Thursday, January 27, 2011

Lesson 4: Operational and Strategic Planning and the Nurse Leader's Role in Health Policy

Reflective Journal entry: I completed my first clinical shift Sunday. I attempted to fax the contact form in, but I don't think it worked, so I will hand deliver a signed copy. I am following a house supervisor on the weekends at Timpanogos Regional Hospital. Initially, I expected to learn how to manage staff, manage a budget regarding staff and patient census, and maybe learn a little more about how to successfully place a peripheral IV in a patient when the other nurses on the floor can not place it.
What I actually learned was that a house supervisor does so many things that are and are not nursing related. For example, we went to an engineering room twice to fix the tube system, which he told me he learned from talking to the engineers on the phone before when they did not want to come in to fix it themselves. I saw one peripheral IV placed, but I didn't consider it remarkable. I was impressed with his ability to handle the staff. We frequented different floors, checking on staff and asking if they needed help. There was a situation on one unit regarding a nurse who was upset with a physician who, according to her, did not want to come in because he had been in at four o'clock in the morning already. The patient needed help, and she had other complaints regarding this physician. The house supervisor instructed her to keep calling the physician repeatedly until he responded appropriately. He explained to me that it is important to listen to concerns objectively, because emotions often direct what you may be hearing from staff. For him to call the physician in that situation may serve to make the physician even more resistant to physically coming in and seeing that patient, and make him less cooperative in the future. I did not learn much about budgeting, because the house supervisor did not have that information. When the patient census is low, staff is called off. The house supervisor stated that he uses his judgment and considers patient acuity when he makes that decision. Labor and Delivery and Emergency Department nurses are never sent home due to lack of predictability.
I enjoy watching the house supervisor's interaction with staff. He is friendly and approachable, and treats each staff member with respect. He calls the people he knows by name, and he asks the name of anyone he is not familiar with. This will impact by nursing career because if I treat everyone with respect, my work environment will be much more pleasant.
He told me that in future shifts, we might go through some patient charts, depending upon how hectic each shift is.

Now to address the objectives:

The primary purpose of operational and strategic planning is to identify priorities that must be addressed to ensure a successful future. According to the textbook, strategic planning focuses on purpose, mission, philosophy, and goals related to the external organizational environment.

Values and beliefs affect an organization's strategic plan. If an organization's mission and staff values and beliefs are the same, there will likely be more success in the organization. If the values and beliefs of the organization and staff conflict, the organization will likely have a more difficult time achieving success.

An organizational mission statement identifies (usually in no more than three to four sentences) the reason that an organization exists. The philosophy comes from the purpose of the mission statement, is the basic foundation that directs all future planning toward the mission, and indicates the set of values and beliefs that guide all actions of the organization. Philosophies must become specific goals and objectives if they are to result in action. Policies are comprehensive statements that are derived from the organization's philosophy, goals, and objectives, and they explain how goals will be met while also guiding the general course and scope of organizational activities. Procedures identify the process or steps necessary to implement a policy. Rules are usually included as part of policy and procedure statements, and describe situations that allow one choice of action.

Regarding the nurse leader's role in strategic planning, there is a list on page 145 in the textbook that is numbered one through ten. I could restate the entire list in this blog, but I don't see the point in that when I can just go back and read it. Regarding a nurse leader formulating health policy, top-level management is more involved in setting organizational policies, and unit managers must decide how those policies will be implemented on their units. Input from subordinates allows the leader-manager to develop guidelines that all employees will support and follow. This is on page 159 in the textbook.

When an organization's values and philosophy differ from a nurse's personal value systems, internal conflict and burnout may occur.

Do I really have to address the objectives every week? The reflective journal combined with the objectives is lengthy!

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