ROSTERING AND EMPOWERMENT

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ROSTERING AND EMPOWERMENT
AN OVERVIEW
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EMPOWERMENT

• Responsible autonomy, or
• Freedom within a framework
• In an empowered situation staff exert greater
  control over problem-solving and decision-making,
  while managers exert influence rather than
  control.

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Three Fallacies About Empowerment

• Quick-Fix Fallacy unwillingness to accept that
  sustained effort is needed to bring about
  people change
• Single-Bullet Solution Fallacy a panacea to
  resolve all problems (!)
• Top-Down Fallacy an oversimplistic assumption
  that hierarchy can cascade change throughout
  the organisation.

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Managers Responses To Empowerment

• Positive
• welcome greater staff involvement
• compliment staff effort
• create opportunities
• offer issues for questioning.

• Negative
• threatened by perceived challenges
• criticise staff failures
• build restrictions
• enforce the rules.

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Managers Responses To Empowerment

• Positive
• Open, shared information
• Coaching and support

• Negative
• Secrecy and telling on a need to know basis
• Tightly-defined roles and tasks.

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Centralised Rostering

• Familiar, efficient, big picture
• Senior nurse management are accountable
• Decisions made remote from the patient
• Dis-empowering of staff (and of CNMs)
• Stops development
• Gives the illusion of control can be used
  unethically.

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Ward-Based Rostering

• Requires development of CNMs
• CNM role moves away from 100 patient care
• More sensitive to rapid change and patient needs
• Staff involvement
• CNM becomes accountable.

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Team-Based Self Rostering

• Agreed staffing guidelines and staff mix form the
  framework
• Staff very involved in the process - negotiate
  with each other, developmental and adult
• Staff become accountable
• Manager still has ultimate accountability.