UNIT 1 A New Approach to Leadership and Management

CHAPTER

1
Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management
The successful nurse executive has the ability to make good decisions consistently.
Thomas R. Clancy

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To cope with the realities of todays health care system, nurses must be prepared to be critical thinkers. They must also be ready to welcome change and thrive in rapidly changing environments. Chapter 1 explores the primary requisites for successful management and leadership: problem solving, critical thinking, and decision making. Decision making is often thought to be synonymous with management and is one of the criteria on which management expertise is judged. Much of any managers time is spent critically examining issues, solving problems, and making decisions. It is the authors belief that problem solving, decision making, and critical thinking are learned skills that improve with practice. So that the processes can be consistently replicated, these learned skills rely heavily on established tools, techniques, and strategies. The quality of the leadermanagers decisions is the factor that weighs most heavily in their success or failure. Decision making is both the innermost leadership activity and the core of management. Therefore, effective leaders and managers must be able to answer the following questions: Do the circumstances warrant that a decision is required? How should the decision be made? Who should be involved in the decision-making process? This unit describes the process of decision making in Chapter 1; explores the development of management theory and management decision-making tools in Chapter 2; and examines leadership theory from historical to contemporary perspectives in Chapter 3. Chapter 1 introduces the reader to problem solving, decision making, and critical thinking and provides several problem-solving and decision-making models that assist leaders and managers in making quality decisions. It also introduces the learning exercise as a new approach for gaining skill in management and leadership decision making.

DECISION MAKING, PROBLEM SOLVING, AND CRITICAL THINKING

Decision making is a complex, cognitive process often defined as choosing a particular course of action. Websters definitionto judge or settleis another view of decision making. Both definitions imply that there was doubt about several courses of action and that a choice was made that eliminated the uncertainty. Problem solving is part of decision making. A systematic process that focuses on analyzing a difficult situation, problem solving always includes a decision-making step. Many educators use the terms problem solving and decision making synonymously, but there is a small yet important difference between the two. Although decision making is the last step in the problem-solving process, it is possible for decision making to occur without the full analysis required in problem solving. Because problem solving attempts to identify the root problem in situations, much time and energy are spent on identifying the real problem. Decision making, on the other hand, is usually triggered by a problem but is often handled in a manner that does not eliminate the problem. For example, a person who handled a conflict crisis when it occurred but did not attempt to identify the real problem causing the

CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management

conflict, used only decision-making skills. The decision maker might later choose to address the real cause of the conflict or might decide to do nothing at all about the problem. The decision has been made not to problem solve. This alternative may be selected because of a lack of energy, time, or resources to solve the real problem adequately. In some situations, this is an appropriate decision. Here is an example of a decision not to solve a problem. A nursing supervisor has a staff nurse who has been absent a great deal during the last 3 months. However, the supervisor has reliable information that the nurse will be resigning soon to return to school in another state. Because the problem will soon no longer exist, the supervisor decides that the time and energy needed to correct the problem are not warranted. Critical thinking, sometimes referred to as reflective thinking, is related to evaluation and has a broader scope than decision making and problem solving. Critical thinking is purposeful, outcome-directed thinking that is based on a body of knowledge derived from research and other sources of evidence (Ignatavicius, 2001, p. 38). Components of critical thinking include reasoning and creative analysis. Ignatavicious (2001) has identified six cognitive skills used in critical thinking, including evaluation and analysis (see Display 1.1). Various theorists define critical thinking differently, but most agree that it is more complex than problem solving or decision making, involves higher-order reasoning and evaluation, and has both a cognitive and affective component. The authors believe that insight, intuition, empathy, and the willingness to take action are additional components of critical thinking. These same skills are necessary to some degree in decision making and problem solving. See Display 1.2 for some additional characteristics of a critical thinker.

Insight, intuition, empathy, and the willingness to take action are components of critical thinking.

VICARIOUS LEARNING TO INCREASE PROBLEM-SOLVING AND DECISION-MAKING SKILLS

Decision making is one step in the problem-solving process, an important task that relies heavily on critical-thinking skills (Marquis & Huston, 1995). How do people become successful problem solvers and decision makers? Although successful decision making can be learned through life experience, not everyone learns to solve

Display 1.1

Six Cognitive Skills Used in Critical Thinking

Interpretation: involves clarifying meaning Analysis: understanding data Evaluation: determining outcome Inference: drawing conclusions Explanation: justifying actions based on data Self-regulation: examining ones professional practice
Adapted from Ignatavicius, D. D. (2001). Critical thinking skills for at-the-bedside nurse. Nursing Management, 32[1], 3739.

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Display 1.2
Open to new ideas Intuitive Energetic Analytical Persistent Assertive Communicator

Characteristics of a Critical Thinker

Flexible Empathic Caring Observant Risk-taker Resourceful Out of the box thinker Creative Insightful Willing to take action Outcome-directed Willing to change Knowledgeable

problems and judge wisely by this trial-and-error method because much is left to chance. Some educators feel that people are not successful in problem solving and decision making because individuals are not taught how to reason insightfully from multiple perspectives. Belcher (2000) maintains that managers critical thinking skills can be improved by having students write management case studies for analysis. She thinks that improved critical thinking skills have a positive effect on the quality of a manager's decision making and problem solving skills. Ignatavicious (2001) feels that anyone can learn critical thinking, but it is a long-term process that must be practiced, nurtured, and reinforced.

The Marquis-Huston Critical-Thinking Teaching Model

The desired outcome for teaching and learning decision making and critical thinking in management is an interaction between learners and others that results in the ability to critically examine management and leadership issues. This is a learning of appropriate social and professional behaviors rather than a mere acquisition of knowledge. This type of learning occurs best in groups; therefore, when teaching management and leadership the group process should be used in some way. Additionally, learners retain didactic material more readily when it is personalized or when they can relate to the material being presented. The use of case studies that learners can identify with assists in retention of didactic material presented. While formal instruction in critical thinking is important, Clancy (2003) maintains that using a formal decision-making process is mandatory for successful decision making. So often new leaders and managers struggle to make quality decisions because their opportunity to practice making management and leadership decisions is very limited until they are appointed to a management position. These limitations can be overcome by creating opportunities for vicariously experiencing the problems that individuals would encounter in the real world of leadership and management. The Marquis-Huston Critical-Thinking Teaching Model assists in achieving desired learner outcomes (Figure 1.1). Basically, the model depicts four overlapping spheres, each being an essential component for teaching leadership and management. There needs to be a didactic theory component, such as the material that is presented in each chapter; secondly, a formalized approach to problem solving and decision making must be used. Thirdly, there must be some use of the group

CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management

Didactic theory

Problem solving

Personalized learning

Group process

Figure 1.1 The Marquis-Huston Critical-Thinking Teaching Model.

process, which can be accomplished by the use of large and small groups and classroom discussion. Lastly the material must be made real for the learner so that the learning is internalized. This can be accomplished through writing exercises, personal exploration, values clarification, and risk-taking that is involved as case studies are examined. This book was developed with the perspective that experiential learning provides mock experiences that have tremendous value in applying leadership and management theory. Throughout this text the authors have included numerous opportunities for readers to experience the real world of leadership and management. Some of these learning situations, which are called learning exercises, include case studies, writing exercises, specific management or leadership problems, staffing and budgeting calculations, group discussion or problem solving, and assessment of personal attitudes and values. Some exercises include opinions, speculation, and value judgments. Since almost all the learning exercises require critical thinking, problem solving, or decision making to some degree, the remainder of this chapter will focus on providing a theoretical foundation for leadership and management problem solving.

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THEORETICAL APPROACHES TO PROBLEM SOLVING AND DECISION MAKING

Clancy (2003) states that there is a great tendency in decision making to bypass a thorough analysis and jump too quickly into solutions. Process and structure are beneficial to the process of decision making and force people to be specific about options and to separate probabilities from values. A structured approach to problem solving and decision making increases critical reasoning and is the best way to learn how to make quality decisions because it eliminates trial and error and focuses the learning on a proven process. A structured or professional approach involves applying a theoretical model in problem solving and decision making. To improve decision-making ability, it is important to use an adequate process model as the theoretical base for understanding and applying critical-thinking skills. Many acceptable problem-solving models exist, and most include a decisionmaking step; only four are reviewed here.

A structured approach to problem solving and decision making increases critical reasoning.

Traditional Problem-Solving Process

The traditional problem-solving model is widely used and is perhaps the most well known of the various models. The seven steps follow. (Decision-making occurs at step 5.) 1. Identify the problem. 2. Gather data to analyze the causes and consequences of the problem. 3. Explore alternative solutions. 4. Evaluate the alternatives. 5. Select the appropriate solution. 6. Implement the solution. 7. Evaluate the results. Although the traditional problem-solving process is an effective model, its weakness lies in the amount of time needed for proper implementation. This process, therefore, is less effective when time constraints are a consideration. Another weakness is lack of an initial objective-setting step. Setting a decision goal helps to prevent the decision maker from becoming sidetracked.

The Managerial Decision-Making Process

The managerial decision-making model, a modified traditional model, eliminates the weakness of the traditional model by adding a goal-setting step. Harrison (1981) has delineated the following steps in the managerial decision-making process: 1. Set objectives. 2. Search for alternatives. 3. Evaluate alternatives. 4. Choose. 5. Implement. 6. Follow up and control. The managerial decision-making process flows in much the same manner as the nursing process. A comparison of the simplified nursing process and a model of decision-making are shown in Table 1.1.

CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management

Table 1.1 Comparing the Decision-Making Process with the Nursing Process Decision-Making Process
Identify the decision Collect data Identify criteria for decision Identify alternatives Choose alternative Implement alternative Evaluate steps in decision

Simplified Nursing Process

Assess Plan Implement Evaluate

The Nursing Process

The nursing process provides another theoretical system for solving problems and making decisions. Educators have identified the nursing process as an effective decision-making model, although there is current debate about its effectiveness as a clinical reasoning model (Pesut & Herman, 1998). As a decision-making model, the nursing process has a strength that the previous two models lack, namely its feedback mechanism. The arrows in Figure 1.2 show constant input into the process. When the decision point has been identified, initial decision-making occurs and continues throughout the process by using a feedback mechanism. Although the process was designed for nursing practice with regard to patient care and nursing accountability, it can easily be adapted as a theoretical
Figure 1.2 Feedback mechanism of the nursing process.

Assess

Diagnose

Evaluate

Plan

Implement

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model for solving leadership and management problems. Table 1.1 shows how closely the nursing process parallels the decision-making process. The weakness of the nursing process, like the traditional problem-solving model, is in not requiring clearly stated objectives. Goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured. However, because nurses are familiar with this process and its proven effectiveness, it continues to be recommended as an adapted theoretical process for leadership and managerial decision making. Many other excellent problem analysis and decision models exist. The model selected should be one with which the decision maker is familiar and one appropriate for the problem to be solved. Using models or processes consistently will increase the likelihood that critical analysis will occur. By cultivating a scientific approach, the quality of ones management and leadership problem solving and decision making will improve tremendously.

Intuitive Decision-Making Model

According to Hansten and Wahburn (2000), many nursing scientists in the past did not value intuition in decision making as they felt intuitive reasoning did not align itself well with the status and power of a true science. Recently, however, there has been a renewed interest in intuitive thinking and Ignatavicious (2001) identifies it as one of the characteristics of an expert critical thinker. It must be remembered, however, that intuition can be overpowered by emotions. Therefore, using an intuitive decision-making model is helpful in order to prevent emotions from clouding the decision-making process. Romiszowski (1981) built on the nursing process in creating the intuitive decisionmaking model shown in Figure 1.3. In this model, the decision maker consciously

1. Assess

2. Recall Possible Nursing Diagnosis and Interventions

Gather Patient Data

4. Implement/ Evaluate Implement Follow Through Evaluate

Patient 3. Plan Analyze Synthesize Exercise Judgment

Figure 1.3 Intuitive decision-making model (Romiszowski, 1981). Reprinted with permission of Journal of Nursing Staff Development.

CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management

incorporates recall or cumulative knowledge that comes from education, both formal and informal, as well as experience, in planning the decision. Inexperienced or novice decision makers spend more time in the assessment, recall, and planning phases, whereas experienced decision makers gather information, recall, and often leap directly to implementation, because planning has become automatic. That novice nurses and experienced nurses process information differently has been supported by Benner (1994). Ironically, this leap from information gathering to implementation may be the greatest weakness of this model. In discussing intuitive decision making, Lamond and Thompson (2000) warn that since the process is largely invisible, there is little information to evaluate if the outcome of the decision is less than positive. Learning Exercise 1.1
Applying Scientific Models to Decision Making You are an RN who graduated three years ago. During the last three years, your responsibilities in your first position have increased. Although you enjoy your family (husband and one preschool-age child), you realize that you love your job, and your career is very important to you. Recently, you and your husband decided to have another baby. At that time, you discussed your career and both of you reached a joint decision that, if you had another baby, you wanted to reduce your work time and spend more time at home with the children. Last week, you were thrilled and excited when your supervisor told you the charge nurse is leaving and that she wants to appoint you to the position. Yesterday, you found out that you are pregnant. Last night, you and your husband talked about your career future. He is an attorney whose practice has suddenly gained momentum. Although he has shared child rearing equally with you until this point, he is not sure how much longer he will be able to do so if his practice continues to expand. If you take the position, which you would like to do, it would mean full-time work. You want the decision you and your husband reach to be well thought-out as it has far-reaching consequences and concerns many people. Assignment: Using a scientific approach (one of the four models just discussed), determine what you should do. After you have made your decision, get together in a group (four to six people) and share your resolution. Were your decisions the same? How did you approach the problem solving differently from others in your group? Did some of the group members identify alternatives you had not considered? How did your personal values influence your decision?

CRITICAL ELEMENTS IN PROBLEM SOLVING AND DECISION MAKING

Because decisions may have far-reaching consequences, problem solving and decision making must be of high quality. Using a scientific approach to problem solving and decision making does not, however, ensure a quality decision. Special attention must be paid to other critical elements. The following elements, considered crucial in the problem-solving process, frequently result in poor-quality decisions.

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Define Objectives Clearly

Decision makers often forge ahead in their problem-solving process without first determining their goal. Even when decisions must be made quickly, there is time to pause and reflect on the purpose of the decision. If a decision lacks a clear objective or if an objective is not consistent with the individuals or organizations stated philosophy, a poor-quality decision is likely. Sometimes the problem has been identified but the wrong objectives are set. Problems can be extremely complex and may need multiple objectives (Clancy, 2003).

Gather Data Carefully

Because decisions are based on knowledge and information available to the problem solver at the time the decision must be made, one must learn how to process and obtain accurate information. The acquisition of information begins with identifying the problem or the occasion for the decision and continues throughout the problem-solving process. Often the information is unsolicited, but most information is sought actively. Acquiring information always involves people, and no tool or mechanism is infallible to human error. Human values tremendously influence our perceptions. Therefore, as problem solvers gather information, they must be vigilant that their own preferences and those of others are not mistaken for facts. Remember that facts can be misleading if they are presented in a seductive manner or taken out of context or if they are past-oriented. Numerous parents have been misled by the factual statement, Johnny hit me. In this case, the information seeker needs to do more fact finding. What was the accuser doing before Johnny hit him? What was he hit with? Where was he hit? When was he hit? Like the parent, the manager who becomes expert at acquiring adequate, appropriate, and accurate information will have a head start in becoming an expert decision maker and problem solver. To gain knowledge and insight into managerial and leadership decision making, individuals must reach outside their current sphere of knowledge in solving the problems presented in this text. Some data-gathering sources include textbooks, periodicals, experts in the field, colleagues, and current research. Questions that should be examined in data gathering are: What is the setting? What is the problem? Where is it a problem? When is it a problem? Who is affected by the problem? Is this your problem or someone elses problem? What is happening? Why is it happening? What are the causes of the problem? Can the causes be prioritized? 9. What are the basic underlying issues? What are the areas of conflict? 10. What are the consequences of the problem? Which is the most serious? 1. 2. 3. 4. 5. 6. 7. 8.

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Learning Exercise 1.2

Gathering Necessary Information Identify a poor decision you recently made because of faulty data gathering. Have you ever made a poor decision because necessary information was intentionally or unintentionally withheld from you?

Generate Many Alternatives

The definition of decision-making implies there are at least two choices in every decision. Unfortunately, many problem solvers limit their choices to two when many more options usually are available. The greater the number of alternatives that can be generated during this phase, the greater the chance that the final decision will be sound. When seeking alternatives, individuals need to expand their horizons; the most common trap managers fall into is limiting the borders of their decision frames (Clancy, 2003). Remember that one alternative in each decision should be the choice not to do anything. When examining decisions to be made using a formal process, it is often found that the status quo is the right alternative. Several techniques can help generate more alternatives. Involving others in the process confirms the adage that two heads are better than one. Because everyone thinks uniquely, increasing the number of people working on a problem increases the number of alternatives that can be generated.

Learning Exercise 1.3

Possible Alternatives in Problem Solving In the personal choice scenario presented in Learning Exercise 1.1, some of the following alternatives could have been generated: Do not take the new position. Hire a full-time housekeeper, and take the position. Ask your husband to quit his job. Have an abortion. Ask one of the parents to help. Take the position, and do not hire child care. Take the position and hire child care. Have your husband reduce his law practice and continue helping with child care. Ask the supervisor if you can work four days a week and still have the position. Take the position and wait and see what happens after the baby is born. Assignment: How many of these alternatives did you or your group generate? What alternatives did you identify that are not included in this list?

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Brainstorming is another frequently used technique. The goal in brainstorming is to think of all possible alternatives, even those that may seem off target. By not limiting the possible alternatives to only apparently appropriate ones, people are able to break through habitual or repressive thinking patterns and allow new ideas to surface. Although most often used by groups, people making decisions alone also may use brainstorming. Clancy (2003) suggests that once a large number of alternatives are generated that the list be revised so that the decision maker is left with three or four, as any more may create too many variables and factors to evaluate effectively.

Think Logically
During the problem-solving process, one must draw inferences from information. An inference is part of deductive reasoning. People must carefully think through the information and the alternatives. Clancy (2003) states that among other things, deep-seated biases often cloud effective decision making. Faulty logic at this point may lead to poor-quality decisions. People think illogically primarily in three ways. 1. Overgeneralizing. This type of crooked thinking occurs when one believes that because A has a particular characteristic, every other A also has the same characteristic. An example of this thinking is when stereotypical statements are used to justify arguments and decisions. 2. Affirming the consequences. In this type of illogical thinking, one decides that if B is good but he or she is doing A, then A must not be good. For example, if a new method is heralded as the best way to perform a nursing procedure and the nurses on your unit are not using that technique, it is illogical to assume that the technique currently used in your unit is wrong or bad. 3. Arguing from analogy. This thinking applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects. An example of this would be to argue that because intuition plays a part in clinical and managerial nursing, then any characteristic present in a good clinical nurse also should be present in a good nursemanager. However, this is not necessarily true; a good nurse manager does not necessarily possess all the same skills as a good nurse clinician. Various tools have been designed to assist managers with the important task of analysis. Several of these tools are discussed later in Chapter 2. In analyzing possible solutions, individuals may want to look at the following questions: 1. What factors can you influence? How can you make the positive factors more important and minimize the negative factors? 2. What are the financial implications in each alternative? The political implications? Who else will be affected by the decision and what support is available? 3. What are the weighting factors? 4. What is the best solution? 5. What are the means of evaluation? 6. What are the consequences of each alternative?

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Choose and Act Decisively

It is not enough to gather adequate information, think logically, select from among many alternatives, and be aware of the influence of ones values. In the final analysis, one must act. Individuals may become vulnerable at this last point in the problem-solving process and choose to delay acting because they lack the courage to face the consequences of their choices. For example, if managers granted all employees requests for days off, they would have to accept the consequences of their decision by dealing with short staffing. It may help the reluctant decision maker to remember that decisions, although often having long-term consequences and far-reaching effects, are not cast in stone. In many cases, judgments found to be ineffective or inappropriate can be changed. By evaluating decisions at a later time, managers can learn more about their abilities and where the problem solving was faulty. However, decisions must continue to be made, although some are of poor quality, because through continued decision making, people develop increased decision-making skills (Display 1.3).

INDIVIDUAL VARIATIONS IN DECISION MAKING

If each person receives the same information and uses the same scientific approach to solve problems, an assumption could be made that identical decisions would result. However, in practice, this is not true. Because decision making involves perceiving and evaluating, and people perceive by sensation and intuition and evaluate their perception by thinking and feeling, it is inevitable that individuality plays a part in decision making. Because everyone has different values and life experiences, and each person perceives and thinks differently, different decisions may be made given the same set of circumstances. No discussion of decision making would, therefore, be complete without a careful examination of the role of the individual in decision making (see Display 1.4).

Values
Individual decisions are based on each persons value system. No matter how objective the criteria, value judgments will always play a part in a persons decision making, either consciously or subconsciously. The alternatives generated and the final choice selected are limited by each persons value system. For some, certain choices

Display 1.3

Critical Elements in Decision Making

Define objectives clearly Gather data carefully Generate many alternatives Think logically Choose and act decisively

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Display 1.4

Individual Variations in Decision Making

Values Life experience Individual preference Individual ways of thinking and decision making

are not possible because of a persons beliefs. Because values also influence perceptions, they invariably influence information gathering, information processing, and final outcome (Marquis & Huston, 1995). Values also determine which problems in ones personal or professional life will be addressed or ignored.

Life Experience
Each person brings to the decision-making task past experiences that include education and decision-making experience. The more mature the person and the broader his or her background, the more alternatives he or she can identify. Each time a new behavior or decision is observed, that possibility is added to the persons repertoire of choices. People vary in their desire for autonomy, so some nurses may want more autonomy than others. It is likely that people seeking autonomy may have much more experience at making decisions than those who fear autonomy. Likewise, having made good or poor decisions in the past will influence a persons decision making.

Individual Preference
With all the alternatives a person considers in decision making, one alternative may be preferred over another. The decision maker, for example, may see certain choices as involving greater personal risk than others and therefore may choose the safer alternative. Physical, economic, and emotional risks, and time and energy expenditures, are types of personal risk and costs involved in decision making. For example, those with limited finances or a reduced energy level may decide to select an alternative solution to a problem that would not have been their first choice had they been able to overcome limited resources.

Individual Ways of Thinking and Decision Making

Our way of evaluating information and alternatives on which we base our final decision constitutes a thinking skill. Individuals think differently. Some think systematicallyand are often called analytical thinkerswhereas others think intuitively. It is believed that most people have either right- or left-brain hemisphere dominance (Good, 2002). Although the authors encourage whole-brain thinking, and studies have shown that people can strengthen the use of the less dominant side of the brain, most people continue to have a dominant side. Analytical,

CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management 15

linear, left-brain thinkers process information differently than creative, intuitive, right-brain thinkers. Intuition is the ability to understand the possibilities inherent in a situation. Some feel that there is a gender difference in how we think and behave. Rudans research (2003) looked at how male and female leaders behaved differently and noted that males and females socialized and communicated differently; males paid much less attention to relationships and resisted being influenced. These differences have the potential to effect decision making. The way one thinks has much to do with individual problem solving and decision making. There is no evidence that either right- or left-brain thinking is preferable. In the past, organizations openly recognized the value of logical, analytical thinkers but more recently have acknowledged that intuitive thinking is a valuable managerial resource. It is felt that right-brain thinkers are more creative, but the current emphasis in teaching and learning is to encourage whole-brain thinking (Good, 2002).

Learning Exercise 1.4

Thinking Styles In a group discussion, examine how each individual in the group thinks. Do you have a majority of individuals with right- or left-brain dominance in your group? Do more women than men belong to one group? Discuss what type of thinkers are represented in your family. Did most individuals in your group have a variety of thinkers in their family?

OVERCOMING INDIVIDUAL VULNERABILITY IN DECISION MAKING

How do people overcome subjectivity in making decisions? This can never be completely overcome, nor should it. After all, life would be boring if everyone thought alike. However, managers and leaders must become aware of their own vulnerability and recognize how it influences and limits the quality of their decision making. Using the following suggestions will help decrease individual subjectivity and increase objectivity in decision making.

Values
Being confused and unclear about ones values may affect decision-making ability (Huston & Marquis, 1995). Overcoming a lack of self-awareness through values clarification decreases confusion. People who understand their personal beliefs and feelings will have a conscious awareness of the values on which their decisions are based. This awareness is an essential component of decision making and critical thinking. Therefore, to be successful problem solvers, managers must periodically examine their values. Values clarification exercises are included in Chapter 7.

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Life Experience
It is difficult to overcome inexperience when making decisions. Benner (1994) refers to this lack of experience as reason in transition. However, a person can do some things to decrease this area of vulnerability. First, use available resources, including current research and literature, to gain a fuller understanding of the issues involved. Second, involve other people, such as experienced colleagues, trusted friends, or superiors, to act as sounding boards and advisors. Third, analyze decisions later to assess their success. By evaluating decisions, people learn from mistakes and are able to overcome inexperience.

Individual Preference
Overcoming this area of vulnerability involves self-awareness, honesty, and risk taking. The need for self-awareness was discussed previously, but it is not enough to be self-aware; people also must be honest with themselves about their choices and their preferences for those choices. Additionally, the successful decision maker must take some risks. Nearly every decision has some element of risk, and most involve consequences and accountability. Those who are able to do the right but unpopular thing and who dare to stand alone will emerge as leaders.

Individual Ways of Thinking

People who make decisions alone are frequently handicapped because they are not able to understand problems fully or make decisions from both an analytical and intuitive perspective. However, in most organizations, both types of thinkers may be found. Using group process, talking management problems over with others, and developing whole-brain thinking also are methods for ensuring that both intuitive and analytical approaches will be used in solving problems and making decisions. Use of heterogeneous rather than homogeneous groups will usually result in better-quality decision making. See Display 1.5 for more information. Indeed, learning to think outside the box is often accomplished by including a diverse group of thinkers to solve problems and make decisions. It is good organizational theory for leaders to surround themselves with a variety of talented people,

Display 1.5

Qualities of Successful Decision Makers

Although not all experts agree, Huston (1990) suggests that the following are qualities of successful decision makers: Courage. Courage is of particular importance and involves the willingness to take risks. Sensitivity. Good decision makers seem to have some sort of antenna that makes them particularly sensitive to situations and others. Energy. People must have the energy and desire to make things happen. Creativity. Successful decision makers tend to be creative thinkers. They develop new ways to solve problems.

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including individuals who sometimes have strange ideas and are out of the box thinkers (Ignatavicius, 2001).

DECISION MAKING IN ORGANIZATIONS

In the beginning of this chapter the need for managers and leaders to make quality decisions was emphasized. The effect of the individuals values and preferences on the decision making process was discussed. But it is important for leaders and managers to also understand how the organization influences the decision-making process. Since organizations are made up of people with differing values and preferences, there is often conflict in organizational decision dynamics.

Effect of Organizational Power on Decision Making

Powerful people in organizations are more apt to have decisions made (by themselves or their subordinates) that are congruent with their own preferences and values. On the other hand, people wielding little power in organizations must always consider the preference of the powerful when they make management decisions. Power is frequently part of the decision factor (Good, 2003). In organizations choice is constructed and constrained by many factors, and therefore choice is not equally available to all people. Additionally, not only does the preference of the powerful influence decisions of the less powerful, but the powerful also are able to inhibit the preferences of the less powerful. This occurs because individuals who remain and advance in organizations are those who feel and express values and beliefs congruent with the organization. Therefore, a balance must be found between the limitations of choice posed by the power structure within the organization and totally independent decision making that could lead to organizational chaos. The ability of the powerful to influence individual decision making in an organization often requires adopting a private personality and an organizational personality. For example, some might believe they would have made a different decision had they been acting on their own, but they went along with the organizational decision. This going along in itself constitutes a decision; people choose to accept an organizational decision that differs from their own preferences and values. The concept of power in organizations is discussed more fully in Chapter 13.

The ability of the powerful to influence individual decision making in an organization often requires adopting a private personality and an organizational personality.

Rational and Administrative Decision Making

For many years, it was widely believed that most managerial decisions were based on a careful, scientific, and objective thought process and managers made decisions in a rational manner. In the late 1940s, Herbert A. Simons classic work revealed that most managers made many decisions that did not fit the objective rationality theory. Simon (1965) delineated two types of management decision makers: the economic man and the administrative man. Managers who are successful decision makers attempt to make rational decisions, much like the economic person described in Table 1.2. Because they realize

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Table 1.2 Comparing the Economic Man with the Administrative Man Economic
Makes decisions in a very rational manner. Has complete knowledge of the problem or decision situation. Has a complete list of possible alternatives. Has a rational system of ordering preference of alternatives. Selects the decision that will maximize utility function.
Adapted from Simon, 1965.

Administrative
Makes decisions that are good enough. Because complete knowledge is not possible, knowledge is always fragmented. Because consequences of alternatives occur in the future, they are impossible to predict accurately. Usually chooses from among a few alternatives, not all possible ones. The final choice is satisficing rather than maximizing.

that restricted knowledge and limited alternatives directly affect a decisions quality, these managers gather as much information as possible and generate many alternatives. Simon believed that the economic model was an unrealistic description of organizational decision making. The complexity of acquiring information makes it impossible for the human brain to store and retain the amount of information that is available for each decision. Because of time constraints and the difficulty of assimilating large amounts of information, most management decisions are made using the administrative model of decision making. The administrative person never has complete knowledge and generates fewer alternatives. Simon argued that the administrative person carries out decisions that are only satisficing, a term used to describe decisions that may not be ideal but result in solutions that have adequate outcomes. These managers want decisions to be good enough so that they work, but they are less concerned that the alternative selected is the optimal choice. The best choice for many decisions is often found to be too costly in terms of time or resources, so another less costly but workable solution is found.

SUMMARY
This chapter has discussed effective decision making, problem solving, and critical thinking as requisites for being a successful leader and manager. The effective leadermanager is aware of the need for sensitivity in decision making. The successful decision maker possesses courage, energy, and creativity. It is a leadership skill to recognize the appropriate people to include in decision making and to use a suitable theoretical model for the decision situation. The manager should develop a systematic, scientific approach to problem solving that begins with a fixed goal and ends with an evaluation step. Managers who make quality decisions are effective administrators.

CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management 19

The integrated leadermanager understands the significance that personal values, life experience, preferences, and ways of thinking have upon selected alternatives in making the decision. The critical thinker pondering a decision is aware of the areas of vulnerability that hinder successful decision making and will expend his or her efforts to avoid the pitfalls of faulty logic and data gathering. Both managers and leaders understand the impact the organization has on decision making and that some decisions that will be made in the organization will be only satisficing. However, leaders will strive to problem solve adequately in order to reach optimal decisions as often as possible.

Key Concepts
The professional decision maker is self-aware, courageous, sensitive, ener
getic, and creative. The professional approach to problem solving begins with a fixed goal and ends with an evaluation process. The successful decision maker understands the significance that each persons values, life experience, preferences, and way of thinking have on selected alternatives. The critical thinker is aware of areas of vulnerability that hinder successful decision making and makes efforts to avoid the pitfalls of faulty logic in his or her data gathering. The act of making and evaluating decisions increases the expertise of the decision maker. There are many models for improving decision making. Using a model reduces trial and error and increases the probability that decisions made will be sound. Left- and right-brain dominance influences to some degree how individuals think. Two major considerations in organizational decision making are how power affects decision making and whether management decision making needs to only be satisficing.

More Learning Exercises and Applications

These exercises may be discussed individually, in groups, or used as written assignments.

Learning Exercise 1.5

Evaluating Decision Making Describe the two best decisions you have made in your life and the two worst. What factors assisted you in making the wise decisions? What elements of critical thinking went awry in your poor decision making? How would you evaluate your decision making ability?

20 UNIT 1 I A New Approach to Leadership and Management

Learning Exercise 1.6

Profile Examining Examine the process you used to decide to become a nurse. Would you describe it as fitting a profile of the economic or the administrative model?

Learning Exercise 1.7

Considering Critical Elements in Decision Making You are a college senior and president of your nursing organization. You are on the committee to select a slate of officers for the next academic year. Several of the current officers will be graduating and you want the new slate of officers to be committed to the organization. Some of the brightest members of the junior class that are involved in the organization are not well liked by some of your friends in the organization. Assignment: Looking at the critical elements in decision making compile a list of the most important points to consider in making the decision for selection of a slate of officers. What must you guard against and how should you approach the data gathering to solve this problem?

Learning Exercise 1.8

Examining the Decision-Making Process You have been a staff nurse for three years, since your graduation from nursing school. There is a nursing shortage in your area and many openings at other facilities. Additionally, you have been offered a charge nurse position at your present employment. Lastly, you have always wanted to do community health nursing and know that this is also a possibility. You are self-aware enough to know that it is time for a change, but which change should you make, and how should you make the decision? Assignment: Examine both the individual aspects of decision making and the critical elements in making decisions. Make a plan including a goal, a list of information and data that you need to gather and areas where you may be vulnerable to successful decision making. Examine the consequences of each alternative available to you. After you have done this, as an individual, form a small group and share your decision making planning with members of your group. How was your decision making like others in the group and how was it different?

CHAPTER 1 I Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management 21

Learning Exercise 1.9

Using Models in Decision Making Do you use a problem-solving or decision-making model to solve problems? Have you ever used an intuitive model? Think of a critical decision you have made in the last year. What model, if any, did you use? Assignment: Write a one-page essay about a problem you solved or a decision that you made this year. Describe what theoretical model you use to assist you in the process. Determine if you consciously used the model or if it was purely by accident. Did you enlist the help of other experts in solving the problem?

Learning Exercise 1.10

Step-by-Step Problem Solving You are a home-health nurse who makes in-home visits to a moribund elderly man with advanced cancer. He is now confined to bed, and his major care needs are comfort-based. In addition to directly providing pain medication to this man, you, as a case manager, are responsible for overseeing other personnel who assist in caring for him. These personnel include rotating health aides who are responsible for bathing the patient, preparing his meals, and providing other basic care not requiring a professional license. The patients family generally stays with him at night. At times, during your in-home visits, you have noticed that there are food crumbs in the bed, that the patients hair is uncombed, and that his teeth have not been brushed, and you suspect that he has not been recently bathed. Assignment: Use one of the problem-solving or decision-making models in this chapter and do the following: 1. Identify a brief (no longer than one or two sentences) problem statement for this case. 2. Determine who owns the problem. 3. List at least three goals or objectives to guide your problem solving. 4. Detail at least three key pieces of information you must consider in data gathering. 5. List at least six alternatives for solving this case, including the pros and cons of each. 6. Identify at least four specific criteria you will use to evaluate your final decision and/or choice of action. Be sure these criteria reflect the decision-making process you used as well as the desired outcome. If time allows, divide into small groups and share the results of your problem solving.

22 UNIT 1 I A New Approach to Leadership and Management

Web Links
Judgment and Decision Making http://www.sjdm.org Promotes the study of normative, descriptive theories of decision processes. http://www.hooah4health.com/spirit/decisions.htm Free tools you can use to solve problems and make decisions in your life. Mission Critical http://www.sjsu.edu/depts/itl The goal of this site is to teach visitors the basic concepts of critical thinking, deductive reasoning, and finding faults in dubious arguments. The site provides tutorials, exercises, and links to related Web sites. References
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Bibliography
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