Introduction
Power dynamics are crucial in defining organisational culture, policy, and communications in the quickly changing healthcare industry. The formal and unofficial power structures within a community-based hospital system in the Southeast United States are examined in this investigation (Anderson, 2019). This study sheds light on the intricate interaction between formal authority and informal influence by looking at the sources of stakeholder power, the consequences of current power structures, and their impact on decision-making processes.
Formal and Informal Power Structures
A blend of formal and informal power structures characterises the healthcare association described. Formally, the physician-centric history of the association has endowed the physician staff, particularly the Chief Medical Officer (CMO), with considerable influence over change, policy, and protocol. The CEO’s recent appointment from a university-combined hospital system signifies an attempt to balance this power dynamic. Informally, the CMO’s long-standing term and local community involvement have solidified his influence (Behson & Seemiller, 2021). This is reflected in his leadership in leading an enterprise similar to the hospitalist model, aimed at expanding the hospitalist group and potentially compromising the compass of practice for Advanced Practice Registered Nurses( APRNs).
Impact on Culture, Policy, and Communications
A cultural environment where nursing competes to establish its impact has been fostered due to the existing dominance of physician-centric power structures. A rift between nursing leadership and the organisation’s larger goals is evident in the cyclical change of Chief Nursing Officers (CNOs) and the decision to renounce the Magnet accreditation. Notably, the CMO’s planned movement of APRNs to the hospitalist group will exacerbate nursing’s marginalisation while undermining the interdependence of the healthcare industry as a whole. Operating under this paradigm inherently biases policymaking favouring medical prerogatives (Rahman & Ranjan, 2020). The proposal for APRN hospital privileges, favouring hospitalist group affiliation, reveals a purposeful move intended to strengthen existing power relations and blatantly indicates this trend. Such a move could escalate already high tensions, leading to the emergence of a hostile environment.
Besides, the intricate web of power dynamics can penetrate correspondence conductors, possibly filling in as obstacles to straightforward and cooperative direction. The transaction of force may obscure the trading of thoughts and incite an environment wherein certain voices gather unnecessary consideration while others stay smothered (Tarkhov, 2023). Exploring this mind-boggling territory requires purposeful work to recalibrate power structures, encouraging a climate where nursing experiences are recognised and embraced, subsequently enhancing the aggregate capacity to accomplish the association’s general goals.
Executive-Level Decision-Making and Power Dynamics
Power dynamics inside the company significantly influence how high-level decisions are made. The CMO can advance programs consistent with his goals because of his authority, which results from his successes in the orthopaedic program and active community involvement. His suggestion to expand the hospitalist group by including APRNs highlights his informal influence and emphasises how different objectives may affect strategic decisions. Additionally, the CMO’s effort to make APRNs eligible for physician hospitalist incentives is to decrease APRN worries while maintaining control. This action highlights how power dynamics may accomplish desired results (Anderson, 2019). The CEO’s experience in a different healthcare system also raises the possibility of a power transfer, which could balance the predominately physician-centric mindset. Power dynamics may change at this crucial point, reflecting the organisation’s efforts to balance and adjust its innate power structures.
Potential Impact on Organisational Policy
The organisational policy has significant implications due to the persisting power relations between nursing and medicine. The proposed move of APRNs to the hospitalist group might set a concerning precedent and hasten the loss of nursing autonomy. Implementing a policy that ties hospital privileges to group membership involves the risk of escalating differences and fracturing the cohesiveness of the healthcare team. A patient-centric attitude can be promoted instead through empowering nursing, which can promote a culture of collaborative policy creation (Behson & Seemiller, 2021). Nursing knowledge may be incorporated into decision-making processes to provide more equitable policies that are responsive to the requirements of the diverse patient population. Giving nursing a key role in determining policy offers a practical strategy to close the gap, promote unity, and create a setting where many viewpoints may coexist peacefully for the benefit of patient care.
Ethical Dimensions of Power
The hypothetical situation highlights the critical ethical aspects of power relations. The CMO’s proposal to link hospital privileges to group membership raises concerns about fairness and equality. Using incentives to influence APRN decisions raises questions about the organisation’s commitment to establishing an ethical and inclusive professional environment. The proposal’s potential for bias questions the moral need for impartiality and doubts the organisation’s dedication to fair procedures (Rahman & Ranjan, 2020). The interaction of power, incentives, and ethical concerns highlights the crucial necessity for open and principled decision-making to maintain the organisation’s primary purpose of inclusion and justice.
Conclusion
In conclusion, power dynamics within the described healthcare association reveal a complex interplay between formal and informal structures. Historically, physician-centric culture has told decision-making, policy expression, and communication channels. The case of APRN transitions to the hospitalist group exemplifies the potential consequences of power struggles on organisational dynamics (Tarkhov, 2023). To achieve a primary strategic ideal similar to Magnet designation, the association must navigate these power dynamics, considering ethical counteraccusations and fostering cooperative decision-making that incorporates different perspectives. Recognising the value of nursing within the broader healthcare team is essential for achieving a harmonious balance of power and advancing the association’s charge.
References
Anderson, B.C. (2019) ‘Power and the nature of pluralistic organisations’, Critical Management Studies, pp. 37–52. doi:10.1108/s2059-65612019027.
Behson, S. and Seemiller, C. (2021) ‘Power Dynamics and politics in organisations, Groups, Teams, and Organizations [Preprint]. doi:10.4135/9781071858738.
Rahman, M.M. and Ranjan, R. (2020) ‘Transnational organisations and Healthcare Sector’, Indian Migrant Organizations, pp. 96–129. doi:10.1093/oso/9780190121341.003.0004.
Tarkhov, K. Yu. (2023) ‘Analysis of the publication activity of Moscow Healthcare Department Organizations’, City Healthcare, 4(1), pp. 38–50. doi:10.47619/2713-2617.zm.2023.v.4i1;38-49.
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