1[1]..decision making & problem solving ‫‬

1
UNIT 1 A New Approach to Leadership
and Management
C H A P T E R
1
Decision Making, Problem
Solving, and Critical Thinking:
Requisites for Successful
Leadership and Management
The successful nurse executive has the ability
to make good decisions consistently.
—Thomas R. Clancy

2 UNIT 1 I A New Approach to Leadership and Management
To cope with the realities of today’s health care system, nurses must be prepared to
be critical thinkers. They must also be ready to welcome change and thrive in rap-
idly changing environments. Chapter 1 explores the primary requisites for success-
ful management and leadership: problem solving, critical thinking, and decision
making. Decision making is often thought to be synonymous with management
and is one of the criteria on which management expertise is judged. Much of any
manager’s time is spent critically examining issues, solving problems, and making
decisions. It is the authors’ belief that problem solving, decision making, and criti-
cal thinking are learned skills that improve with practice. So that the processes can
be consistently replicated, these learned skills rely heavily on established tools,
techniques, and strategies.
The quality of the leader–managers’ decisions is the factor that weighs most
heavily in their success or failure. Decision making is both the innermost leadership
activity and the core of management. Therefore, effective leaders and managers
must be able to answer the following questions:
• Do the circumstances warrant that a decision is required?
• How should the decision be made?
• Who should be involved in the decision-making process?
This unit describes the process of decision making in Chapter 1; explores the
development of management theory and management decision-making tools in
Chapter 2; and examines leadership theory from historical to contemporary per-
spectives in Chapter 3. Chapter 1 introduces the reader to problem solving,
decision making, and critical thinking and provides several problem-solving and
decision-making models that assist leaders and managers in making quality deci-
sions. It also introduces the learning exercise as a new approach for gaining skill in
management and leadership decision making.
DECISION MAKING, PROBLEM SOLVING, AND
CRITICAL THINKING
Decision making is a complex, cognitive process often defined as choosing a partic-
ular course of action. Webster’s definition—to “judge or settle”—is another view of
decision making. Both definitions imply that there was doubt about several courses
of action and that a choice was made that eliminated the uncertainty.
Problem solving is part of decision making. A systematic process that focuses on
analyzing a difficult situation, problem solving always includes a decision-making
step. Many educators use the terms problem solving and decision making synony-
mously, but there is a small yet important difference between the two. Although
decision making is the last step in the problem-solving process, it is possible for
decision making to occur without the full analysis required in problem solving.
Because problem solving attempts to identify the root problem in situations, much
time and energy are spent on identifying the real problem. Decision making, on the
other hand, is usually triggered by a problem but is often handled in a manner that
does not eliminate the problem. For example, a person who handled a conflict cri-
sis when it occurred but did not attempt to identify the real problem causing the

conflict, used only decision-making skills. The decision maker might later choose
to address the real cause of the conflict or might decide to do nothing at all about
the problem. The decision has been made not to problem solve. This alternative
may be selected because of a lack of energy, time, or resources to solve the real prob-
lem adequately. In some situations, this is an appropriate decision.
Here is an example of a decision not to solve a problem. A nursing supervisor
has a staff nurse who has been absent a great deal during the last 3 months. How-
ever, the supervisor has reliable information that the nurse will be resigning soon to
return to school in another state. Because the problem will soon no longer exist, the
supervisor decides that the time and energy needed to correct the problem are not
warranted.
Critical thinking, sometimes referred to as reflective thinking, is related to evalu-
ation and has a broader scope than decision making and problem solving. “Critical
thinking is purposeful, outcome-directed thinking that is based on a body of
knowledge derived from research and other sources of evidence” (Ignatavicius,
2001, p. 38). Components of critical thinking include reasoning and creative analy-
sis. Ignatavicious (2001) has identified six cognitive skills used in critical thinking,
including evaluation and analysis (see Display 1.1).
Various theorists define critical thinking differently, but most agree that it is
more complex than problem solving or decision making, involves higher-order rea-
soning and evaluation, and has both a cognitive and affective component. The
authors believe that insight, intuition, empathy, and the willingness to take action
are additional components of critical thinking. These same skills are necessary to
some degree in decision making and problem solving. See Display 1.2 for some
additional characteristics of a critical thinker.
VICARIOUS LEARNING TO INCREASE PROBLEM-SOLVING AND
DECISION-MAKING SKILLS
Decision making is one step in the problem-solving process, an important task that
relies heavily on critical-thinking skills (Marquis & Huston, 1995). How do people
become successful problem solvers and decision makers? Although successful deci-
sion making can be learned through life experience, not everyone learns to solve
3CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management
Interpretation: involves clarifying meaning
Analysis: understanding data
Evaluation: determining outcome
Inference: drawing conclusions
Explanation: justifying actions based on data
Self-regulation: examining one’s professional practice
Adapted from Ignatavicius, D. D. (2001). Critical thinking skills for at-the-bedside nurse. Nursing Management, 32[1],
37–39.
Six Cognitive Skills Used in Critical ThinkingDisplay 1.1
Insight, intuition,
empathy, and the
willingness to take
action are components
of critical thinking.

problems and judge wisely by this trial-and-error method because much is left to
chance.
Some educators feel that people are not successful in problem solving and deci-
sion making because individuals are not taught how to reason insightfully from
multiple perspectives. Belcher (2000) maintains that managers’ critical thinking
skills can be improved by having students write management case studies for analy-
sis. She thinks that improved critical thinking skills have a positive effect on the
quality of a manager's decision making and problem solving skills. Ignatavicious
(2001) feels that anyone can learn critical thinking, but it is a long-term process
that must be practiced, nurtured, and reinforced.
The Marquis-Huston Critical-Thinking Teaching Model
The desired outcome for teaching and learning decision making and critical think-
ing in management is an interaction between learners and others that results in the
ability to critically examine management and leadership issues.This is a learning of
appropriate social and professional behaviors rather than a mere acquisition of
knowledge. This type of learning occurs best in groups; therefore, when teaching
management and leadership the group process should be used in some way.
Additionally, learners retain didactic material more readily when it is personal-
ized or when they can relate to the material being presented. The use of case stud-
ies that learners can identify with assists in retention of didactic material presented.
While formal instruction in critical thinking is important, Clancy (2003) main-
tains that using a formal decision-making process is mandatory for successful deci-
sion making. So often new leaders and managers struggle to make quality decisions
because their opportunity to practice making management and leadership decisions
is very limited until they are appointed to a management position.These limitations
can be overcome by creating opportunities for vicariously experiencing the problems
that individuals would encounter in the real world of leadership and management.
The Marquis-Huston Critical-Thinking Teaching Model assists in achieving
desired learner outcomes (Figure 1.1). Basically, the model depicts four overlap-
ping spheres, each being an essential component for teaching leadership and man-
agement. There needs to be a didactic theory component, such as the material that
is presented in each chapter; secondly, a formalized approach to problem solving
and decision making must be used. Thirdly, there must be some use of the group
Open to new ideas Flexible Creative
Intuitive Empathic Insightful
Energetic Caring Willing to take action
Analytical Observant Outcome-directed
Persistent Risk-taker Willing to change
Assertive Resourceful Knowledgeable
Communicator “Out of the box” thinker
Characteristics of a Critical ThinkerDisplay 1.2

process, which can be accomplished by the use of large and small groups and class-
room discussion. Lastly the material must be made real for the learner so that the
learning is internalized. This can be accomplished through writing exercises, per-
sonal exploration, values clarification, and risk-taking that is involved as case stud-
ies are examined.
This book was developed with the perspective that experiential learning pro-
vides mock experiences that have tremendous value in applying leadership and
management theory. Throughout this text the authors have included numerous
opportunities for readers to experience the real world of leadership and manage-
ment. Some of these learning situations, which are called learning exercises, include
case studies, writing exercises, specific management or leadership problems,
staffing and budgeting calculations, group discussion or problem solving, and
assessment of personal attitudes and values. Some exercises include opinions, spec-
ulation, and value judgments. Since almost all the learning exercises require critical
thinking, problem solving, or decision making to some degree, the remainder of
this chapter will focus on providing a theoretical foundation for leadership and
management problem solving.
Didactic
theory
Personalized
learning
Group
process
Problem
solving
Figure 1.1 The Marquis-Huston Critical-Thinking Teaching Model.

THEORETICAL APPROACHES TO PROBLEM SOLVING AND
DECISION MAKING
Clancy (2003) states that there is a great tendency in decision making to bypass a
thorough analysis and jump too quickly into solutions. Process and structure are
beneficial to the process of decision making and force people to be specific about
options and to separate probabilities from values. A structured approach to prob-
lem solving and decision making increases critical reasoning and is the best way to
learn how to make quality decisions because it eliminates trial and error and focus-
es the learning on a proven process. A structured or professional approach involves
applying a theoretical model in problem solving and decision making.
To improve decision-making ability, it is important to use an adequate process
model as the theoretical base for understanding and applying critical-thinking
skills. Many acceptable problem-solving models exist, and most include a decision-
making step; only four are reviewed here.
Traditional Problem-Solving Process
The traditional problem-solving model is widely used and is perhaps the most well known
of the various models.The seven steps follow. (Decision-making occurs at step 5.)
1. Identify the problem.
2. Gather data to analyze the causes and consequences of the problem.
3. Explore alternative solutions.
4. Evaluate the alternatives.
5. Select the appropriate solution.
6. Implement the solution.
7. Evaluate the results.
Although the traditional problem-solving process is an effective model, its
weakness lies in the amount of time needed for proper implementation. This
process, therefore, is less effective when time constraints are a consideration.
Another weakness is lack of an initial objective-setting step. Setting a decision goal
helps to prevent the decision maker from becoming sidetracked.
The Managerial Decision-Making Process
The managerial decision-making model, a modified traditional model, eliminates
the weakness of the traditional model by adding a goal-setting step. Harrison (1981)
has delineated the following steps in the managerial decision-making process:
1. Set objectives.
2. Search for alternatives.
3. Evaluate alternatives.
4. Choose.
5. Implement.
6. Follow up and control.
The managerial decision-making process flows in much the same manner as the
nursing process. A comparison of the simplified nursing process and a model of
decision-making are shown in Table 1.1.
A structured approach to
problem solving and
decision making
increases critical
reasoning.

The Nursing Process
The nursing process provides another theoretical system for solving problems and
making decisions. Educators have identified the nursing process as an effective
decision-making model, although there is current debate about its effectiveness as a
clinical reasoning model (Pesut & Herman, 1998).
As a decision-making model, the nursing process has a strength that the previ-
ous two models lack, namely its feedback mechanism. The arrows in Figure 1.2
show constant input into the process. When the decision point has been identified,
initial decision-making occurs and continues throughout the process by using a feed-
back mechanism. Although the process was designed for nursing practice with regard
to patient care and nursing accountability, it can easily be adapted as a theoretical
Assess
Implement
Evaluate Plan
Diagnose
Figure 1.2 Feedback
mechanism of the
nursing process.
Table 1.1 Comparing the Decision-Making Process with the
Nursing Process
Decision-Making Process Simplified Nursing Process
Identify the decision Assess
Collect data
Identify criteria for decision Plan
Identify alternatives
Choose alternative Implement
Implement alternative
Evaluate steps in decision Evaluate

model for solving leadership and management problems.Table 1.1 shows how closely
the nursing process parallels the decision-making process.
The weakness of the nursing process, like the traditional problem-solving
model, is in not requiring clearly stated objectives. Goals should be clearly stated in
the planning phase of the process, but this step is frequently omitted or obscured.
However, because nurses are familiar with this process and its proven effective-
ness, it continues to be recommended as an adapted theoretical process for leader-
ship and managerial decision making.
Many other excellent problem analysis and decision models exist. The model
selected should be one with which the decision maker is familiar and one appropri-
ate for the problem to be solved. Using models or processes consistently will
increase the likelihood that critical analysis will occur. By cultivating a scientific
approach, the quality of one’s management and leadership problem solving and
decision making will improve tremendously.
Intuitive Decision-Making Model
According to Hansten and Wahburn (2000), many nursing scientists in the past
did not value intuition in decision making as they felt intuitive reasoning did not
align itself well with the status and power of a true science. Recently, however, there
has been a renewed interest in intuitive thinking and Ignatavicious (2001) identi-
fies it as one of the characteristics of an expert critical thinker. It must be remem-
bered, however, that intuition can be overpowered by emotions.Therefore, using an
intuitive decision-making model is helpful in order to prevent emotions from
clouding the decision-making process.
Romiszowski (1981) built on the nursing process in creating the intuitive decision-
making model shown in Figure 1.3. In this model, the decision maker consciously
Patient4. Implement/
Evaluate 3. Plan
2. Recall
Possible
Nursing
Diagnosis
and
Interventions
1. Assess
Gather
Patient
Data
Implement
Follow Through
Evaluate Exercise Judgment
Synthesize
Analyze
Figure 1.3 Intuitive decision-making model (Romiszowski, 1981). Reprinted with
permission of Journal of Nursing Staff Development.

CRITICAL ELEMENTS IN PROBLEM SOLVING AND
DECISION MAKING
Because decisions may have far-reaching consequences, problem solving and deci-
sion making must be of high quality. Using a scientific approach to problem solving
and decision making does not, however, ensure a quality decision. Special attention
must be paid to other critical elements. The following elements, considered crucial
in the problem-solving process, frequently result in poor-quality decisions.
Applying Scientific Models to Decision Making
You are an RN who graduated three years ago. During the last three years,
your responsibilities in your first position have increased. Although you enjoy
your family (husband and one preschool-age child), you realize that you love
your job, and your career is very important to you. Recently, you and your
husband decided to have another baby. At that time, you discussed your
career and both of you reached a joint decision that, if you had another
baby, you wanted to reduce your work time and spend more time at home
with the children. Last week, you were thrilled and excited when your super-
visor told you the charge nurse is leaving and that she wants to appoint you
to the position. Yesterday, you found out that you are pregnant.
Last night, you and your husband talked about your career future. He is
an attorney whose practice has suddenly gained momentum. Although he
has shared child rearing equally with you until this point, he is not sure how
much longer he will be able to do so if his practice continues to expand. If
you take the position, which you would like to do, it would mean full-time
work. You want the decision you and your husband reach to be well
thought-out as it has far-reaching consequences and concerns many people.
Assignment: Using a scientific approach (one of the four models just dis-
cussed), determine what you should do. After you have made your deci-
sion, get together in a group (four to six people) and share your resolu-
tion. Were your decisions the same? How did you approach the problem
solving differently from others in your group? Did some of the group
members identify alternatives you had not considered? How did your per-
sonal values influence your decision?
Learning Exercise 1.1
incorporates recall or cumulative knowledge that comes from education, both formal
and informal, as well as experience, in planning the decision. Inexperienced or novice
decision makers spend more time in the assessment, recall, and planning phases, where-
as experienced decision makers gather information, recall, and often leap directly to
implementation, because planning has become automatic.That novice nurses and expe-
rienced nurses process information differently has been supported by Benner (1994).
Ironically, this “leap” from information gathering to implementation may be the
greatest weakness of this model. In discussing intuitive decision making, Lamond
and Thompson (2000) warn that since the process is largely invisible, there is little
information to evaluate if the outcome of the decision is less than positive.

Define Objectives Clearly
Decision makers often forge ahead in their problem-solving process without first
determining their goal. Even when decisions must be made quickly, there is time to
pause and reflect on the purpose of the decision. If a decision lacks a clear objective
or if an objective is not consistent with the individual’s or organization’s stated phi-
losophy, a poor-quality decision is likely. Sometimes the problem has been identi-
fied but the wrong objectives are set. Problems can be extremely complex and may
need multiple objectives (Clancy, 2003).
Gather Data Carefully
Because decisions are based on knowledge and information available to the problem
solver at the time the decision must be made, one must learn how to process and
obtain accurate information. The acquisition of information begins with identify-
ing the problem or the occasion for the decision and continues throughout the
problem-solving process. Often the information is unsolicited, but most informa-
tion is sought actively.
Acquiring information always involves people, and no tool or mechanism is
infallible to human error. Human values tremendously influence our perceptions.
Therefore, as problem solvers gather information, they must be vigilant that their
own preferences and those of others are not mistaken for facts. Remember that
facts can be misleading if they are presented in a seductive manner or taken out of
context or if they are past-oriented. Numerous parents have been misled by the
factual statement, “Johnny hit me.” In this case, the information seeker needs to
do more fact finding. What was the accuser doing before Johnny hit him? What
was he hit with? Where was he hit? When was he hit? Like the parent, the man-
ager who becomes expert at acquiring adequate, appropriate, and accurate infor-
mation will have a head start in becoming an expert decision maker and problem
solver.
To gain knowledge and insight into managerial and leadership decision making,
individuals must reach outside their current sphere of knowledge in solving the
problems presented in this text. Some data-gathering sources include textbooks,
periodicals, experts in the field, colleagues, and current research.
Questions that should be examined in data gathering are:
1. What is the setting?
2. What is the problem?
3. Where is it a problem?
4. When is it a problem?
5. Who is affected by the problem?
6. Is this your problem or someone else’s problem?
7. What is happening?
8. Why is it happening? What are the causes of the problem? Can the causes
be prioritized?
9. What are the basic underlying issues? What are the areas of conflict?
10. What are the consequences of the problem? Which is the most serious?

Generate Many Alternatives
The definition of decision-making implies there are at least two choices in every
decision. Unfortunately, many problem solvers limit their choices to two when
many more options usually are available. The greater the number of alternatives
that can be generated during this phase, the greater the chance that the final deci-
sion will be sound. When seeking alternatives, individuals need to expand their
horizons; the most common trap managers fall into is limiting the borders of their
decision frames (Clancy, 2003).
Remember that one alternative in each decision should be the choice not to do
anything. When examining decisions to be made using a formal process, it is often
found that the status quo is the right alternative. Several techniques can help gen-
erate more alternatives. Involving others in the process confirms the adage that two
heads are better than one. Because everyone thinks uniquely, increasing the number
of people working on a problem increases the number of alternatives that can be
generated.
Possible Alternatives in Problem Solving
In the personal choice scenario presented in Learning Exercise 1.1, some
of the following alternatives could have been generated:
Do not take the new position.
Hire a full-time housekeeper, and take the position.
Ask your husband to quit his job.
Have an abortion.
Ask one of the parents to help.
Take the position, and do not hire child care.
Take the position and hire child care.
Have your husband reduce his law practice and continue helping with
child care.
Ask the supervisor if you can work four days a week and still have the
position.
Take the position and wait and see what happens after the baby is
born.
Assignment: How many of these alternatives did you or your group gen-
erate? What alternatives did you identify that are not included in this list?
Gathering Necessary Information
Identify a poor decision you recently made because of faulty data gather-
ing. Have you ever made a poor decision because necessary information
was intentionally or unintentionally withheld from you?

Brainstorming is another frequently used technique. The goal in brainstorming
is to think of all possible alternatives, even those that may seem “off target.” By not
limiting the possible alternatives to only apparently appropriate ones, people are
able to break through habitual or repressive thinking patterns and allow new ideas
to surface. Although most often used by groups, people making decisions alone also
may use brainstorming. Clancy (2003) suggests that once a large number of alter-
natives are generated that the list be revised so that the decision maker is left with
three or four, as any more may create too many variables and factors to evaluate
effectively.
Think Logically
During the problem-solving process, one must draw inferences from information.
An inference is part of deductive reasoning. People must carefully think through
the information and the alternatives. Clancy (2003) states that among other things,
deep-seated biases often cloud effective decision making. Faulty logic at this point
may lead to poor-quality decisions. People think illogically primarily in three ways.
1. Overgeneralizing. This type of “crooked” thinking occurs when one believes
that because A has a particular characteristic, every other A also has the
same characteristic. An example of this thinking is when stereotypical state-
ments are used to justify arguments and decisions.
2. Affirming the consequences. In this type of illogical thinking, one decides that
if B is good but he or she is doing A, then A must not be good. For example,
if a new method is heralded as the best way to perform a nursing procedure
and the nurses on your unit are not using that technique, it is illogical to
assume that the technique currently used in your unit is wrong or bad.
3. Arguing from analogy. This thinking applies a component that is present in
two separate concepts and then states that because A is present in B, then A
and B are alike in all respects. An example of this would be to argue that
because intuition plays a part in clinical and managerial nursing, then any
characteristic present in a good clinical nurse also should be present in a
good nurse–manager. However, this is not necessarily true; a good nurse–
manager does not necessarily possess all the same skills as a good nurse–
clinician.
Various tools have been designed to assist managers with the important task of
analysis. Several of these tools are discussed later in Chapter 2. In analyzing possi-
ble solutions, individuals may want to look at the following questions:
1. What factors can you influence? How can you make the positive factors
more important and minimize the negative factors?
2. What are the financial implications in each alternative? The political implica-
tions? Who else will be affected by the decision and what support is available?
3. What are the weighting factors?
4. What is the best solution?
5. What are the means of evaluation?
6. What are the consequences of each alternative?

Choose and Act Decisively
It is not enough to gather adequate information, think logically, select from among
many alternatives, and be aware of the influence of one’s values. In the final analy-
sis, one must act. Individuals may become vulnerable at this last point in the
problem-solving process and choose to delay acting because they lack the courage
to face the consequences of their choices. For example, if managers granted all
employees’ requests for days off, they would have to accept the consequences of
their decision by dealing with short staffing.
It may help the reluctant decision maker to remember that decisions, although
often having long-term consequences and far-reaching effects, are not cast in stone.
In many cases, judgments found to be ineffective or inappropriate can be changed.
By evaluating decisions at a later time, managers can learn more about their abili-
ties and where the problem solving was faulty. However, decisions must continue to
be made, although some are of poor quality, because through continued decision
making, people develop increased decision-making skills (Display 1.3).
INDIVIDUAL VARIATIONS IN DECISION MAKING
If each person receives the same information and uses the same scientific approach
to solve problems, an assumption could be made that identical decisions would
result. However, in practice, this is not true. Because decision making involves per-
ceiving and evaluating, and people perceive by sensation and intuition and evaluate
their perception by thinking and feeling, it is inevitable that individuality plays a
part in decision making. Because everyone has different values and life experiences,
and each person perceives and thinks differently, different decisions may be made
given the same set of circumstances. No discussion of decision making would,
therefore, be complete without a careful examination of the role of the individual in
decision making (see Display 1.4).
Values
Individual decisions are based on each person’s value system. No matter how objec-
tive the criteria, value judgments will always play a part in a person’s decision mak-
ing, either consciously or subconsciously. The alternatives generated and the final
choice selected are limited by each person’s value system. For some, certain choices
• Define objectives clearly
• Gather data carefully
• Generate many alternatives
• Think logically
• Choose and act decisively
Critical Elements in Decision MakingDisplay 1.3

are not possible because of a person’s beliefs. Because values also influence percep-
tions, they invariably influence information gathering, information processing, and
final outcome (Marquis & Huston, 1995). Values also determine which problems
in one’s personal or professional life will be addressed or ignored.
Life Experience
Each person brings to the decision-making task past experiences that include edu-
cation and decision-making experience. The more mature the person and the
broader his or her background, the more alternatives he or she can identify. Each
time a new behavior or decision is observed, that possibility is added to the person’s
repertoire of choices. People vary in their desire for autonomy, so some nurses may
want more autonomy than others. It is likely that people seeking autonomy may
have much more experience at making decisions than those who fear autonomy.
Likewise, having made good or poor decisions in the past will influence a person’s
decision making.
Individual Preference
With all the alternatives a person considers in decision making, one alternative may
be preferred over another. The decision maker, for example, may see certain choic-
es as involving greater personal risk than others and therefore may choose the safer
alternative. Physical, economic, and emotional risks, and time and energy expendi-
tures, are types of personal risk and costs involved in decision making. For example,
those with limited finances or a reduced energy level may decide to select an alter-
native solution to a problem that would not have been their first choice had they
been able to overcome limited resources.
Individual Ways of Thinking and Decision Making
Our way of evaluating information and alternatives on which we base our final
decision constitutes a thinking skill. Individuals think differently. Some think
systematically—and are often called analytical thinkers—whereas others think
intuitively. It is believed that most people have either right- or left-brain hemi-
sphere dominance (Good, 2002). Although the authors encourage whole-brain
thinking, and studies have shown that people can strengthen the use of the less
dominant side of the brain, most people continue to have a dominant side. Analytical,
• Values
• Life experience
• Individual preference
• Individual ways of thinking and decision making
Individual Variations in Decision MakingDisplay 1.4

linear, left-brain thinkers process information differently than creative, intuitive,
right-brain thinkers. Intuition is the ability to understand the possibilities inherent
in a situation.
Some feel that there is a gender difference in how we think and behave. Rudan’s
research (2003) looked at how male and female leaders behaved differently and
noted that males and females socialized and communicated differently; males paid
much less attention to relationships and resisted being influenced. These differ-
ences have the potential to effect decision making.
The way one thinks has much to do with individual problem solving and decision
making. There is no evidence that either right- or left-brain thinking is preferable. In
the past, organizations openly recognized the value of logical, analytical thinkers but
more recently have acknowledged that intuitive thinking is a valuable managerial
resource. It is felt that right-brain thinkers are more creative, but the current emphasis
in teaching and learning is to encourage whole-brain thinking (Good, 2002).
OVERCOMING INDIVIDUAL VULNERABILITY IN
DECISION MAKING
How do people overcome subjectivity in making decisions? This can never be com-
pletely overcome, nor should it. After all, life would be boring if everyone thought
alike. However, managers and leaders must become aware of their own vulnerabili-
ty and recognize how it influences and limits the quality of their decision making.
Using the following suggestions will help decrease individual subjectivity and
increase objectivity in decision making.
Values
Being confused and unclear about one’s values may affect decision-making abili-
ty (Huston & Marquis, 1995). Overcoming a lack of self-awareness through val-
ues clarification decreases confusion. People who understand their personal
beliefs and feelings will have a conscious awareness of the values on which their
decisions are based. This awareness is an essential component of decision making
and critical thinking. Therefore, to be successful problem solvers, managers must
periodically examine their values. Values clarification exercises are included in
Chapter 7.
Thinking Styles
In a group discussion, examine how each individual in the group thinks.
Do you have a majority of individuals with right- or left-brain dominance
in your group? Do more women than men belong to one group? Discuss
what type of thinkers are represented in your family. Did most individuals
in your group have a variety of thinkers in their family?

Life Experience
It is difficult to overcome inexperience when making decisions. Benner (1994)
refers to this lack of experience as “reason in transition.” However, a person can do
some things to decrease this area of vulnerability. First, use available resources,
including current research and literature, to gain a fuller understanding of the issues
involved. Second, involve other people, such as experienced colleagues, trusted
friends, or superiors, to act as sounding boards and advisors. Third, analyze deci-
sions later to assess their success. By evaluating decisions, people learn from mis-
takes and are able to overcome inexperience.
Individual Preference
Overcoming this area of vulnerability involves self-awareness, honesty, and risk
taking.The need for self-awareness was discussed previously, but it is not enough to
be self-aware; people also must be honest with themselves about their choices and
their preferences for those choices. Additionally, the successful decision maker
must take some risks. Nearly every decision has some element of risk, and most
involve consequences and accountability. Those who are able to do the right but
unpopular thing and who dare to stand alone will emerge as leaders.
Individual Ways of Thinking
People who make decisions alone are frequently handicapped because they are not
able to understand problems fully or make decisions from both an analytical and
intuitive perspective. However, in most organizations, both types of thinkers may
be found. Using group process, talking management problems over with others,
and developing whole-brain thinking also are methods for ensuring that both intu-
itive and analytical approaches will be used in solving problems and making deci-
sions. Use of heterogeneous rather than homogeneous groups will usually result in
better-quality decision making. See Display 1.5 for more information.
Indeed, learning to think “outside the box” is often accomplished by including a
diverse group of thinkers to solve problems and make decisions. It is good organi-
zational theory for leaders to surround themselves with a variety of talented people,
Although not all experts agree, Huston (1990) suggests that the following are qualities of
successful decision makers:
• Courage. Courage is of particular importance and involves the willingness to take risks.
• Sensitivity. Good decision makers seem to have some sort of antenna that makes them
particularly sensitive to situations and others.
• Energy. People must have the energy and desire to make things happen.
• Creativity. Successful decision makers tend to be creative thinkers.They develop new
ways to solve problems.
Qualities of Successful Decision MakersDisplay 1.5

including individuals who sometimes have strange ideas and are “out of the box”
thinkers (Ignatavicius, 2001).
DECISION MAKING IN ORGANIZATIONS
In the beginning of this chapter the need for managers and leaders to make quality
decisions was emphasized. The effect of the individual’s values and preferences on
the decision making process was discussed. But it is important for leaders and man-
agers to also understand how the organization influences the decision-making
process. Since organizations are made up of people with differing values and pref-
erences, there is often conflict in organizational decision dynamics.
Effect of Organizational Power on Decision Making
Powerful people in organizations are more apt to have decisions made (by them-
selves or their subordinates) that are congruent with their own preferences and val-
ues. On the other hand, people wielding little power in organizations must always
consider the preference of the powerful when they make management decisions.
Power is frequently part of the decision factor (Good, 2003). In organizations
choice is constructed and constrained by many factors, and therefore choice is not
equally available to all people.
Additionally, not only does the preference of the powerful influence decisions of
the less powerful, but the powerful also are able to inhibit the preferences of the less
powerful. This occurs because individuals who remain and advance in organiza-
tions are those who feel and express values and beliefs congruent with the organi-
zation. Therefore, a balance must be found between the limitations of choice posed
by the power structure within the organization and totally independent decision
making that could lead to organizational chaos.
The ability of the powerful to influence individual decision making in an organ-
ization often requires adopting a private personality and an organizational person-
ality. For example, some might believe they would have made a different decision
had they been acting on their own, but they went along with the organizational
decision. This “going along” in itself constitutes a decision; people choose to accept
an organizational decision that differs from their own preferences and values. The
concept of power in organizations is discussed more fully in Chapter 13.
Rational and Administrative Decision Making
For many years, it was widely believed that most managerial decisions were based
on a careful, scientific, and objective thought process and managers made decisions
in a rational manner. In the late 1940s, Herbert A. Simon’s classic work revealed
that most managers made many decisions that did not fit the objective rationality
theory. Simon (1965) delineated two types of management decision makers: the
economic man and the administrative man.
Managers who are successful decision makers attempt to make rational deci-
sions, much like the economic person described in Table 1.2. Because they realize
The ability of the
powerful to influence
individual decision
making in an
organization often
requires adopting a
private personality and
an organizational
personality.

that restricted knowledge and limited alternatives directly affect a decision’s quali-
ty, these managers gather as much information as possible and generate many alter-
natives. Simon believed that the economic model was an unrealistic description of
organizational decision making. The complexity of acquiring information makes it
impossible for the human brain to store and retain the amount of information that
is available for each decision. Because of time constraints and the difficulty of
assimilating large amounts of information, most management decisions are made
using the administrative model of decision making. The administrative person
never has complete knowledge and generates fewer alternatives. Simon argued that
the administrative person carries out decisions that are only “satisficing,” a term
used to describe decisions that may not be ideal but result in solutions that have
adequate outcomes. These managers want decisions to be “good enough” so that
they “work,” but they are less concerned that the alternative selected is the optimal
choice.The “best” choice for many decisions is often found to be too costly in terms
of time or resources, so another less costly but workable solution is found.
SUMMARY
This chapter has discussed effective decision making, problem solving, and critical
thinking as requisites for being a successful leader and manager. The effective
leader–manager is aware of the need for sensitivity in decision making. The suc-
cessful decision maker possesses courage, energy, and creativity. It is a leadership
skill to recognize the appropriate people to include in decision making and to use a
suitable theoretical model for the decision situation.
The manager should develop a systematic, scientific approach to problem solv-
ing that begins with a fixed goal and ends with an evaluation step. Managers who
make quality decisions are effective administrators.
Table 1.2 Comparing the Economic Man with the
Administrative Man
Economic Administrative
Makes decisions in a very rational Makes decisions that are good enough.
manner.
Has complete knowledge of the Because complete knowledge is not possible,
problem or decision situation. knowledge is always fragmented.
Has a complete list of possible Because consequences of alternatives
alternatives. occur in the future, they are impossible
to predict accurately.
Has a rational system of ordering Usually chooses from among a few
preference of alternatives. alternatives, not all possible ones.
Selects the decision that will The final choice is “satisficing” rather than
maximize utility function. maximizing.
Adapted from Simon, 1965.

The integrated leader–manager understands the significance that personal val-
ues, life experience, preferences, and ways of thinking have upon selected alterna-
tives in making the decision. The critical thinker pondering a decision is aware of
the areas of vulnerability that hinder successful decision making and will expend
his or her efforts to avoid the pitfalls of faulty logic and data gathering.
Both managers and leaders understand the impact the organization has on deci-
sion making and that some decisions that will be made in the organization will be
only satisficing. However, leaders will strive to problem solve adequately in order to
reach optimal decisions as often as possible.
❊ Key Concepts
• The professional decision maker is self-aware, courageous, sensitive, ener-
getic, and creative.
• The professional approach to problem solving begins with a fixed goal and
ends with an evaluation process.
• The successful decision maker understands the significance that each per-
son’s values, life experience, preferences, and way of thinking have on select-
ed alternatives.
• The critical thinker is aware of areas of vulnerability that hinder successful
decision making and makes efforts to avoid the pitfalls of faulty logic in his
or her data gathering.
• The act of making and evaluating decisions increases the expertise of the
decision maker.
• There are many models for improving decision making. Using a model
reduces trial and error and increases the probability that decisions made will
be sound.
• Left- and right-brain dominance influences to some degree how individuals
think.
• Two major considerations in organizational decision making are how power
affects decision making and whether management decision making needs to
only be “satisficing.”
More Learning Exercises and Applications
These exercises may be discussed individually, in groups, or used as written assign-
ments.
Evaluating Decision Making
Describe the two best decisions you have made in your life and the two
worst. What factors assisted you in making the wise decisions? What ele-
ments of critical thinking went awry in your poor decision making? How
would you evaluate your decision making ability?

Profile Examining
Examine the process you used to decide to become a nurse. Would you
describe it as fitting a profile of the economic or the administrative
model?
Considering Critical Elements in Decision Making
You are a college senior and president of your nursing organization. You
are on the committee to select a slate of officers for the next academic
year. Several of the current officers will be graduating and you want the
new slate of officers to be committed to the organization. Some of the
brightest members of the junior class that are involved in the organiza-
tion are not well liked by some of your friends in the organization.
Assignment: Looking at the critical elements in decision making compile a
list of the most important points to consider in making the decision for
selection of a slate of officers. What must you guard against and how
should you approach the data gathering to solve this problem?
Examining the Decision-Making Process
You have been a staff nurse for three years, since your graduation from
nursing school. There is a nursing shortage in your area and many open-
ings at other facilities. Additionally, you have been offered a charge nurse
position at your present employment. Lastly, you have always wanted to
do community health nursing and know that this is also a possibility. You
are self-aware enough to know that it is time for a change, but which
change should you make, and how should you make the decision?
Assignment: Examine both the individual aspects of decision making and
the critical elements in making decisions. Make a plan including a goal, a
list of information and data that you need to gather and areas where you
may be vulnerable to successful decision making. Examine the conse-
quences of each alternative available to you. After you have done this, as
an individual, form a small group and share your decision making plan-
ning with members of your group. How was your decision making like
others in the group and how was it different?

Using Models in Decision Making
Do you use a problem-solving or decision-making model to solve prob-
lems? Have you ever used an intuitive model? Think of a critical decision
you have made in the last year. What model, if any, did you use?
Assignment: Write a one-page essay about a problem you solved or a
decision that you made this year. Describe what theoretical model you use
to assist you in the process. Determine if you consciously used the model
or if it was purely by accident. Did you enlist the help of other experts in
solving the problem?
A
Step-by-Step Problem Solving
You are a home-health nurse who makes in-home visits to a moribund
elderly man with advanced cancer. He is now confined to bed, and his
major care needs are comfort-based. In addition to directly providing pain
medication to this man, you, as a case manager, are responsible for over-
seeing other personnel who assist in caring for him. These personnel
include rotating health aides who are responsible for bathing the patient,
preparing his meals, and providing other basic care not requiring a pro-
fessional license. The patient’s family generally stays with him at night.
At times, during your in-home visits, you have noticed that there are
food crumbs in the bed, that the patient’s hair is uncombed, and that his
teeth have not been brushed, and you suspect that he has not been
recently bathed.
Assignment: Use one of the problem-solving or decision-making models
in this chapter and do the following:
1. Identify a brief (no longer than one or two sentences) problem state-
ment for this case.
2. Determine who owns the problem.
3. List at least three goals or objectives to guide your problem solving.
4. Detail at least three key pieces of information you must consider in
data gathering.
5. List at least six alternatives for solving this case, including the pros and
cons of each.
6. Identify at least four specific criteria you will use to evaluate your final
decision and/or choice of action. Be sure these criteria reflect the deci-
sion-making process you used as well as the desired outcome.
If time allows, divide into small groups and share the results of your prob-
lem solving.

Web Links
Judgment and Decision Making
http://www.sjdm.org
Promotes the study of normative, descriptive theories of decision processes.
http://www.hooah4health.com/spirit/decisions.htm
Free tools you can use to solve problems and make decisions in your life.
Mission Critical
http://www.sjsu.edu/depts/itl
The goal of this site is to teach visitors the basic concepts of critical thinking, deductive
reasoning, and finding faults in dubious arguments. The site provides tutorials, exercises,
and links to related Web sites.
References
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