March 20,2007
Kathy Leavitt
Action Research Plan for creating a supportive environment for nursing staff who are without a nurse in charge.
Project Description
The project that I am undertaking for this assignment is to develop a system ( with feedback and assistance from the staff) that will provide clinical support to this specific group of nursing staff members when the position of Nurse in Charge is vacated. Presently, and for the 25 years I have been employed in this institution, the role of Nurse in Charge has been in place for the purpose of providing clinical support to the staff and to maintain efficiency of each, individual service specialty.
The position is not immediately being filled so I feel it is a priority to talk to staff about their ideas and thoughts on what responsibilities associated with this role are felt necessary to be assumed in order for them to continue to provide excellent care to their patients and feel supported.The Action Research project will encompass the steps to attempt achievement of this goal. Staff members have different needs, ideas regarding support and possess a wide range of skill levels( advanced beginner to expert) so the process will require much discussion, planning and evaluation of ideas. I am hopeful that a plan may be implemented but realize that there are strong feelings about leaving the position vacant.

KSL+Eval+Clock.doc
KSL KAQF.doc

References

http://www.cna-nurses.ca/CNA/documents/pdf/publications/NN_Nursing_Leadership_05_e.pdf
The title of this article is “Nursing Leadership in a Changing World”. Multiple factors are discussed that impact nursing leadership and the future of nursing. New models of leadership which will assist in promoting a combination of accountability, teamwork and resourcefulness are explained. This concept involves nurses leading nurses and nurses at all levels have the opportunity to exercise some degree of leadership. The nurses delivering care to their patients are the ones who advance nursing practice by contributing to decisions that influence their professional practice. Nurses will develop and hold themselves accountable for their thoughts and actions which is different from the current model where management holds the individual accountable.
My thoughts from this article include the level of development I would like to see my staff achieve where they are active in the decision making process on issues that affect them and their patients and also achieving a higher degree of individual accountability. Moving away from the idea that I am responsible for fixing what bothers them and towards the idea that they are responsible for being involved in formulating solutions to the issues they bring forth.


http://www.juns.nursing.arizona.edu/articles/Fall%202002/Valentine.htm
“Nursing Leadership and the New Nurse” focuses on the current nursing shortage and the high impact it has on nursing leaders as well as nursing staff. The nurses delivering bedside care rarely are exposed to events or opportunities to allow them to develop as leaders. Nurses providing direct care are at the first level of decision-making and therefore have the ability to influence outcomes. Three models of nursing leadership are discussed and the Dynamic Leader-Follower Relationship Model is the one I am most interested in for implementing in my Action Research plan. “The leader provides direction to the employee, not control, allowing for maximum participation by the employee or a dynamic relationship” (Laurent, 2000, p.87). This relationship and interaction between the new nurse and the leader can inspire commitment and motivation.
This article focuses on the new nurse but I feel it can also be applied to the proficient or expert nurse also. This is the model that I see as being in place for a period of time after the departure of the current NIC. The advantages I see for this model are what were identified in the article where the new nurse and the leader develop a relationship and the manager does not have control over but rather invites and supports the nurse to be an active participant in decision making.

Managing for Success in Health Care
Porter-O'Grady, T.; Malloch, K.
Source: 2007, Mosby Elsevier, St. Louis, Missouri
The concept of a team approach is discussed and the factors that are necessary to experience success. These factors include problems that arise in relationships, productivity, communication and interaction among all members. Empowering team members allows them to be effective and it is a must that accountability within each individual’s role is assumed by all members. The style of management involves moving from parent to partner where the manager does not exert control over the staff but rather empowers them to become active and influential in decision-making.
This model is what I am striving for where the staff and I work together to make decisions regarding their practice and their environment. All individuals take control over issues related to practice, quality of care, competence and evaluation where the staff have a larger role in their workplace.

Leadership Roles and Management Functions in Nursing
Marquis, B. L.; Huston, C. J.
1996, Lippincott-Raven Publishers, Philadelphia, PA, Second Edition

Organizational Effectiveness is where staff understands the structure and know where to go for assistance. The staff sees where their tasks align with the common tasks of the organization and the organizational structure serves to enhance the environment such as communication, sense of community, decision-making and development of future leaders.
Bridging the authority power gap so that each staff member feels genuinely cared for and feels that her efforts are inline with the goals of the manager for the institution. Empowering staff is defined as “an interactive process that develops, builds, and increases power through cooperation”. Empowering creates and upholds an environment where employees choose to invest in and utilize personal behaviors and actions that result in positive contributions to the institution’s mission.
My goals are similar with the concepts discussed in this book. The model of decreasing the levels of management so that the staff knows who to go to with issues and realize that the goals are aligned makes sense to me. Empowering is the strongest and most common word I have found within the references. The ability to empower seems to result in the accountability of each individual for their practice and their delivery of quality care.

Staff Survey

1. What do you feel is the primary role of the NIC?
2. What duties do feel are part of NIC responsibilities?
3. What duties do you feel are not related to the role?
4. Do you feel the NIC should be responsible with the Pod person to provide
reliefs?
5. How do you think nurses should be assigned to the role?
6. What do you see as benefits to having the role rotated among staff?
7. What tasks do you think could be relegated to a non-clinical person?
8. How do you envision this role to better support the staff?
9. What qualities do you feel are important in this role?