Organizational Analysis Paper - Personal websites at UB


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Organizational Analysis Paper - Personal websites at UB

  1. 1. 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: Charge Nurse Registered Nurse Registered Nurse Registered Nurse Patients Patients Patients
  2. 2. 3. Direct Chain of Command RN Manager Charge Nurse RN Nursing Student RN Supervisor
  3. 3. Indirect Chain of Commands 4. Physical/Psychosocial Focus 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 youare providingthem. Nurse Manager RN Nursing Manager Student Nurse
  4. 4. Image 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, occupational therapists,speechpathologists,aids,nursingstudents,andfamilies. Deportment 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. Large/Small PowerDistance 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. Individualism/Collectivism An individual nurse usuallydecideswhatnursingcare a clientneedsfollowingorders from the physician’s assistantordoctor. The nurse’stendtoworkalone unlessthey needhelpcompletingatask. Criticism/Approval We have notwitnessedcriticismof RN to RN,however,RN toaidand RN to studenthas occurred. Criticism hasoccurredbothpubliclyandprivately. We have overheard
  5. 5. 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. Personal Insights 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.
  6. 6. Item Number Total Score Range of Score (1-6) Mean Score 1 5+5+6+6= 22 5-6 5.5 2 5+5+5+6= 21 5-6 5.25 3 4+5+5+2= 16 2-5 4 4 4+4+5+3= 16 3-5 4 5 5+5+5+5= 20 5 5 6 4+5+5+6=20 4-6 5 7 2+2+5+4= 13 2-5 3.25 8 3+3+3+2= 11 2-3 2.75 9 6+5+6+3=20 3-6 5 10 2+3+4+2= 11 2-4 2.75 11 5+3+4+5= 17 3-5 4.25 12 4+3+2+3=12 2-4 3 13 5+6+6+6= 23 5-6 5.75 14 4+6+5+6= 21 4-6 5.25 15 1+2+1+2=6 1-2 1.5 16 4+4+5+2=15 2-4 3.75 17 5+5+5+5= 20 5 5 18 5+5+5+2=17 2-5 4.25 19 5+5+5+6= 21 5-6 5.25 20 5+2+4+5= 16 2-5 4 21 5+5+2+2=14 2-5 3.5 22 6+5+3+6= 20 3-6 5 23 6+5+3+6=20 3-6 5 24 5+4+5+2=16 2-5 4 25 4+3+5+1=13 1-5 3.25 26 5+4+2+5=16 2-5 4 27 5+3+2+5= 15 2-5 3.75 Grand Total: 4.185
  7. 7. 1 Pay, Reward 2 Interaction/Cohesion 3 Administration 4 Professional Status Grand total Mean 3.57+3.14+2.14+ 3.86/4=3.1175 6+5.29+5.14+4.29/4= 5.18 3+4.17+4.5+3.33/4= 3.75 4.71+5+4.71+5.2 9/4=4.93 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 for oneshealth.