Please write a 200-word response to this discussion
I work for Banner Health, a private, not-for-profit healthcare organization. This organization is a multistate healthcare system that has
expanded to Arizona. In 2015 Banner Health merged with the University Medical Center Tucson (UMCT) and South Campus (UMSC)
hospitals. Since then, they have purchased many outpatient clinics and urgent care facilities in Tucson and Phoenix. According to the
description by Weiss and Tappen (2015), my organization is the “bull elephant” since it is aggressive and seems to be winning the race
with the local competitors. Banner Health has state-of-the-art departments for cardiac surgery, cardiac and kidney transplant, neurosurgery, etc. Tucson’s people find these services only available at Banner Hospital, which helps it eliminate the competition and be the
“guided missile” discussed by Weiss and Tappen (2015).
The culture at Banner Health emphasizes patient safety and just culture. The four cornerstones of a strong safety culture are creating a
learning culture, developing an open and fair culture, designing safe systems, and managing behavioral choices (The Just Culture
Company, [JCC] 2008). A learning culture of patient safety means understanding risks at individual and organizational levels by learning
about the adverse events and near misses and observing our behaviors and the behaviors of those around us. Everybody must learn from mistakes and share this learning to support systems designs and safe choices (JCC, 2008).
An organization that creates an open and fair culture moves away from punitive reactions to events and errors. The erring provider must
report the event so the others can benefit from the learning opportunity. However, a strong safety culture reinforces accountability for
safety across all levels of the organization, from the CEO to staff ( JCC, 2008). Designing safe systems means creating healthcare
delivery systems that anticipate human error, capture errors before they become critical, and permit recovery when errors reach the
patient (JCC, 2008). Managing behavioral choices is crucial for a safety culture that values essential decision-making skills and asks
every healthcare provider to continuously evaluate the risk associated with their choices (JCC, 2008).
My organization’s goals are to grow, pay the bills, avoid falling into debt and have an excellent status. The last is provided through the
professionalism and courtesy of its employees and the unicity of services offered. Banner Health has a traditional hierarchical structure.
Weiss and Tappen (2015) compare this structure with a ladder where employees are ranked from top to bottom with the CEO at the top,
administrators then managers and physicians, nurses somewhere in the middle parallel with therapists and the nursing aides, technicians, housekeepers and maintenance crews at the bottom. My organization has formal and informal processes. Banner Health has formal
processes, which are written policies and procedures. In my hospital, we also use informal processes as need it.
Power is the ability to have something done as required or to have someone do something needed (Polat & Sonmez, 2018). Power types
are grouped as personal power and positional power. The personal power types are divided into four groups: referent or charismatic,
expert, persuasion, and connection (Polat & Sonmez, 2018). Positional power has five subcategories: legitimate, reward, coercive,
resources, and information (Polat & Sonmez, 2018). Expert power is a type of personal power that an individual with specialized
knowledge, experience, and unique talents possess (Polat & Sonmez, 2018). Legitimate power means an authority gained in a position
and used by the person in this position (Polat & Sonmez, 2018). The department managers, physicians, and nurse practitioners have the
right to give orders to employees. Reward power belongs to those with the authority and sources to reward persons by wage increase,
giving them a higher position, giving more responsibilities, praising, and appreciating (Polat & Sonmez, 2018).
Power affects the relationships between employees of different departments in many ways. Each organization has a hierarchy and a chain of command determined by different power types: legitimate, expert, reward, and coercion. Employees in various disciplines are members of the care teams for patients and utilize expert power to achieve the best outcomes possible. The nurses and different types of
therapists and technologists work with orders from physicians, which affects the relationships between these individuals in positive and
Nurses delegate nursing assistance with tasks within these employees’ job descriptions. When the aids do a timely and good job, they are in a friendly relationship because nurses have more time to do their work, and the aids are praised and recognized for their efforts.
However, there are times when is frustration either because the nurses can ask for too much and do not help the aids or contrary the aids are slow, not well trained, not focused, etc. Although at the bottom of the hierarchy, nursing assistants and technicians have power since
their jobs are important, and patient care is greatly affected if they don’t show up to work. Thus, nurses reward them and help them when possible, which leads to friendly relationships
Managers have reward power, compensating staff for a job well done. According to Eatough (2021), this type of power has positive consequences because the employees who are rightly paid for their efforts have the energy necessary to push the company forward, and everyone is happy. The people from the financial department and administrators are involved by approving the finances for rewards such as
salary increases and bonuses. Managers use coercive power when disciplining or firing employees, making assignments, granting days
off, etc. (Weiss & Tappen, 2015).
Eatough, E. (2021). Reward power in the workplace and how to motivate employees. https://www.betterup.com/blog/reward-power
Polat, S., & Sonmez, B. (2018). The Correlation between the Power Styles Used by Nurse Managers and Bullying Behaviour[PDF].
International Journal of Organizational Leadership, 7(1), 84-99. https://ijol.cikd.ca/article_60327_ee964c8adf89fd049e9d03aaa57c 0ec2.pdf
The Just Culture Company. (2008). Patient safety and the just culture overview [Brochure] LLC. Curators of the Just Culture
Weiss, S. & Tappen, R. (2015). Essentials of nursing leadership and management (6th ed.). F.A. Davis Company.
Please write a 200-word response to this discission
Module 3 Discussion
Organizations have diverse characteristics, cultures, structures, and goals depending on the nature of activities therein, and as guided by the organizational mission and vision. This discussion provides a snapshot of my current organization and describes types of power, and
how they affect various disciplines within the organization.
My current organization is a long-term care facility for residential care of the elderly and disabled. The organization is committed to
providing patient-centered care as recommended by evidence-based practice. Culture often implies many things, including policies and
standards of practice. My organization believes in teamwork. Therefore, care for the clients within the facility does not rest on a single
individual or department. Rather, there is an interdisciplinary collaboration where nurses, physicians, and other staff consult on best
practices to improve the welfare of the residents. The formal goals within my organization are those documented in the policies and
include preventing deterioration and promoting social adjustment to stages of decline, given that the clients are aging. The informal goals are the unwritten ones often evident from the organization’s culture. Such include activities as involving the family in care processes may
feature in the informal goals of the organization.
My organization’s structure consists of the traditional hierarchical model in which employees are ranked from the top to the bottom. The
people at the top of the ladder have the authority to issue orders, spend the organization’s money, and hire and fire people. Much of this
authority is delegated to people below them, but they retain the right to reverse a decision or regain control of these activities whenever
they deem necessary (Weiss &Tappen, 2015). On the other hand, those at the bottom have little authority but do have other sources of
power. They usually play no part in deciding how money is spent or who will be hired or fired but are responsible for carrying out the
directions issued by people above them on the ladder. Essentially, the CEO is at the top, then the director of care is next in rank. Activity
coordinators, clinical nurse managers, the maintenance team, administrators, and senior housekeepers are almost at the same level.
Under the nurse manager operate the staff nurses, senior healthcare assistants, and physiotherapists. The senior housekeeper heads
unior housekeepers, while other healthcare assistants report to the senior healthcare assistant.
Power describes the ability to control people even when there is resistance. The three kinds relevant to nursing include control over the
content of nursing practice. This may not provide adequate power for nurses since it requires autonomy. The second kind of power is
control over the context of power, which promotes decision-making and collegial relationship with physicians. The third kind of power is
control over the competence of nursing practice supported by advanced education which has been linked with improved patient outcomes. Power affects relationships in an organization, in that, power influences policy-making, adherence, and thus the success or failure of
Weiss, S. A., Tappen, R. M. (2015). Essentials of nursing leadership & management (6th ed.). FA Davis.
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