The Decision-making Process
The decision-making process is a systematic series of sequential steps.
The steps include
1- Recognizing the problem
2- Gathering and processing information
3- Evaluating alternatives
4- Deciding, selecting, or choosing
5- Implementing post-decision activities
The first necessary condition for a decision is a problem.
Problems exist where goals are to be attained and uncertainty exists
about an appropriate solution. A problem must also suggest more than
one alternative solution, The decision-making process is then a
sequential and reiterative series of psychological and physical activities
in which the decision-ma.ker seeks and evaluates information to
achieve the required level of confidence to reach a decision.
The process is not rigid; it allows a person to move backward or
forward or to skip stages, For example, in some instances gathering
and processing information may precede problem recognition, for
nurse administrators may be seeking information to arrive at one
decision only to learn of a need for an additional related decision, For
example, when using fomis to collect data and attempting to tabulate
information and write a quarterly or annual report, the administrator
may realize that the fomi circulated did not satisfactorily request the
needed information, The situation men requires new, Lmexpected
decisions. For organizational reasons, we will discuss decision-making
steps in their listed sequence.
Recognizing the Problem
Identifying a problem is an essential prerequisite for decision making.
Although this step at first glance appears simple, it is actually the most
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complex, for it involves a perception of the current state of affairs.
Because people view reality differently from one another, each holds a
slightly different preference about what an ideal state, situation, or
outcome should be. One might postulate that a perfect situation would
exist whenever the actual and the ideal were totally congruent, but this
seldom occurs, as both actual and ideal are in a continuous state of
flux. lncongruence between actual and ideal does not alone constitute a
problem; rather the incongruence must be of sufficient magnitude to
provoke problem recognition.
It is easy to get caught up in symptoms and never really identify
the real problem. Thus, it is helpful to state specifically what is wrong
and what improvements seem feasible. Then, the nursing administrator
can gather facts, investigate possible causes, and determine the real
problem,
Nursing administrators, who are continually faced with limited
resources, must establish priorities about the importance of various
problems, For example, a problem involving inadequate office space
may be irritating to a nursing supervisor or clinical specialist, yet it
may not be recognized or perceived as a problem by those in upper
levels of hospital administration. The nursing administrator must
therefore choose either to ignore the unsatisfactory situation or to
gather sufficient information to convince the hospital administrator that
a problem does exist. The decision will depend on the amount of time
and energy that can be devoted to the issue at a given time, after the
nursing administrator has taken other demands and priorities into
consideration.
When evaluating a problem, the decision maker needs to look at
both the problem’s priority and its potential for being solved. Nursing
administrators will occasionally encounter high-priority problems that
have limited potential for being solved. The nursing administrator
faced with high staff tumover might find, for example, that the
problem largely stems from the unusual demands of one surgeon who
insists on beginning a surgical schedule at 4 A.M. The hospital
administrator, while acknowledging the nursing problem, refuses to
intervene in the physician’s control of the hospital schedule because
the physician brings a large number of patients to the hospital. In this
case, the problem, although important to the nursing administrator,
may be unsolvable.
Faced with such situations, nursing administrators must often
establish priorities for dealing with problems. Reitz suggests three
possible ways of choosing priorities.
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The first problem encountered is the first problem solved, In
other words, deal with problems in the order in which they
appear.
2. Problems that can be dispensed with immediately are given priority
over more time-consuming ones. That is, give the easiest problems
to solve first priority.
3. Give crisis or emergency problems priority over all others.
Once a nursing administrator has arranged problems according to
priority and degree of solvability, it is time to begin gathering and
processing information.
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