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Management Focus attendees participate in specialized session content, networking lunch, and special exhibit hours; Tuesday, April 23, 2002 - Management Focus

At the 2002 AORN Congress, Tuesday, April 23 was the day chosen for a focus on perioperative managers and leaders. AORN's Management Focus was designed specifically for perioperative managers interested in the latest trends, developments, and information. In addition to sessions on dealing with a middle management position, improving job satisfaction, preventing sentinel events, and preparing for natural disasters and acts of terrorism, attendees were invited to attend a networking reception, a box lunch, and special exhibit hours for managers only.

MIDDLE POWER

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In her presentation "Middle Power in Organizations," Nancy Aronson, PhD, divided organizations into three areas: top, middle, and bottom. Those at the top, according to Dr Aronson, have overall responsibility for the system or some piece of the system and may distribute resources as they see fit. The bottom space is inhabited by workers who make products or provide services, and in the middle are the middle managers who mediate the interactions of those above and below them.

"Middles juggle the priorities of others," said Dr Aronson. As managers enter the middle space, they find themselves pulled toward those above and below, and they are stretched between the two. Those in the middle can start to feel weak because they are not sure what is right, said Dr Aronson. They lose their sense of independent thought and are so tuned into others' needs and priorities that they start to lose track of their own. If middle managers get enough negative feedback, they begin to think something is wrong with them, said Dr Aronson. This is a symptom of middle space disease.

She noted that the first step toward empowerment as a middle manager comes from getting out of the middle. Dr Aronson recommended that middles concentrate on helping to solve issues, but that they should not make issues their own. Dr Aronson said that a manager can get out of the middle position by assuming the leadership role, serving as a reality check for upper management, coaching upper and lower groups on how to deal with one another, and being a facilitator for communication between both groups.

Middle managers need to enter the top level when required, but they also have to accept the consequences of being at the top, said Dr Aronson. This is not a rebellious attitude; it is one of independent thought and action. Being the leader when it is needed means the middle manager is exercising judgment in service to the system.

In addition, those at the top of an organization often are disconnected from the reality of every day, which is the reason they sometimes give middle managers "garbage" to pass down the line, said Dr Aronson. When this happens, middle managers must serve as the reality check and stop this information from being passed along. This protects those on the bottom from unnecessary information.

When those at the top or bottom levels of an organization ask a middle manager to respond to a situation, that manager often assumes he or she has to meet people's needs. Instead, the manager should coach those below about how to deal with those at the top. In addition, middle managers can coach those at the top about when those at the bottom need to hear from them.

There also are times when the middle manager must serve as a facilitator, said Dr Aronson. By bringing people together from the different levels to solve their problems and supporting their efforts, the middle manager helps facilitate the problem-solving process.

NANCY K. KUEHL SENIOR EDITOR

JOB SATISFACTION

Is a satisfied OR nurse a goal, myth, or reality, asked Janine Spencer, RN, EdD, CNOR, in her session "Improving Nurse Job Satisfaction." She said that because of the nursing shortage, managers have to be more concerned about job satisfaction, which helps retain nurses; however, managers also need to reflect on how satisfied they are, because this will trickle down to staff members. Job satisfaction affects productivity, patient outcomes, and patient satisfaction, said Dr Spencer, adding that happier nurses equal happier patients.

The new generation of nurses does not necessarily have the same philosophy as nurses who came before, said Dr Spencer. She noted that though older nurses may have entered nursing envisioning it as a career choice, many new graduates see nursing as a job and not as a career.

Dr Spencer has found that the OR environment has differences that affect how new nursing school graduates view job satisfaction. Two major areas of complaint among new nurses are scheduling and preceptor issues. Generation X is not interested in call, said Dr Spencer. They are not interested in overtime pay because their personal lives are more important to them. This is not necessarily a bad thing, although it is a different philosophy than that possessed by many older nurses. Dr Spencer recommended that nurses stop living and working within models that worked in the past and concentrate on what works in the present. "We have clouded memories of the past," said Dr Spencer. "The past doesn't help us solve problems in the current environment."

Health Care Industry

Management Focus attendees participate in specialized session content, networking lunch, and special exhibit hours; Tuesday, April 23, 2002 - Management Focus

AORN Journal, July, 2002

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