Clinical Assessment Continued: Strategic Management in Nursing Environment

Subject: Nursing
Pages: 8
Words: 2249
Reading time:
8 min


The nursing environment requires convenience to realize healthcare goals. To achieve this, nurses are required to implement good nursing strategies. These strategies should aim at improving productivity in a nursing environment. Nurses should also handle conflicts efficiently and effectively. As a trained nurse, I believe that strategic management is essential in improving staff morale, achieving patient safety, and improving the quality of service. Additionally, good strategies in the nursing environment are essential in limiting work-related stress for caregivers. In essence, effective strategies can improve the working environment. This paper will explore strategic management in a nursing environment. It will also integrate middle-range theories in solving clinical practice problems (Fawcett & Garity, 2009).

Description of selected clinical practice problem

Decision-making for managers in the nursing sector has been challenging. Most managers encounter complex situations in a nursing environment. As a nurse manager, I have to think thoughtfully to ensure that units within the clinic work effectively. Working relationships are usually at stake in nursing environments. Strategic management is, therefore, necessary for the efficient delivery of services. In a nursing environment, roles and responsibilities tend to overlap; this requires collaboration as well as tolerance to achieve teamwork objectives. Conflicts and overlapping roles are sometimes encountered in a nursing environment where caregivers tend to perform similar tasks. Strategic management is vital for solving such issues in a nursing environment. In essence, nurse managers are required to be well equipped with conflict resolution skills to manage the nursing environment. As a DNP student, I believe that strategic management must be integrated into management skills to enable nurses to accomplish nursing goals. Therefore, I believe that implementing effective strategic management is a clinical practice problem that challenges nurses all over the world.

Strategic management in the health care sector is crucial to its development. Additionally, it enables management to handle issues in a punctual and effective manner. Clear communication is essential for the effective management of health care issues. Moreover, perceived areas of conflict should be understood to pave the way for convenient resolution. This cannot happen without a clear strategy for handling conflict issues. It should also be noted that a healthy working environment could only be achieved through tolerance. The health sector brings together people from different cultures and perspectives in life. These people cannot work together without a good strategy for handling cultural differences. Poor management strategies have the ability to cause patient errors because of breakdown in communication, among others. Therefore, I believe that strategic management is a significant issue for health care managers. Strategic management is essential in achieving good nursing practices such as collaboration and understanding. Additionally, it promotes unity and commitment among workers, which fosters quality health care delivery (Murrock & Higgins, 2009).

Summary of two selected theories

To achieve strategic management, a number of middle-range theories can be utilized. These theories include Peplau’s theory on interpersonal relations and Leininger’s theory on Transcultural nursing. For effective management of the nursing environment to be achieved fully, these theories are vital for incorporation into nursing strategies.

Peplau’s theory on interpersonal relations

This theory talks about the importance of good interpersonal relations in a nursing environment. As stated earlier, there are many nursing responsibilities. Usually, these responsibilities overlap, which has the ability to cause tensions between nurses on how to share responsibilities. Additionally, nurses may be involved in conflict with other professionals in hospital settings. Frequently, these issues come up due to misunderstandings, which can easily be resolved through implementing good interpersonal relations. In essence, effective communication should be cultivated in a nursing environment. This would help to minimize gross misunderstandings. Additionally, it would assist in fostering collaboration between various departments in a nursing environment. Nurses need to incorporate personalities with considerations for patients. Essentially, nurses who are committed to their work tend to incorporate psychodynamic nursing in their work. This helps to instill tolerance and understanding in a nurse’s work. Peplau’s theory on interpersonal relations is, therefore, essential for the efficient delivery of healthcare services.

Peplau notes that most nurses have advocated for good interpersonal relations without knowing its benefits fully. Moreover, he states that nurses have worked to relate well with patients in the past. In essence, the theory of interpersonal relations has been practiced before and nurses keep working to perfect it. Peplau expands on interpersonal relations with the aim of deepening its understanding to nurses who would wish to be socially useful and effective in the working environment. Clinical instructors have also been tasked with the responsibility of advancing ways of promoting nurses’ skills in interpersonal relations. All these efforts are geared towards improving the relationship between nurses and their patients as well as between nurses and colleagues. Peplau outlines principles that nurses, who are useful to patients, portray. Additionally, Peplau explores principles and concepts that motivate interpersonal relations. These principles also help to change working environments into fields of learning.

Leininger’s theory on transcultural nursing

The second middle-range theory concerns Leininger’s theory on transcultural nursing. Universality is a term that is common to multinational companies. Globalization is another term that has been used widely to refer to universality. Globalization has brought about people from different cultures in many sectors, including the nursing environment. According to Leininger, organizational culture is essential in solving cultural differences in the health sector. Moreover, she advocates for cultural tolerance. These principles are important in mitigating conflicts as well as assisting in conflict resolution. As stated earlier, nurses’ responsibilities and roles overlap in many instances; this, together with cultural diversity, has the propensity of causing conflict in a nursing environment. Therefore, to avoid such instances, transcultural theory principles should be incorporated into nursing work. Interestingly, most nurses have implemented organizational culture without knowing its benefits. However, health care managers should teach nurses the importance of organizational culture as well as the promotion of tolerance among workers.

The nursing environment has changed dramatically. In fact, technology has introduced online medical services in addition to hospital care. These changes have exposed nurses to various parts of the world where different practices are encouraged. Moreover, professionals in the nursing environment have found themselves in foreign countries while seeking employment. For instance, the United States has offered employment to people from different parts of the world, especially in nursing. It should be noted that such areas are prone to intercultural conflict because people have different values. Leininger’s transcultural theory is therefore essential in resolving cultural issues. Additionally, it aids nurses in adapting to a new field of employment (Jacelon, Furman, Rea, Macdonald & Donoghue, 2011).

Evaluation of theories using evaluation criteria

Peplau advocates for psychodynamic nursing to help nurses improve on interpersonal relations in a nursing environment. Psychodynamic nursing is a concept that is aimed at entrenching interpersonal skills in nursing practice. Peplau utilizes evidence as well as research-based practice to support his arguments for psychodynamic nursing. Moreover, Peplau believes that improved interpersonal skills would cement relationships between nurses and their patients. Additionally, it would improve relationships between nurses and their colleagues. This theory is well researched with a wide range of perspectives tailored to it. Moreover, it proposes a conceptual framework for improving relationships in the nursing environment. Peplau also utilizes evidence-based practices to support his proposals (McEwen & Wills, 2010).

Leininger explores the theory of culture and its dimensions in health settings. Moreover, Leininger proposes organizational cultures to minimize cultural conflicts. Leininger explains the philosophical basis of transcultural as well as its implications. She goes on to propose tolerance in the nursing environment. She uses research-based qualitative studies to support her theory. She is well versed with information on requirements for a culturally diverse nursing environment. Leininger supports nursing values that are entrenched in cultural ethics and professionalism. This theory is significant in the development of effective organizational cultures in the nursing environment. Leininger provides principles and concepts of managing a culturally diverse institution of health (McEwen & Wills, 2010).

Determination of appropriate theory for addressing the clinical problem

Strategic management is vital for the survival of any organization. Nursing managers should entrench effective strategies in their organizations to achieve high productivity and efficiency. Strategic management is important in solving organizational issues since it lays out the procedures for resolving such matters. The Healthcare sector requires nurses and other professionals to collaborate to perform their tasks effectively. Additionally, it should be noted that effective communication is vital for collaboration to be achieved. As stated above, the clinical problem at stake is on resolving conflicts in the nursing environment. These conflicts may arise due to cultural differences between the patient and the nurse or the nurse and his/her colleagues. Additionally, conflict may arise due to a breakdown in communication between departments, workers, or other stakeholders in a nursing environment. Notably, conflicts can also arise from a breakdown in communication during health-related procedures. These are tantamount to patient errors, which can adversely affect patient health as well as nurses’ motivation.

Of great concern is nurse motivation that affects his/her relationship with a patient directly. In essence, the motivation of nurses should be encouraged by hospital heads. Based on the issues discussed, it should be noted that both theories are applicable in resolving nursing issues. Most especially, it should be noted that both theories work to repair or maintain workable relationships between stakeholders in a nursing environment. However, Peplau’s theory of interpersonal skills best fits the practice problem because it is also applicable in transcultural nursing. In essence, Peplau’s theory is the most appropriate for addressing the clinical problem. Peplau’s theory can be integrated into transcultural nursing because it addresses tolerance and appropriate communication. Moreover, the theory on interpersonal relations addresses the core issues of communicating effectively, especially during health-related tasks such as surgery, among others. In case of inappropriate communication during surgery, failure can be the most likely outcome due to patient error (DeSanto-Madeya & Fawcett, 2009).

Reasons for selecting the theory

Peplau’s theory on interpersonal skills is essential to all organizations. Interpersonal skills help resolve avoidable conflicts. In fact, it helps by minimizing problems that may arise for ineffective communication. Competence in Interpersonal skills leads to effective communication, which is central for the coordination of activities in nursing settings. The theory of interpersonal relations is crucial for correcting the coordination of information in nursing settings. For instance, during surgery, surgeons relay information to nurses who are tasked with the role of assisting surgeons. This cannot be carried out effectively if there is a barrier to effective communication. Moreover, where there is a conflict, it is impossible to coordinate activities as planned. That is, conflict resolution is essential as well as effective communication. Communication should be tailored to understand the needs in a given situation. Peplau’s theory works well in advancing understanding and unity among workers as well as between nurses and patients.

I chose Peplau’s theory because it incorporates practice into theory. Additionally, it helps one to practice how to work with patients effectively. Moreover, it contains concepts that can be utilized to repair strained relationships between workers, management, and patients. Moreover, it ensures that openness is created to improve trust among workers and patients. Skills in interpersonal relations are also important in establishing unity among workers as well as patients. Moreover, it strengthens the commitment of nurses to their functions. Peplau’s theory also brings about a sense of responsibility among workers. This helps when accountability is required. Additionally, nurses are able to work freely and within their areas of jurisdiction. Peplau’s theory also assists nurses in working together in collaboration as well as helping one another whenever necessary. Peplau’s theory provides nurses with adequate ingredients to achieve success in their working environment. However, this is not to say that Leininger’s theory on transcultural nursing is limited in its ability to unify health workers. Nonetheless, Peplau’s theory encompasses a wider picture of events in the nursing environment (Fawcett & Garity, 2009).

Refined clinical/research question based on the propositions of the theory selected

Peplau’s theory proposes that nurses incorporate concepts and principles which can improve their relations with patients as well as improve their relations with other colleagues. Essentially, these principles and concepts are critical to efficiency and efficacy in the delivery of nursing services. Therefore, nursing managers should work towards creating management strategies that focus on improving relationships between nurses and patients, nurses and their colleagues as well as nurses and other professionals. A research question that can arise out of this is whether strategic management that emphasizes effective interpersonal relations can improve working conditions and clinical outcomes.


Nursing managers are required to portray their skills by implementing effective strategies. For instance, strategies geared towards effective communication are essential for the dissemination of healthcare services to patients. Moreover, strategies geared towards transcultural nursing are significant in establishing organizational culture. The nursing environment is usually complex because it encompasses different professionals with overlapping duties. For instance, nurses and caregivers share some responsibilities and roles. Additionally, nurses share some roles with other professionals like clinical officers or doctors. Additionally, nurses may share leadership and management responsibilities. These tasks are complex and have the propensity of creating conflicts between individuals. Leaders in nursing organizations should therefore establish and implement working management strategies aimed at addressing conflicts within the nursing environment. Moreover, the challenges involved in formulating working management strategies should be prevailed upon by commitment to a holistic approach in nursing. Essentially, nursing managers are tasked with the responsibility of formulating and implementing effective management strategies aimed at creating a conducive working environment for nurses.


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Fawcett, J. & Garity, J. (2009). Evaluating Research for Evidence-Based Nursing: Evaluation of middle-range theories. Philadelphia, Pennsylvania: F. A. Davis.

Jacelon, C., Furman, E., Rea, A., Macdonald, B., & Donoghue, L. (2011). Creating a professional practice model for postacute care: Adapting the Chronic Care Model for long-term care. Journal of Gerontological Nursing, 37(3), 53–60.

McEwen, M. & Wills, E. (2010). Theoretical Basis for Nursing (3rd ed.). New York City, NY: Lippincott Williams & Wilkins. Print.

Murrock, C. J., & Higgins, P. A. (2009). The theory of music, mood and movement to improve health outcomes. Journal of Advanced Nursing, 65 (10), 2249–2257. Web.