Strategic Planning Reflective Journal

1) I predicted we would learn about how to make our planning processes more meaningful and purposeful.

2) I actually learned that strategic planning is the nuts and bolts of how we’re getting from where we are to our ultimate goal (Lecture Part 1). Strategic plans used to be about 5 years long. Since CEOs have a turnover rate of about 18-36 months, strategic plans are now about 6-, 12-, 18-, and 24-months long. A nurse leader must consider the organization’s goals for utopia, and then determine a plan of action on how they will get there. It is important to remember to keep the organization’s mission/vision/values in line with their goals. If they are conflicting, the outcomes will be poor. From an administration viewpoint, a strategic plan may be building another hospital in a neighboring city within 3 years. From a nurse leader’s view, a strategic plan can be planning ways to meet goals on their individual unit, such as providing excellent patient care to total-hip patients in a short time period. Training, instructions, and written-plans are important for the best possible outcomes when strategically planning. One must also consider the operational aspects and data support throughout the process.

From our readings, I learned that organizations that look to the future and meet the challenges head on will have a better chance of survival (https://www.ache.org/pubs/Zuckerman_Ch1.pdf). Strategic plans should be inquisitive, expansive, prescient, inventive, inclusive and demanding. It is important to first assess the internal/external environment and ask the question, “Where are we now?” After considering the positioning for your future and direction you want to go, strategy formulation is the next step. This is where one establishes goals and objectives. The next step is Implementation Planning, in which actions required are identified. Lastly, execution updates that are consistently communicated, will help make the strategic planning process a success.

The benefits of strategically planning are:

            -Secures the future

            -Provides a road map, direction and focus

            -Sets priorities

            -Allocates resources

            -Establishes measures

            -Gathers input/ideas

            -Generates commitment

            -Coordinates action

(Refer to https://www.ache.org/pubs/Zuckerman_Ch1.pdf)

I also learned the typical problems that limit effectiveness of strategic planning. First is failure to involve the appropriate people, including too many, too few, or not the “right” stakeholders. Next, conducting strategic planning independently of financial planning can lead to poor outcomes. Falling prey to analysis paralysis, not addressing critical issues, failure to achieve consensus, lacking flexibility and responsiveness to dynamic environments, and ignoring resistance to change are the other problems that limit effectiveness of strategic planning (https://www.ache.org/pubs/Zuckerman_Ch1.pdf).

3) I enjoyed the discussion about creating some type of Masters in Nursing program at our university. I liked researching the nearby schools and the programs they offered. I got this feeling of competitiveness inside me, while trying to come up with a strategic plan for our university. I wanted to positively position UVU by having it offer a Masters in Nurse Anesthesia program.  I still believe it would be in high demand.

4) I plan to utilize the information I have learned  in my nursing practice by aligning departmental goals with the organization’s mission, vision, and values. I understand in order for a hospital to be successful, it takes active participation from all departments. By working together and aligning their goals with the hospital’s mission, the company can be more successful as a whole. In a sense, it gives more strength and unity. Employees feel a part of the organization. My goal, as a future nurse leader, is to help my fellow employees understand the importance behind goal creation and visions for the future.

5) I enjoyed the material covered. I liked how strategic planning can be compared to playing the game of chess. This is a game I love since you  plan your offensive moves, while predicting the moves of your opponent, all the while trying to win. It can easily be applied to the goals of an organization, and “strategically planning” your way to get there.   

Reflective Journal- Change Unit

1) I expected to learn about change in the workplace.

2) I actually learned from the unit about responses to change, how a leader can better implement change, and how to involve others in change for it to be more effective. 

Change is a universal constant and we are not exempt from it. Most people resent change, become emotional about it, or run from change. It is difficult to find persons who truly enjoy the changing experience, especially when it is unplanned and unforeseen.

While watching the video, “Who Moved My Cheese?”, I realized I could most relate to the character Haw. He struggled with the change of the cheese being gone initially. He had to process it in his mind. Eventually, with time, he began to plan for change, document it, and move forward with his life. As he took active steps towards changing, he was able to personally grow, become more satisfied with his life, and be more successful in his future attempts.  Like Haw, I struggle with change at first. I need time to process it and realize why it is important for me. I literally have to look at the pros and cons involved with the change, and try planning for the future with it. In time, I adapt to the change and learn more about myself and my abilities than I knew before. Most often I am greatful for the change that took place as it always allows for personal growth and improvement.

I learned the best way a leader can better implement change is to consult with his followers (employees) for their feedback and views. By aligning your organization’s values and aims with the needs of the followers, change is more likely to be successful. This way, they feel more needed and valued or involved. Consulting with employees enables the leader to see both sides and gives you better ideas on how to make the change most successful. It is important educate members on why the change is needed as well.

One must remember that change must be realistic, achievable, and measureable. If people feel they are being forced into or manipulated into changing, they will resist it at all costs. So, a manager needs to be open, compassionate, and use thoughtfulness and sensitivity when implementing change. People will feel this be more receptive to it.

3) I enjoyed learning of how others on my team respond to change. Most of them stated they could relate most with Haw. Some seemed to enjoy change and the new adventures that come with it. Others stated they usually grieved over what they lost or had before the change occurred.

I also enjoyed trying the game our professor encouraged us to play this week. I stated in my mind, “Wouldn’t that be just like me to….feed my feelings since I am feeling sad?” Instead of eating sugary foods, I decided to read a book instead. On a different day of the week, I chose to go on a walk with my family instead of stay at home for family night. These experiences were fun, and things I hope to continue incorporating into my life to better myself.

4) As a future nurse leader, I plan to be a positive example of change. I realize a manager’s behavior is the single most important factor in how people in the organization view change. If I view it as a good thing and involve others, more people will go along with it instead of resent it.

5) I enjoyed learning about change. It was nice to learn that most everybody struggles with it, not just me. I enjoyed learning new techniques to actively plan for and adapt to change. I hope to incorporate change into my daily life in order to become more comfortable with it. 

Career Development & Staffing

Expectation

       I had expected to learn about developing my own career and what staffing means. From the lectures and PowerPoint presentations, I was correct that we would be learning about developing our careers in nursing. An additional aspect of staff development was added as well. I also learned about the nurse manager’s role in staffing.

What I learned

       According to our lectures, many nurses lack a career focus which is limiting personally and professionally. It is important that we, as nurses, plan for our individual futures by creating a 3-,5-, and 10-year career development plans. These plans with goals allows for advancement and personal growth. The stages of a nurse’s career are as follows: education, experience (where you work your way up), finding a mentor for guidance, experience in your area of choice, and then mentoring others. I enjoyed the quote presented to us from Carolyn Hope Smeltzer. She stated, “Every individual you hire for a leadership role should have the capability to grow into your role.” I feel that the mentoring stage is where a nurse leader can influence others to emulate their example and advance in their careers/personal growth as well.

       When staffing a unit as a nurse manager, it is important to consider the policies. Clear rules need to be in effect regarding sick leave, vacations, holidays, call-offs for low census, on-call pay, and tardiness or absenteeism. Next, is the method of staffing. There are two different types of way to staff a unit. The first is the centralized model. In this model, decisions are made for all units by a central office. Policies are implemented consistently which is viewed as more fair to employees. This also frees up the manager to do other things and is more cost effective. The second is the decentralized model which is done at the unit level. It is more flexible for individual needs since direct input can be given to the manager by employees. Its drawbacks are that it increases the risk for unequal treatment of employees and is more time consuming for the unit manager.

        A nurse manager must assess the needs of her unit in order to ensure there are enough bodies to meet those needs. The types of nurses, whether seasoned or new-grads, is important to take into account. Staffing by acuity, where patients are grouped according to a specific set of characteristics, is another way to best meet unit needs. This may be perceived better by employees since they will feel like their patient load is equal in difficulty to that of the other nurses. Some nurse managers may also view that self-scheduling is most effective for their unit. Others might choose repeating schedules. It is important to note that no one way is best when it comes to scheduling.

        It is important to remember that when the economy improves, staffing shortages are likely to occur. These shortages are cyclical in nature and have occurred throughout our nation’s history. By taking note of and being aware of the economy, a nurse manager can help prepare to adequately recruit and retain employees.

Team Activities

       I enjoyed learning about my team member’s individual career development plans. It was fun to see what they wanted to “be when they grew up.” I realized the importance of ensuring my goals were obtainable myself, while developing a detailed map of how I was going to get there.

Utilization of Information

       After interviewing Gordon M., owner of Marble Ventures, Incorporation, I have decided to emulate his example of reviewing my personal financial budget on a weekly basis. I feel, by establishing these good habits now, I will be more effective as a future nurse leader who may be in charge of managing a departmental budget and ensuring goals are met.

Personal Feelings about Material

        I think my favorite part of the material covered was learning about the three different reasons for staff development. First it establishes competence. Second, it helps meet new learning needs. And lastly, it satisfies the interests staff may have. When being a nurse leader, whether in a nurse educator, clinical coach role, or whatever, it is important to allow for the growth of others as well. I think I have at times had the “Queen Bee” syndrome in which I have been entirely concerned about my own success, and not the success of others. I have at times been unwilling to teach others new skills since I felt they “should have” already been competent with them. I realize now that part of being a nurse leader is mentoring others so they can succeed as well. I do not want to be one of those nurses who “eat their young” and I won’t.  

Budget Interview Summary

            I interviewed Gordon M. owner of Marble Ventures, Incorporated. Gordon uses Quickbooks and Microsoft Office to track his budget, along with Google Docs so he can access his budget at any time. He hires a specific employee to keep track of the budget who is required to report weekly to Gordon about the company’s progress. Gordon will then analyze them in his executive meetings, which are weekly as well.

            Gordon initially anticipates growth production and then assigns a budget for the year. He will project monthly actuals and then tweak the budget as needed for excess growth or unforeseen expenses. Gordon feels that cash flow revenue affects his budget more than expenses do. Although, he will immediately cut expenses if his company has not met monthly budget goals.

            The areas that are allocated the most monies in his budget are definitely Payroll to employees. Ideally, Gordon would like to have a 3-year budgeted plan for the future, but he has not quite gotten there yet. He does, however, continue with his annual projected budgets and compares it to past years.

            Gordon’s company is dependent on the housing market and its interest rates. When the economy failed in 2008, the “bottom fell out of the housing market” and he had to cut expenses more in his company. Upticks in the interest rates, slows the housing market down, and his company usually sees the effects of it 3 to 6 months later. To be prepared for this, Gordon looks at bank projections for growth in the upcoming years, as well as the nationwide finances since this is what causes interest rates to fluctuate. Gordon considers an interest rate of less than 5% for the housing market as “good”, but an interest rate of less than 4% is considered “fabulous” for his company. This means increased revenue and growth for his company.

             Overall, I was impressed at how often Gordon analyzes his budget. By looking at expenses and revenue weekly, he is able to tweak his budget accordingly and ultimately be more prepared for what the future brings. I feel this diligence is what keeps a company thriving, even when the economy is down and housing interest rates are higher. I like how he uses up-to-date budgeting systems such as Quickbooks and Google Doc spreadsheets. This way the monies are tracked efficiently and documented in an organized way. In summary, I want to follow his example with my own personal financial budget, and hope to carry those habits over to a corporate situation when I take on that role in my nursing profession. 

Reflective Journal Entry: Leaders as Educators/Future of Nursing

I expected to learn about nurses as educators and how they can help impact the future of nursing. I actually learned a great deal about where the future of nursing is headed, the Institute of Medicine’s recommendations for nursing, and how I can prepare myself now to be a nurse leader.

The Robert Wood Johnson Foundation (RWJF) approached the Institute of Medicine (IOM) with a challenge to determine what the future of nursing would be like with America’s new healthcare system. A committee was made and research was performed. As a result, four key messages were portrayed reflecting the discussions and recommendations from the IOM.

            1. Nurses should practice to the full extent of their education and training.

            2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

            3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.

            4. Effective workforce planning and policy making require better data collection and improved information infrastructure.

           

            (Robert Wood Johnson Foundation, 2011)

With the estimated 32 million Americans receiving health insurance, due to the Affordable Care Act, nursing is seen as a great opportunity to respond to these needs.  Preparing nurses now by furthering their education and obtaining advanced degrees is what will enable them to be more visible and dominant in leadership roles.

I enjoyed the team activities and discovering the different views of my team members about the future of nursing. Once of them stood out to me the most. By emphasizing achieving higher levels of education, and hopefully having more financial incentive with it, nurses will feel more empowered to get their bachelor’s degree and beyond. Although, I can see a major problem happening in the future. The baby boomer generation is going to retire soon and be in need of nursing care. With this increased need for nurses, hospital employers will be more likely to hire new graduate nurses, or those with less experience. This way they can be paid less, and the company can hire a bunch of these types of nurses to fill their positions. The problem is, there will be no incentive for nurses to further their educations if they will likely not be employed (since having a bachelor’s degree or more experience will equate to higher pay, resulting in a decreased chance of being hired compared to a new graduate nurse).  I am hoping this problem can be prevented in the future, where seasoned and educated nurses will be in just as much a demand (and hopefully more) as newly graduated nurses.

I plan to obtain my bachelor’s degree and then continue on to become an Advanced Practice Nurse. I also plan to utilize the information I have learned by being confident in my abilities as a nurse and filling leadership roles (i.e. team lead, clinical coach, etc).

Personally, I feel the lecture material was very insightful. I am excited for the future of nursing. I hope that nurses will obtain more positions of power and leadership in the future, and be financially rewarded for their endeavors.    

Reference

Shalala, D. E. (2011). Initiative on the future of nursing: IOM recommendations. Retrieved online from Robert Wood Johnson Foundation http://www.thefutureofnursing.org/recommendations