It’s a great feeling when you know that the work you did for a person has saved their life, but what about those feelings you had before the job well done or the feelings you get when you cannot see a job done at all? Nursing is perceived as a strenuous job. It is full of potential physical stressors, including frequent lifting and bending, changeable shifts or rosters, noisy work environments, and long hours. As well, many nurses face exposure to infection and toxic substances on a regular basis. In 1960, researcher Menzies identified four causes of stress among nurses, including “patient care, decision making, taking responsibility, and change.” According to the American Holistic Nurses’ Association, nurses are experiencing workplace stress at higher rates than most other professions. These stressors include physical demands, management issues, lack of resources, and difficulty in balancing home and work responsibilities. This report can serve as a list of recommendations that I believe will be beneficial in changing the company culture as well as address the stress issues employees at Parkway Nursing Care have experienced.
The Appreciative Inquiry (AI) approach is used to identify the unique qualities and unique strengths of an organization, which can then be built on to improve performance (Robbins & Judge, 2017). This method involves four steps – discovery, dreaming, design, and destiny – often done in large group settings lasting between 2 to 3 days and overseen by a trained change agent. During the discovery stage the purpose is to identify what people think are the organization’s strengths. This stage is the time where employees can reflect on when they felt the best at their job. In the dreaming stage, employees use information from the discovery phase to speculate on possible futures. In design, participants find a coma shared vision of how the organization will look to the future and agree on its unique qualities. During the final stage, destiny, participants seek to define the organization’s destiny or how to fulfill their dream. They typically follow up by writing action plans and develop implementation strategies. Using this approach an organization can focus on its successes and not problems which is the method I followed to build my recommendations off of.
CC-30. What do the data on employee injuries, incidents, absences, and turnover suggest to you? Is there reason for concern about the company’s direction?
The data on employee injuries, incidents, absences, and turnover suggests that as the company continues to expand so will the number of injuries, incidents, absences, and turnovers. This makes sense to me because with the influx of new patients the stress and pressure on the workers will increase. They have more patients to take care of, and with the stress levels already high they will continue to rise.
Right now I would say that there is not a reason to be concerned. Being that management is aware of the stress levels their employees are facing, and they are making efforts to change those factors. The company wants to keep its strong position in the industry so they should be willing to take any necessary actions to ensure their employees are satisfied with their jobs. Long as they are committed to improvements and the betterment of their staff then, in my opinion, they will see success.
CC-31. The company is going to be making some significant changes based on the AI process, and most change efforts associated with resistance. What are the most common forms of resistance, and which would you expect to see at Parkway?
It’s important to note that resistance to change can be seen as a decisive factor but only if it leads to open discussion and change (Robbins & Judge, 2017). Since we are trying to make matters better at Parkway, we want to ensure that whatever the next steps we take are supported and desired by those who it will effect. Resistance to change can take place in many forms which they are often characterized by their sources. These sources can be either individually inspired that reside in human characteristics or driven based on the organization structure. Some common forms of individually inspired forms of resistance are habits, security, economic factors, fear of the unknown, and selective information processing. A common form of resistance that I expect to see at Parkway is the security aspect. People with a high need for security are likely to resist change because it threatens their feelings of safety. Some common forms of organizational inspired forms of resistance are structural inertia, limited focus of change, group inertia, threat to expertise, and threats to establish power relationships. A common form of organizational resistance factors at Parkway would be the limited focus of change. This can be seen in the way they enter patient data. Most of the seasoned employees rather they do not change the method of entering data whereas the newer staff members feel as though they should have an updated method of doing such. The veteran workers feel if they change one aspect then they would have to change other parts and that could throw things off for them.
CC-32. Given the board of directors’ desire to re-energize the workforce, what advice would you provide for creating a leadership strategy? What leader behaviors should nursing home directors and nurse supervisors demonstrate?
When considering what approach to take in creating leadership strategies I would suggest they look at their staff and see how they respond to each type of leadership theory. Some common theories to follow that would be beneficial for re-energizing their workforce are:
- A participative theory which takes into consideration the input of their associates.
- A situational theory which proposes that the leaders must choose the best course of action depending on the situational variables.
- Contingency theory focuses on the environmental variables which can be used to determine what type of leadership practices will be suitable for a specific situation.
- A transformational theory focuses on connections which have been formed between the followers and the leader.
Having those theories in mind, the best leadership strategy I advise Parkway to use would be based on the situational theory style. This way those in leadership positions can analyze what is currently or could happen and use that to make decisions.
The behaviors of nursing home directors and nurse supervisors should demonstrate those centered on selling and coaching. They have rights while making decisions however in such a set up the communication process should no longer be single sided, as we saw this was an issue for some of the employees. “We’re the ones who are with the patients most of the time, but when it comes to doing this the right way, our point of view gets lost” (Robbins & Judge, 2017). It’s evident that management does not take into consideration what policies and practices work best for the team.
CC-33. What are the major sources of job stress at Parkway? What does the research on employee stress suggest you should do to help minimize the experience of psychological strain for employees?
According to the text, there are two types of stressors that have an impact on people’s lives; they are hindrance and challenge stressors. A hindrance stressor is any obstacle that keeps a person from reaching their goals. A challenge stressor is any obstacle that comes from the workload, pressure to complete tasks, and time urgency. Out of the two challenge stressors have less strain than what hindrance stressors do. Reading over the case the employees at Parkway experienced both types of stressors that had an impact on their performance.
The primary challenge stressors that I was able to identify at Parkway dealt with staffing issues, the amount of workload they had and scheduling concerns. For example, Bobby Reed, a nurse aid at Parkway, said that “No one is intentionally negligent – there just are too many patients to see” (Robbins & Judge, 2017). The workload is causing him stress which in turn is causing problems for him. The major hindrance stressors evident at Parkway include people not taking their jobs seriously resulting others to pick up their slack and communication issues between the shifts that cause a delay in information being shared.
For helping and minimizing experiences of the psychological strain on the employees, the company must create the change and reenergize their sense of mission which can be done by following the Appreciative Inquiry (AI) method. The AI method collects the employee input and uses that data to create change that everyone will support.
A plan for reducing stress at Parkway would be to:
- Produce a pleasant and comfortable work environment
- Allow employees the chance to offer their input on the decisions that will help improve their performance
- Create a space for employees to mediate that would serve along the lines of a quiet room.
- Have an exercise room that the employees can utilize to reduce stress.
CC-34. Based on the information collected in the focus group, design a survey to hand out to employees. What sort of data should the survey gather? What types of data analysis methods would you like to employ for these data?
When gathering data management should use methods that follow a qualitative approach. These approaches are useful for further exploration of effects and unintended consequences of a program. This way can be expensive and time-consuming to implement so be sure to be efficient and effective when designing a survey. You want to hold interviews and conduct observations to get an understanding of what is going on and how to handle it appropriately. An example survey for Parkway to conduct is attached.