An Open Systems Theory Approach

This author spoke with several nurses to discuss Summa’s shared governance. There were two that had two opposing views of it. One nurse, who was younger, felt that the shared governance was just for show to achieve Magnet status. The cons she found was that the recommendations that staff nurses made were just ignored. Another problem she found was that the work that was put into it was not being reimbursed financially. Problem with shared governance is that it is believed to exist where there is empowerment, but it is has more to do with traditional board governance with some staff input. The result is that it is not founded in the actions of the staff nurse, but the actions of administration (Joseph & Bogue, 2016). The other nurse, who was older, was very excited to discuss shared governance. Her department was the first at Summa to initiate shared governance. Some of the pros were nurses had a voice and a path to follow to institute change. She explained how she

The Health Care System 's purpose is to meet the physical and mental health needs of the communities in which they serve, these systems operate using people working within heal care facilities as well as other health delivery resources. One group of individual that help with facility operations are nursing administrators. Nursing Administrators contribute in managing along with directing the nursing care delivery system. Their leadership style, characteristics, communication strategies, including the way that they negotiate as well as manage conflicts can determine the quality of the healthcare services treat the facility provide as well as help to develop a set of guidelines to standardize the type and quality of the nursing services. (Cipriano, 2011) Together the Nurse Mangers work toward the same goals along with guiding nurses in their practice and contribute to the facilities successes. (Frankel, 2011) The nursing leaders are advocates who directly affect the quality of the nursing care along with also having a positive impact on healthcare through leadership.

An organization’s purpose and primary objectives, its internal function is defined in its mission statement. The mission statement assures that external and internal stakeholders understand the plan and goals the organization is trying to accomplish. An organizations philosophy explains the beliefs used to carry out that mission. The purpose of this paper is to discuss my organization’s mission, and my unit’s mission, and how they are aliened. I will discuss centralized and decentralized structures that apply to my facility. Furthermore, I will look at pros and cons of the facilities nursing model and discuss ways nursing could strengthen the organization.

Nurses work in systems that are complex, rapidly changing, and beleaguered with financial and workforce pressures. One response to these chal­lenges is to find alternative ways to make an insufficient or detrimental system work for the nurse to get the job done and to achieve the desired patient out­come. While perhaps well intention-ed to produce the desired result, workarounds

Meyer, R.M., & O?Brien-Pallas, L.L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828-2838. Retrieved from Walden Library

Staffing models play a significant part in the deliverance of care in a health system as it allows systems to put forth adequate staffing to provide a high level of care. The quality of care providers deliver is influenced by individual provider characteristics such as knowledge and experience, as well as human factors such as fatigue. The quality of care is also influenced by the health care organization or system, which involve not only staffing levels, but also patient need, the availability and organization of other staff and support services, and the climate and culture created by leaders in that setting. The same nurse may provide care of differing quality to patients with similar needs under variable staffing conditions and in different work environments. According to The National Center for Biotechnology Information, staffing and patient care quality and safety are directly related. Figure 1 generically illustrates staffing model framework and

Nursing-sensitive indicators are important in all aspects of patient care. A great deal of bedside care is given by nurses. Nursing-sensitive indicators are factors that rely directly on the nursing care of the patient. Quality nursing care improves patient care and therefore patient outcomes. Nursing-sensitive quality indicators promote patient safety and quality patient care. Since these quality indicators are reflective primarily on bedside care provided by nursing staff it is important that all nursing staff be aware of these indicators and their role in promoting quality patient care. There are specific indicators that could have been taken into account to promote patient

While smaller businesses operating on tighter budgets may find it expensive to pay overtime, the bigger companies with few employees on the managerial positions are capable of paying for overtime for the employees whose category will fall below the minimum exempt. Furthermore, all the options available for employers to handle the proposed rule should it come into effect will still benefit the American worker. One remedy is to follow the law and raise the annual salaries of employees who are overtime-exempt which will motivate workers who are already earning a salary close to that minimum (Rossheim, 2016). The second option is to re-classify workers as no-exempt, a move that would see the workers who are earning below the proposed exempt minimum qualify for overtime pay or reduce the workload for employees so that they only work for 40 hours in a week (Rossheim, 2016). The last option would be to hire more workers and avoid paying overtime which is a good move in providing employment for the unemployed. It is evident that the options available for employers would work towards improving employees’ welfare as well as saving the organization from the challenges of low remuneration.

The health care is reforming in a way that care delivery models have been formed and people will be paying for quality of care as a whole (Fairman, Rowe, Hassmiller, & Shalala, 2011). The health care reform law is attempting to balance the system of health care resources in that a balance will be yielded to award care value over the volume of care provided. This reform calls into nurse leadership and the input of nurses who contribute the largest labor to the health care system. Registered nurses are vital in the delivery model of patient centered care system.

Nurse leaders are faced with issues or problems on a daily basis that are often expected and sometimes unexpected. It “comes with the territory” so to speak. If there were no issues to solve or hurdles to overcome the necessity of designating a leader would not seem quite as important. Nurse leaders can tackle issues that occur in their work environment using nursing theory to guide them. Nursing theory provides a framework that nurse leaders can use to implement interventions or changes to positively impact the staff they lead. This framework of the theory will set the standards for achieving the desired outcomes and is based on knowledge that is gleaned from practice and/or research.

Dr. Avedis Donabedian developed a model for categorizing and measuring the quality of healthcare providing a framework that conceptualized quality in broad terms and classification to measure and assess different aspects of quality in nursing care (Sollecito & Johnson, 2013). In the footsteps of Donabedian’s framework, Dr. Beatrice Kalisch developed a model conceptualizing missed nursing care otherwise known as “unfinished nursing care” or “care left undone”. Missed nursing care as defined in the Missed Nursing Care Model is any aspect of required patient care that is omitted, either in part or whole, or delayed (Kalisch, Landstrom, & Hinshaw, 2009). The structural aspects Kalisch’s model include labor resources, nursing staff, competency level of staff, education and experience, material resources, teamwork and communication. Kalisch model indicates that nurses with recent restricted resources in the nursing process determining clinical priorities is costly making decisions either to delay or omit certain care and is heavily influenced by team perception, nurse judgment, ("Missed Nursing Care AHRQ," 2015).

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

The culture of an organization, especially one such as a hospital that involves a lot of different people and their values can greatly increase or decrease the chance of the success of an organization. The hospital doctors, nurses, and other health care workers greatly influence the care of the patient either positively or negatively. Policies and procedures govern the internal making of the regulatory aspects of the patient care. Following policies is a must, and usually leads to the safety of the patient (Jasper, Kangasniemi, Turunen, & Vaismoradi, 2013). The culture of the nursing staff in particular can help influence the retention of nurses, and

According to Sieloff and Raph (2011), nursing management theories are used to describe, explain, predict or prescribe nursing acts. There are a variety of ways to solve a nursing problem or issue, but nursing management theories are specifically designed for issues nurses and nurse managers come across on a daily basis. Hildebrandt and Persily’s theory of community empowerment is a perfect example of how nursing management could overcome the challenges of relocating to a new unit.

Moving away from “Mechanistic” metaphor originated from the bureaucratic organizational theories in the early 1920s. Morgan (2006) presents a more biological view of the organization. Described as a living system the “Organism” metaphor is dependent on wider environment and functions. Such organizations are open systems and more inclined to adapt, grow, survive and to meet the needs of organizations to operate more efficiently. The flexibility to change to the best-suited structure also introduced. As organizations tend to appear and thrive in certain environments, the functions are adjusted to establish more orderly and stable environments. In line with Morgan’s “Organism” metaphor (Morgan. 2010), if they do not adapt, organizations become week and die when those needs not met.