Case Scenario 1
The feeling of powerlessness is one of the reasons that undermine morale in the working team. In the case example this feeling makes nurses resign since lack of power means lack of freedom and initiative. This feeling is usually a result of authoritarian style of management adopted by the team leaders. The authoritarian style of management is based on strict orders and regulations that do not let the subordinates express any objections or opinions (Hackman & Johnson, 2009). The authoritarian management style can be effective in extreme situations or under the conditions of low labor discipline. However, its main disadvantage is low morale of the personnel due to restriction on initiative through the system of fines and other penalties.
In the case scenario the management style is not mentioned directly. Still, the morale of the staff is a significant aspect of managerial work. The manager’s efficiency is not measured in report figures and statistics. Good moral climate of the team is also a feature of an effective manager. High employee turnover rate mentioned in the scenario is a result of administrative incompetence; it decreases the overall experience of the staff. Besides, highly qualified specialists are unlikely to work under such conditions and the professional level of the whole team inevitably falls. Each style of management has its advantages and disadvantages, but if the personnel morale is poor, the style must be changed towards a more democratic one.
Another reason for the feeling of powerlessness among nurses is lack of communication and social activities in the team. The power is not just an ability to command other people, it is also a possibility to realize one’s own ambitions in other spheres. A person’s active social position may bring satisfaction and motivation for efficient work. Such activities include, for instance, discussion of complicated situations, mutual aid, organization of different events, celebrations, meetings, etc.
In general, reasons for low personnel morale can be divided into two big groups: external and internal. External causes depend on other people and surrounding environment. For example, such reasons can be low salary, lack of career perspective, bad relations with colleagues (including the head), poor equipment of the working place, strict rules and instructions, above-mentioned style of management, etc. (Ryan & Deci, 2000). Internal reasons are personal interest and the level of nurse’s professionalism. A person may work for low salary, without any perspective of career, use old equipment, not to communicate with colleagues – but still like the job and be satisfied with it. Vice versa, neither modern clinic, nor money, prospect, nor colleagues can make nurse’s work happy, if he or she does not have an internal desire for it. So, trying to raise the staff morale one must take into account both aspects of motivation, internal and external ones.
Particular actions, which Nancy can take to raise the moral level, may include the following:
- To discuss the news and complex operational issues with the staff and, accordingly, to plan a way out of the crisis together;
- Happy people are those who know where to move on. People want to believe that they are doing something significant and they want be proud of it. Thus, the manager may emphasize this aspect, especially in the case of emergency department nurses. Every day they solve the questions of life and death, even this is enough not to feel “powerless”;
- Nancy has to pay attention to personal interests and skills of every team member. Each of the nurses should get an area of responsibility according to his or her abilities. The area can be large or small, but it must be present. Every staff member must feel needed and important for the whole team.
Certainly, this list is not complete. A lot of other actions can be taken to increase the moral level of the personnel. However, first of all Nancy has to realize the problem herself, since for 2 years she has not paid much attention to it, and now it will not be easy to establish a positive moral climate in the team.
Case Scenario 2
A shared governance model mentioned in the second case is a system of management based on distribution of power among the team members. It is important to understand that power is not only rights and freedom, but also responsibility and duties. This model involves a democratic style of management, which is opposite to the authoritarian one probably used in the first case. The democratic style is characterized by the provision of autonomy to subordinates within the functions they perform and their skills (Martindale, 2011). This is a collegiate style that gives more freedom of action to the subordinates. It usually results in high morale and initiative of the staff.
A democratic manager collects and analyzes information from the subordinates and their opinion before making a final decision. In the case example, the possibility of returning to 8-hour shift must be discussed with the rest of the staff. The information that should be collected and discussed concerns the number of errors made by employees; how the errors quantity changes with time, if it increases with 9, 10 and more hours of work; whether the employees will be able to perform the duties fully in the case of 8-hour shift. The topic presentation must include all of these opinions as this approach makes the report more objective. Since the speaker represents the whole facility staff, their opinions must be incorporated into the report. Besides, the shared governance model is not anarchy, so the opinion of higher management should not only be taken into account, it should seriously influence the final decision and the conclusion of the report.
Except the teammates’ and managers’ opinions the report must include diversified research of various aspects of the problem. Patient satisfaction survey should be added, consultations with external experts (lawyers, economists, psychologists, etc.) should be conducted, and advantages and disadvantages of the reform must be analyzed and summarized. People need to be heard, they need a feeling of power and self-worth not to get into the situation depicted in the case 1. However, the staff members represent only one side of the dilemma, so other information must also be collected and taken into account.
The shared governance model means high responsibility of its participants. The wish to ease the working conditions is natural for workers, but this intention should not decrease the common efficiency of the group. This issue is especially sensitive in medicine, when the effectiveness of work is not just monetary gain, but people’s health and even lives. So, the shared governance model implies the priority of common interests over the individual ones. Besides, the central point of the model is the patient. The system must be comfortable for the staff, for the management, but first of all it must take into account the patient’s interests.
In conclusion, the questions of leadership are among the most problematic. It is difficult to find the balance between good working discipline and obeying rules and instructions, which are advantages of the authoritarian management style, and great freedom, initiative and personal responsibility appropriate for the democratic style (case 2). The flip side of these benefits is low morale and the feeling of powerlessness (case 1) under the authoritarian style, and the danger of anarchy under the democratic one. Each of the styles can be preferable in certain circumstances, so the manager must closely monitor the internal life of the team and change the vector of development accordingly.