Nursing Management

Contents GLOSSARY ABSTRACT/SUMMARY INTRODUCTION DM 45 DEVELOPING MANAGEMENT STYLE 1. Self- assessment analysis 2. Stakeholders analysis 3. S. W. O. T analysis DM 46 RECRUITMENT AND SELECTION DM 47 MANAGING PERFORMANCE DM 48 DEVELOPING TEAMS & INDIVIDUALS RECOMMENDATION REFERENCES BIBLIOGRAPHY APPENDIX Glossary D. O. H Department Of health N. H. S National Health Service N. S. F National Service Frame trifle P. E. S. T. O Political Economical Social proficient Others 7 S Shargond Values Strategy Structure System Staff air Skill S. M. A. R. T Specific Measurable Achievable Rea inclineicTime-bound S. W. O. T Strengths Weaknesses Opportunities Threats Abstract/Summary I am currently functional as a Charge Nurse/ Deputy cellblock Manager on Ward X , a Diabetic and Renal cellblock based at a North London Hospital. The protect contains 21 acute medical staminate beds and a team of 28 rounds which includes 6 student nurses, 2 domestics, 1 guard clerk, 7 health cargon assistan ts, 6 junior nurses, 4 precedential nurses and 2 ward sister/charge nurse. Some of my main responsibilities on the ward includes the assessment of c atomic number 18 needs for patient role ofs, the victimisation of programmes of care and their implementation and military rating and most importantly carrying turn up all relevant names of care without direct supervision, and licence procedures to, and supervise qualified and unqualified module and contribute to the overall life-threatening of the organisation by being a positive role model and treating all staff, visitors and service users with courtesy ( vermiform process 1). In this assignment I leave behind demonstrate the use of knowledge, management concepts and theories that I pick up acquired while undertaking this module of Managing People and re after-hours them to my clinical area.Certain area of practice will be identified, analysed and evaluated finished useful people management victimisation the CLINLAP mode l (Jumaa (1997) ), ( Jumaa & Alleyne (2001) ) at bottom the ward labelting. CLINLAP is defined as a strategic nursing leadership and learning work on that positions strategic learning as a driving force in spite of appearance health and social care organisations, on a day to day basis, in the management of nursing goals nursing roles nursing processes and nursing relationships (Jumaa & Alleyne, 1997 & 2001)Introduction The National service frameworks (NSFs) are long term strategies for improving specific areas of care. They set measurable goals within set time frames. NSFs set national standards and identify key interventions for a defined service or care group put in aim strategies to uphold implementation establish ways to ensure progress within an hold time scale form one of a range of measures to impose quality and decrease variations in service, introduced in The New NHS and A First Class Service.The NHS propose re-emphasised the role of NSFs as drivers in deliveri ng the Modernisation Agenda. Each NSF is substantial with the assistance of an extraneous Reference Group (ERG) which brings together health professionals, service users and carers, health service managers, partner agencies, and other advocates. ERGs adopt an inclusive process to prosecute the full range of receives. The Department of Health supports the ERGs and manages the overall process. (DOH, (2005) )The NSF disembowels it clear that the NHS is committed to building a modernisation programme to provide high quality patient care and improving the working lives of all NHS staff. In terms of patient care, it draws the attention to the need to look at each service from the patients point of view and to ensure that a patient focus is embedded in the culture. In order to achieve this, new and better ways of working are required through, for example Investing in the workforce in terms of more staff and better develop Giving frontline staff responsibility, freedom, skills and res ources to do a better origin, using their initiative for local innovation within national standards Reducing bureaucracy whilst increasing accountability so that thither are clear and transplant process for holding the NHS to account for their delivery of services Requiring staff to work effectively in teams, for example, through managed clinical networks Working in partnership with staff and involving them through re encloseationNHS is critically dependent on its employees for delivering the strategic and operational goals at corporate, departmental, functional and team levels and managing people efficiently and effectively has fix a central part of the ward manager/sister/charge nurses task at all levels particularly with a view to improving the performance of employees and thereby the performance of the NHS in delivering services. Ward managers increasingly are being expected to take great responsibility or the personnel department management aspects of their work. This im plies that we are able to function effectively in 4 key aspects of managing people evolution our own management style Employee recruitment and woof Managing performance by motivating and developing staffs Developing Teams and Individuals by improving staffs performance at both individual and team levels. Dm 45 Developing Management Style In this unit I will identify 3 ways of assessing my current skills and competence as a manager.These methods will brook me to discern clearly my strenghs and weaknesses and thereby identify areas on the ward in which improvements squeeze out be made and devise act plans which will then be monitored for progress. The 3 methods chosen will be, firstly self-assessment and analysis through estimate, secondly the stakeholder analysis tool and thirdly the pulverisation analysis tool. Self- assessment analysis Self-assessment step - 1. Arrange a meeting with Ward Manager to agree on an appraisal date. 2. Ward Manager distributes pre-appraisal meeting self-assessment form. Appendix 2) 3. Work through the pre-appraisal form making nones and identifying potential areas for improvement. (Appendix 2) 4. Meeting with Ward Manager on agreed appraisal date. Work through the Personal Development Plan form (Appendix 3) to make agreement on the current performance and potential areas for improvement 5. Following the meeting the Ward Manager distributes completed Personal Development Plan and list of potential areas for improvement 6. Ward Manager agrees and complete draft performance plan to forward to Matron 7.Matron follows up and verifies the Personal Development Plan. (Appendix 3) 8. Action plan agreed with matron. Ensure that all points on the action plan meet the SMART (Jumaa & Alleyne, (1998))criteria Specific, Measurable, Action based, Realistic and Time bound. (Appendix 3) Stakeholders analysis An integral part of the clinical plaque review process is feedback from stakeholders. The Hospitals definition of stakeholder s includes staff, patients, relatives of patients, carers, other local NHS organisations, voluntary groups and other people with an interest in the trust.The information provided through stakeholder work helps shape some of the areas that the clinical governance review will concentrate on. Clinical Governance is a framework through which NHS organisations are accountable for ceaselessly improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish. It aims to ca-ca not only a culture, but systems and ways of working which assure that the safety and the quality of care is at the heart of the business at every level. Appendix 1, Unit 5) As a Deputy ward manager it is important for me to take into account feedback from stakeholders for effective managerial performance and to provide high standards of care. In order to do so the table that I have produced below will help me to identify the role of individuals, or stakeholder groups who are embarrassd or affected by the clinical governance programme and after part thereby affect its success or failure. Stakeholder analysis chart Programme Organisation External Clinical Governance Hospital Diabetes UK , Patients Staffs, Patients Relatives, carers, PCTs Who wants the team to Succeed Yes Yes Fail No No Who is betting on the Succeeding Yes Yes team Failing No No Who is supporting the Visibly Yes No team Invisibly No Yes Whose success Affects the team Yes No Does the team affect Yes Yes Who does the teams Benefit Yes No change Damage Yes No Who can the teams Happen without No Yes change Not happen without Yes Yes In the above table it can be noted that the group of stakeholder who are mostly involved and influence a programme are mainly the patients and the staffs. As part of my objectives I will in future concentrate on feed back from my staff on the ward and our group of patients. This can be achieve by organising ward meetings with staffs or actually having a one-to-one interview with them at least once in a month. As for feedback from patients this can be organised by their allocated staff nurse in the form of an informal one-to-one interview at some point prior to the patient being discharged home. SWOT analysis A SWOT analysis is a tool, used in management and strategy formulation. It can help to identify the Strengths, Weaknesses, Opportunities and Threats of an organisation.Strengths and weaknesses are inhering factors that create or destroy value. They can include assets, skills or resources that the ward has at its disposal to provide care to patients. They can be measured using an internal assessment tool such as Peters & Watermans 7Ss. The table below will help me assess the internal factors of the ward and identify my goals and make them SMART (Jumaa & Alleyne (2001)) This will help me to identify areas for development. Sha red Values live The ward believes in team working providing quality care Goal To support staffs and encourage them to carry on working as a team Provide them with feedback from patient on quality of care on the ward. StrategyCurrent The ward believes in staffs further development and clinical skills. Goal To send every qualified staff on inhouse study days to develop their clinical skills Structure Current Staffs does not communicate clearly between each other to promote continuity of Care. Goal To meet up with staffs on a one-to-one basis or ward meeting and discuss appropriate communication. System Current Staff appraisals only being carried out once in a year Goal To discuss with manager if appraisals can be done every 6 months Staff Current The trust is introducing elder Health Care Assistant posts.Goal Identify if every of the present Health Care Assistants on the ward are suitable candidates for the post by appropriate supervision. Style Current The ward has a team with mult icultural staffs Goal Encourage staffs to respect each others cuture and thereby work more efficiently. Skill Current The ward has staffs with several(predicate) skill mix. Goal Give positive feedback on their skills and encourage them to share their knowledge and attend study days to expand them. Opportunities and threats are away factors that create or destroy value. Usually an organisation cannot control them and they emerge from Political, Economical, Social, Technological and Others.The assessment below using PESTO will help me to identify the goals set up by external factors and which needs to be included on the ward to meet expectations and thereby identify areas for my own professional development. Political Current The NHS Plan outlines a new delivery system for the NHS and changes for social services, and changes for NHS staff groups. It as well as sets out plans for cutting waiting times, clinical priorities and reducing inequality. Goal get regular ward meetings to d iscuss with team how to incorporate changes on the ward. Economical Current The NHS budget has doubled since 1997, and will have almost trebled by 2008.All NHS organisations including my ward are receiving above inflation funding increases, both this year and next. Goal Meet up with team and prioritise our expenses so we can work within our budget Sociological Current The Hospital accommodate patients from different ethical background and beliefs. Goal Ensure that the trust can meet certain requirements for its ethnic minority group. For example providing them with special diet want halal meal in the case of muslim patients. Technological Current The trust is currently using advance computer system to handle patients data. Goal Ensure that members of the staffs who are not computer literate attend IT course for quicker access to patients data. OtherCurrent The Hospital has performed puff up in maintaining and encouraging The clean our hands campain and reducing the risk of cross infection Goal Encourage the team by giving them positive feedback and reinforce infection control policy. DM 46 Recruitment and Selection Once a trust has decided on its goals, it is of the essence(p) that it identifies whether it has the people necessary to achieve them. Trusts need to develop ways of assessing the number of employees that they need to provide specific services. The implications of the recent policy changes in the NHS are that there will be further major changes in the numbers and deployment of employees across trusts. DOH, (2005)) As a Deputy Ward Manager part of my responsibilities is also to have a clear view of the number of staffs that we have on the ward and the number that we need to deliver the trusts objectives. Currently on my ward we have vacancies for 2 permanent Senior Staff nurses post previously known as grade E. The new post which is now named Band 5b match to the agenda for change has been created by the trust due to our increase in bed turnover and high demand of standards of care. Before the posts were advertised I had a meeting with my Ward Manager and Matron so we can focus on the basic stages of recruitment which are 1. Agree the vacancy 2. Prepare a job description 3. Prepare a person specification 4. Attract applicants through good advertisement(Appendix 4a) 5. Selection 6. InductionIt is important for us team leaders to use vacancies as an opportunity for re-assessing peoples needs and the organisations structure so objectives can be achieved. Therefore an agreement between team leaders is important to reach our goals. After the agreement me and my ward manager we devised the job description and person specification taking into account an analysis of the following criterias (Kneeland, (1999)) the present or expected duties of the job changes which might impact on the job in the future existing duties which might be done more effectively or efficiently by some one else new duties that could be added to the job While preparing the job description my manager and I focused on 5 important aspects which were Accuracy in order not to understate or overstate the role and duties associated with the post. (Appendix 4b, segmentation A) Clarity in terms of tasks, duties, roles and responsibilities(Appendix 4, Section B) Up-to-date (Appendix 4b, Section A, E) Flexibility (Appendix 4b, Section A, B) Non-discriminatory particularly in terms of gender,marital status or ethinic background The use of person specifications have a different purpose and it actually aims to identify the qualifications, skills, experience and abilities which are seen as essential or desirable in the post-holder and is used primarily to assist those involved in the selection process. (Appendix 5)After the posts were advertised and the applications received me and my ward manager short-listed 8 candidates out of 23 applications. This was undertaken by eliminating those who did not meet the pre-agreed essential requirements as set out in the person specification. (Appendix 5). For example some candidates did not have the knowledge of the KSF of Diabetes which is an essential requirement for the post as we specialise in this area or did not have a minimum of 12 months experience as a qualified staff nurse. We made sure that the necessary information virtually the selection process were recorded and appropriate feedback given to unsuccessfull candidates about their performance at the interview.Once the 2 candidates out of the 8 were successfull and appointed, it was important for me to plan induction and development for them. Given the investment made in new employees it is important that they should receive an appropriate induction so they can bring maximum contribution to the trust. At the Whittington Hospital, the trust induction covers areas such as the trust objectives so that the employee understands what they are trying to achieve, individualized objectives so that the staff understands what is expected from them and relevant immediate schooling so that the person can properly undertake their job. Though it is a policy for every new employees to attend the trust nduction, I would personally barrack that all new starters on my ward should have a mentor to supervise them for at least the first 2 weeks of employment or pull down suggest an informal visit to the ward prior to interview so that candidates feel that the working environment is appropriate for their futur development. DM 47 Managing deed Performance management encompasses a range of standard management techniques and is not necessarily a formal system and is not necessarily the corresponding as an appraisal system. (Templar, (2001)). On my ward, performance management systems is a common benefit which enable my staffs to see more clearly their role on the ward and the trusts objectives. The key elements of managing my group of staffs involve setting objectives for the ward, assessing their development needs, making it happen, review it and doing better. Staffs on the ward need to know what is expected of them. Setting objectives which are S. M. A. R.T for action means that they can be sure what they should deliver, when and how. (Appendix 6). Discussion about individual objectives will also enable my staffs to understand why they should do the things that they have to do and how they fit into and contribute to the wider goals and aims of the trust. It is important to assess the pedagogy and development needs of my staffs to improve their ability to reach the standards of performance expected of them in their jobs. This process should leave alone in planned actions to meet individual needs, and will, where appropriate. (Appendix 6). In order to make the assessment happened, communication between me and my staffs should be improve.Many tangible and intangible factors contribute to an effective working environment. As a deputy manager it is important for me to focus on the creation of a shared understanding and sense of purpose in my workplace, in particular, communication,culture and climate. Good communication is essential for effective performance management. For example on my ward internal communication such as team briefings, staff meeting, noticeboards and emails enables me and my ward manager to ensure that all our staffs are clear about the wards goals and that messages are given and received to and from staffs. This include aims and objectives as well training and development opportunities.Peoples performance is affected by their working environment. Morale,motivation, frustration, enthusiasm and commitment all influence the performance that the trust can achieve, so understanding what is important to staffs and listening to and acting on their views is an essential part of organising effectively. (Templar, (2001)). Having set objectives for individual staffs it is essential that performance and progress are regularly reviewed with individuals so that st affs feel recognised for their achievement and can identify areas where performance can improve. Reviews are necessary to improve individual and organisational performance but at the same time identify execrable performance.The scenario below will demonstrate a situation where one of my junior staff nurse was constantly showing poor performance on the ward and the action taken against her. Scenario Miss X, a junior staff nurse on the ward has been persistently coming late to work and is very slow in carrying out her daily tasks. Several members of Senior staff nurses have been reporting to me that standard of care for the group of patient she was looking after, has been deteriorating. I had a formal meeting on a one-to-one basis with Miss X where her poor performance issues were raised and an action plan was devised. It was discussed that she will be on a 3 months probation and will be supervised at all times by a sr. member of staff and feedback will be given to me if her perform ance was improving.A copy of her job description and a self-assessment form was provided to her so she can set her personal objectives and discuss it with my manager or myself. The disciplinary and grievance process of the trust states that no disciplinary action will be taken against an employee until the case has been full investigated. However, it should be recognised that there may be occasions when a full investigation is impossible e. g imprisonment. For example individuals will be certain of specific complaints against them in writing and will be given the opportunity to state their case directly to those who are considering disciplinary action before any decisions are made.Individuals and their Trade Union representative will be given a written explanation of any penalty imposed and its duration and in the case of written warnings , will have the right to appeal against this penalty. Usually no employee will normally be dismissed for a first rift of discipline except in ca ses of gross misconduct where summary dismissal without notice or pay in lieu of notice will be appropriate sanction. It, should, however, be recognised that there will be occasions, not covered by gross misconduct, when it will be necessary, because of the seriousness of the offence, for disciplinary action to begin at any stage of the procedure up to and including dismissal with notice for a first offence. (The Hospital disciplinary and grievance policy, (2006) )In the case of a first offence or disciplinary measures my role will be to discuss it first with my line manager as they are the one who are allowed to issue oral warning, dismissals and discuss the circumstances with Human Resources. DM 48 Developing Teams & individuals To get the topper from employees, managers need to know who will be doing what, where the strengths and weaknesses of staffs are and which skills need to be developed by their teams. Properly set, achievable objectives that make clear what is expected, by when and to what standard, benefit both staffs and managers by clarifying roles and responsibilities, and assist in delivering value for money in the use of people resources.Setting performance objectives with staffs will also enable us managers to assess how our team can be best be used productively and identify any areas where staffs are producing different results and output. This can be useful in benchmarking performance and identifying individual, team and departmental areas for improved productivity. (Templar, (2001)) When performance objectives and standards are set for a team, it is necessary to assess whether the team has the skills to meet the standards being set and to agree how skills will be developed if they do not already exist. This is particularly important when ways of working are being changed.The Developmental plan below which has been devised with a team member and also reflect the teams objectives as a whole, demonstrate the organisational and individual needs that can be met in many ways Development Plan Individual/Team Work shadowing Get full support from Senior members of the team and provide feedback. Special Projects Encourage staffs to actively get involve with hospital projects such as campaings. Planned self-development Meet at least every 6 months for appraisal and plan self -development Mentoring Offer support to impudently qualified staff in the form of mentorship/preceptorship for the first 2 weeks of joining the team Coaching and guidance Provide staffs with support and guidance whenever and wherever required. learning for professional qualifications Encourage staff to go for further studies for example encourage Diploma holder to complete their Degree or send people for specialiser course such as the Diabetic Course. Planned delegation Ensure that Senior staff nurses take responsibility in delegating tasks to junior staffs, H. C. As and student nurses On-the-job training Encourage staffs to attend in-ho use clinical skills study days. New responsibilites Allocate new rsponsibilities to members of the team. For example making each member of the staff responsible for certain part of the ward like for instance in charge of the treatment rooms general tidiness. Off the- job training Negociate with staffs if there is any external training they want to attend and provide them with leave or day off. Job rotation/secondment Senior staff nurses to act as team leader in the absence of myself or the ward manager. Membership of professional societies Encourage staffs to join professional bodies like the Royal College of Nursing and UNISON In the above table it can be noted that the individual development needs add up to the team development needs and trust-wide development needs.Individual managers must have a view of the team needs across the trust so that common needs can be met in the most cost-effective way and competing needs can be prioritised. Recommendations Staff develop ment should be linked to the achievement of the trusts goals and targets. If a key priority for the trust is to improve patient care, development plans at individual, team, departmental and corporate level should reflect that goal by direction on enhancing the skills of staffs to deliver the required levels of patient care. Staffs will know which aspects of their work need support and development and are well placed to identify training and development needs to help them perform better in their jobs ReferencesDepartment of Health (2005), The New NHS plan London D. O. H Jumaa, M. O & Alleyne, J. (2001), Managing and Leading in a constanly changing contexts in Health and Social Care Middlesex University Kneeland, S. (1999), Recruiting for Results How To Books Ltd Templar, R. (2001), Fast Thinking Appraisal Pearson Education Ltd The Hospital (2006)Disciplinary and Grievance policy The Whittington Hospital Bibliography Belbin, R. M. (1996). Managing Teams why they succeed or fail. Oxf ord Butterworth-Heinemann. Johnson, G. & Scholes, K. (2001). Exploring Corporate Strategy 6th Edition Prentice-Hall Martin, V. & Henderson, E. (2001). Managing in Health and Social Care Routeledge