Nursing Management Ch 19 Motivating And Developing Staff

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MOTIVATION & ABILITY = major determinants of job performance

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MOTIVATION & ABILITY

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MOTIVATION are factors that initiate and direct behavior includes compensation, benefits, job design, leadership style, recruitment and selections, employee needs, goals and abilities

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MOTIVATION

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ABILITY includes responsibilities , basic/advanced education, continuing education and skills/abilities

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ABILITY

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Six Categories of Performance
1. Daily job performance=
2. Attendance
3. Punctuality
4. Adherence to policies and procedures
5. Absence of incidents, errors, and accidents
6.Honesty and trustworthiness

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Six Categories of Performance

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FACTORS TO CONSIDER WHEN USING THE PERFORMANCE MODEL
1. Establish and communicate clear descriptions of daily job performance so that deviations from expected behaviors can easily be identified and documented
2. Behaviors considered troublesome in one department may be acceptable in the other

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FACTORS TO CONSIDER WHEN USING THE PERFORMANCE MODEL

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Content theories- emphasizes individual needs or the rewards that may satisfy those needs; attempt to explain why a person behaves in a particular manner

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Content theories

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TYPES of content theories
- instincts – are inherited or innate tendencies that predisposed individuals to behave in certain ways;
- need theories (Maslow, Alderfer & Herzberg) – support the concept that motives were learned behaviors

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TYPES of content theories

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Hierarchy of Needs Theory (Maslow)- identified five hierarchical needs: from the lowest
1. physiological needs. Lower-level need controls behavior until it is satisfied and then the next higher need energizes and directs behavior
2. safety needs,
3. belongingness or social needs,
4. esteem needs
5. self actualization.

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Hierarchy of Needs Theory (Maslow)- identified five hierarchical needs

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Two-Factor Theory (Herzberg) explains motivation as a function of job satisfaction; that job satisfaction and job dissatisfaction are not opposite ends of the same phenomena rather they are two different phenomena; factors that lead to NO JOB SATISFACTION are different form those that lead to JOB SATISFACTION.

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Two-Factor Theory (Herzberg)

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HERZBERG maintained that motivating factors or job satisfiers (factors intrinsic to the job):
1. sense of achievement for performing a task successfully,
2. recognition and praise,
3. responsibility for one’s own or another’s work,
4. growth, and advancement or changing status thru promotion),
5.are present in the work itself and encourage people to want to work and to do that work well, thus when they experience job satisfaction the employee will be highly motivated to perform the job effectively.

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HERZBERG maintained that motivating factors or job satisfiers (factors intrinsic to the job) created-

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Hygiene or maintenance factors (are extrinsic factors )–
1. pay, supervision, organizational policies, relationship with co-workers, working conditions, personal life, status and job security;

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Hygiene or maintenance factors (are extrinsic factors )–

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Unsatisfactory hygiene factors lead to dissatisfaction, resulting to increased absences, grievances, or resignations

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Unsatisfactory hygiene factors

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Intrinsic motivation can be defined as the motivation that comes from within the person and drives him or her to be productive.

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Intrinsic motivation

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Extrinsic motivation is enhanced by the job environment or by external rewards.

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Extrinsic motivation

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Process – emphasize how the motivation process works to direct an individual’s effort into performance

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Process

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Reinforcement Theory (Skinner) – also known as behavior modification views that behavior is learned through a process called operant conditioning – that people could be conditioned to behave in a certain way based on a consistent reward or punishment system. Behavior becomes associated with consequences.

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Reinforcement Theory (Skinner)

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Consequences may be positive, as well as with praise or recognition or negative

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Consequences

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Positive reinforcers are used for the express purpose of increasing a desired behavior

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Positive reinforcers

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Negative reinforcers are used to inhibit an undesired behavior

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Negative reinforcers

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Techniques of negative reinforcers:
1. Punishment- effects are generally temporary. Undesirable behaviors will be suppressed only as long as the manager monitors the situation and the threat of punishment is present
2. Extinction – by removing a positive reinforcer, undesired behavior is extinguished. (e.g. the chronic complainer)
3. Shaping –selectively reinforcing behaviors that are successively closer approximation to the desired behavior; here, behavior modification may take sometime. ( e.g. chronic latecomer)

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Techniques of negative reinforcers

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Expectancy Theory (Vroom) –emphasizes the roles of rewards and their relationship to the performance of desired behaviors; regards people as reacting consciously and actively to their environments;

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Expectancy Theory (Vroom)

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1. Vroom asserts that individuals are motivated by their expectancies (beliefs) about future outcomes (consequences of behavior) and by the value they place on those outcomes

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Expectancy Theory (Vroom)

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2. If staff members do not believe that they are capable of performing a task (expectancy) or if they believe there is a little chance of reward (instrumentality) or if the value of an outcome is low (valence), motivation is reduced.

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Expectancy Theory (Vroom)

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3. THREE COMPONENTS important in predicting what and how much effort a person will exert:
 Expectancy -degree to w/c people expect they can do something
 Instrumentality – belief that a given performance level or behavior will lead to some outcome (reward/or punishment)
 Valence – the perceived (attractive/unattractiveness) value of an outcome

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Expectancy Theory (Vroom)

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Matching employee ability and skills of employees with job requirements is important because no amount of leadership, motivation or organizational resources can make up for deficiencies in abilities or skills.

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Matching ability with skill

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Managers can arrange for staff to participate in the development programs that upgrade knowledge and skill of employees such as intensive workshops and continuing education.

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Inyensive Workshops and Continuing Education

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STAFF DEVELOPMENT – the process of enhancing staff performance with specific learning activities. INCLUDES NEEDS ASSESSMENT, PLANNING, IMPLEMENTATION, EVALUATION

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STAFF DEVELOPMENT

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Education must be viewed as a lifelong continuous process and must become a partnership between the learner and experts so that it occurs everyday in an unstructured manner.

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STAFF DEVELOPMENT

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Needs Assessment for an educational program is the first step in staff development

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STAFF DEVELOPMENT

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Regulatory requirements : Some educational programs are disctated by federal, state or local regulations. Among these mandatory classes are the following:
 Infection control
 Employee fire and patient safety
 Quality assurance/quality improvement (QA/QI)
 CPR
 Handling of hazardous material
 Bioterrorism

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STAFF DEVELOPMENT
Regulatory requirements

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PLANNING is the second step in the staff development. Entails identifying learner objectives and matching them with educational methods. Learner objectives should be SPECIFIC, MEASURABLE STATEMENTS ABOUT DESIRED BEHAVIOR, SKILLS OR KNOWLEDGE TO BE ACQUIRED WITHIN A SPECIFIC TIME FRAME.

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PLANNING

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THREE MAIN QUESTIONS should be considered in assessment and planning:
1. Can the learner do what is required?
2. How should the staff development program be arranged to facilitate learning?
3. What can be done to ensure that what is learned will be transferred to the job?

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THREE MAIN QUESTIONS should be considered in assessment and planning

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THREE LEARNING THEORIES OF STAFF DEVELOPMENT
1. Social Learning Theory (Bandura) – behavioral theory based on reinforcements; Bandura believed that people learn new behaviors through direct experience or by observing other people performing the behaviors, which result in positive or negative outcomes.
• According to social learning theory, the anticipation of reinforcement influences what the person does or does not observe.
• The observer learns that successful behaviors should be retained and behavior that is punished or not rewarded should be abandoned.
• This response suggests that observational learning is more effective when the observer is rewarded for imitative behavior.

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THREE LEARNING THEORIES OF STAFF DEVELOPMENT

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THREE LEARNING THEORIES OF STAFF DEVELOPMENT
2. Relapse prevention – emphasizes learning as a set of self –control and coping strategies in order to increase retention of newly learned behaviors

The premise behind this model is that learners are (a) taught to anticipate high risk situations, (b) taught coping strategies for avoiding high-risk situations and (c0 taught that slight slips or relapses are predictable and need to become failures.

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THREE LEARNING THEORIES OF STAFF DEVELOPMENT

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THREE LEARNING THEORIES OF STAFF DEVELOPMENT
3. Adult education theory – described differences in the learning styles of adults and children. Knowles suggests four basic conceptual differences between adult and child:
-SELF-CONCEPT – the adult learner sees himself as capable of self-direction; a climate of openness and respect is helpful in identifying what the learners want and need to learn
-EXPERIENCE- adults bring a lifetime of experience to the learning situation. Less use of transmittal techniques, MORE of experiential techniques. To reject adult experience is to reject the adult. Adult defines who he is in terms of his experience while youths tend to regard to experience as something that has happened to them
-READINESS TO LEARN- adult developmental tasks increasingly move towards social and occupational role competence and away from the more physical developmental task of childhood.
-TIME PERSPECTIVE (problem-centered) – adults tend to think of learning as a way to be more effective in problem solving today whereas youths think of education as the accumulation of knowledge for use in the future. More problem-oriented than theoretically –oriented. Formal curriculum development is less valuable than finding out what the learners need to learn

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THREE LEARNING THEORIES OF STAFF DEVELOPMENT

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IMPLEMENTATION is the gathering together of educators, learners and the materials and methods needed in the staff development

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IMPLEMENTATION

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Although most staff development is carried out by the staff development or education department, it is also a unit responsibility. Nurse manager is involved in 2 areas:
-Orientation – easing a new employee into the organization by providing relevant information; it ia a joint responsibility of both the organization’s staff development personnel and the nursing manager. It reduces the anxiety that new employees feel when beginning the job; socializing the employee into the workplace contributes to unit effectiveness by reducing dissatisfaction, absenteeism and turnover.
• One function of orientation is to correct any unrealistic expectations.
-On-the –Job-Training (OJT)
•PRECEPTOR model is one method of orientation; used to assist new employees and to reward experienced staff nurses. The preceptor model provides a means for orienting and socializing the new nurse as well as providing a mechanism to recognize exceptionally competent staff nurses.

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Unit responsibility

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PRECEPTORSHIP- Primary goal is for preceptors to assist new nurses to acquire the necessary knowledge and skills so they can function effectively on the job.
1. It offers new nurses the advantage of an OJT program tailored specifically to their needs
2. Preceptors (staff nurses) benefit by having an opportunity to sharpen their clinical skills and increasing their personal and professional satisfaction
3. THE NEW NURSE WORKS CLOSELY WITH THE PRECEPTOR FOR APPROXIMATELY 3 WEEKS, though duration varies according to the nurse’s individual learning needs and on organization policies.
4. PRIMARY FUNCTION OF THE PRECEPTOR IS TO ORIENT THE NEW NURSE INTO THE NEW UNIT.

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PRECEPTORSHIP

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Staff development methods can be divided into INTERNAL (on the unit) and EXTERNAL (off the unit):
1. INTERNAL SOURCES =includes on –the- job instruction, workshop for the staff and inservice programs
2. EXTERNAL SOURCES= are formal workshops presented by an education department within the hospital and educational activities outside the hospital, including college courses, conferences and continuing education workshps

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Staff development methods

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On-the-job instruction is the most widely used educational method; involves assigning new employees to experienced nurses, preceptors or the nurse manager. The kearner is expected to learn the job by observing the experienced employee and by performing the actual tasks under supervision.
1. It is cost effective
2. Learners learned while providing necessary nursing services
3. Reduces need for outside instructional facilities and reliance on professional educators
4. Learning occurs while on the job

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On-the-job instruction

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Other educational techniques are self-learning modules such as online computer classes, closed-circuit television, computerized clinical simulations, interactive video instruction, satellite broadcasts, audiotapes, videotapes, and long-distance via cable television.
1. Convey information in a uniform manner on several locations at one time. Enhances instructor’s presentaion as well as reduce the need for an instructor to present every detail in person.

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Other educational techniques

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EVALUATION is an investigative process to determine whether the education was cost-effective, the objective was achieved and learning was applied to the job.
-Purpose: to determine whether the educational program has a positive effect on day-to-day operating problems and to identify elements of the program that need improvements,

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EVALUATION

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FOUR EVALUATIONS CRITERIA
-Learner Reaction –questionnaire completed at the end of the program to assess the program, whether learners liked the program and positive reactions used to support the program

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FOUR EVALUATIONS CRITERIA

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FOUR EVALUATIONS CRITERIA
-Learning acquired- assess the knowledge (facts and figures), learned in the educational program, measured by paper-pencil test that can include true and false, multiple choice, fill in the blanks, matching and essay questions

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FOUR EVALUATIONS CRITERIA

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FOUR EVALUATIONS CRITERIA
-Behavioral change-did it helped the employee transfer the new behavior to the job? Transfer from the classroom to the job is critical to the success of the educational program.

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FOUR EVALUATIONS CRITERIA

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FOUR EVALUATIONS CRITERIA
-Organizational impact-reduced turnover, fewerer grievances, reduced absenteeism, improved quality of care and fewer accidents. Cost-related data should be collected because they can provide evidence to ahigher administration that educational efforts do affect organizational effectiveness

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FOUR EVALUATIONS CRITERIA

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Designing Staff Development Programs for a Multicultural Staff
1. Other cultures are more group-oriented than Americans and often place group needs over individual needs in an attempt to promote harmony and solidarity

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Designing Staff Development Programs for a Multicultural Staff

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Designing Staff Development Programs for a Multicultural Staff
2. Some avoid confrontation and emphasize commitment, cooperation and gentleness

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Designing Staff Development Programs for a Multicultural Staff

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Designing Staff Development Programs for a Multicultural Staff
3. The goal of designing culturally sensitive programs is to eliminate stereotypes, remove barriers, prevent misinterpretations and promote functioning

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Designing Staff Development Programs for a Multicultural Staff

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Designing Staff Development Programs for a Multicultural Staff
4. Common social barriers are language and cultural expectations

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Designing Staff Development Programs for a Multicultural Staff

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Designing Staff Development Programs for a Multicultural Staff
5. Important to include during the orientation period information about the role of the nurse, including interdependent and independent functions, management expectations and effective communication skills.

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Designing Staff Development Programs for a Multicultural Staff

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Designing Staff Development Programs for a Multicultural Staff
6. Common components of designing culturally staff development programs include
a)Socialization into the nursing role
b)How to understand and be understood
c)Development of social skills
d)Use of preceptors

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Designing Staff Development Programs for a Multicultural Staff