Chisengantambu-Winters Christine, Robinson Guy M, Evans Nina
School of Nursing and Midwifery, Australian Catholic University, North Sydney, New South Wales 2060, Australia.
School of Geography, Environment and Population, University of Adelaide, Adelaide, South Australia 5005, Australia.
Heliyon. 2019 Dec 30;6(1):e03128. doi: 10.1016/j.heliyon.2019.e03128. eCollection 2020 Jan.
Decision making is an inherent, complex and vital component of the work of managers. Its importance and role in operationalizing the activities of an organisation are well-evidenced in management literature. Yet, there is a dearth of literature about the processes used by nurse managers to make decisions. The principal aim of this paper is to identify the different types of decisions made by nurse managers and explore the related decision-making processes. A 'dependency model' is proposed, which illustrates the factors affecting the art of decision making. Structured interviews were conducted to identify types of decisions made by nurse managers in different health-care settings and the factors underpinning these decisions. The research focused on an intensive study of a small group of nurse managers working in rural and regional health institutions in South Australia. The sample included nurse unit managers, after-hours coordinators and directors of nursing. Hermeneutic principles and interpretive research were used to conduct interviews with nurse managers who make numerous and varied types of decisions, though often without following a step-by-step approach. The study identified dependency factors that influence how decisions are made, and developed a model based on eight key variables: (1) the situation to be addressed; (2) the time period in which the decision has to be made; (3) required inputs from colleagues; (4) complexity of the task and the environment, (5) the duration and time it takes to make a decision, (6) availability of resources, (7) the decision-making environment, and (8) personal characteristics. These eight variables are interrelated and have both direct and indirect impacts on how decisions are made. Nurse managers make pragmatic decisions reflecting the complexity of their roles and responsibilities. Awareness of the factors on which decisions depend helps understanding of how they navigate through decision-making processes. The findings are presented as a model that can be used to support decision making by nurse managers in various health settings.
决策是管理者工作中固有的、复杂且至关重要的组成部分。其在组织活动实施过程中的重要性和作用在管理文献中有充分体现。然而，关于护士长决策过程的文献却很匮乏。本文的主要目的是识别护士长做出的不同类型决策，并探讨相关的决策过程。文中提出了一个“依赖模型”，该模型阐述了影响决策艺术的因素。通过结构化访谈来确定不同医疗环境下护士长所做决策的类型以及这些决策背后的因素。该研究聚焦于对一小群在南澳大利亚农村和地区医疗机构工作的护士长进行深入研究。样本包括科室护士长、夜间协调员和护理主任。运用诠释学原理和诠释性研究方法，对做出众多不同类型决策（尽管通常并非遵循一步步的方法）的护士长进行访谈。该研究确定了影响决策方式的依赖因素，并基于八个关键变量构建了一个模型：（1）需解决的情况；（2）做出决策所需的时间段；（3）同事的必要投入；（4）任务和环境的复杂性；（5）做出决策所需的时长和时间；（6）资源的可获取性；（7）决策环境；（8）个人特征。这八个变量相互关联，对决策方式既有直接影响也有间接影响。护士长做出务实的决策，这反映了他们角色和职责的复杂性。了解决策所依赖的因素有助于理解他们在决策过程中的行事方式。研究结果呈现为一个模型，可用于支持不同医疗环境下护士长的决策制定。
