Job design for hospital pharmacists.
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Through analysis of medical and administrative director positions it is possible to identify an organizational structure for medical departments that enhances departmental operations. Possible roles and tasks that describe managerial responsibilities are considered, and a review of the literature identifies options for how these roles or tasks can be shared between medical and nonmedical managers at the departmental level. These options are refined based on interviews with department-level managers at a case study hospital. Three models are then explored: unity of command, shared accountability, and split accountability. The unity of command model is recommended. In this model, the medical director assumes total authority and accountability for departmental operations through some sort of "enfranchisement." A more formal planning process and a review of job descriptions are also recommended.
The article describes the role of ward managers at middle-sized hospitals and analyzes that role with respect to motivation, role content, and skills and competencies, as well as challenges and problems. The most striking result of this study was the unwillingness of Swedish executive nurses to return to nursing. Among the findings that explain this "career with no return" are an increased taste for challenges; an irrevocable, new professional identity; and a loss of nursing skills and the ability to subordinate. The article discusses the implications for recruitment and education.
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The purposes of this study were to determine preceptors' expectations of students in the supervised practice setting; to identify rewarding and discouraging experiences in precepting; and to establish the perceived effect of the changing health care structure on precepting. A survey consisting of ten open-ended questions was mailed to 430 clinical instructors, representing five allied health programs. Results indicated that observing student growth was the most rewarding aspect of the preceptor role. Frustrating preceptor experiences included low student motivation and poor personal and professional behavior. Respondents expected students entering the clinical experience to have appropriate technical and communication skills. Increased pressures from health care restructuring are decreasing the internal rewards for preceptors. The findings of this study support both further preparation for students entering the clinical experience and a reward system for preceptors.
This study investigated the relationships among role conflict, role ambiguity, organizational commitment, and job satisfaction experienced by clinical team members in a hospital undergoing reengineering. The sample consisted of 409 registered nurses (RNs) and 278 non-RNs. Participants who experienced much role conflict and ambiguity exhibited less organizational commitment and job satisfaction. RNs had more role conflict and ambiguity than non-RNs. No significant differences in role conflict and role ambiguity, organizational commitment, and job satisfaction were observed between RNs working on medical-surgical units and those on specialty units. Strategies that reduce role conflict and role ambiguity to increase organizational commitment and job satisfaction are discussed.
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There is a lot of talk about the importance of persons in organization and leadership, nothing that the keys to lead the organizational milieu in a positive and beneficial manner have been established for several decades. These keys are related to the values of nursing as a profession and to how these may constitute intangible assets. Nonetheless, identifying such values and intangible assets is not the exclusive responsibility of business managers in the nursing field.
This article will explore the development of terms such as autonomous and independent in the national and international nursing literature, with particular reference to the development of the nurse practitioner (NP)/advanced nursing role. It will examine the complexity of power relationships in health care and explore the apparent dissatisfaction of nurses with their status, as demonstrated by such issues as the proliferation of nursing ethics and the problems surrounding recruitment and retention. It will discuss why the development of advanced practice roles has been greeted with such suspicion by some medical organizations, and what barriers and benefits there are to collaborative practice. It will explore the relationship between the bodies of knowledge of medicine and nursing, and the perceived blurring of roles that advanced practice can potentiate. Finally, it will make some suggestions for intelligent and harmonious coexistence, which would refocus medical and nursing practice on patient care, rather than on "bunker dwelling."
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Hiring executives has always been a daunting task--and today's economy makes it tougher than ever. The global scope and breakneck pace of business, the shrinking supply of job candidates, and the constant shift of organizational structures have increased the stakes exponentially; one wrong hire can quickly derail a company. Yet recent studies indicate that between 30% and 50% of executive-level hires end in firings or resignations. What makes hiring go wrong so often? And how can executives substantially improve the outcome of the process? This article provides some surprising answers to those questions. Fernández-Araóz presents ten common hiring traps and many real-world examples of how those traps have scuttled business plans in a variety of industries worldwide. A large consumer goods company, for instance, slipped into the delegation gaffe trap when it handed over the screening and interviewing process to a mismatched team of managers that had an agenda different from the CEO's. And the ignoring emotional intelligence trap tripped up a U.S. telecommunications company that hired a CEO with a great track record--only to fire him less than a year later when his lack of cross-cultural social skills was discovered. Hiring well is a strategy-perhaps an organization's most important one, the author says. To sidestep the hiring traps, he suggests ways to systematically assess the company's needs and to determine how those needs mesh with the open job description--before candidates walk through the door. Fernández-Araóz's search strategy incites managers with hiring responsibilities to be creative, determined, and courageous when embarking on a candidate search.
To keep patients from falling through the cracks, each point of service in a healthcare system must understand its role in the patient's overall care and have access to the right information at the right time. Communication and a system's organization play significant roles in making coordinated care work: Some health systems prefer to keep patients with common diagnoses in service lines that take them from preadmission to home care; others set up separate organizational entities to coordinate care for all patients with chronic illness. Regular meetings on patient status, standardized forms and clear job descriptions all help minimize confusion.