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ROSTERING AND EMPOWERMENT

ROSTERING AND EMPOWERMENT. AN OVERVIEW. 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. Three Fallacies About Empowerment.

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ROSTERING AND EMPOWERMENT

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  1. ROSTERING AND EMPOWERMENT AN OVERVIEW

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

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