Vision and the organizational structure

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1.Vision and the Organizational Structure (graded)
As the nurse administrator, discuss your vision for the organizational structure for SLMC.

The Impact of Theories Within the Organization
As we begin this weeks lesson, it is important to reflect upon how theories may impact management and the organization. We will begin with an overview of select theories related to aspects of management. Previously in the course, we touched on organizational theory and how theory can influence an organization. This week, we will explore this concept in more depth.
Organizing may involve various responsibilities and activities being organized into workable units, which can delineate communication and lines of authority. Theories can assist leaders in organizational structuring and organizing various aspects, such as group and work assignments, coordination of activities, and influence the mission and philosophy of an organization. There are key principles involved in shaping organization structures, which include policies, coordination, delegation, the chain and unity of command, bureaucracy, line and staff, and span of control and specialization (Roussel, 2013).
As a nurse leader, it is important your team members all receive adequate information and consistent role expectations. When this does not occur, employees can experience role conflict and have ineffective performance and job dissatisfaction (Roussel, 2013). This information process is initiated with the interview process. Initial and ongoing education and incentives can assist with reinforcing ones role. When role theory is used effectively, there is typically a positive correlation in work quality.
As mentioned previously, there are variations in organizational structure and organizational charts depending on the nature of the structure, with advantages and disadvantages of each. Last week, we discussed shared governance as a participatory-management approach. New organizational structures or models may be developed to focus on a specific need.
The Association of Nurse Executives (AONE) developed the AONE nurse leader patient-safety-model to support an environment of safety and high-quality care utilizing leadership (Roussel, 2013). Patient safety is a priority focus for most agencies throughout the country. The development of the organizational climate and culture is a reflection of the organization personality. In some instances, for example, an organization that may wish to pursue Magnet designation may need to change the organizational climate. Patient safety and quality are key items involved in Magnet designation criteria. In other organizations, there may be a need to attain a more positive organizational climate. There are several activities nurse leaders can encourage to promote and help achieve a positive climate for their organization. A few examples include promoting teamwork, role modeling the expected and desired performance regarding roles, and developing the mission, philosophy, vision, and goals with input from the staff (Roussel, 2013).
As the nurse leader, monitoring the effectiveness of your organization is beneficial to determine if adjustments in various organizational aspects need to be incorporated. Some indications to monitor the organizational effectiveness may include: patient and family satisfaction regarding care, staff and management satisfaction, community relationships, and organizational health (Roussel, 2013).
Team building is one way to develop a cohesive environment for your staff and is an example of participatory management. This group cohesiveness can assist with committee or group work, patient care, and goal achievement for the team. We will discuss team building in more depth later in the course.
The nurse leader has the overall responsibility to ensure a motivational work climate is available for employees. See below for additional information related to creating a motivating work climate for your team.
After monitoring the effectiveness of your organization, you may determine some restructuring is needed in one or several aspects of your monitoring criteria or other areas. Before making any changes within the organization, a careful evaluation and strategic plan are prudent to help ensure a positive change related to organizational restructuring. Ongoing follow up and monitoring is recommended to ensure a change is embraced and maintained after implementation.
Motivational Theory
There are several theories related to motivation. Different persons can be motivated by different factors, and what motivates an individual may vary depending upon the influences at that particular time.
Motivation is the force within the individual that influences or directs behavior (Marquis & Huston, 2015, p. 415)
Motivation may be of an intrinsic nature, such as within the person, or extrinsic nature, which is related to the work that has been completed.
As we discussed above, the nurse leader takes the lead for ensuring the environment has a motivating climate for employees. In the work setting, motivation can be combined into an employees job position. Generally, if an employee has high job satisfaction, productivity is high (Roussel, 2013). In routine positions, where an employee may do the same task or routine every shift, expanding the employee\’s role or rotating to a different area can help reduce boredom and maintain motivation. Some persons are intrinsically motivated, and others are extrinsically motivated by external rewards or their job environment (Marquis & Huston, 2015). The notion of motivation has been studied by researchers in different aspects to try to gain a better understanding of the concept.
Last week, we discussed the Magnet model; within this model, adding higher levels of responsibility to a role, for example, participating on the shared governance council, can add more value to the role and commitment to the organization. The annual-review process is a great time for nurse leaders to discuss and set specific goals for their employees. Generally, a challenging goal that the employee embraces can enhance their motivation. Many organizations that utilize the Magnet model also include a clinical-ladders program, whereby the nurse can set specific goals and be motivated for a change in status, which also typically translates into a monetary increase. There is incentive for the nurse to continue to be motivated and keep this new monetary increment; as well, expanded opportunities can be available as you move up the clinical ladder. Different facilities may designate a similar program with a different name. The benefits of this program are actualized by the employee, the organization, and ultimately, the patient.
To create and sustain a motivating climate for employees can be challenging at times, as different employees have different aspects of what motivates them. The organizational climate and culture can influence the external motivation or morale of an employee. It is prudent for the nurse leader to get to know the employees and be aware of what motivates each employee. Sometimes, a simple Thank you or telling an employee You did a great job today can be extremely motivating and rewarding as positive reinforcement for an employee. Some strategies may work for your team, and some may not. As a nurse leader, over time, you will get to know what motivates your employees and develop a motivating climate.
This week, we explored some select aspects of theories that may impact management and the organization; specifically motivation of an employee. Next week, we will focus on management of influence, power, and conflict.

Marquis, B.L. & Huston, C.J. (2015). Leadership roles and management functions in nursing: Theory and application. (8th ed.). Philadelphia: Lippincott Williams & Wilkins.
Chapter 18: Creating a Motivating Climate
Roussel, L. (2013). Management and leadership for nurse administrators. (6th ed.). Boston: Jones & Bartlett Learning.
Chapter 7: Organizational Structure and Analysis (Review)
Chapter 12: Managing the Process of Care Delivery, p. 488
Nickitas, D. & Frederickson, K. (Jul/Aug 2015). Nursing knowledge and theory: Where Is the economic value? Nursing Economic$, 33(4), 190-239. Link to article
Hamdan, Y., Jetha, A., & Norman, C. (2011, November). Systems thinking perspectives applied to healthcare transition for youth with disabilities: A paradigm shift for practice, policy and research. Child: Care, Health and Development. 37(6), 806-14.
Leibler, J. & McConnell, C. (2004) Management principles for health professionals. Sudbury, MA: Jones and Bartlett.
Marquis, B.L. & Huston, C.J. (2015). Leadership roles and management functions in nursing:Theory and application (8th ed.). Philadelphia: Lippincott Williams & Wilkins.
Roussel, L. (2013). Management and leadership for nurse administrators. (6th ed.). Boston: Jones & Bartlett Learning.

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