Group problem solving
Investigate what has already been tried to solve the issue.
Brainstorm about potential solutions.
Gather information to define the problem.
Categorize information in order of reliability.
“The day shift just wants to shift work onto the evening shift.”
“Everyone likes to bathe right before bed.”
“I read a research article that reported that clients sleep better if they have been bathed right before bedtime.”
“The physician staff will be upset if we change our morning routine.”
“If we let them change this, they will want to make lots of other changes, too.”
The manager has historically used trial and error as a decision-making strategy.
The manager takes unnecessary risks when staffing the unit.
The manager is not concerned when staff members arrive late to work.
The manager uses old ways of thinking to solve the day-to-day issues of the unit.
The manager does not consider the advice of the unit comanager when making a decision.
“I would like to change the format we use for shift report, but I’m afraid it would upset staff members who have been here a long time.”
“This is the decision I have made, and there is no room for discussion.”
“I would like to thank everyone for your hard work and dedication while we have been short staffed.”
“I am certain that our new assignment system is going to make the workload more equitable.”
“I know this week has been rough. I feel a little like sandpaper myself.”
Obtain funding for a simulation mannequin.
Write standardized scripts for volunteers who will portray clients.
Add more information to existing care plans as the study unfolds.
Assign client care debate topics to teams of three or four students.
When disagreements occur on the unit, the manager privately asks the dissenters to be silent about the issue at meetings.
Tell staff members that they must present one opinion regarding the solutions they desire.
Demonstrate a genuine desire to find our why there is dissention.
Develop “tunnel vision” when it comes to problems on the unit.
Political decision-making model
Rational decision-making model
Are there different situational effects or contexts to be considered?
How has the problem usually been handled?
What is the easiest and least expensive alternative?
Can the problem be solved using the nursing process?
“I am always curious about why we do things the way we do.”
“I think we need to hurry up and make a decision.”
“Can you help me understand your perspective a little better?”
“I don’t think that your concern is necessarily pertinent to this issue.”
“I don’t think I can make that decision until I have more information.”
Calling local beverage distributors to inquire about service pricing
Asking all employees to write down their ideas about a solution
Determining what type of drinks most clients might want
Encouraging clients to bring a drink from home
This nurse is too inexperienced to realize the behavior is inappropriate.
This nurse is learning to be creative.
This nurse believes that new nurses are more knowledgeable than those who have worked several years.
This nurse misunderstands the work of the committee.
Watch others implement creative solutions.
Work with a group to implement a creative solution.
Evaluate the effectiveness of creative solutions.
Practice the steps of the process as often as possible.
“We should gather a group together to make important unit decisions to ensure fairness.”
“I should practice making decisions by developing potential solutions and then choosing one.”
“We can make a decision and then ask for input from others to make sure it was the right choice.”
“I know I will never be able to improve my decision-making skills because I am not a strong person.”
The nurse manager discovers that two clients require the use of a new piece of equipment and that the one the hospital has is the only one in the state.
The nurse has made a medication error on an experimental medication.
The nursing student makes an error when changing a client dressing.
The nurse manager scheduled too many nurses for the client census on the night shift, and all of the nurses scheduled have already been asked to take a low-census unpaid day off this month.
A decision made by a group is often better than a decision made by one person.
A decision made by an individual results in greater commitment.
Groups can provide more input into the process.
A decision made by a group can create a greater obligation to achieve results.
Routine decisions are more often made by individuals.
The nurse manager works with the staffing schedule until all requested days off are honored.
The nurse manager reposts a job opening because no applicants were a good fit for the current unit staff.
The nurse manager agrees with a proposed budget that does not provide badly needed new client beds.
The nurse manager insists on firing a nurse who is chronically late to work.
Provide opportunities for staff to interact with nurses from outside the facility.
Give the nurses freedom to design their work environment.
Create a spreadsheet for nurses to complete describing their creative efforts.
Assign each nurse 15 minutes of a staff meeting to talk about his or her creative efforts.
Be receptive to ideas even if they seem strange at the beginning.
“I am not following the policies and rules well.”
“I should review the procedure manual.”
“I’m good at using my previous experiences to guide my decisions.”
“I am strongest in making decisions when the problems are very unusual or unclear.”
“I make good decisions when the situation is novel.”
Do not suggest any solution that is prohibitively expensive.
Suggest only ideas that the group has not already tried.
Do not critique any ideas presented.
Limit the session to the first 15 ideas.
Allow some time to pass to see if the situation resolves.
Support both nurses as they work through this issue.
Provide any resources the nurses may need to help solve the problem.
Intervene if the problem begins to impact client care.
Ignore the situation.
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