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UNIT 1 A New Approach to Leadershipand Management

C H A P T E R

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Decision Making, ProblemSolving, and Critical Thinking:Requisites for SuccessfulLeadership and Management

The successful nurse executive has the ability

to make good decisions consistently.

—Thomas R. Clancy

2 UNIT 1 � A New Approach to Leadership and Management

To cope with the realities of today’s health care system, nurses must be prepared tobe critical thinkers. They must also be ready to welcome change and thrive in rap-idly changing environments. Chapter 1 explores the primary requisites for success-ful management and leadership: problem solving, critical thinking, and decisionmaking. Decision making is often thought to be synonymous with managementand is one of the criteria on which management expertise is judged. Much of anymanager’s time is spent critically examining issues, solving problems, and makingdecisions. It is the authors’ belief that problem solving, decision making, and criti-cal thinking are learned skills that improve with practice. So that the processes canbe consistently replicated, these learned skills rely heavily on established tools,techniques, and strategies.

The quality of the leader–managers’ decisions is the factor that weighs mostheavily in their success or failure. Decision making is both the innermost leadershipactivity and the core of management. Therefore, effective leaders and managersmust 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 thedevelopment of management theory and management decision-making tools inChapter 2; and examines leadership theory from historical to contemporary per-spectives in Chapter 3. Chapter 1 introduces the reader to problem solving,decision making, and critical thinking and provides several problem-solving anddecision-making models that assist leaders and managers in making quality deci-sions. It also introduces the learning exercise as a new approach for gaining skill inmanagement and leadership decision making.

DECISION MAKING, PROBLEM SOLVING, AND CRITICAL THINKING

Decision making is a complex, cognitive process often defined as choosing a partic-ular course of action. Webster’s definition—to “judge or settle”—is another view ofdecision making. Both definitions imply that there was doubt about several coursesof action and that a choice was made that eliminated the uncertainty.

Problem solving is part of decision making. A systematic process that focuses onanalyzing a difficult situation, problem solving always includes a decision-makingstep. Many educators use the terms problem solving and decision making synony-mously, but there is a small yet important difference between the two. Althoughdecision making is the last step in the problem-solving process, it is possible fordecision making to occur without the full analysis required in problem solving.Because problem solving attempts to identify the root problem in situations, muchtime and energy are spent on identifying the real problem. Decision making, on theother hand, is usually triggered by a problem but is often handled in a manner thatdoes not eliminate the problem. For example, a person who handled a conflict cri-sis when it occurred but did not attempt to identify the real problem causing the

conflict, used only decision-making skills. The decision maker might later chooseto address the real cause of the conflict or might decide to do nothing at all aboutthe problem. The decision has been made not to problem solve. This alternativemay be selected because of a lack of energy, time, or resources to solve the real prob-lem adequately. In some situations, this is an appropriate decision.

Here is an example of a decision not to solve a problem. A nursing supervisorhas a staff nurse who has been absent a great deal during the last 3 months. How-ever, the supervisor has reliable information that the nurse will be resigning soon toreturn to school in another state. Because the problem will soon no longer exist, thesupervisor decides that the time and energy needed to correct the problem are notwarranted.

Critical thinking, sometimes referred to as reflective thinking, is related to evalu-ation and has a broader scope than decision making and problem solving. “Criticalthinking is purposeful, outcome-directed thinking that is based on a body ofknowledge derived from research and other sources of evidence” (Ignatavicius,2001, p. 38). Components of critical thinking include reasoning and creative analy-sis. 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 ismore complex than problem solving or decision making, involves higher-order rea-soning and evaluation, and has both a cognitive and affective component. Theauthors believe that insight, intuition, empathy, and the willingness to take actionare additional components of critical thinking. These same skills are necessary tosome degree in decision making and problem solving. See Display 1.2 for someadditional characteristics of a critical thinker.

VICARIOUS LEARNING TO INCREASE PROBLEM-SOLVING ANDDECISION-MAKING SKILLS

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

3CHAPTER 1 � Decision Making, Problem Solving, and Critical Thinking: Requisites for Successful Leadership and Management

Interpretation: involves clarifying meaningAnalysis: understanding dataEvaluation: determining outcomeInference: drawing conclusionsExplanation: justifying actions based on dataSelf-regulation: examining one’s professional practice Adapted from Ignatavicius, D. D. (2001). Critical thinking skills for at-the-bedside nurse. Nursing Management, 32[1],

37–39.

Six Cognitive Skills Used in Critical Thinking Display 1.1

Insight, intuition,empathy, and thewillingness to takeaction are componentsof critical thinking.


problems and judge wisely by this trial-and-error method because much is left tochance.

Some educators feel that people are not successful in problem solving and deci-sion making because individuals are not taught how to reason insightfully frommultiple perspectives. Belcher (2000) maintains that managers’ critical thinkingskills can be improved by having students write management case studies for analy-sis. She thinks that improved critical thinking skills have a positive effect on thequality 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 processthat must be practiced, nurtured, and reinforced.

The Marquis-Huston Critical-Thinking Teaching Model

The desired outcome for teaching and learning decision making and critical think-ing in management is an interaction between learners and others that results in theability to critically examine management and leadership issues. This is a learning ofappropriate social and professional behaviors rather than a mere acquisition ofknowledge. This type of learning occurs best in groups; therefore, when teachingmanagement and leadership the group process should be used in some way.

Additionally, learners retain didactic material more readily when it is personal-ized or when they can relate to the material being presented. The use of case stud-ies that learners can identify with assists in retention of didactic material presented.

While formal instruction in critical thinking is important, Clancy (2003) main-tains that using a formal decision-making process is mandatory for successful deci-sion making. So often new leaders and managers struggle to make quality decisionsbecause their opportunity to practice making management and leadership decisionsis very limited until they are appointed to a management position. These limitationscan be overcome by creating opportunities for vicariously experiencing the problemsthat individuals would encounter in the real world of leadership and management.

The Marquis-Huston Critical-Thinking Teaching Model assists in achievingdesired learner outcomes (Figure 1.1). Basically, the model depicts four overlap-ping spheres, each being an essential component for teaching leadership and man-agement. There needs to be a didactic theory component, such as the material thatis presented in each chapter; secondly, a formalized approach to problem solvingand decision making must be used. Thirdly, there must be some use of the group

Open to new ideas Flexible CreativeIntuitive Empathic InsightfulEnergetic Caring Willing to take actionAnalytical Observant Outcome-directedPersistent Risk-taker Willing to changeAssertive Resourceful KnowledgeableCommunicator “Out of the box” thinker

Characteristics of a Critical ThinkerDisplay 1.2

process, which can be accomplished by the use of large and small groups and class-room discussion. Lastly the material must be made real for the learner so that thelearning is internalized. This can be accomplished through writing exercises, per-sonal exploration, values clarification, and risk-taking that is involved as case stud-ies are examined.

This book was developed with the perspective that experiential learning pro-vides mock experiences that have tremendous value in applying leadership andmanagement theory. Throughout this text the authors have included numerousopportunities for readers to experience the real world of leadership and manage-ment. Some of these learning situations, which are called learning exercises, includecase studies, writing exercises, specific management or leadership problems,staffing and budgeting calculations, group discussion or problem solving, andassessment of personal attitudes and values. Some exercises include opinions, spec-ulation, and value judgments. Since almost all the learning exercises require criticalthinking, problem solving, or decision making to some degree, the remainder ofthis chapter will focus on providing a theoretical foundation for leadership andmanagement problem solving.


Didactictheory

Personalizedlearning

Groupprocess

Problemsolving

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


THEORETICAL APPROACHES TO PROBLEM SOLVING AND DECISION MAKING

Clancy (2003) states that there is a great tendency in decision making to bypass athorough analysis and jump too quickly into solutions. Process and structure arebeneficial to the process of decision making and force people to be specific aboutoptions and to separate probabilities from values. A structured approach to prob-lem solving and decision making increases critical reasoning and is the best way tolearn how to make quality decisions because it eliminates trial and error and focus-es the learning on a proven process. A structured or professional approach involvesapplying a theoretical model in problem solving and decision making.

To improve decision-making ability, it is important to use an adequate processmodel as the theoretical base for understanding and applying critical-thinkingskills. Many acceptable problem-solving models exist, and most include a decision-making step; only four are reviewed here.

Traditional Problem-Solving Process

The traditional problem-solving model is widely used and is perhaps the most well knownof 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. Thisprocess, therefore, is less effective when time constraints are a consideration.Another weakness is lack of an initial objective-setting step. Setting a decision goalhelps to prevent the decision maker from becoming sidetracked.

The Managerial Decision-Making Process

The managerial decision-making model, a modified traditional model, eliminatesthe 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 ofdecision-making are shown in Table 1.1.

A structured approach toproblem solving anddecision makingincreases criticalreasoning.

The Nursing Process

The nursing process provides another theoretical system for solving problems andmaking decisions. Educators have identified the nursing process as an effectivedecision-making model, although there is current debate about its effectiveness as aclinical reasoning model (Pesut & Herman, 1998).

As a decision-making model, the nursing process has a strength that the previ-ous two models lack, namely its feedback mechanism. The arrows in Figure 1.2show constant input into the process. When the decision point has been identified,initial decision-making occurs and continues throughout the process by using a feed-back mechanism. Although the process was designed for nursing practice with regardto patient care and nursing accountability, it can easily be adapted as a theoretical


Assess

Implement

Evaluate Plan

Diagnose

Figure 1.2 Feedback mechanism of thenursing process.

Table 1.1 Comparing the Decision-Making Process with theNursing Process

Decision-Making Process Simplified Nursing Process

Identify the decision AssessCollect dataIdentify criteria for decision PlanIdentify alternativesChoose alternative ImplementImplement alternativeEvaluate steps in decision Evaluate


model for solving leadership and management problems. Table 1.1 shows how closelythe nursing process parallels the decision-making process.

The weakness of the nursing process, like the traditional problem-solvingmodel, is in not requiring clearly stated objectives. Goals should be clearly stated inthe planning phase of the process, but this step is frequently omitted or obscured.

However, because nurses are familiar with this process and its proven effective-ness, it continues to be recommended as an adapted theoretical process for leader-ship and managerial decision making.

Many other excellent problem analysis and decision models exist. The modelselected should be one with which the decision maker is familiar and one appropri-ate for the problem to be solved. Using models or processes consistently willincrease the likelihood that critical analysis will occur. By cultivating a scientificapproach, the quality of one’s management and leadership problem solving anddecision making will improve tremendously.

Intuitive Decision-Making Model

According to Hansten and Wahburn (2000), many nursing scientists in the pastdid not value intuition in decision making as they felt intuitive reasoning did notalign itself well with the status and power of a true science. Recently, however, therehas been a renewed interest in intuitive thinking and Ignatavicious (2001) identi-fies it as one of the characteristics of an expert critical thinker. It must be remem-bered, however, that intuition can be overpowered by emotions. Therefore, using anintuitive decision-making model is helpful in order to prevent emotions fromclouding the decision-making process.

Romiszowski (1981) built on the nursing process in creating the intuitive decision-making model shown in Figure 1.3. In this model, the decision maker consciously

Patient4. Implement/Evaluate 3. Plan

2. Recall

PossibleNursingDiagnosisandInterventions

1. Assess

GatherPatientData

Implement

Follow Through

Evaluate Exercise Judgment

Synthesize

Analyze

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

CRITICAL ELEMENTS IN PROBLEM SOLVING AND DECISION MAKING

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


Applying Scientific Models to Decision MakingYou are an RN who graduated three years ago. During the last three years,your responsibilities in your first position have increased. Although you enjoyyour family (husband and one preschool-age child), you realize that you loveyour job, and your career is very important to you. Recently, you and yourhusband decided to have another baby. At that time, you discussed yourcareer and both of you reached a joint decision that, if you had anotherbaby, you wanted to reduce your work time and spend more time at homewith the children. Last week, you were thrilled and excited when your super-visor told you the charge nurse is leaving and that she wants to appoint youto the position. Yesterday, you found out that you are pregnant.

Last night, you and your husband talked about your career future. He isan attorney whose practice has suddenly gained momentum. Although hehas shared child rearing equally with you until this point, he is not sure howmuch longer he will be able to do so if his practice continues to expand. Ifyou take the position, which you would like to do, it would mean full-timework. You want the decision you and your husband reach to be wellthought-out as it has far-reaching consequences and concerns many people.Assignment: Using a scientific approach (one of the four models just dis-cussed), determine what you should do. After you have made your deci-sion, get together in a group (four to six people) and share your resolu-tion. Were your decisions the same? How did you approach the problemsolving differently from others in your group? Did some of the groupmembers identify alternatives you had not considered? How did your per-sonal values influence your decision?

Learning Exercise 1.1

incorporates recall or cumulative knowledge that comes from education, both formaland informal, as well as experience, in planning the decision. Inexperienced or novicedecision makers spend more time in the assessment, recall, and planning phases, where-as experienced decision makers gather information, recall, and often leap directly toimplementation, because planning has become automatic.That novice nurses and expe-rienced nurses process information differently has been supported by Benner (1994).

Ironically, this “leap” from information gathering to implementation may be thegreatest weakness of this model. In discussing intuitive decision making, Lamondand Thompson (2000) warn that since the process is largely invisible, there is littleinformation to evaluate if the outcome of the decision is less than positive.


Define Objectives Clearly

Decision makers often forge ahead in their problem-solving process without firstdetermining their goal. Even when decisions must be made quickly, there is time topause and reflect on the purpose of the decision. If a decision lacks a clear objectiveor if an objective is not consistent with the individual’s or organization’s stated phi-losophy, a poor-quality decision is likely. Sometimes the problem has been identi-fied but the wrong objectives are set. Problems can be extremely complex and mayneed multiple objectives (Clancy, 2003).

Gather Data Carefully

Because decisions are based on knowledge and information available to the problemsolver at the time the decision must be made, one must learn how to process andobtain accurate information. The acquisition of information begins with identify-ing the problem or the occasion for the decision and continues throughout theproblem-solving process. Often the information is unsolicited, but most informa-tion is sought actively.

Acquiring information always involves people, and no tool or mechanism isinfallible to human error. Human values tremendously influence our perceptions.Therefore, as problem solvers gather information, they must be vigilant that theirown preferences and those of others are not mistaken for facts. Remember thatfacts can be misleading if they are presented in a seductive manner or taken out ofcontext or if they are past-oriented. Numerous parents have been misled by thefactual statement, “Johnny hit me.” In this case, the information seeker needs todo more fact finding. What was the accuser doing before Johnny hit him? Whatwas he hit with? Where was he hit? When was he hit? Like the parent, the man-ager who becomes expert at acquiring adequate, appropriate, and accurate infor-mation will have a head start in becoming an expert decision maker and problemsolver.

To gain knowledge and insight into managerial and leadership decision making,individuals must reach outside their current sphere of knowledge in solving theproblems 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:

1. What is the setting?2. What is the problem?3. Where is it a problem?4. When is it a problem?5. Who is affected by the problem?6. Is this your problem or someone else’s problem?7. What is happening?8. 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?

Generate Many Alternatives

The definition of decision-making implies there are at least two choices in everydecision. Unfortunately, many problem solvers limit their choices to two whenmany more options usually are available. The greater the number of alternativesthat can be generated during this phase, the greater the chance that the final deci-sion will be sound. When seeking alternatives, individuals need to expand theirhorizons; the most common trap managers fall into is limiting the borders of theirdecision frames (Clancy, 2003).

Remember that one alternative in each decision should be the choice not to doanything. When examining decisions to be made using a formal process, it is oftenfound that the status quo is the right alternative. Several techniques can help gen-erate more alternatives. Involving others in the process confirms the adage that twoheads are better than one. Because everyone thinks uniquely, increasing the numberof people working on a problem increases the number of alternatives that can begenerated.


Possible Alternatives in Problem SolvingIn the personal choice scenario presented in Learning Exercise 1.1, someof 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 gen-erate? What alternatives did you identify that are not included in this list?


Gathering Necessary InformationIdentify a poor decision you recently made because of faulty data gather-ing. Have you ever made a poor decision because necessary informationwas intentionally or unintentionally withheld from you?



Brainstorming is another frequently used technique. The goal in brainstormingis to think of all possible alternatives, even those that may seem “off target.” By notlimiting the possible alternatives to only apparently appropriate ones, people areable to break through habitual or repressive thinking patterns and allow new ideasto surface. Although most often used by groups, people making decisions alone alsomay use brainstorming. Clancy (2003) suggests that once a large number of alter-natives are generated that the list be revised so that the decision maker is left withthree or four, as any more may create too many variables and factors to evaluateeffectively.

Think Logically

During the problem-solving process, one must draw inferences from information.An inference is part of deductive reasoning. People must carefully think throughthe information and the alternatives. Clancy (2003) states that among other things,deep-seated biases often cloud effective decision making. Faulty logic at this pointmay lead to poor-quality decisions. People think illogically primarily in three ways.

1. Overgeneralizing. This type of “crooked” thinking occurs when one believesthat because A has a particular characteristic, every other A also has thesame characteristic. An example of this thinking is when stereotypical state-ments are used to justify arguments and decisions.

2. Affirming the consequences. In this type of illogical thinking, one decides thatif 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 procedureand the nurses on your unit are not using that technique, it is illogical toassume that the technique currently used in your unit is wrong or bad.

3. Arguing from analogy. This thinking applies a component that is present intwo separate concepts and then states that because A is present in B, then Aand B are alike in all respects. An example of this would be to argue thatbecause intuition plays a part in clinical and managerial nursing, then anycharacteristic present in a good clinical nurse also should be present in agood nurse–manager. 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 ofanalysis. Several of these tools are discussed later in Chapter 2. In analyzing possi-ble solutions, individuals may want to look at the following questions:

1. What factors can you influence? How can you make the positive factorsmore important and minimize the negative factors?

2. What are the financial implications in each alternative? The political implica-tions? 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?

Choose and Act Decisively

It is not enough to gather adequate information, think logically, select from amongmany alternatives, and be aware of the influence of one’s values. In the final analy-sis, one must act. Individuals may become vulnerable at this last point in theproblem-solving process and choose to delay acting because they lack the courageto face the consequences of their choices. For example, if managers granted allemployees’ requests for days off, they would have to accept the consequences oftheir decision by dealing with short staffing.

It may help the reluctant decision maker to remember that decisions, althoughoften 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 abili-ties and where the problem solving was faulty. However, decisions must continue tobe made, although some are of poor quality, because through continued decisionmaking, 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 approachto solve problems, an assumption could be made that identical decisions wouldresult. However, in practice, this is not true. Because decision making involves per-ceiving and evaluating, and people perceive by sensation and intuition and evaluatetheir perception by thinking and feeling, it is inevitable that individuality plays apart in decision making. Because everyone has different values and life experiences,and each person perceives and thinks differently, different decisions may be madegiven the same set of circumstances. No discussion of decision making would,therefore, be complete without a careful examination of the role of the individual indecision making (see Display 1.4).

Values

Individual decisions are based on each person’s value system. No matter how objec-tive the criteria, value judgments will always play a part in a person’s decision mak-ing, either consciously or subconsciously. The alternatives generated and the finalchoice selected are limited by each person’s value system. For some, certain choices


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

Critical Elements in Decision MakingDisplay 1.3


are not possible because of a person’s beliefs. Because values also influence percep-tions, they invariably influence information gathering, information processing, andfinal outcome (Marquis & Huston, 1995). Values also determine which problemsin one’s personal or professional life will be addressed or ignored.

Life Experience

Each person brings to the decision-making task past experiences that include edu-cation and decision-making experience. The more mature the person and thebroader his or her background, the more alternatives he or she can identify. Eachtime a new behavior or decision is observed, that possibility is added to the person’srepertoire of choices. People vary in their desire for autonomy, so some nurses maywant more autonomy than others. It is likely that people seeking autonomy mayhave much more experience at making decisions than those who fear autonomy.Likewise, having made good or poor decisions in the past will influence a person’sdecision making.

Individual Preference

With all the alternatives a person considers in decision making, one alternative maybe preferred over another. The decision maker, for example, may see certain choic-es as involving greater personal risk than others and therefore may choose the saferalternative. Physical, economic, and emotional risks, and time and energy expendi-tures, 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 alter-native solution to a problem that would not have been their first choice had theybeen able to overcome limited resources.

Individual Ways of Thinking and Decision Making

Our way of evaluating information and alternatives on which we base our finaldecision constitutes a thinking skill. Individuals think differently. Some think systematically—and are often called analytical thinkers—whereas others thinkintuitively. It is believed that most people have either right- or left-brain hemi-sphere dominance (Good, 2002). Although the authors encourage whole-brainthinking, and studies have shown that people can strengthen the use of the lessdominant side of the brain, most people continue to have a dominant side. Analytical,

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

Individual Variations in Decision MakingDisplay 1.4

linear, left-brain thinkers process information differently than creative, intuitive,right-brain thinkers. Intuition is the ability to understand the possibilities inherentin a situation.

Some feel that there is a gender difference in how we think and behave. Rudan’sresearch (2003) looked at how male and female leaders behaved differently andnoted that males and females socialized and communicated differently; males paidmuch less attention to relationships and resisted being influenced. These differ-ences have the potential to effect decision making.

The way one thinks has much to do with individual problem solving and decisionmaking. There is no evidence that either right- or left-brain thinking is preferable. Inthe past, organizations openly recognized the value of logical, analytical thinkers butmore recently have acknowledged that intuitive thinking is a valuable managerialresource. It is felt that right-brain thinkers are more creative, but the current emphasisin teaching and learning is to encourage whole-brain thinking (Good, 2002).

OVERCOMING INDIVIDUAL VULNERABILITY IN DECISION MAKING

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

Values

Being confused and unclear about one’s values may affect decision-making abili-ty (Huston & Marquis, 1995). Overcoming a lack of self-awareness through val-ues clarification decreases confusion. People who understand their personalbeliefs and feelings will have a conscious awareness of the values on which theirdecisions are based. This awareness is an essential component of decision makingand critical thinking. Therefore, to be successful problem solvers, managers mustperiodically examine their values. Values clarification exercises are included inChapter 7.


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



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 dosome things to decrease this area of vulnerability. First, use available resources,including current research and literature, to gain a fuller understanding of the issuesinvolved. Second, involve other people, such as experienced colleagues, trustedfriends, or superiors, to act as sounding boards and advisors. Third, analyze deci-sions later to assess their success. By evaluating decisions, people learn from mis-takes and are able to overcome inexperience.

Individual Preference

Overcoming this area of vulnerability involves self-awareness, honesty, and risktaking. The need for self-awareness was discussed previously, but it is not enough tobe self-aware; people also must be honest with themselves about their choices andtheir preferences for those choices. Additionally, the successful decision makermust take some risks. Nearly every decision has some element of risk, and mostinvolve consequences and accountability. Those who are able to do the right butunpopular 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 notable to understand problems fully or make decisions from both an analytical andintuitive perspective. However, in most organizations, both types of thinkers maybe found. Using group process, talking management problems over with others,and developing whole-brain thinking also are methods for ensuring that both intu-itive and analytical approaches will be used in solving problems and making deci-sions. Use of heterogeneous rather than homogeneous groups will usually result inbetter-quality decision making. See Display 1.5 for more information.

Indeed, learning to think “outside the box” is often accomplished by including adiverse group of thinkers to solve problems and make decisions. It is good organi-zational theory for leaders to surround themselves with a variety of talented people,

Although not all experts agree, Huston (1990) suggests that the following are qualities ofsuccessful 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.

Qualities of Successful Decision MakersDisplay 1.5

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 qualitydecisions was emphasized. The effect of the individual’s values and preferences onthe decision making process was discussed. But it is important for leaders and man-agers to also understand how the organization influences the decision-makingprocess. Since organizations are made up of people with differing values and pref-erences, 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 them-selves or their subordinates) that are congruent with their own preferences and val-ues. On the other hand, people wielding little power in organizations must alwaysconsider the preference of the powerful when they make management decisions.Power is frequently part of the decision factor (Good, 2003). In organizationschoice is constructed and constrained by many factors, and therefore choice is notequally available to all people.

Additionally, not only does the preference of the powerful influence decisions ofthe less powerful, but the powerful also are able to inhibit the preferences of the lesspowerful. This occurs because individuals who remain and advance in organiza-tions are those who feel and express values and beliefs congruent with the organi-zation. Therefore, a balance must be found between the limitations of choice posedby the power structure within the organization and totally independent decisionmaking that could lead to organizational chaos.

The ability of the powerful to influence individual decision making in an organ-ization often requires adopting a private personality and an organizational person-ality. For example, some might believe they would have made a different decisionhad they been acting on their own, but they went along with the organizationaldecision. This “going along” in itself constitutes a decision; people choose to acceptan organizational decision that differs from their own preferences and values. Theconcept of power in organizations is discussed more fully in Chapter 13.

Rational and Administrative Decision Making

For many years, it was widely believed that most managerial decisions were basedon a careful, scientific, and objective thought process and managers made decisionsin a rational manner. In the late 1940s, Herbert A. Simon’s classic work revealedthat most managers made many decisions that did not fit the objective rationalitytheory. Simon (1965) delineated two types of management decision makers: theeconomic man and the administrative man.

Managers who are successful decision makers attempt to make rational deci-sions, much like the economic person described in Table 1.2. Because they realize


The ability of thepowerful to influenceindividual decisionmaking in anorganization oftenrequires adopting aprivate personality andan organizationalpersonality.


that restricted knowledge and limited alternatives directly affect a decision’s quali-ty, these managers gather as much information as possible and generate many alter-natives. Simon believed that the economic model was an unrealistic description oforganizational decision making. The complexity of acquiring information makes itimpossible for the human brain to store and retain the amount of information thatis available for each decision. Because of time constraints and the difficulty ofassimilating large amounts of information, most management decisions are madeusing the administrative model of decision making. The administrative personnever has complete knowledge and generates fewer alternatives. Simon argued thatthe administrative person carries out decisions that are only “satisficing,” a termused to describe decisions that may not be ideal but result in solutions that haveadequate outcomes. These managers want decisions to be “good enough” so thatthey “work,” but they are less concerned that the alternative selected is the optimalchoice. The “best” choice for many decisions is often found to be too costly in termsof time or resources, so another less costly but workable solution is found.

SUMMARY

This chapter has discussed effective decision making, problem solving, and criticalthinking as requisites for being a successful leader and manager. The effectiveleader–manager is aware of the need for sensitivity in decision making. The suc-cessful decision maker possesses courage, energy, and creativity. It is a leadershipskill to recognize the appropriate people to include in decision making and to use asuitable theoretical model for the decision situation.

The manager should develop a systematic, scientific approach to problem solv-ing that begins with a fixed goal and ends with an evaluation step. Managers whomake quality decisions are effective administrators.

Table 1.2 Comparing the Economic Man with the Administrative Man

Economic Administrative

Makes decisions in a very rational Makes decisions that are good enough.manner.

Has complete knowledge of the Because complete knowledge is not possible,problem or decision situation. knowledge is always fragmented.

Has a complete list of possible Because consequences of alternatives alternatives. occur in the future, they are impossible

to predict accurately.Has a rational system of ordering Usually chooses from among a few

preference of alternatives. alternatives, not all possible ones.Selects the decision that will The final choice is “satisficing” rather than

maximize utility function. maximizing.Adapted from Simon, 1965.

The integrated leader–manager understands the significance that personal val-ues, life experience, preferences, and ways of thinking have upon selected alterna-tives in making the decision. The critical thinker pondering a decision is aware ofthe areas of vulnerability that hinder successful decision making and will expendhis or her efforts to avoid the pitfalls of faulty logic and data gathering.

Both managers and leaders understand the impact the organization has on deci-sion making and that some decisions that will be made in the organization will beonly satisficing. However, leaders will strive to problem solve adequately in order toreach 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 andends with an evaluation process.

• The successful decision maker understands the significance that each per-son’s values, life experience, preferences, and way of thinking have on select-ed alternatives.

• The critical thinker is aware of areas of vulnerability that hinder successfuldecision making and makes efforts to avoid the pitfalls of faulty logic in hisor her data gathering.

• The act of making and evaluating decisions increases the expertise of thedecision maker.

• There are many models for improving decision making. Using a modelreduces trial and error and increases the probability that decisions made willbe sound.

• Left- and right-brain dominance influences to some degree how individualsthink.

• Two major considerations in organizational decision making are how poweraffects decision making and whether management decision making needs toonly be “satisficing.”

More Learning Exercises and Applications

These exercises may be discussed individually, in groups, or used as written assign-ments.


Evaluating Decision MakingDescribe the two best decisions you have made in your life and the twoworst. What factors assisted you in making the wise decisions? What ele-ments of critical thinking went awry in your poor decision making? Howwould you evaluate your decision making ability?



Profile ExaminingExamine the process you used to decide to become a nurse. Would youdescribe it as fitting a profile of the economic or the administrativemodel?


Considering Critical Elements in Decision MakingYou are a college senior and president of your nursing organization. Youare on the committee to select a slate of officers for the next academicyear. Several of the current officers will be graduating and you want thenew slate of officers to be committed to the organization. Some of thebrightest members of the junior class that are involved in the organiza-tion are not well liked by some of your friends in the organization. Assignment: Looking at the critical elements in decision making compile alist of the most important points to consider in making the decision forselection of a slate of officers. What must you guard against and howshould you approach the data gathering to solve this problem?


Examining the Decision-Making ProcessYou have been a staff nurse for three years, since your graduation fromnursing school. There is a nursing shortage in your area and many open-ings at other facilities. Additionally, you have been offered a charge nurseposition at your present employment. Lastly, you have always wanted todo community health nursing and know that this is also a possibility. Youare self-aware enough to know that it is time for a change, but whichchange should you make, and how should you make the decision?Assignment: Examine both the individual aspects of decision making andthe critical elements in making decisions. Make a plan including a goal, alist of information and data that you need to gather and areas where youmay be vulnerable to successful decision making. Examine the conse-quences of each alternative available to you. After you have done this, asan individual, form a small group and share your decision making plan-ning with members of your group. How was your decision making likeothers in the group and how was it different?



Using Models in Decision MakingDo you use a problem-solving or decision-making model to solve prob-lems? Have you ever used an intuitive model? Think of a critical decisionyou 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 adecision that you made this year. Describe what theoretical model you useto assist you in the process. Determine if you consciously used the modelor if it was purely by accident. Did you enlist the help of other experts insolving the problem?

Learning Exercise 1.9A

Step-by-Step Problem SolvingYou are a home-health nurse who makes in-home visits to a moribundelderly man with advanced cancer. He is now confined to bed, and hismajor care needs are comfort-based. In addition to directly providing painmedication to this man, you, as a case manager, are responsible for over-seeing other personnel who assist in caring for him. These personnelinclude rotating health aides who are responsible for bathing the patient,preparing his meals, and providing other basic care not requiring a pro-fessional license. The patient’s family generally stays with him at night.

At times, during your in-home visits, you have noticed that there arefood crumbs in the bed, that the patient’s hair is uncombed, and that histeeth have not been brushed, and you suspect that he has not beenrecently bathed.Assignment: Use one of the problem-solving or decision-making modelsin this chapter and do the following:1. Identify a brief (no longer than one or two sentences) problem state-

ment 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 deci-sion-making process you used as well as the desired outcome.

If time allows, divide into small groups and share the results of your prob-lem solving.



Web Links

Judgment and Decision Makinghttp://www.sjdm.orgPromotes the study of normative, descriptive theories of decision processes.http://www.hooah4health.com/spirit/decisions.htmFree tools you can use to solve problems and make decisions in your life.

Mission Criticalhttp://www.sjsu.edu/depts/itlThe goal of this site is to teach visitors the basic concepts of critical thinking, deductivereasoning, and finding faults in dubious arguments. The site provides tutorials, exercises,and links to related Web sites.

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