Title: INFORMATION PROCESSING STYLES OF NURSES AND NURSE MANAGERS
1INFORMATION PROCESSING STYLES OF NURSES AND NURSE
MANAGERS
- Presented by
- Beatrice J. Kalisch
- Titus Distinguished Professor of Nursing and
- Director, Nursing Business and Health Systems
- University of Michigan
- Ann Arbor, Michigan
2CONCEPTUAL FRAMEWORK
Gary Salton, "Organizational Engineering"
3Information Processing Model
TRANSMISSION FOLLOWS BASIC MODEL
LEARNER
4Information Processing
5Input-Output Strategies Graph
REACTIVESTIMULATOR
LOGICALPROCESSOR
RELATIONAL INNOVATOR
HYPOTHETICAL ANALYZER
6Changers
Performers
Perfectors
Conservators
HYPOTHETICAL ANALYZER Structured Thought
7RS Characterization
METHOD Unpatterned
MODE Action
OBSERVABLE BEHAVIORS Fast execution Low
rule/norm compliance Intense Exciting/excited Focu
s on when Low tolerance for routine
8HA Characterization
METHOD Structured
MODE Thought
OBSERVABLE BEHAVIORS High conceptual planning
and clarity Thoughtful Unhurried Focus on
why Low tolerance for forced action/decision
making
9LP Characterization
METHOD Structured
MODE Action
OBSERVABLE BEHAVIORS Decisive High operational
clarity Stable/steady Focus on how Low
tolerance for uncertainty
10RI Characterization
METHOD Unpatterned
MODE Thought
OBSERVABLE BEHAVIORS Mission level
horizon Variable intensity Innovation
creativity Enthusiastic Focus on what Low
tolerance for confined decisions
11STUDY QUESTIONS
12STUDY QUESTIONS
- Do the information processing styles of nurses
differ - from the general population (i.e. school
teachers, engineers, IT staff, customer service
staff, etc.)? - by specialty (i.e., medical-surgical, intensive
care, emergency department, surgery etc.) ? - by staff role (i.e. registered nurses, licensed
practical nurses, nursing assistants, unit
secretaries)? - Do the information processing styles of nursing
staff differ from nursing managers?
13STUDY METHOD
14STUDY METHOD
- Sample
- 578 nursing staff in two hospitals (210 bed
community hospital and 98 bed Veterans
Administration hospital) - RNs 344
- LPNs 41
- Nursing Assistants (NA) 101
- Unit Secretaries 40
- Nursing Management 52
15STUDY METHOD (continued)
- Instrument I-Opt Survey
- Validity
- Face validity50 professionals 14,655 survey
results found less than 1 disagreement (n128,
0.87) - Construct validity Different populations 75
distinct groups, 887 people compared to database
population (n8700) p.0152 - Content validity84-92 of survey responses were
traced directly to a specific dimension of the
underlying theory 100 of 50 member expert panel
agreed that response structure in survey not
contaminated by respondent misunderstanding
16STUDY METHOD (continued)
- Validity (continued)
- Convergent validity19 similar companies, 188
people no significant differences plt.05 - Discriminate validitycluster analysis
discriminated among three groups that should be
different - Concurrent validityexpert panel felt number of
inaccurate reports was zero - Conclusion validitytests satisfy criteria of
identical dispersions, equality of variances etc. - Reliabilitypairwise combinations for 1994-1999
using Kruskal-Wallis test no significant
differences in the data between years
17STUDY FINDINGS
18STUDY FINDINGS
- Populations Comparison of two facilities
- RNs More RIs at VA than community hospital
(p.045, df576)
Question 1 Nurses vs. non-nurses
19- Nurses (N396) vs.Plant Operators (N591)
- More nurses are Processors (LP)
- No Difference in Analyzer (HA)
- More plant operators are Innovators (RI) and
Stimulators (RS)
- Nurses (N396) vs. Engineers (N938)
- More nurses are Processors (LP) and Analyzers
(HA) - More engineers are Innovators (RI) and
Stimulators (RS)
p-value df
RI .000 985
RS .000 985
LP .000 985
HA .064 985
p-value df
RI .000 1332
RS .000 1332
LP .000 1332
HA .002 1332
plt.05
plt.05
20- Nurses (N396) vs.
- School Teachers (N606)
- More nurses are Analyzers (HA) and Processors
(LP) - More school teachers are Innovators (RI) and
Stimulators (RS)
p-value df
RI .000 1000
RS .000 1000
LP .000 1000
HA .064 1000
plt.05
21Relational Innovators
22Reactive Stimulators
23STUDY FINDINGS (continued)
- Question 2 Differences by nursing specialty
No significant differences - Question 3 Differences by role
- RNs vs. LPNs
- RNs higher on Innovator (RI) (p.009, df383)
- RNs lower on Processor (LP) (p.000, df383)
- RNs vs. NAs
- RNs higher on Innovator (RI ) (p.032, df443)
- NAs higher on Processor (LP) (p.000, df443) and
HA (p.011, df443)
24STUDY FINDINGS (continued)
- Question 3 Differences by role (continued)
- RNs and US
- RNs higher on Stimulator (RS) (p.038, df382)
- USs higher on Processor (LP) (p.009, df382)
- No statistical difference among
- LPNs, NAs, Unit Secretaries
25EXAMPLE UNIT A
Reactive Stimulator
Relational Innovator
Logical Processor
Hypothetical Analyzer
MOSTLY DAYS
MOSTLY NIGHTS
26EXAMPLE UNIT B
Reactive Stimulator
Relational Innovator
MOSTLY NIGHTS
Logical Processor
Hypothetical Analyzer
MOSTLY EVENINGS
MOSTLY DAYS
27EXAMPLE UNIT C
Reactive Stimulator
Logical Processor
Relational Innovator
Hypothetical Analyzer
MOSTLY DAYS
MOSTLY NIGHTS
28HOSPITAL LEADERSHIP GROUP
Reactive Stimulator
Relational Innovator
Logical Processor
Hypothetical Analyzer
29Nurses vs. Administrators
HOSPITAL ADMINISTRATORS
NURSES
30STUDY FINDINGS (continued)
- Question 4 Nursing staff vs. nurse managers
Information Processing Style p-value df 95 Confidence Interval of the Difference Lower 95 Confidence Interval of the Difference Upper
Innovator (RI) .000 394 -5.800 -2.741
Stimulator (RS) .000 394 -5.959 -2.535
Processor (LP) .000 394 2.103 6.659
Analyzer (HA) .000 394 2.469 6.112
plt.05
31Changers
Performers
Nurse Managers
RNs, LPNs, NAs, USs
Perfectors
Conservators
HYPOTHETICAL ANALYZER Structured InputThought
Output
32DISCUSSION OF FINDINGS
33DISCUSSION OF FINDINGS (continued)
- Vast majority nursing staff are HAs and LPs very
few RIs and RSs - Strengths
- Ideally suited to stable environments which value
carrying out existing processes/procedures - Performs at a consistent rate and with unvarying
quality - Precisely executes established programs
34DISCUSSION OF FINDINGS (continued)
- Vast majority nursing staff are HAs and LPs few
RIs and RSs (continued) - Vulnerabilities
- Limited action (RS) resources
- Lack of out of the box idea generation
- Advantages of unpatterned thinking are lost
- Lowest of any group studied
- High resistance to change
- Lack of capacity to take risks over-cautious
- Intolerant of uncertainty
- Meeting ones obligations is the definition of
success
35DISCUSSION OF FINDINGS (continued)
- Staff nurses look very much alikevery few nurses
outside the conservator quadrant - Why is this? education, practice settings?
- RS and RI nurses move to management, academics
etc. - Are nurse commodities? (Commodities are all
alike you always buy the cheapest) - Is this consistent with a professional?
- Professionals have ideas that drive improvement
nurses appear to not have or express many - Is the stability, clear expectations, functional
regularity etc. contributing to low prestige?
36DISCUSSION OF FINDINGS (continued)
- Coalitions of same thinking nursing staff
dominate decision making - Everyone should be just like me only way is my
way - If you come up with a different way of doing
something, I will not trust you - The rare RI/RS are probably not be heard
- Dominant teams orientation may be blind to
viable options that do not conform to the teams
preferences
37DISCUSSION OF FINDINGS (continued)
- Nurses work as individuals, not team members
(varying strengths) - Nurse managers looks like managers in other
fields but the group they are managing doesnt
look like any other group managers are facing - It is much tougher
- Nothing is being done to help managers meet this
challenge - Wonder why staff wont change
- Need to approach it differently
38IMPLICATIONS
39RECOMMENDATIONS
- For nursing education
- Team training
- Special effort to retain and develop the
Stimulators (RSs) and Innovators (RIs) - For practice settings
- Measure style present to staff strategize how
they will overcome their vulnerabilities - Develop culture that utilizes the skills and
knowledge of Innovators (RIs) and Stimulators
(RSs) and keeps them engaged
40RECOMMENDATIONS (continued)
- For nursing management
- Training to assist managers to deal effectively
with LPs and Has, particularly in terms of change - It will take a long time
- Must be presented with extensive detail
- Staff need to feel there is a strong likelihood
for success - Easier to incrementally improve existing
processes
41FURTHER RESEARCH
- Does nursing (the educational program and/or the
practice setting) attract LP/HAs or do RI/RSs
leave nursing/nursing programs? - How can we recruit for and retain the RI/RS
capability in nursing?
42The End