope I never have to take on this role in the hospital setting, but it is possible. It is not my strong suit and I don’t enjoy that aspect of management very much. I know that I will need to use others as a resource in the future to help me with that until I can fully understand it on my own. For right now, I think its important in my nursing practice to recognize that others do need to set a budget and I can be very helpful as an employee to manage resources and do my best to not be wasteful. I can always look for more efficient ways to provide patient care and be on the lookout for potential problems that could lead to budget issues.