Conceptual Analysis of Delegation - Essay Example

Running Head Conceptual Analysis- Delegation Conceptual Analysis - Delegation The modern environment, nursing requires professional skills and knowledge, high level of expertise and managerial skills. Thus, delegation is one of the most important functions which help professional nurses to share responsibilities and involve non-professional staff. Delegation combines the ability to meet requirement of a new age and respond effectively to clients' needs. Delegation needs careful analysis and planning process to be effective and save for the penitent. In nursing, effective delegation means sharing of tasks which she or he can control; releases. Knowledge and competence are criteria that allow decisions to be made at the appropriate level. This means that all members of staff must accept responsibility for achieving high-quality management and not leave that responsibility to the senior management team or middle managers. Healthcare organizations start to apply this concept into practice seeing it as a high level of specialist practice and competitive advantage in healthcare services. Today, a special attention is given to proper function of medical staff and empowerment which helps to improve efficiency of medical practices and introduce technological innovation more rapidly and effectively. Introduction Delegation is one of the most important management functions which help a person to handle a task over to another person. At the beginning of the 21st century, healthcare needs nurses able to cope with changing environment, technological challenges and culturally diverse clients. If nurses are able to exhibit strategic leadership that achieves a long-term focus, promotes development and application of core competences, emphasizes the development of human capital, develops an effective culture, and achieves strategic control simultaneously with the allowance of autonomy, restructuring efforts are more like to be successful. Delegation of responsibilities allows nurses to improve their performance and effectively manage daily tasks. 'Delegation' Defined There are different definitions of delegation. In the article The Art of Delegation, Blair defines it as: " Delegation is a skill of which we have all heard - but which few understand. It can be used either as an excuse for dumping failure onto the shoulders of subordinates, or as a dynamic tool for motivating and training your team to realize their full potential". A nursing position and role in healthcare has defined responsibilities or functions, together with the authority to carry them out. Nurses tend to have responsibilities for more work than they can possibly execute themselves. Another definition of delegation can be successfully applied to nursing profession: "delegation is the universally required ability to maintain responsibility yet relinquish authority" (The New Oxford American Dictionary 2001, p. 38). Most managers agree that decisions ought to be delegated to the lowest possible level where they can be made intelligently and where the relevant facts and required judgment are available. Often, in practice, they violate this rule by micromanaging or just telling their subordinates what to do. Or they make the mistake of dumping the decision without enough guidance or taking it back and doing it themselves. All of these mistakes have negative consequences (Blair, n.d.). The personality type of both the boss and the subordinate can have a profound effect on whether effective delegation takes place. Intuitive types may not explain all the details or responsibilities to the subordinate because they believe they have given a broad enough picture. Introverts may not fully communicate all the necessary information they have; their delegation will be patchy and inconsistent. Extroverts may wander with their thoughts and not be concise in their communications (Gulanick and Myers, 2006). Using these definitions, it is evident that delegation in nursing can be defined as the process when nurses give subordinates (usually non-professional medical staff or care takers) the responsibility to act and perfume certain tasks. Delegation, when done well, extends the tasks from what a person can do to what she or he can control; releases time for more important work; develops subordinates' initiative, skills, knowledge, and competence; and allows decisions to be made at the appropriate level. The cardinal principle in delegation lies in the type of decision that must be made. A policy decision clearly belongs in the hands of top management. Operating decisions, however, where the problems are best solved by those with special expertise should be made by middle and lower management. The measurements for delegation in real world can include (1) quality and accuracy of practices and tasks performed by another person, (2) their impact on the patient and environment, (3) time necessary for the task performance. The main characteristics that describe the concept of delegation involve compliance, risk management and performance management. These concepts can be used in the empirical world to test delegation and its effectiveness. Implications for Nursing Profession They need to delegate some of responsibilities to others, together with some of their own positional authority. The benefit of effective delegation in nursing is that it gives a nurse more time to lead and manage, especially where the following are involved: complex and difficult management tasks; novel healthcare developments, strategic opportunities, quality improvement, communication of vision and strategy, key staff appointments and staff development and training (Alexander et al 2006).. Many nurses are in a position requiring strategic or operational leadership, and they are coming under severe time pressures, in such cases they should delegate. "Nursing has traditionally coordinated and supervised personnel on patient units. Nursing may hold on fiercely to non-clinical responsibilities that provide an alternative career ladder" (Burns 1989, p. 350). For nurses, the main types of work they should consider delegating are: repetitive routines of an administrative nature; minor decisions, technical or functional specialty activities as opposed to leading/managing functions, assignments that will give variety to routine work (for instance, home care) (Alexander et al 2006). For nurses, both the training process and subsequent delegation require considerable two-way communication skills on both parts. What is being delegated must be clearly defined; the authority to do it must be spelt out, others involved also need to be informed. In healthcare, it is important to check understanding and make sure the person knows the wider context. In nursing practice, delegation is a two-way process. Wiggins (1998) suggests that: "The time to delegate is when another person can do a task cheaper, faster, or better than you can do it yourself. Also, jobs you dislike doing are perfect for assigning to someone else, especially if the other person enjoys the task" (p. 29). It is necessary for both parties to work carefully and sensitively towards full delegation of a task. The delegatee is helped and supported, with gradually decreasing monitoring, by the delegation. The delegated task is defined so that both parties are clear about expected outcomes, time, legal and financial constraints, and available resources. It is important to note that: Administration, on the other hand, is a newer profession to the hospital that has only recently begun to extend its domain into clinical areas. The established prerogatives and interests of nursing appear to dictate that new administrative ventures into the clinical areas proceed gradually, with care taken not to encroach on the turf of other professions" (Burns 1989, p. 350). Four Paradigms Taking into account the four paradigms, nurse, person, health and environment, it is possible to say that delegation affects all of them require careful analysis and consideration of these four functions. Delegation influenced a patient and his health; it affects the environment and requires strong management skills and professional vision of a nurse herself (Delegation of Nursing Functions n.d.). The main problem and threat of delegation in healthcare is that methods of working are often discussed but not defined, so that the delegate (home caretaker or unprofessional staff) can develop his/her ways of working, which may be different from those of the delegator (Dougherty and Lister, 2004). Thorough preparation is essential for both parties. At the planning meeting there needs to be explicit agreement about programs of action, timetables and future monitoring discussions or meetings (Ross, 1993). In order to measure effectiveness of delegation, regular support and encouragement should be available in addition to the planned meetings. This again is a two-way process, each reassuring the other that the delegated task is being performed well. The planned meetings are review meetings, reviewing objectives, progress, limitations, training needs, resources and future plans. The inclusion of the hopes and fears of both parties is not irrelevant to the success o delegation in healthcare. If delegation is not going well the reasons for the difficulties should be found without the delegator taking over and with much determination to learn from the experience (Dougherty and Lister, 2004). Again, even at the risk of 'overkill', it is important to emphasize that both parties should be involved in this learning process. Wiggins (1998) explains that: "reverse delegation is a situation in which you delegate a task and you wind up finishing it yourself. Reverse delegation is appropriate if a subordinate lacks the time or ability to properly do the job" (p. 29). Taking into account the 'person' and 'health' paradigms of nursing, it is important to note that impersonal and hypercritical thinking types can arouse anxiety and uncertainty in an insecure subordinate. Feeling types may seek harmony and avoid conflict, which will come back to haunt them later on. Judging types may push too hard for the outcome and operate out of a crisis management mode. Perceptive types may procrastinate by mulling over the problem or task and not delegate until a crisis explodes. For subordinate (a care taker or unprofessional medical staff), these types of perception play a crucial role in effective management and performance (Dougherty and Lister, 2004). With training, staff come to know what good management is and, in situations where they are suffering from poor management, they are able to articulate what they believe the required improvements might be. Barriers to Effective Delegation In nursing, barriers to effective delegation may also exist because attempts at delegation by managers may be perceived as weakness, laziness or incompetence. Another important consequence of having poor role models is that both staff and management may believe that delegating means off-loading jobs which managers want to relinquish. It is perceived by some staff as load-shedding, which should be resisted as strongly as possible, particularly as the pressures on staff have already been greatly increased by the apparently endless changes of the standards (Gulanick and Myers, 2006). Delegating is more rarely perceived by staff and management as a two way process in which the nurse learns how to coach and the subordinate has increased opportunities to learn about managerial responsibilities. Most often, those with a strong need for achievement carry out tasks alone, not as part of a team, and may be unable to give up their personal involvement through delegation. "In any process it is always cheaper and better to do the job right the first time. There are no exceptions to this rule. Rework is never a superior alternative. When delegating jobs, make sure you correct mistakes as quickly and as early as possible" (Wiggins 1998, p. 29). A manager with an exclusive need for achievement who tries to delegate may hover, trying to do others' work for them while ignoring the big picture. Other disadvantages include isolation from those who can give productive feedback, excessive rivalry with colleagues, secrecy or redundancy in accomplishing tasks, and stress from trying to excel at all costs. A decision-making is an integral part of healthcare that involves a choice whereby a nurse forms a conclusion about a situation. The delegation has a direct impact on decision-making which leads to optimal results. In this case, delegation implies that nurses use limited information for analysis and accept the first decision. In contrast, other models of decision making are aimed to find he best possible solution to the problem under analysis. This represents a course of behavior about what must or what must not be done (Gulanick and Myers, 2006). In sum, delegation plays a crucial role in nursing profession but hides many threats for unprofessional medical staff. The task and duty of a nurse is to delegate those responsibilities which can be easily performed by other persons and do not harm a patient. A decision-making is the point at which plans, policies and objectives are translated into concrete actions. Delegation is effective if all tasks and responsibilities are clearly defined and explained to the subordinate. References 1. Alexander, M.F., Fawcett, J.N., Runciman, P.J. (2006). Nursing Practice: Hospital and Home. The Adult: Hospital and Home - The Adult. Churchill Livingstone; 3 edition. 2. Blair, J. (n.d.). The Art of Delegation. Retrieved 04 October 2007, from http://www.see.ed.ac.uk/gerard/Management/art5.html 3. Burns, L.R. (1989). Matrix Management in Hospitals: Testing Theories of Matrix Structure and Development. Administrative Science Quarterly 34 (3), 349-351. 4. Delegation of Nursing Functions to Unlicensed Persons (n.d.). Retrieved 04 October 2007, from www.ok.gov/nursing/delegation.pdf 5. Dougherty, L., Lister, S. (2004). The Royal Marsden Hospital Manual of Clinical Nursing Procedures Sixth Edition (Royal Marsden Nhs Trust). Blackwell Publishing; 6Rev Ed edition. 6. Gulanick, M., Myers, J.L. (2006). Nursing Care Plans: Nursing Diagnosis and Intervention. Mosby; 6 edition 7. Wiggins, D. (1998). Stop Doing It All Yourself! Some Keys to Effective Delegation Journal of Environmental Health 60 (9), 29. 8. Ross, T. E. (1993). Linking Ethical Principles With Community Practice. Journal of Community Health Nursing 10 (4), 233-230. 9. The New Oxford American Dictionary. (2001). Eds. Jewell, E.J., Abate, F.R. Oxford University Press, USA; Har/Cdr edition. Read More