Managing in Health Care

A Guide for Nurses, Midwives and Health Visitors

Lesley Dowding, Jill Barr

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781317877486
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Appropriate for health administrators in departments of sociology, social policy and nursing.
Students in pre-registration programmes and those meeting management theory for the first time.
There can be little doubt that the reforms of the last few decades within the health service have had a major impact on the management responsibilities for nurses, midwives and health visitors. Integrating management theory and principles with nursing practice, Managing in the Healthcare demonstrates how the concepts and principles of management are intrisically linked to the work that nurses do.

Part

I

The individual

1

Getting Started

By the end of this chapter you will have had the opportunity to:

• recognise the importance of self-awareness within a health care environment

• undertake a SWOT analysis in order to develop a meaningful career path

• discuss the advantages and disadvantages of various time management strategies

• describe the difficulties of coping with stress and the systems that may contribute to its successful management

Introduction

Whenever patients and clients comment about the quality of care they receive from health care professionals they are referring to how that care has been organised and delivered, by whom and to what standard. This suggests that there is a connection between the ability of the nurses, midwives and health visitors to manage and the quality of care that is being delivered in a particular environment. In order to manage care effectively and efficiently it is important for those involved in the delivery of that care first to acquire an awareness of themselves as people and, second to have personal goals, aims and objectives to work towards.

This chapter aims to provide the building blocks for nurses, midwives and health visitors to develop a career route or pathway. It will address issues of self-awareness; the identification of individual strengths and weaknesses; goal setting; time management; coping with stress; and managing support systems.

Self-awareness

There is no single definition of self-awareness but it may be seen as a dynamic state of mind that a person reaches after examining their strengths and weaknesses in individual abilities, attributes, and roles. It involves the influences and reactions from significant others and may be dependent on time and place. Within a caring profession it is important that we are aware of the image we portray to our patients, as it is one of the major factors that encourages or detracts from the healing process. Sometimes assumptions about ourselves do not correspond with the perceptions of others, but when considering our own views and those of others the overall effect is to help us to develop self-awareness. York (1995) indicated that self-awareness should imply that the individual:

• has reached a balanced and as honest a view as possible of his/her abilities and limitations without overestimating or underestimating self;

• is aware that his/her behaviour always has effects on others and may, therefore, regularly need modification to achieve effective communication and relationships;

• takes positive steps to ascertain the views of others about his/her behaviours and takes particular note of any consensus of views. (York 1995)

There are numerous issues where self-awareness and self-knowledge will be of help to nurses, midwives and health visitors: attitudes and beliefs about abortion; single parents; euthanasia; and refusal of treatment, to name but a few. However, irrespective of a nurse's own beliefs and values, a nurse may not refuse to care for a patient except in certain circumstances, e.g. a nurse may refuse to help with the actual abortion, but following this the patient's needs override any personal view that the nurse may hold.

It may be useful to identify stressful elements within your daily life and you should be encouraged to develop networks, which may include partners, friends, colleagues or relatives, to assist in reducing the effects of stressors. Awareness of one's capabilities and limitations is particularly important when considering a career where interaction with the general public at a time of illness, stress or trauma is a feature. Most of life involves interpersonal relationships of one sort or another, so there is a clear need for effective communication and collaboration if one is to take responsibility in attaining the goals of life.

In interpersonal terms, self-awareness concerns perceptions that have been highlighted within a model known as Johari's Window (see Figure 1.1). This describes the perceptual differences and possible conflicts of behaviour that were identified by two psychologists, Joe Luft and Harry Ingham (York 1995). The window has four ‘panes’ which relate to aspects of self. It can be said that by identifying the areas or traits of oneself related to areas 1–3, then the elements that make up area 4 will inevitably become smaller. This makes individuals more able in terms of ability to consider the effects of their behaviour on others and the identification of positive steps that might be

Figure 1.1 Johari's Window
Adapted from York (1995)

taken in order to effect an improvement. So self-awareness can be used as a significant force for developing and improving individuals, helping them make sound decisions for life and working careers and developing important skills in interpersonal relationships.

While self-awareness is important for personal and interpersonal purposes, it is vital when work involves any form of leadership. If one is to become an effective leader then it can only be achieved by knowing oneself and the impact one has on others (Chapter 7). The only people who can give managers reliable feedback about leadership style and the effect that it has on the workforce are the members of that workforce. However, this can be extremely difficult, particularly if the workforce does not see the leader in a favourable light and if that leader has the power to ‘hire and fire’. Wherever possible an exercise of self-analysis, should be carried out. The leader could describe themselves in terms of their main characteristics; following this they could ask the views of ‘safe’ but honest people or relatives to do the same thing. Then, by comparing the views, an overall picture will be developed. It must be recognised that traits demonstrated at work may not necessarily be demonstrated at home. Similarly the converse may be true. This is an excellent method of gaining insight into self and using it as a tool for improvement.

Strengths and weaknesses

Occasionally it is useful to take a long, hard look at yourself and what better time than at the start of your career in health care. It is relatively easy to identify your perceived weaknesses, but when it comes to strengths things are a little more difficult. It is only by identifying these two elements that you can go on to consider your opportunities for yourself and identify the threats that may stop you from achieving your overall goal. Figure 1.2 shows the elements of a SWOT analysis and the format it may take.

Figure 1.2 SWOT analysis to identify strengths, weaknesses, threats and opportunities

• Take a few moments to look at yourself in order to undertake a SWOT analysis,

• Keep your findings in the p...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Contents
• Preface
• Acknowledgements
• Part I The individual
• Part II The team
• Part III The business of health care
• Part IV Conclusion
• Useful websites
• Index