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By: Mae G. Marcojos, RN
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Define verbal communication and non verbalcommunication
List down the components of communicationprocess using a diagram direction
Discuss the ten basics for good communication Use an assertive style of communication using
the nurses Bill of Rights as identified byHermann and differentiate between aggressive
and passive style of communication List down common blocks to communication and
discuss on how to improve them
Use through examples the common patterns of
communication networks.
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What is Communication?
Communication by definition is the transfer of
information and understanding from one person
to another.
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Elements of Communication
Sender
Message
receiver
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The Message
What you are trying to convey through verbal
or non-verbal Words mean different things to different
people.
Nonverbal behavior
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The Message
1. Verbal WHAT
2. Non -verbal HOW
3. Communication climate Positive-enhances the message
Negative-detracts from understanding the
message.
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Components
Encoding
Transmission.
Decoding
The response, or feedback
The nurse leader or manager uses
communication skills in all aspects of
organizational life.
Appropriate manner of communication process
is essential.
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Basics for Good
Communication
1. Clarify your ideas and analyze your
thoughts. Provide an opportunity for
questions and answers
2. Consider the setting, both physical andpsychological
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Climate Behavioral Characteristics
Listening
Empathy
Acceptance
Shared problem solving attitude
Openness
Evaluating
Advice giving
Superiority
Supportive
Climate
Defensive
Climate
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Positive Climate
The value of a positive communication climate
is that it fosters behaviors among the leader
and followers that lead totrustful and
cooperative working relationships.It isa kind of climate that will foster innovationsin the work place, making change apossibility.
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3. Consult with others when necessary to be
exact and objective.
4. Be mindful of the overtones as well as the
message itself.
5. Take the opportunity to convey something to
help, value, or praise to the receiver.
6. Follow up your communication
Basics for GoodCommunication cont
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7. Be sure your actions support your
communication. "What I say. I do".
8. Be an active listener. Practice what you
preach.
9. Give credit for the contributions of others
when genuinely deserved.
10. Be assertive when expressing your view.
Basics for GoodCommunication cont.
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Nurse's Bill of Rights by
Herman The right to be treated with respect
The right to be listened to
The right to have and to express thoughts,feelings, and opinions
The right to ask questions and to challenge
The right to understand job expectations as wellas have them written
The right to say "no" and not feel guilty
The right to be treated as an equal member of thehealth team
The right to change one's mind
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Nurse's Bill of Rights by Herman
cont.
The right to ask for change in the system
The right to have a reasonable workload
The right to make a mistake
The right to make decisions regarding health
and nursing care
The right to initiate health teaching
The right to be a patient advocate or to help apatient speak for himself or herself
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Assertive VS Aggressive
direct and clear
Listen to others
objective words
direct eye contact spontaneous verbal
expressions
well-modulated
voice based on self-
respect andconsideration for
other people.
concerned with the
rights of one position
loud, inappropriate,
confronting, or hostile.
Subjective
Confronting,
sarcastic,
Verbal approach with
an air of superiorityand rudeness
Belittles others
The rights of others
not considered.
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Passive
Not consider any rights
Uninvolved or unable to share
thoughts
withdrawn and shy orpurposefully withholding
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Things to
remember:
Communication is an essential hallmark of health
care.
Leader and followers have a basic right to give
and to receive information in a professional
manner.
Communication skills grow and develop over timeand are the means by which leadership is
exercised.
Communication does not necessarily mean
agreement or harmony over every issue but is
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Blocks to Communication
prevent the message from being delivered or
understood.
Some common reasons for blocks to
communication are: poor listening habits
Psychological blocks,
Environmental distractions Semantic barriers (Davis).
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Blocks to communication are the reason why
people leave meetings with half messages
and incomplete or inaccurate information.
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Listening Skills
Active listening begins as you give full
attention to the person speaking.
This means that you listen carefully with your
mind as well with your gestures and facialexpressions.
Active listening will enhance the
understanding of messages
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Psychological Blocks
When an individual hears something that
produces a profound emotional reaction.
An intense response to communicated
message very likely will produce a block tothe rest of the message.
Emotions are powerful forces that may
interfere with reason and must be recognizedand respected before constructive
communication may continue.
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Environmental Distractions
Considered to be a block to communication
when it interferes with the communication
process.
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Semantic Barriers
Since words are symbolic, their meaning is
subject to multiple interpretations.
The leader should try to be aware of the
choice of words or phrases Using messages in the proper context will
reduce misinterpretation.
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Communication Networks
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CONFLICTS
By: Mae G. Marcojos, RN
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Objectives:
Identify aspects of your professional role thatpredisposes to conflict with nurse administratorsor physicians
Analyze an ongoing conflict in your organizationand identify the manifest conflict, the felt conflict,antecedent conditions and internal and externalfactors influencing the conflict.
Differentiate the three common methods of
conflict resolution
Elaborate the different ways of conflictmanagement and identify the most preferred ofconflict management
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Conflict Resolution
Conflict is inevitable
In health care organizations the potential for
conflict is HEIGHTENED. WHY?
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What is Conflict?
Expressed struggle between at least
two interdependent parties, who
perceive incompatible goals, scarce
rewards, and interference from the otherparty in achieving their goals.
They are in a position of opposition in
conjunction with cooperation.
It produces afeeling of tension,
h i i f fli
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5 characteristics of a conflict
situation
1. at least two parties are involved in some form ofinteraction
2. difference in goals and/or values either exists oris perceived to exist by the parties involved
3. the interaction involves behavior that will defeat,reduce, or suppress the opponent, or gain avictory
4. the parties come together with opposing actionsand counteractions
5. each party attempts to create in imbalance, orfavored power position (Filley, 1975).
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Inter-group conflicts
occur between two small groups, two large
groups, or between a large group and a small
group.
Has certain predictable consequences. Cohesiveness increases, but members
become more task oriented and less
concerned with the needsof individualmembers.
Autocratic group leader
Highly structured
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Inter-group conflicts
Increased cohesion increase production
Stereotyping and hostile behaviors
destructive
Conflict management strategiesshould therefore be used to ensure that the
conflict will have a HEALTHY OUTCOME.
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Personal-Group Conflicts
Conflicts between an individual and a small
group or between an individual and a large
group are In this type of conflict an
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Intrapersonal Conflicts
Disagreement withinhim-or herself.
May result from
having to make achoice between twothings of generallyequal value
Management ofintrapersonal conflictMUST COME fromthe individual
involved.
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Conflict Resolution Theory
Filley 1975 argues that the conflict resolution
process moves 6 steps:
(1) antecedent conditions
(2) perceived conflict
(3) felt conflict
(4) manifest behavior
(5) conflict resolution or suppression
(6) resolution aftermath
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Antecedent Conditions
certain conditions exist which can lead toconflict, though they do not always do so.
Conflict may develop from a number of
antecedent sources, including: Incompatible goals
Distribution of scarce resources when individualshave high expectations of rewards
Regulations, when an individuals need forautonomy conflicts with anothers need forregulating mechanisms
Personality traits, attitudes, and behaviors
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Antecedent Conditions con
Interest in outcomes
Values
Roles, when two individuals have equal
responsibilities but actual boundaries are unclear,or when they are required to simultaneously fill
two or more roles that present inconsistent or
contradictory expectations.
Tasks, when outputs of one individual or groupbecome inputs for another individual or group, or
outputs are shared by several individuals or
groups.
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Perceived Conflict
Two or more individuals logically
and objectively recognize that
their aims are incompatible.
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Felt Conflict
Individuals experience feelings of
threat, hostility, fear or mistrust.
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Manifest Behavior
OVERT action or behavior takes place
- oppression, competition, debate, or problem
solving.
2 kinds of behaviors in response to perceivedand felt conflict:
(1) Conflictive behaviors (Negative)
(2) Problem solving behaviors (Positive)
Conflict Resolution or
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Conflict Resolution or
Suppression
the conflict is resolved or suppressed either byall parties' agreement or else by the defeat ofone party.
Behavior directed toward the resolution ofconflict can be characterized by 3 differentcommunication strategies:
(1) Win- LoseCommon (2) Lose- LoseAvoid
(3) Win -Win. Suppressing but not sacrificingneeds
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Resolution Aftermath
Individuals experience or live with the
consequences of the Resolution
During this phase, participants experience
feelings directly related to the outcomes of theresolution process.
If the conflict is resolved in a positive or
negative fashion
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Conflict
Process
Conflict Management /Styles of
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Conflict Management /Styles of
Approaching Conflict/
Do individuals have different ways of handling
conflict?
In addition, how do the styles employed by
individuals affect the outcomes of theconflicts?
I t l C fli t 5 t l b
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Interpersonal Conflict 5 styles by
Kilmann and Thomas (1976)
(1) Avoidance
(2) Competition
(3) Accommodation unassertive but
cooperative
(4) Compromise not ignore neither
struggle
(5) Collaboration assertive andcooperative
Effective communication
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Compromising
Innovative solutions are
sacrificed in favor of quick
solutions.
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STAFF DEVELOPM
Wh t i St ff D l t ?
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What is Staff Development ?
PROCESS directed towards the personal andprofessional growth of nurses and otherpersonnel while they are employed by a health
care agency.
Refers to all training and education providedby an employee to improve the occupational
and personal knowledge, skills and attitudes of
vested employees.
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Staff Development
A process consisting of orientation,in-service education and continuingeducation for the people of
promoting the development ofpersonnel within any employmentsetting, consistent with the goals and
responsibilities of the employment.(ANA)
Why do we need Staff
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Why do we need Staff
Development?
Social change and scientific advancement
Advancement in the field of science like
medical science and technology.
To provide the opportunity for nurses to
continually acquire and implement the
knowledge, skills, attitudes, ideals and valued
essentials for the maintenance of high qualityof nursing care:
As part of an individual's long-term career growth.
To add or improve skills needed in the short term
Why do we need Staff
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Why do we need StaffDevelopment? Cont.
Being necessary to fill gap in the past
performance
To change or correct long-held attitudes of
employeeNeed to increase the productivity and quality of
the work.
To motivate employees and to promote employee
loyalty
Fast growing organizations.
Goals
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Assist each employee (nurse) to
improve performance in his/her
position.Assist each employee (nurse) to
acquire personal and professional
abilities that maximize the
possibility of career advancement.
Goals
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Objectives
To increase employee
productivity.To ensure safe and effective
patient care by nurses.
To ensure satisfactory job
performance by personnel.
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Objectives cont.
To orient the personnel to careobjectives, job duties, personnel
policies, and agency regulations.
To help employees cope with newpractice role.
To help nurses to close the gap
between present abilities and thescientific basis for nursing practice that
is broadening through research.
Steps of staff development
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Steps of staff development
program
Assess the educational needs of all staffmembers
Set priority
Develop general objectives for the staffdevelopment program
Determine the resources needed to reach thedesired objectives
Develop a master calendarfor an entire year Develop and maintain staff development
record system
Establish files on major educational topics
Resources:
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Resources:
Public libraries,
Audiovisual program in addition to many books
and computers, research activities and
speakers to community groups. Schools and universities
Association Health and inter service agency
Other nursing homes Ones own staff
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Types of Staff Development
Induction
training
Job
orientation
In-service
education
Continuing
education
Training for
specialfunction
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Induction Training
It is a brief, standardised indoctrination
to an agencys philosophy, purpose,
policies and regulations given to each
worker during her or his first 2 or 3
days of employment in order to ensure
his or her identification with agencys
philosophy, goals and norms.
Why do we need Induction
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Why do we need Induction
Training?
Increased retention of newly hire
employees,
Improved employee morale andIncreased productivity.
St f I d ti
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Steps of Induction:
1. Tour of
facilities
2. Introductionto the other
employees,superiors andsubordinates.
3. Description of
organizationalfunctions.
4.Departmentalvisit
5. Orientation
to philosophygoals andobjectives
6. Administration policies andprocedures
J b O i t ti
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Job Orientation
Individualised training programme
intended to ACQUAINT a newly hiredemployee with job responsibilities work
place, clients and co-workers.
The process ofcreating awarenesswith an individual of his/her roles,
responsibilities and relationships in the
new work situation.
C t
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Components
A new employee to his or her job
setting to aware her job responsibility
and expectation.
Present employee to the job
responsibilities of his/ her expandedand enriched role.
The old employees to the policy
changes.
T f O i t ti
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Types of Orientation
Generalorientation
Specificorientation
Importance of orientation
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Importance of orientation
programme
Provides essential, relevant andnecessary information
Helps employee to gain confidence, Lessen the time for the employee to
learn about new situations related to
his/her job setting.Helps the new employee to develop
a sense of belonging
Eli i t
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Eliminates:
Learning by trial and error
Passing of incorrect information by old
employees and peers.
Reduces misinterpretation
Mistakes and confusion
Apprehension
Help new employee in solving initial problemsand adjust the new situation/environment,
Acquaints her with personnel services readily
with in the institution/community
C t t f O i t ti P
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Content of Orientation Program
The
organisation
and its
environment
Policies,
rules and
regulation
Personnel
ServiceFunctions to
be
undertaken
I S i Ed ti
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In-Service Education
Planned learning experience
provided by the employing agency for
employees.
planned educational experience
provided in the job setting and closelyidentified with services in order to
help person perform more effectively
as a person and as a worker. C t f i i d ti
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Concept of in-service education
Closely identified with services
Help a persons to improve
performance effectivelyPlanned education activities
Provided in a job setting
Why do we need In-Service
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y do e eed Se ce
Education?
Social changes and scientific
advancement
Changes and advancement in thefield of service
Increased the demand of nursing
services.Consumer demand quality care
Why do we need In-Service
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y
Education? Cont.
Rapid changes in medical and
nursing practice create a need for in
service educationAs health care delivery system
become more complex, the need for
continues skill training also increased.
Aims
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Aims
Improvement of client through upgrading
the services rendered with scientific
principles.
To keep in face in changing society to theirneeds.
Acquisition of new knowledge
Improvement of performance
To develop specific skills required for
practice.
Aims cont
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Aims cont.
To develop right concept of client care.
To maintain high standards of nursing
To observe and bring change in staff members
chances for promotion It reduces turnover, absenteeism.
To discover potentialities, to alert personnel in
working environment.
T f I S i T i i
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Types of In-Service Training
Centralized in-service training
one department will held
responsibility for improvement ofknowledge, skills, practice of their
nursing staff. They will devote full
time for in-service activities.
Types of In Service Training
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Types of In-Service Training
Decentralized in-service education
Planned for staff members who work
together, giving care for clients withsimilar conditions and share similar
goals.
Types of In Service Training
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Types of In-Service Training
Combined in-service approach
higher nursing authorities and all
staff development occurs in proposedprogramme of education. They plan,
conduct and evaluate the programme
and further plan their programmebasing on the need arises.
Steps in in service education:
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Steps in in-service education:
Assessment:Pinpoint needs,
prioritize needs, set training
objectives, and develop criteria
Implementation: Climatic check,
actual conduction of training with
ongoing monitoring
Steps in in-service education
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p
cont.
Evaluation: Establishment of criteria,
pre test to the participants, post test
following completion of the training or
program. Observation on transfer of
learning to the job, follow up studies
for assessment of extent of retention
of learning.
Continuing Education:
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Continuing Education:
Continuing education is all the
learning activities that occur after
an individual has completedhis/her basic education.
(COOPER)
The education which builds onprevious education. (SHANON)
Why do we need Continuing
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y g
Education?
To ensure safe and effective
nursing care as nurses need to
keep abreast with interest,knowledge and technical
advances.
To meet the needs of population.
To develop the nurses by
updating their knowledge and
Why do we need Continuing
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y g
Education? Cont.
For career advancement.
With the advancement of technology, new role
change takes place and to play those roles,
education is required. To acquire special skills.
Due to shortage of nurses (because their
movement to abroad, more hospital andtraining college), more knowledgeable person
is required.
Functions of Continuing
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g
Education:
To meet the health needs andpublic expectations.
To develop the practicing abilitiesof the nurse.
To recognize gaps in knowledge.
To test abilities of participants todo formal academic study.
Functions of Continuing
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Education cont.
To improve the communication betweenthe participants, faculty, community and
health sector.
To shape or support university educationalpolicies and practices.
To ensure the quality of education.
To grant the budget for extension studies. To maintain the academic standards.
To provide opportunities for educational
growth.
Functions of Continuing
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Education cont.
To maintain the roles as bed side nurses
and to assume more supervisor,
administrative, to specialize and to
generalize the practice. To provide and prepare faculty who see
continuing nursing education as a personal
responsibility. To provide a variety of continuing nursing
education opportunities of high quality to
nurses in both education and service
Training for Specific Function
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Training for Specific Function
developing expert technical or manualskills, communication and helps the
personnel to perform their functions
effectively.
Objectives:
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Objectives:
To help the nursing personnel toperform correct methods and
procedures with understanding.Establishing standards and quality
of nursing services.
Procedure to skill nurses to skillednurses.
T f Skill
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Types of Skills:Psychomotor skill
Cognitive skill
Teaching skills
Affective skill
Communication skill
Supervisory skills
Why do we need Skill
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Training?
Individual nurse needed to have greaterfreedom to choose the specific field of nursing
in which she would work.
Good work to be recognized and reward.A venues of advancement and promotion need
to be better development
Fear of making mistakes
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Standards ofstaff
developmentprogramme
(ANA)
Standard 1 Organization and
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Standard 1 Organization and
Administration
The nursing service department
and the nursing staff developmentunit philosophy, purpose and
goals address the staff
development needs of nursingpersonnel.
Standard II Human Resources
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Standard II Human Resources
Qualified administrative,educational and support
personnel are provided to meetthe learning and developmental
needs by nursing services
personnel.
Standards III Learner
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Standards III Learner
Nursing staff development
educators assist nursing
personnel in identifying theirlearning needs and planning
learning activities to meet those
needs.
Standard IV Program Planning
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Standard IV Program Planning
Provides the unit systematically,
plans and evaluate the overall
nursing staff developmentprogram in response to health
care needs.
Standard V Educational Design
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Standard V Educational Design
Educational offering and learningexperience are designed through
the use of educational processand incorporate adult education
and learning principles.
Standard VI Material Resources
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Standard VI Material Resources
And Facilities
Material sources and facilities are
adequate to achieve the goalsand implement the functions of
the overall nursing staff
development unit.
Standard VII Records And
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Standard VII Records And
Reports
The nursing staff development
unit establishes and maintains arecord keeping and report system
Standard VIII Evaluation
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Standard VIII Evaluation
Evaluation is an integralongoing and systematic
process, which includesmeasuring the impact on the
learning
Standard IX Consultation
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Standard IX Consultation
Nursing staff developmenteducators use the consultation
process to facilitate and enhanceachievement of individual,
departmental and organizational
goals.
Standard X Climate
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Standard X Climate
Nursing staff developmenteducators foster a climate which
promotes open communication,learning and professional growth.
Standard XI Systematic
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Standard XI Systematic
Enquiring
Nursing staff development
educators encouragesystematic inquiry and
applications of the results into
nursing practice.
Potential difficulties in staffdevelopment & training
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development & training
activities:
Lack of time
Inadequate resources at disposal
Under-funded training budgetsConflicting priorities
Lack of Clarity about what should be
done
Potential difficulties in staffdevelopment & training activities
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development & training activities
cont.Failure to identify, or accept the need.
Shortfall in training skill or experience
Fear that trained employee will leavethe organization or will be poached by
competitor.
Cynical attitude to Staff development-Not directly measurable. Treated as
Cost not investment.
Methods of delivering staffdevelopment programme:
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development programme:
InductionPhysical
tour of thefaculities
Groupdiscussion
SeminarHand book
andpamphlet
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Job orientation
Orientation
Seminar
Discussion
Hand out or book and pamphlets
I i d ti
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Leadership training
Continuing education
Skill training
Orientation
In-service education
Continuingeducation
Lecture
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education
DemonstrationSeminarJournal club
Book reviewCorrespondence
courseFormal course
Clinical research
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Training
for skillDemonstration Discussion
Role-play
method.
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DECISIONMAKING
Decision Making
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g
Objectives: Describe the types of decisions
Explain the mechanisms of decision-making
Discuss the steps of logical decision-making
Identify the factors responsible for decision-making
Discuss the importance of decision making for
nurse managers? Recognize the decision-making tools
Explain the barriers for decision-making andmechanisms of overcoming it
What is Decision Making?
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a choice made between two or morealternatives
It is choosing the best alternative to
reach the predetermined objective.
Thus decision making is a process of
identifying and selecting a course of
action to solve specific problem
Types of Decisions
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yp
Decisions made in the nursing servicecan be categorized depending upon the
following criteria:
How much time the manager spends inmaking decision
What proportion of the organization must
be involved in making decisionThe organization function/ the
nursing/midwifery functions on which
they focus
3 Classifications
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On the basis of these there arethree classifications:
1. Ends -Means2. Administrative-Operational
3. Programmed-Non-
programmed
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2. Administrative-Operational
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p
Administrative: made by seniormanagement, which have significantimpact throughout the organization.
Usually this type of decision is concernedwith policy, resource allocation andutilization.
Operational: are generally made bymid level and first line managers andaddress day to day operational activitiesof a particular organizational
3. Programmed-Non -
programmed
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programmed
Programmed-these are repetitiveand routine in nature. Since they can
be programmed, procedures, rules
and often manuals are formulated to
cover those situations
None programmed: unique andnon- routine
Conditions that initiate decision
making
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making
1. Opportunity/threat
2. Crisis
3. Deviation4. Improvement
Ways of Decision Making
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y g
1. Relying on tradition: taking the samedecisions that had been undertaken whensimilar problem arouse in the past
2. May appeal to authority and make decisions
based on suggestions from an expert/ahigher level management
3. Priority reasoning: based on assumption
4. Logical decision making: is a rational,intelligent and systematic approach tondecision making
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Factors Influencing Decision
Making
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Making
1. Decision makers attribute Knowledge, experience, and
judgmentPerception and personality
Values and philosophy
Factors Influencing DecisionMaking
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cont.2. The Situation Urgency of solution and time pressures
Magnitude and importance
Structure and uncertainty and risk
Cost benefit
3. Environmental ConstraintsExternal Internal
Encouraging creativity
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Convergent thinking-the problem is dividedinto smaller and smaller pieces to find a
more manageable perspective.
Divergent thinking: One's view of theproblem is expanded. The problem is
considered in different ways
Brain storming: under favorable
circumstances a group working together can
identify more ideas than an individual or the
group of individuals working separately. It is
a technique managers can use to create a
Decision Making Tools
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1. Probability theory - is the likelihood that anevent or outcome will actually occur andallow decision makers to calculate anexpected value for each alternative.
Expected Value (EV) = Income it wouldproduce (I) x its probability of making thatincome (P).
2. Decision tree - are graphic decision makingtools used to evaluate decisions containing aseries of . steps
Deciding to decide
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1. Is the problem easy to deal with
Tip: avoid being bogged down in
trivial details. Effective managers
reserve decision making techniques
for problems that require them.
2. Might the problem resolve itselfTip: prioritize and rank problems in
order of importance
Deciding to decide cont.
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3. Is it my decision Tip: the closer to the origin of the problem
the decision is the better. Before deciding
ask the following questions: Does the issue affect other
departments?
Will it have a major impact on thesuperior's area of responsibility?
Does it need further information from
higher level?
3 Is it my decision cont.
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Does it involve serious breach ofmy departments budget?
Is this problem outside my area of
responsibility or authority?
If the answer to any of thesequestions is 'YES' pass it to your
superior.
Barriers to Effect Decision-Making
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Making
1. Easy recall: the more easily canrecall the event, the more frequently they
believe it occur
2. Easy search: not to put effort toseek information from the appropriate
sources
3. Misconception of chance:Most people do not understand the nature
of random solution based on past
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Barriers to Effect Decision-Making cont
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Making cont.
6. Defensive avoidance: Faced with aproblem and unable to find a good
manager seeks a way out. He/she may
let someone else make decisions. Thisresigned posture may prevent
consideration of more viable alternative
7. Panic: the manager feels pressurized
not only by the problem but also time
vercom ng arr ers oindividual problem solving
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1. Setting priority
2. Acquiring relevant information
3. Proceeding methodically andcarefully
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THANK YOU FORLISTENING!
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