Running Head: PERFORMANCE MANAGEMENT

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Running head: PERFORMANCE MANAGEMENT

Performance Management

Kelly Smith

Management Class

Professor Verdi

December 8, 2008

Performance Management

Each country has to have a highly developed Nursing system, which will be available to help all people who are sick, injured or just need help. Although it may be a very frustrating job at times it is worth the while. Nursing is a chance to make a difference in all people and ages. Anyone can enter the Health Care field straight out of highschool. Health Care offers all levels of education a person wants and the kinds of lifestyles and incomes he/she desires.

Presently there is a high shortage of nurses in many countries, and the demand is growing faster than ever daily. A nurse is “an administering nursing care to ill or injured.” Registered nurses provide health care to injured, sick, and healthy people. Duties vary depending upon whether they work in a hospital, doctor’s office, health clinic, industrial plant, or a school. General responsibilities include the nursing care of patients, teaching health care, instruction of nursing skills, administration of drugs, performance of treatments, and functioning with physicians and paramedics in a health care team to assist patients’ return to health. Presently, an expanded role for nurses is being practiced which enables physicians to delegate more complex medical procedures to them.

Registered nurses must have average eye-hand coordination and use of hands and fingers. They must also be able to do precise work and to see slight differences in objects and people. They should also be able to picture objects from sketches and drawings and to make decisions based on facts. Good verbal and numerical ability is important. These nurses should be able to work with others and work using facts.

Registered nurses provide nursing care to patients and may specialize in surgery, neurology, emergency, intensive care, obstetrics, gerontology or other areas of health care. RNs work with individuals, families, groups and communities from a caring and a health promotion perspective. Their duties can include everything from assisting in surgery or giving out medications to observing and monitoring patients, helping with rehabilitation and comforting or counseling patients. Registered nurses usually specialize in different areas of health care, such as pediatrics, geriatrics, surgery and emergency medicine. You’ll find most registered nurses working in hospitals and nursing homes. However, there are also opportunities for registered nurses in doctor’s offices, clinics, public health care agencies, government offices, schools and industrial plants.

Becoming a registered nurse requires college study and a licensing examination. While there are discussions of raising the educational requirements to include a bachelor’s degree, the current rules require only some post-secondary study in one of the nursing programs around the country. Many nurses do obtain four-year degrees and still others do graduate work. In Many hospitals, these extra educational qualifications will mean salary bonuses. Most nursing requires applicants to complete the Basic Life Support certification, as well as standard first aid. The certification must be kept current throughout the nursing program. All graduates from either diploma or degree programs must write examinations set by their nurses’ association in order to obtain registration.

Advanced Practice Nurses are bound by ethics and professional standards to provide comprehensive care with the aim of helping their clients reach an optimal level of health and well-being. The role of the Advanced Practice Registered Nurse with a Psychiatric Mental Health (APRN-PMH) specialty, either as Nurse Practitioner or Clinical Nurse Specialist, is largely an autonomous one, and people are accountable for evidence-based practice. Thus, it is essential that people keep abreast of the latest research and patient outcomes. It is our fundamental responsibility to educate ourselves, and in turn our clients, about various treatment options.

According to the current revision of the clinical nursing practice standards of the American Nurses Association (ANA), “It is clear in this era of profound change, that the challenge for the nurse is to retain the core values of psychiatric nursing, while integrating the new knowledge and skills that are required to provide the highest level of quality care” (American Nurses Association, American Psychiatric Nurses Association, & International Society of Psychiatric-Mental Health Nurses, 2000).

Nursing is professionally dominated by females-94.6% are women. But in earlier centuries, nursing care was usually provided by volunteers who had little or no training, most commonly men and women of various religious orders. “During the Crusades, for example, some military orders of knights also provided nursing care, most notably the Knights Hospitalers” (Encarta 98’ Encyclopedia). Toward the end of the 18th century nursing was considered an unsuitable occupation for young women, due to the fact that hospitals in those days were dirty, and pestilent places where patients usually died.

Modern nursing began in the mid-19th century with the advent of Nightingale training schools for nurses. World War I established the need for more nurses in both military, and civilian life. As a result, nursing schools increased their enrollments, and several new programs were developed. During the depression of the 1930s, many nurses were unemployed, and the number of schools declined. World War II, however, brought about another increased demand for nurses. Since the end of World War II, technological advances in medicine, and health have required nurses to become knowledgeable about sophisticated equipment, to learn about an increasing number of medications, and to design nursing care appropriate for health care delivery system during a period of rapid change.

Nurses could be men or women but who ever enters this profession should have these qualities: understanding, caring, sympathetic, accepting of responsibility, able to supervise others, follow orders precisely, and determined to the job successfully.

The Nursing schedule is a big factor why some people may not want to become a nurse. In fact, since hospitals are open twenty-four hours a day and seven days a week to care for the sick and injured they guarantee a variety of work schedules. There is the traditional eight hours shifts while some people would rather work only on weekends and have their weekdays off. There is also the option to work twelve hour days, then have several days off in a row. Whether you want more time with family, vacations, for advancing education or for other needs, you’ll find someway to fit your lifestyle.

Speaking about management in nursing system I can say that its functions are pretty much the same compared to other spheres of work. The four basic functions of manager’s: planning, organizing, leading, and controlling-traditionally referred to as the management process by management writers (Dessler, 2001)-are essential functions for managers everyday. Within any organization, it is vital to manage each of these functions before, during, and after any problem or a disaster and in every day life.

Since September 11, 2001, no one can no longer say, “A disaster could never happen here.” Whether or not a hospital is a direct target, its staff will be involved, but all too often, the functions of management during a crisis are forgotten, producing more chaos than was already present.

The management planning process is always future-oriented, but when disaster hits, planning is now. A ten-year study completed before September 11 by National Science Foundation (NSF) found that disaster planning often does not go as expected (Glass, 2001). This is true in health care institutions, because the NSF study also found that disaster drills are often only mandatory for nursing staff and house officers, but during disasters, senior medical staff and non-emergency room medical personnel who seem to always end-up working together, do not know the drills. As observed during September 11, the majority of victims that made it to hospitals had minor injuries. No one was really sure what people should do, why it must be done, where it will be done, when it will be done, how it will be done, and who will do it.

These uncertainties require the next function of management: organizing. Nurse managers must organize and coordinate responsibilities so that they are assigned to the right people for the right job, at the right place, at the right time, and in the right numbers. Managers must also ensure fiscal and material resources are used effectively. Nursing managers must make sure their own unit supplies are stocked and equipment is in constant working order. Lack of organization at anytime can spell chaos. Maintaining establishment of the staff’s responsibilities involves leadership, the next function.

Nurse managers can influence the staff to continually carryout their responsibilities properly and effectively, without hesitation through leadership, direction, morale, and communication. The NSF study also found that disaster drills are rarely designed to include communication failure (Glass, 2001), which leads to panic and confusion. During a disaster, the staff will be empowered to be self-directed, control their own relationships, and work well in teams if they have supportive, strong managers. Leadership will remain strong, if accompanied with control, the next function.

According to Cuny (1999): “…control in disaster management, primarily is a function of direct, on-site supervision, coordination and administration” (Cuny, 1999, p. 199). Managers must be given flexibility in the control process, because the goal is not to ensure that everything runs according to plan, but to ensure that victims are helped to the greatest extent possible (Cuny, 1999). All managers exercise control by establishing standards, measuring performance against standards, and correcting deviations from standards (Rowland & Rowland, 1997). During a disaster or any other problem situation, there are three basic conditions necessary for control: establishment of standards and critical pathways, information showing deviations in practice, and authority to correct problems (Cuny, 1998).

Aside from the staff’s responsibilities of caring for victims during a disaster, they are also responsible for the care of their families. The ability of staff to remain at the hospital for extended periods of time depends on the ability of their families to be cared for (Bentley, 2001). One strategy is to allow staff to bring their families to the hospital to stay. However, there may not be room and may not be safe. Another strategy is to allow staff to go home, get their family care arranged, and then return to the hospital. Obviously, though, many staff will be reluctant to return (Bentley, 2001). Managers must develop a coordinated, efficient callback system that includes a wide variety of staff from multiple resources.

Disasters and various problem situations are inevitable and no matter the organization, with or without disaster, the four basic functions of management are truly the key to success. In health care institutions, nurse managers should begin disaster drills during new employee orientation, continue regularly and be mandatory for all staff. Not only will education of these functions, as well as drills give the staff a clearer understanding of their responsibilities, but will also enhance their awareness and preparedness, providing harmony and synchronicity.

Disasters are not the time for debate, nor the time for discussion to reach consensus. Instead, disasters are the time for the staff to prove their abilities. No matter what type of disaster occurs, the functions will provide a powerful, guiding framework, and during disasters, the four basic functions of management means now.

There are many articles that tell us about a desperate demand in nurses. And we know that staffing really matters at the hospital. The more nurses that are on staff, the more of a lower death rate of patients. The levels of RN’s makes a difference in patient mortality also. The more experienced, the less of a death rate in patients. If the patient isn’t properly taken care of, they will die. The nurse needs to…

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