NURS FPX 8010 Assessment 1 Political Landscape Analysis

Name

Capella university

NURS-FPX 8010 Executive Leadership in Contemporary Nursing

Prof. Name

Date

Political Landscape Analysis

Political landscape analysis is an approach that assesses and describes an organization’s political environment. The analysis is based on comprehending power structures and their implications on organizational environment, policies, and communication channels. In this paper, the political landscape of a community-based healthcare facility is analyzed. This facility is located in the southeastern region of the US. 

Formal and Informal Lines of Power

Ramos et al. (2019) explain formal and informal lines of power within an organization are described as power due to hierarchical structure or position and power attained from relationships, community standing, and professional reputations, respectively. This organization has several existing formal and informal lines of power. The Chief Executive Officer (CEO) with the ultimate authority, followed by the Chief Medical Officer (CMO) and other executive leadership, are formal lines of power. Moreover, the old physician-centric approach has provided significant power to the medical staff, especially the CMO. However, within the formal political structure, the nursing leadership has struggled to influence organizational operations due to the pressure from medical staff in power, as evidenced by the turnover in the Chief Nursing Officer (CNO) position. This power dynamics has influenced decision-making processes, favoring medical perspectives over nursing perspectives. 

The informal power dynamics lie with the CMO due to the long-standing tenure and community involvement, permitting the leadership of substantial initiatives such as the proposed transfer of advanced practicing nurses to the hospitalist group. Additionally, the strong ties with local community boards suggest a network of informal power. Several sources of power are evident in the organization, such as authority, expertise, reputation, and coercion. While the CEO holds authority as the source of power within the organization, the CMO employs authority within the medical team. Secondly, expertise is defined as the possession of knowledge or skills in particular areas (Ramos et al., 2019), as evident in the development of orthopedics as a lucrative service line. This initiative provides another source of power to the CMO.

NURS FPX 8010 Assessment 1 Political Landscape Analysis

Additionally, both the CEO and CMO possess personal power, which is described as the power attained from reputations and relationships within the community and the organization. Lastly, the indication of coercion through forced policies on advanced practicing nurses to join the hospitalist group is another significant source of power (Ramos et al., 2019). Such coercive policies through power may hinder collaboration and interdisciplinary teamwork. Moreover, this will impact communication channels where medical priorities overshadow the concerns and perspectives of the nursing team.

Organizational Power Influences on Executive-Level Decision-Making

Based on the organizational power structures and my perspectives as a CNO, the best evidence-based solution to the concerns raised by APRNs is advocating for their autonomy, professional development, scope of practice, and professional competence. According to Htay and Whitehead (2021), patient care led by advanced practicing nurses yields positive impacts on patient satisfaction, patient outcomes, cost-effectiveness, and the management of chronic diseases. Thus, advocating for their role is imperative through a dialogue with the CMO and other key stakeholders to find a solution that preserves the APRNs’ roles within the nursing department. At the same time, it also meets the needs of the hospitalist group.

Another response involves negotiating with the CMO to create a hybrid model. This model will allow APRNs to maintain their affiliation with the nursing department and also work collaboratively with the hospitalist group. This approach will retain their scope of practice and other benefits and foster interdisciplinary collaboration to improve patient care outcomes (Kaiser et al., 2022).

Several assumptions underlie this decision, including the value of multidisciplinary collaboration and navigating power dynamics while advocating for nursing interests. Moreover, commitment to evidence-based practice and the integration of research findings into decision-making processes is imperative. Thus, a balanced approach is employed to find the best solutions that consider the APRN’s interests and patients’ benefits. 

The Impact of Power on Organizational Policy

The proposed policy of transferring APRNs from the nursing domain to hospitalist groups and preventing hospital privileges from those who show unwillingness to join is significantly influenced by power dynamics within the organization. The physician-centric political system and CMO’s influencing character due to the long tenure of services, professional reputation, and community engagement are the drivers of this policy change. Generally, power dynamics within organizations have a significant impact on the development and implementation of policies.

Individuals with position power, such as executives or key decision-makers, often shape policies to align with their interests, objectives, and priorities. However, these power dynamics may have negative impacts on organizational operations. These influences are reflected in prioritizing specific initiatives and teams over others (Ziemianski, 2022), as evident in the case study. Moreover, power dynamics within the organization can affect the degree of inclusivity, where individuals with less power may have limited influence on shaping policies, leading to disparities in representation and outcomes. Thus, managing and mitigating power issues is crucial for a fair and inclusive policymaking process, serving the best interests of all stakeholders within the organization.

Sources of Power 

   The best applicable sources of power for achieving the objective of advocating for the autonomy and professional development of APRNs while promoting interdisciplinary collaboration and positive patient outcomes are expertise and cooperation. As a CNO, I could use authority and coercion, given the hierarchical power structures within the organization. Still, these sources of power may lead to disputes of resentment and ultimately cause suboptimal patient outcomes (Ramos et al., 2019). On the other hand, leveraging expertise and fostering collaboration leads to shared governance and evidence-based practice and complies with the principles of ethical leadership. 

Considering ethical principles while exercising power within an organization is paramount, particularly in healthcare settings. Decision-making in patient care areas directly impacts patients and their health outcomes. Thus, ethically sound decisions are fruitful for effective healthcare delivery (Smith, 2023). Coercion and manipulation may achieve short-term objectives but can erode trust and undermine the morale of healthcare professionals, thus compromising the quality of care delivered to the patients. Instead, expertise and interprofessional collaboration foster a culture of mutual respect and teamwork, promoting positive patient outcomes and upholding the dignity and professional autonomy of healthcare providers. 

Conclusion 

In conclusion, this organization has complex power dynamics, primarily due to the overruling power of the medical team. Therefore, to navigate the complexities of organizational power dynamics, the CNO must carefully assess the formal and informal lines of power, recognizing the influence of stakeholders and the implications for organizational culture and policy. CNO should address the concerns of APRNs while promoting collaboration and ethical leadership. This political landscape analysis is essential to maintaining smooth organizational operations and ensuring patient safety and positive health outcomes remain a priority. 

References

Htay, M., & Whitehead, D. (2021). The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. International Journal of Nursing Studies Advances, 3, 100034. https://doi.org/10.1016/j.ijnsa.2021.100034

Kaiser, L., Conrad, S., Neugebauer, E. A. M., Pietsch, B., & Pieper, D. (2022). Interprofessional collaboration and patient-reported outcomes in inpatient care: A systematic review. Systematic Reviews, 11(1), 169. https://doi.org/10.1186/s13643-022-02027-x 

Ramos, V., Franco-Crespo, A., González-Pérez, L., Guerra, Y., Ramos-Galarza, C., Pazmiño, P., & Tejera, E. (2019). Analysis of organizational power networks through a holistic approach using consensus strategies. Heliyon, 5(2), e01172. https://doi.org/10.1016/j.heliyon.2019.e01172

Smith, C. S. (2023). Applying a systems oriented ethical decision making framework to mitigating social and structural determinants of health. Frontiers in Oral Health, 4, 1031574. https://doi.org/10.3389/froh.2023.1031574 

NURS FPX 8010 Assessment 1 Political Landscape Analysis

Ziemianski, P. (2022). Identifying and mitigating the negative effects of power in organizations. Journal of Applied Social Science, 16(1), 140–159. https://doi.org/10.1177/19367244211014789