LEARNING KEY SKILLS IN NURSING MANAGEMENT
Still other problem-solving techniques rely on past experience and intuition. Everyone has various and countless experiences. Individuals build a repertoire of these experiences and base future actions on what they considered successful solutions in the past. If a particular course of action consistently resulted in positive outcomes, the person will try it again when similar cir- cumstances occur. In some instances, an individual’s past experience can determine how much risk he or she will take in present circumstances.
The nature and frequency of the experience also contribute significantly to the effectiveness of this problem-solving method. How much the person has learned from these experiences, posi- tive or negative, can affect the current viewpoint and can result in either subjective, narrow judg- ments or wise ones. This is especially true in human relations problems. Intuition relies heavily on past experience and trial and error. The extent to which past experience is related to intuition is difficult to determine, but nurses’ wisdom, sensitivity, and intuition are known to be valuable in solving problems.
Some problems are self-solving: if permitted to run a natural course, they are solved by those personally involved. This is not to say that a uniform laissez-faire management style solves all problems. The nurse manager must not ignore managerial responsibilities, but often difficult situations become more manageable when participants are given time, resources, and support to discover their own solutions.
This typically happens, for example, when a newly graduated nurse joins a unit where most of the staff are associate degree RNs who resent the new nurse’s level of education as well as the nurse’s lack of experience. If the nurse manager intervenes, a problem that the staff might have worked out on their own becomes an ongoing source of conflict. The important skill required here is knowing when to act and when not to act. (See Chapter 12 for a discussion of conflict.)
The Problem-Solving Process Many nursing problems require immediate action. Nurses don’t have time for formalized pro- cesses of research and analysis specified by the scientific method. Therefore, learning an orga- nized method for problem solving is invaluable. One practical method for problem solving is to follow this seven-step process, which is also outlined in Box 8-3.
1. Define the problem. The definition of a problem should be a descriptive statement of the state of affairs, not a judgment or conclusion. If one begins the statement of a problem with a judgment, the solution may be equally judgmental, and critical descriptive elements could be overlooked.
Suppose a nurse manager reluctantly implements a self-scheduling process and finds that each time the schedule is posted, evenings and some weekend shifts are not adequately covered. The manager might identify the problem as the immaturity of the staff and their inability to function under democratic leadership. The causes may be lack of interest in group decision making, minimal concern over providing adequate patient coverage, or, per- haps more correctly, a few nurses’ lack of understanding of the process.
If the nurse manager defines the above problem as immaturity and reverts to making out the schedules without further fact-finding, a minor problem could develop into a major upheaval.