Organizational Analysis Paper - Personal websites at UB
Amanda White, Mary Purcell, Jinkyoung Yu, Katherine Hage
N472 Nursing Management of Patient Care
Due December 3, 2007
1. The unit we are on is a medical rehab unit consisting of stroke, hip/knee replacement, heart
attacks,lumbar laminectomy, and craniotomy patients. The focus of the unit is to improving the
health, functioning, and quality of life of patients transitioning from an acute care facility. It is a 20
bed unit that promotes the independence of individuals and focuses on self-care, transfers, boweland
bladder control, communication, locomotion, and social cognition. The patient care model used is
total patient care which involves a registered nurse being responsible for all aspects of the care of one
or more patients. The advantages of this system include a continuous, holistic, expert nursing care,
total accountability for the nursing care provided, and continuity of communication with the patient,
family, physician, and staff from other departments. The disadvantage to they system is that the RN
spends some time doing tasks that could be done by a less skilled person.
2. Patient Care Model:
Patients Patients Patients
3. Direct Chain of Command
Indirect Chain of Commands
Our firstimpressionswhenwe came ontothe unitwasthat the atmosphere was
welcomingandthe staff wasexcitedtosee us. The factors thatwere mostpleasing
were thatthe staff wasexcitedtosee usbecause ittheneasedouranxietyonthe first
day of clinical. The factorthat was mostanxiety –provoking waswhenwe gotassigned
our patientforthe day and were expected toknow everythingthatneededtobe done
and the nurseswere notto pleasedwhenwe hadtoaskthemquestions regarding
patientcare. One thisunit,it ismore importantto meetthe client’sphysical needsover
theirpsychosocial needssince theyare recoveringfromsurgeryandanticipatingtobe
dischargedhome soon. Psychosocial needsare notdisregardedthoughandalsoplaya
huge role isdischarge planning. Itisveryimportanttobe organizedandefficient
because youneedtoprioritize yourcare sothat the patientsneedsare metproperly
whetherthatbe that the patientreceivesparticularmedicationbefore breakfastorthat
theirAMcare isdone before goingtophysical therapy. Itisalso extremelyimportantto
understandthe client’spointof view aswell astheirvaluesbecauseyouwanttomake
sure you are meetingtheirneedsandtakingintoaccounttheirperspectivesonthe care
The nurseson the unitwearscrubs of differentcolorsandpatterns. Itissometimes
hard to tell the difference betweenthe nursesonthe unitandthe nursesaidsbecause
theytypicallywearthe same uniform. The doctorsonthe unitweara labcoat with
eithergreenscrubsora formal shirtandtie and dresspants. Both nursesaidsand
registerednurseshave theirname writtenonadry erase boardineverypatientroomso
the patientisaware of who istakingcare of them. Each healthcare professional wears
a name tag withappropriate title toclarifytheirstatus. The nurse’sstationiscrowded
withmanypeople andthe countersare filledwithmanybindersandpaperworkleaving
little space tochart. Overall though,the hospital israthercleanandsanitary. The
patientroomsare small,cluttered,dark,andnotveryappealingtothe patient. The
seatingforpaperworkis veryminimal andwe oftenhadto standwhenchartingand the
workingconditions are verycrowdedattimeswithdoctors,RNs,physical therapist,
The level of courtesyshowntothe patients’familiesisgood andthe nursesare seenas
beingveryhelpfultothe familieswhentheyhave questionsorconcerns. Menand
womenbothworkon the unitand appearto be treatedequally. Theyworktogether
and helpeachotherout whentheyneedit. We have notseenanygender-basedbias
toward anyone. All the healthcare workersonthe unitare treatedwithrespect.
Nursesare on a firstname basis witheach other,the doctorsare greetedwiththeirtitle
and lastname. Managers and supervisorsare alsoona firstname basis.
The nurse manager onfor the shiftholdsa democraticstyle. The charge nurse,nurse
manager,and doctorcan tell the staff nurse whatto do. Some nursesare more
powerful thanothersdue tolevel of experience andeducation.
An individual nurse usuallydecideswhatnursingcare a clientneedsfollowingorders
from the physician’s assistantordoctor. The nurse’stendtoworkalone unlessthey
We have notwitnessedcriticismof RN to RN,however,RN toaidand RN to studenthas
occurred. Criticism hasoccurredbothpubliclyandprivately. We have overheard
conversationsthathave impliedinadequaciesaboutnursingstudentsas well asbeing
directlyspokentoaboutour wayof administeringcare.
Strong/WeakUncertaintyAvoidance (Preferenceforchange ormaintainingstatusquo)
The nursestendto stay withpastwaysof doingthingsandappearto set intheirways
doingthings. The policiesandprocedure manualsare readilyavailable andare updated.
We have not witnessedthe nursesreferringtotheirmanuals,perhapsbecause they
alreadyknowandare experienced,andhave foundquicker waysof completingatask.
We believethatthe nursesonthe unitare veryconfidentintheirskillsandfeelstrongly
about theirwayof doingthingsisthe correct way.
The nursesappearto be veryconscientiousabout theirpatientsandtheydon’tneglect
theirpatients. Thisis apparentbecause theyare controllingandslightlyarrogantaboutit.
The most significantbarriertothe deliveryof care isa negative attitude andtheir
unwillingnesstochange. Thisisa barrierbecause itbringseveryone else’sattitudesdown
on the unitand can affectthe patients,if theyencounterthisbehavior. The mostimportant
lessonwe have learnedworkingonthisunitisteamwork,time management,organizational
skills,andprioritizingcare. We learnedthisthroughourcare plans,havinga limitedtime
frame to getthingsdone as we were onlyonthe unitfor 6 hours,anddeterminingwhat
needsof the patientwere of firstpriority.
1 Pay, Reward 2
3 Administration 4 Professional
1. The statementsthatshow the most satisfactionare numberone whichstatesthat
whenI’mworkinginthishospital,the time generallygoesby quicklyandnumber13
whichstatesthat theystronglydisagree withwhatIdoon myjob doesn’taddupto
anythingsignificant. Theyagree thattheyare so busywhile atworkthat the time
goesby quicklyandthat theirjobis important.
2. The statementsthatshow the leastsatisfactionare number8 and10. The staff feels
that theirpayis notsufficientwhencomparingittothe workthat theydo. Theyare
unsatisfiedwithnotbeingable toparticipate inthe administrative decisionmaking
processbecause theyfeel thatdon’thave avoice.
3. The mean score for the entire tool tellsusthatoverall theyare prettysatisfiedwith
theircareerbut there isalwaysroomfor improvement.
4. The staff is not satisfiedwithpay/rewardoradministration. Thisisdue tolowpay
and nothavinga voice. Theyare satisfiedwithinteractionsandprofessionalstatus
because theyhave goodteamworkand theyfeel confidentintheirabilitiestocare