The classical theory consists of organizational design that subdivides work and specifies tasks. The classical theory allows the different departments to run with efficiency by giving staff members different task to perform. The classical theory is composed of four elements: division and specialization of labor, chain of command, organizational structure, and span of command. Division and specialization of labor reduces the workload of the employee that will increase proficiency throughout the organization. The chain of command is authority, power, and responsibility delegated from high levels of authority to the lower levels. Organizational structures are how the departments are arranged and how command is maintained and how communication is achieved through a formal system.
The span of control is how many employees a manager can effectively manage. (Sullivan, 2012). The structure of this organization provides for an environment for client centered care by offering services of acute care with different levels of care such as emergency services, med-surgical units, intermediate care unit, intensive care and labor and delivery. Each division is managed by a specific leader, such as the manager, who reports to the chief of nursing. The managers are more in contact with staff and have direct communication with staff members as well as patients in the hospital.
This personal level of communication allows for managers effectively to communicate the importance of the mission of the hospital, which is to exceed expectations and provide quality health care to all at all times. With this mission in mind, it can lead to a close relationship with client care. The use of information systems is the way to communicate throughout the hospital to staff members. There are two charting systems used in the organization and an assignment board system in each department. The first one is Emergency Data Management, which is used in the emergency department, and the second is the Meditech, used in the other departments in the hospital. All information systems are visible to all nursing staff but cannot be edited interdepartmentally. Verbal communication method can be in the form of informing peers concerning the level of care already delivered to a patient and expecting others to follow through.
We are expected to formally inform each other of what need to be done concerning our patient via the Emergency Data Management and Meditech. The GroupWise E-mail system is used by staff for internal communication and exchange purposes, and it can be accessed both in the hospital and at home via the internal intranet. Information from different departments comes to staff via e-mail, and all are encouraged to check their email daily. Staff members are also provided with a physical mailbox, with their names on it where everyone is provided with departmental information. Decision-making regarding policy change may be done by departmental basis, but must be approved by the chief nursing executive.
For example, the standard of work was change in the triage process, but before management implemented the change, it had to be approved by the chief nurse executive, and he or she will decide based on the Nurse Practice Act. Restructuring of nurse leadership is currently in progress to allow nurses to have more input on leadership and its decision making pattern in organizations. The chief nurse executive reports to the regional vice-president of nursing, whereas all directors of each nursing department reports to the chief nurse executive.
The organizational structure has its strength and weakness. One weakness that exists in this structure is the lack of communication between departments. Strength in this structure is that the chief-nursing executive is not left to make all decisions on his or her own because they have the help of managers and directors of the different departments. These informal structures of the organization is constantly at test as staff do frequently communicate with each other about what is expected in the plan of care to achieve an efficient client centered care.
The charge nurse writing on the assignment board the activity of plan of care into the system as per each department to allocate patients to nurses and the staff nurse reports uses formal communication in the day-to-day operations of the organization the activity of plan of care into the system as per each department. For example there are formal meetings daily with the house supervisor, the managers, and leaders of the department to discuss bed availability in the hospital. Issues of power and control exist between the different floors and the emergency department. There is always competition for staffing resources, and if there is a float pool nurse on call, the charge nurses have to show who has a greater need for the float pool nurse leading to charge nurses to compete for the nurse. St. Luke’s Hospital is located in a lower middle-class neighborhood and caters to all ages.
The hospital caters socially to the infants and pediatric patients. It has recently expanded the acute-stroke and short-stay unit also known as an observation unit. There are patients of different ethnicities while there are many patients who do not speak English; the use of the language phone has come into use quite often. The language phone removes language barriers between the patient and the health care provider and allows the patient to receive proper care. A lot of patients in the community have stated they come to our hospital because they have read in magazines that we are a great hospital. Generational differences that influence organizational culture are on the rise in the work environment. There are a great number of new younger nurses coming out of nursing schools, which means new ideas.
The older nurses sometimes have problems accepting new nurses because they seem to want to change things. Some of the older nurses feel they are being pushed out of the nursing field by the new nurses and feel they are being forced to retire. In this paper there has been a discussion of organizational structure and functions, creation of client-centered care, information systems, power issues within the organization as well as decision making abilities. There have been discussions about social and cultural influences and how they integrate into delivery of care in the organization, and finally how generational differences influence organizational culture of the workplace as it shapes the future. It will be appropriate to expect more input into decision making culture via a developed formal and informal system to increase the input from the first responder group-the staff nurses and certified nursing assistants.
Sullivan, E. J. (2012). Effective leadership and management in nursing (8th ed.). Boston, MA: