Manpower management in nursing--Comparing …

1 The Journal of Human Resource and Adult Learning Vol. 4, Num. 1, June 2008 21 comparing Two rational decision - making Methods in the Process of Resignation decision Chih-Ming Luo, Assistant Professor, Hsing Kuo University of management ABSTRACT There is over 15 percent resignation per year in Taiwan resulted in crises of nursing Manpower . The purpose of this study is to assists intuitional decision with system of rational thinking, structural practical experiences and tacit knowledge, and overcome the weakness of intuitional decision for lacking scientific decision process. This study is to compare two rational decision - making methods, the Even Swaps method and the Kepner-Tregoe (KT) method, applied in nursing for Manpower management . This study used action research methodology to discover an agenda of change in aspects of Manpower practice in nursing.

2 This study selected twelve nurses. The nurses required at least 5 years of experience in nursing and must have participated in taking care of SARS patients. Through in-depth interviews, this study analyzed the participants by using rational decision - making method during the period from September 2004 to April 2006. This study found that any drawbacks to intuitive decisions can be overcome by using rational decision - making method. The Even Swaps method will be more complete with the use of the KT method. In addition, it provides intuitive decision - making using a systematic and structural decision - making process. No research has yet compared the Even Swaps of rational decision - making method and KT methods for Manpower management in a nursing field. Finding an appropriate decision - making method to assist employee effectively manage their tacit knowledge of intuition has become increasingly important in today s high resignation environment.

3 These two rational decision - making based methods allow a user accurately to improve decision - making quality apply structural practical experiences and tacit knowledge. INTRODUCTION Literature reviews indicated that intuition appears to be used by members of every level of staff from student to expert. However, the disadvantage of intuitive decision processes can not be presented as a systematic and structural approach. There is a need for future study to explore rational decision - making processes in order to manage tacit knowledge of intuition. Thus, research on how to systematically and structurally enhance the process of intuitive decisions is a very important issue. According to the National Health Insurance System, the working environment for nursing staff has become difficult with a reduction in payroll and an increase in workload (Tzeng, 2002).

4 For example, a nurse in Taiwan takes care of an average of 12 patients, whereas in America, a nurse may take care of an average of patients (Adams & Bond, 2000). As a result, a resignation crisis arose within the nursing staffs. LITERATURE REVIEW Theorists of decision - making in nursing can be seen to take four different approaches pragmatists, systematisers, diagnosticians, and intuition (Davies & Fox-Young, 2002). But there is not yet a research The Journal of Human Resource and Adult Learning Vol. 4, Num. 1, June 2008 22 comparing Even Swaps (ES) and KT and applying them to decision making in Manpower field (Hallett, et al., 2000). The purpose of this study is to assists intuitional decision with system of rational thinking, structural practical experiences and tacit knowledge, and overcome the weakness of intuitional decision for lacking scientific decision process.

5 Theorists of decision - making in nursing take various approaches to their work (Hallett, et al., 2000). 'Pragmatists' focus on the sources of information used in making decisions (Lamond, et al., 1996). 'Systematisers' focus on the decision - making process as a structured, schematic entity and who often draw on cognitive psychology (Bryans and McIntosh, 1996). 'Diagnosticians' see clinical decision - making as a process of 'diagnostic reasoning' (Acton, et al., 1997). Moreover, intuition is a process of problem solving often described in such terms as 'gut feeling', 'pattern recognition', 'know how' and 'tacit knowledge' (Easen and Wilcockson, 1996). Cioffi (1997) further argues that claims to the use of intuition can still make nurses feel stigmatized because of the association of this term with lack of scientific objectivity.

6 Certain studies have shown that clinical health care decisions are deeply affected by intuition (King and Appleton, 1997). However, Easen and Wilcockson (1996) believed that decision - making could not be separated into rational decision - making and intuitive decision - making without concern. In addition, intuition may be considered as an irrational process with a rational basis. Therefore, the purpose of this study is to assists intuitional decision with system of rational thinking, structural practical experiences and tacit knowledge, and overcome the weakness of intuitional decision for lacking scientific decision process. METHODS Methodology Action research is a critical social activity, relying on participation and collaborative working to generate change and new knowledge.

7 One of the benefits of such an approach is the emphasis on using experiential knowledge to inform an agenda of change in aspects of practice, and this is particularly valuable when practitioners are marginalized in some manner (Winter and Munn-Giddings, 2005). Therefore, this study belongs to the category of action research, according to the literature s definition. Data Collection This study uses two methods to collect data, literature review and in-depth interview. These databases include BSP/EBSCO host, and Medline. The period covered was from the early 1990s to 2005. Johnson (2002) believes that in-depth interviewing means seeking deep information and understanding. Based on Bobbie s (1998) and Johnson s (2002) points of view, a successful in-depth interview requires the researcher to have a clear understanding of the research object and to understand the interview questions and the information that the study intents to gain.

8 Research Framework There are four steps in the research framework: 1. Topic research, 2. Data collection method, 3. Research method, 4. Results. The details of each research step will be discussed in the coming section. In methodology, the cycle of Planning- Action- Evaluation- Reflect represents the action research spiral. As shown in Figure 1. The Journal of Human Resource and Adult Learning Vol. 4, Num. 1, June 2008 23 Research QuestionMethodologyData collectionLiterature reviewIn-depth interviewResignation in nursingPlanningEvaluationReflect (revisit the spiral)Action1. Criteria for selecting the research Methods familiarityIn-depth interviewAt least 5 years working experienceThe average training time was two ~20052. Database: EBSCO host, Medline 12 experts nursesAction Research SpiralResult3.

9 Training classes4. Post test interviewIn-depth interview one-to-one trainingIn order to further understand their reflections on the decision - making process one-to-one trainingTo ensure no difficulty in applying ES and KT methods Figure 1: The Research Framework Methods Familiarity in the Research Participants The twelve nursing staffs were required to study the ES and KT methods. The average training time was two hours, with the classes being taught by the researchers on a one-to-one training to ensure no difficulty in applying ES and KT methods. After the twelve nurses accepted the training of ES and KT methods, they were tested with their decision - making ability using vocation selection as the matter to be decided, following the influence of the SARS event. The time required in the decision - making process was also recorded.

10 Post Test Interviews After the test, all participants were subjected to in-depth interviews in order to further understand their reflections on the decision - making process. This study wants to realize the influence of the SARS The Journal of Human Resource and Adult Learning Vol. 4, Num. 1, June 2008 24 event on the vocation-selection process targeted twelve participants. The study employed the ES and KT methods in the same decision - making question. It was found that using the two different method, eleven participants resulted in the same decision being made, while the other one produced different results. CASE ILLUSTRATION A nurse was chosen to case illustration for the use of the ES and KT methods. A decision was made regarding to the change of career in this case.