decion making and problem solving in Nursing.ppt

decision making ,Problem solving, power, conflict and bargaining

2. Decision making is a process of identifying and choosing
alternative course of action in a manner appropriate to the
demand of the situation.
Problem solving It is a part of decision making. A systematic
process that focuses on analyzing a difficult situation,
problem solving always includes a decision making step.

3. CHARACTERISTICS OF DECISION MAKING
It is a process of choosing a course of action from among the
alternative course of action.
 It is a human process involving to great extent the
application of intellectual abilities.
It is the end process preceded by deliberation and reasoning.
It is always related to the environment. A manger may take
one decision in a particular set of circumstances and another
in a different set of circumstances.
 It involves a time dimension and a time lag.
It always has a purpose.

4. TECHNIQUES OR BASIS FOR
DECISION MAKING
Intuition
 Facts
Experience Past experience of a person becomes a good basis for taking
decisions
Considered options
Operations research The traditional methods of taking decision on the basis
of intuition, experience, etc. are replaced by systematic techniques based on
analysis of data.
Linear programming This technique is used to determine the best use of
limited resource for achieving given objectives
 Values Being confused and unclear about one‘s values may affect decision-
making ability

5. ELEMENTS OF DECISION MAKING
AND PROBLEM SOLVING PROCESS
 Identification of problem situation
 Definition of problem situation
Specification of objectives
Collection of data
 Developing alternative course of action
 Evaluation of alternative course of action
Selecting appropriate techniques
Implementation of decision

6. Power - ability to influence behavior.
Power can be defined as the capacity to produce or
prevent changes. – Sullivan and Decker 1997.
Power is the ―force of energy to accomplish a task,
meet a goal, promote changes or influence others.

7. CHARACTERISTICS OF POWER:
Power is fleeting, never permanent.
 Power is a neutral concept, neither good nor bad in
itself.
Power can be constructive and useful / it can be
destructive and harmful.
Power controls, corrects and corrupts.
Power is reciprocal ie, when one person answers control
other person gives it up.

8. TYPES OF POWER:
Legitimate power
Reward power
Coercive power
Expert power
 Referent power

9.  Legitimate Power It is the position power. Authority also is called
legitimate power. It is the power gained by a title or official position with
in an organization.
Reward Power: Reward Power is obtained by the ability to grant favors
or reward others with whatever they value. The arsenal of Reward that a
manager can dispense to get employees to work toward meeting
organization goals is very broad a great deal of loyalty towards leader.
Punishment Power The Punishment Power is opposite of Reward power
is based on fear of punishment if the expectation are not met. The
manager may obtain compliance through Threat of Transfer, demotion, or
dismissal
Expert power It is gained through knowledge, expertise or experience
having critical knowledge allows a manager to gain power over others
who needs that knowledge.
 Referent power. Referent power is power a person has because others
identify with that leader. People also may develop referent power because
others perceive them a powerful it is based on respect

10. STRATEGIES FOR DEVELOPING POWER /
POWERFUL IMAGE:
Self image
 Grooming and well dressed – grounded hair and face, good clothing and
neat appearance.
Good manners – treating people with courtesy and respect.
 Good body language – good postures, good eye contact, confident
movement.
 Speech - firm, confident voice, good grammer, appropriate
vocabulary,good communication skills.
 Own values, attitude and beliefs.
Career commitment. Networking – political skill

Mentoring – mentors are competent, experienced professionals who
develop a relationship with a trainee for the purpose of providing advice
and support

11. STRATEGIES TO ENHANCING POWER
Expend personal resources:- Power nd energy goes hand
in hand. The manager must relax and talking time for
significant relationship as well as develop outside
interest to expand their resources.
Present a powerful picture to others
Understanding and working with in the formal and
informal power structures are necessary
Learn the language and symbols of the organization
 Learn how to use the organization priorities
 Increase professional skill and knowledge
Maintain a broad vision
 Use experts and seek and knowledge

12. POWER IN NURSING:
control over the content of practice
control over the context of practice
 control over competence.

13. Power and Nurses Roles Nurse historically had limited power in the
health care system. But nor nursing organization are working to
provide nurses with a voice at higher decision making level in health
care
Working together: By understanding the political realities and the
way in which decisions are by working together to speak with a
unified voice, nurses can increase their power in the system
Nursing education programs Increasingly try to educate nurses to
out as client advocate and agent of change. The higher educations
like M.Sc (N), M.Phil(N), and Ph.D in nursing and specialized
courses will help the nurses to gain power in health system.
Collective bargaining and shared governance It helps the nurses
with mechanism for demanding recognition of the importance of
their role for being participants in decision-making process.

14. BARGAINING
Bargaining is a process of meeting, presenting demands,
discussing, presenting counter offers, cajoling,
threatening and host of other activities which go into the
bargaining of an agreement.

15. TYPES
It is of two types
1) INDIVIDUAL BARGAINING
2) COLLECTIVE BARGAINING

16. INDIVIDUAL BARGAINING
Individual employment agreements are
negotiated between an individual and their
employer, and bind only those parties

17. DEFINITION:
Collective bargaining is a process where a group of
workers, represented by a trade union, negotiate
with their employer to establish the terms and
conditions of employment. The goal of collective
bargaining is to reach a written agreement, or
contract, that improves the rights and benefits of the
workers.

18. IMPORTANT POINTS FOR INDIVIDUAL
BARGAINING
 Personal reputation
Prior bargaining experience
Status and position in hierarchy
Understanding of bargaining process
Confidence, ability to resist persuasion and
patience
Superior communication and presentation skills.

19. FACTOR LEADING TO COLLECTIVE
BARGAINING:


For job security


Improved wages


Better benefits


In response to poor working condition


Unequal treatment


Limited opportunity for advancement


Lack of recognition


work rules and procedures

20. 5 STAGES OF COLLECTIVE
BARGAINING
Preparation
During the first stage, a group of employees meets several times to decide
what they want to negotiate. In many instances, this can refer to long-term
issues that the union has been fighting for, like improvement in workplace
diversity and inclusion.
Establishing representatives
As employees are preparing for negotiations, they engage in research and
select one person to represent them in meetings with the employer.
Depending on what they want to accomplish, they may do this by joining an
already existing union or creating a new one. Both options have their
benefits. Joining an existing union makes the entire bargaining process less
time-consuming because it gives them access to people who have experience
in negotiating with employers. Creating their own union presents employees
with more responsibility, but it also allows them to choose one of their own
as the representative.

21. Opening
The opening stage begins when the union presents their proposal to the
employer. If the changes they demand are contractual, the employer is likely
to request some time to process the proposal and consult with the legal,
human resources and even accounting departments. During this phase, it's
critical to determine the importance of the issues and clarify each party's
position.
Trading
During trading, the employer openly reacts to the proposal. Depending on the
situation and what's in the proposal, the employer can accept it immediately,
reject it or propose additional changes that work better for the organisation
based on its current business model and valid contracts.
Agreement
Once both parties agree on what they've decided, a labour relations specialist
begins preparing a draft of the agreement. When the final proposal is
complete, both sides once again review it to confirm their demands. It's
necessary to document this step formally, for example, by collecting
handwritten signatures from representatives of both the organisation and the
union.

22. APPLICATIONS TO NURSING
 Nurses should be aware of and clarify their values regarding collective
bargaining and strikes when choosing a work place.
Nurses should also need to protect themselves from unfair management
practices
Nurses working in health care organization with a collective bargaining
agreement should obtain a study a copy of the collective bargaining
contract which specifies conditions of employment, such as salaries,
workload, fringe benefits and advancement of opportunities as well as
specific procedures for filling grievances regarding various issues.
Collective bargaining contracts establish nurse practice committees which
allow employees to become involved in health care decisions
In a health care organization that displays minimal concern for employee
satisfaction, a nurse leader may become instrumental in lobbying for a
collective bargaining agreement.

23. ADVANTAGES OF COLLECTIVE
BARGAINING
Higher wages and better help for union members.
Fairer work rules and policies
Improved job joy, productivity, and loyalty.
More social justice through the fairer distribution of economic
gains.
Safer working needs.
Greater worker voice and input
More stable job and income
More economic equality..
Early resolution of disputes

24. The term ‘organizational politics’, also known as
workplace politics or office politics, refers to the agenda
of each employee within a company and the activities
they engage in to acquire, increase, and wield power and
resources to gain a desired outcome.
Organizational politics is present in most organizations.
Every business has a hierarchy, and with this hierarchy
comes an uneven distribution of power.
Certain employees are more likely to pursue this power
than others, which is considered political behavior in the
workplace.

25. OBJECTIVES OF ORGANIZATIONAL
POLITICS INCLUDE:
Gaining power
Boosting productivity
Gaining recognition
Resolving disputes
Promoting personal objectives
Protecting self-interest
Earning money and income
Developing power contacts

26. DEFINITION OF CONFLICT
•According to Follett, “ Conflict is the appearance of
difference , difference of opinions, of interests.”
•According to Louis R. Pondy, ‘Conflict’ is:
(i)Antecedent conditions, for example: Scarcity of
resources, policy differences among individuals, etc.,
(ii)Effective states of the individuals involved, for example:
stress, tension, hostility, anxiety, etc.,
(iii)Cognitive states of individuals, i.e., their perception of
awareness of conflict situations.
(iv)Changed behavior ranging from passive resistance to
overt aggression.

27. NATURE OF CONFLICT
•Conflict occurs when individuals are not able to choose among
the available alternative courses of action.
•Conflict between two individuals implies that they have
conflicting perception, values and goals.
•Conflict is a dynamic process as it indicates a series of events.
•Conflict must be perceived by the parties to it. If no one is
aware of a conflict, then it is generally agree that no conflict
exists.

28. Level of conflict Types of conflict
Organization
Group
Individual
Within & between
organization
Within & between group
Within & between individual

29. PROCESS OF
CONFLICT
Latent Conflict
Perceived Conflict
Felt Conflict
Manifest Conflict
Functional
Conflict
Dysfunctional
Conflict

30. •Latent Conflict (Stage 1): When two or more parties
need each other to achieve desired objectives, there is
potential for conflict. Latent Conflict often arises when
change occurs. Conflict is likely to be caused by a
budget cutback, a change in organizational direction, a
change in personal goals or the assignment of a new
project to an already overloaded team.
•Perceived Conflict (Stage 2): This is the stage at which
members become aware of a problem. Incompatibility of
needs is perceived and tension begins as the parties
being to worry about what will happen. But no party
feels that it is being overly threatened.
•Felt Conflict (Stage 3): At this stage parties become
emotionally involved and begin to focus on differences
of opinion and opposing interests. Internal tensions and
frustration being to crystallize, and people begin to
build and emotional commitment to their position.

31. •Manifest Conflict (Stage 4): At this stage parties engage
in actions that help to achieve their own objectives and
ruin those of others. Conflict behaviors vary from the
subtle, indirect and highly controlled forms of interface to
direct, aggressive, violent and uncontrolled struggle. At
the organisational level strikes or lock-outs are the
result.
•Conflict Outcome (Stage 5): The conflict finally results in
an outcome which may be functional or dysfunctional. If
handled well, the result is functional conflict. If
mishandled, the consequences are dysfunctional conflict.

32. •Resolving Inter-Group Conflict: The approaches that are
available for resolving inter-group conflict are as follows.
a.Problem-Solving
b.Avoidance
c.Smoothen
d.Compromise
e.Expansion of Resources
f.Organization Redesign
g.Superordinate goals

33. Key points to remember
•Be a model of calm and control
•Don't give in to emotional outbursts
•Don't assume people are being difficult
intentionally
•Find a quiet place in to resolve
conflicts....privately Set some ground rules for the discussion:
•No raising of voices
•This is not a debate
•Speak only for yourself..."I" phrases
•Confront the issues, not the people
•Maintain or enhance self-esteem