Nurses VS Doctors - An Age Old Battle

We recently covered in PADM 5322 incidents relating to the disparity between nurses and doctors.  It made me think back to some of the stories my mother used to tell my father (and me when I become of age to discuss “grown folks” issues).

My mother used to be an RN for Phoebe Putney hospital back in the 80s.  I remember her talking to my father about her day was.  She would always speak highly of her patients and most of her co-workers, but she would rarely say anything about the doctors.  Surely she had a good relationship with them.  This was evidenced by the amount of doctors that assisted her anytime one of us had a fundraiser.  They would always give the most.  Surely they didn’t mistreat her.  She was well trained and graduated top of the class at the illustrious Albany State University.  She also quickly rose through the ranks and eventually became the director over southwest GA in her field.  No, she told me later in life that she realized there was a “line drawn” between nurses and doctors.  She also witnessed how doctors treated other nurses disrespectfully and even condensending.  Now, even though she never had this happen to her, she had enough insight on how to handle herself in interactions with the doc tors.  This also was the reason why she left Phoebe Putney after over 10 years of service.  

In looking for material, I found a blog written by one of my colleagues.  She was dead on with her recommendations.  Clear communication, accountability, and an examination of policies would certainly help even the playing field.  I’m not saying that doctors and nurses are both one in the same…but I am saying that they are both human beings in the business of saving lives.  We certainly need these two parties to get along famously so that we can have continued efficiency and quality in healthcare.  

http://melaniechambers21.blogspot.com/2012/03/pln-7-physician-nurse-conflict.html 

Toxic Comination - Bad Coding & Bureaucracy

Upon performing my research for a paper in my PADM 5322 class, I stumbled across an article about how a combination of bad coding and bureaucracy is the problem with healthcar.gov.  There was a quote from a programmer that stated, off the record of course, that the requirements were constantly changing.  Seeing how the programmers were using the waterfall method, I can see how that creates issues.  In a nutshell, the waterfall method begins with the requirement process, and then move to coding, then move to testing, and then releases an entire system.  If there was interference with this method (i.e. requirement changes), this would point to political pressure.  In addition to tampering with the requirements, this article pointed to the timeframe the developers were held to even though they insisted that the product was not ready.  This, again, points to political pressure.  It would be beneficial, at least in the aforementioned scenarios, for the government to allow the programmers to do their job without constraints and with as static requirements as possible.  Indeed, bureaucracy and bad coding make a devastating tandem. 

http://www.healthcareitnews.com/news/bad-code-bureaucracy-prove-toxic-combo-healthcaregov?single-page=true

Is Organizational Culture Important?

Is Organizational Culture Important?

Organizational culture is the behavior of humans who are part of an organization and the meanings that the people attach to their actions. Culture includes the organization values, visions, and norms, working language, systems, symbols, beliefs and habits (Organizational Culture, 2013).  It could also be defined as the values and behaviors that contribute to the unique social and psychological environment of an organization (What is Organizational Culture, 2013).  Imagine it as the how or why that drives an organization toward its goals and honors its mission statement.  An organization’s culture definitely shapes how workers administer services or render services.  A happy employee will go above and beyond and will typically spread joy to his or her co-workers.  Conversely, a disgruntled employee will only do just enough to get back.  These will be the “middle of the packers” and can be a cancer to your organization’s culture, spreading ill and malicious will.  In my years as an assistant call center manager, I have witnessed both good and bad organizational cultures in action.  I have seen where a company, initially for its employees happiness and well-being, be reduced to a “meat shop” where all employees were treated like assembly line parts with a back-up already prepared in inventory.  What this brought about for the company was 1000’s of employees either quitting or getting terminated and a branded reputation around the city as a bad company to work for.  The benefits to improving an organization’s culture are better aligning with the company towards achieving its vision, higher employee morale, and increased team cohesiveness (Organizational Culture, 2013).  As a manager, one of the best pieces of advice that I could issue out is to never forget about the people.  A company is nothing without its human capital.  In the end, shaping employees visions and behaviors is a part of immersing them and having them acclimated to an organization’s culture.  If it is to be successful, it will require a joint effort from management, human resources, and the rank and file employees!

For an example of poor organizational culture, please see the YouTube video below:

http://www.youtube.com/watch?v=i7_R921f1OA

Works Cited:

Organizational culture. (2013). Retrieved from http://en.wikipedia.org/wiki/Organizational_culture

What is organizational culture?. (2013). Retrieved from http://www.businessdictionary.com/definition/organizational-culture.html

NPR vs PM: The Battle of the Dichotomy

NPR vs PM: The Battle of the Dichotomy

Dichotomy, as viewed on the public administrative levels, can be viewed as separation or as a hierarchy. Historically, many politicians were fans of “big government”. In their eyes, it was better to have multiple divisions of tasks divided up into departments that report to somebody that reports to somebody and so on until the President or CEO is reached. A major change took place around the 90’s. Politicians begin to tinker with the notion of shrinking government to make processes more efficient. Moreover, some presidents even attempted at taking private sector approaches to everyday public administration activities. Two programs take center stage in this discussion, National Performance Review (NPR) and President’s Management Agenda (PMA). Policies such as the NPR and the POMA are part of a broader government reform trend in American public administration and its European counterparts. Let’s take a look at these two policies in more detail.

National Performance Review was enacted during the Clinton-Gore administration (1993 – 2001). The goal of NPR was to reform the federal government. This was to be done by reinventing government principles and exhorted federal agencies to downsize, eliminate unnecessary regulation, focus on results, and offer customer service equal to or better than “the best in business”. The Clinton administration wanted the federal agencies to become more like businesses. Essentially, the NPR viewed the citizens as customers and treated them in the same manner businesses would seek customer satisfaction. The NPR targeted opportunities for waste reduction and offered hundreds of specific recommendations for managerial and technological improvements. High level initiatives avoided extreme politicization and received generally positive evaluations for achieving most major goals. Reform proposals were drawn from private manufacturing successes in Japan and the United States during the previous decade and selectively converted to the public-service sector. As mentioned in the opening paragraph, many ideas originated in other countries where national governments exercised significantly greater centralized federal control over budget than governments in the United States.

The results of the NPR were mixed. These reforms resulted in the lowest government employment totals, as a percentage of the national population, since the 1950s. However, in terms of shrinking the dichotomy, Clinton and Gore failed to demonstrate how they decreased government’s size and improved its efficiency and what difference it made to the average voter even though the size of government was smaller than when they took office! Although the Clinton administration’s capacity-building efforts initially received tacit support from Congress, management reforms were highly politicized and limited in scope. Nonetheless, the NPR did help prepare many federal agencies for the unimaginable challenges to public management and homeland security that they have faced since 9/11. These reforms had little impact on public opinion or electoral results for the incumbent administration.

President’s Management Agenda was the George W. Bush’s performance management plan for the federal government. The ideological blueprint of the Bush administration, PMA sought to use performance data to make budgetary and programmatic decisions. PMA wanted to implement “pure” top-down, corporate, private-market-based performance management approach. Partly in response to budgetary restraints, changing national priorities, deficit spending, and fiscal stress, Bush favored the broader use of private alternatives such as competitive outsources as a PM measure.

The Bush administration shelved many of the NPR initiatives in early 2001 and the momentum for institutional reforms stalled in the 108^th Congress. As a real-time test of the Bush administration’s PMA reforms, the federal agencies was less satisfactory than many had expected or been promised. Ironically, during his administration in 2001- 2099, the size of bureaucracy as well as the total amount of federal spending and public debt increased more than under any other president since Franklin D. Roosevelt in the 1940s!

In closing, it appears that while both the NPR & PM have benefits it would appear that NPR was more successful in attaining the goals. NPR was also successful in shrinking the dichotomy in government, but PM (or the Bush administration in actuality) increased the hierarchy. What the Clinton administration was unsuccessful in was ensuring that the voting public saw all of the benchmarks accomplished via NPR. Bush piggy backed off of NPR’s vision and edited down to a structure of government to his and his constituents liking.

References:
Milakovich, M., & Gordon, G. (2007). Public administration in America. (10th ed.). Boston: Wadsworth.

Dichotomy. (2011). Retrieved from http://en.wikipedia.org/wiki/Dichotomy

Public Policy

Public Policy

Public policy is something that we as citizens encounter daily. The text book pointed out an example of an automobile and how all of its intricacies had a relation to public policy. This began me thinking about other everyday items such as televisions and microwaves. Each of these items have policies and regulations guiding them from their birth in the factory (regulation of transistor parts of the radio or tubing specifications mandated by legislation of the televisions) all of the way to our consumption (frequency regulations or content ratings). The textbook defines public policy as a relatively stable, purposive course of action or inaction followed by an actor or set of actors in dealing with a problem or matter of concern. Simply put, public policy is what the government does or does not do. In order to carry out public policy, officials utilize the public policy process.

In order to have a need for public policy, an issue or need has to arise. This could stem from a new issue or in rebuttal to a newly implemented public policy. Once this need/issue has a voice through public outcry or petition, it is sent up by public officials to potentially become part of the agenda. This step is called problem identification and agenda setting. All public issues/needs do not make it on the agenda. In fact, very few actually make it.

The next step in the public policy process is policy formation. During this phase all possible alternatives to solving the problem are identified. It is here where examination of a series of options is performed to identify the best course of action.

The next phase in the public policy process is called policy adoption. Here, the option of how to solve the public problem is chosen. It is also here that the solution is developed completely so that it can be legitimized or authorized. This can also include taking no action.

The fourth step is called policy implementation. This is the application of the policy to the problem. This can also be viewed as administration the policy. As our text states, the attention in this phase is on what is done to carry the policy into effect or apply adopted policies.

Policy evaluation is the next step in the public policy process. This basically asks the question “Did the policy work?” The bulk of the duties done in this phase are intended to determine what a policy is accomplishing, whether it is achieving its goals, and whether it has other consequences. For example, by implementing a policy on anti-abortion did it cause an outcry from pro-abortion activists?

The final step in the public policy process is policy termination. This commonly is seen when policy isn’t successful. This step basically poses the question “what wasn’t this policy successful?”

As we have covered, public policy is truly an iterative process. It must be flexible and measurable. It also must stay impartial, seeking the best overall outcome.