Contents
Introduction
Shortage of Personnel
"Shortages" as a Rationalization
The Functional Method of Patient Care
Consequences of the Functional Method
Better Utilization of Human Resources
Chapter 1. Psychological and Social Needs of Staff
1. Social Approval
2. Sense of Accomplishment
3. Sense of the Importance of the Job
4. Security
5. Support in Anxiety-Inducing Situations
The Desire for Self-Actualization
Work Groups in Their Benefit to Employees
Problems of Maintaining Small Groups in Hospitals
The Informal Organization of the Institution
Hospital Administration and Small Work Groups
Methods of Working with Staff Groups
Chapter 3. The Formal Structure of the General Hospital
The Hospital's Organization Chart
Nursing as an Arm of Hospital Administration
Patients and the Organization Chart
The Competing Chain of Command
The Dual Value System
Practical Consequences of the Evolutionary Process
1. Multiple Subordination
2. The Conflict Between Dependency and Authority
The Need for Positive Leadership from Physicians
Chapter 4. Communication and Coordination of Patient Care
Why Lateral Communication Is Impeded
Inadequacy of Written Communication
Hypotheses About the Nature of Oral Communication
Communication and Meeting Patients' Needs
Improving Nurses' Skill in Communication
Chapter 5. Motivation
The Medical Profession
The Newer Health Professions
Technicians
Health Workers Without Formal Preparation
Differentiated Attempts to Stimulate Motivation
Stimulating Motivation Among the Auxiliary Personnel
Chapter 6. Effecting Change - I
Staff's Request for More "Information"
Orientation and Continuing Staff Development
Ward Staff Meetings
Group Psychotherapy Sessions
Staff Studies of Patient Care
Meeting the Need for Accomplishment and Recognition
Administrative Ineptitudes
Distortions of Perception
Decision-Making by Staff
The Committee on Patient Care
Achievements of Committee
Planning for the Future
The Challenge of "Responsibility"
Appendices