THE INDIVIDUAL IN DECISION MAKING Although using a decision-making model and improving our ability to think critically, assists

us in making good decisions, these methods are still influenced by individual bias. If individuals receive the same information and use the same theoretical process in making a decision, they should independently reach identical decisions. Because individuals posses different values and life experience, we arrive at different decisions given the same set of circumstances. Values, life experience, individual preference and the individual decision makers willingness to take risks, all influence decision making. VALUES AND DECISION MAKING All decisions we make are influenced either consciously or unconsciously by our value system. The alternatives that are generated and the final choice that is selected in the decision-making process are limited to some extend by this value system. For some individuals certain options are not possible because of personal beliefs. Because our values influence our perceptions they also influence our information gathering and processing. Our values tell us what information is important or unimportant and what problems need to be addressed. LIFE EXPERIENCE Each decision maker brings experiences from the past to decision making. These experiences include education as well as prior encounters with decision making. The more experienced an individual is and broader his or her background, the more alternatives for decision making he\ she may be to bring forth. INDIVIDUAL PREFERENCE AND WILLINGNESS TO TAKE RISKS In all the alternatives considered in decision making, the individual decision maker may see certain alternatives as involving greater personal risk than others, and may therefore choose the alternative that carries the least personal cost. Physical, economic and emotional risks, as well as time and energy expenditure are several types of personal risks and cost involved in decision making. CHARACTERISTICS OF THE SUCCESSFUL DECISION MAKER Hutson [1990] notes the following qualities of successful decision makers Courage : Involves the willingness to take risks Sensitivity: good decision makers seem to have an antenna that makes them particularly sensitive and others. Energy : people must have the energy and desire to make things happen Creativity: successful decision makers tend to be creative thinkers, developing new ways to solve problems. GROUP DECISION MAKING Group plays an important role in decision making in organizations. Most of the decisions in organizations are made in a group context only because they offer the advantages of experience. GROUP DECISION MAKING TECHNIQUES Nominal group technique: [Van de ven and Delbecq 1974] It is a structured and precise method of eliciting written questions, ideas and reactions from group members. NGT is a group process in name only because no direct exchange occurs among members. It consists of

Silently generating ideas in writing Round table presentation by group members of their individual ideas. Discussion of each recorded idea for clarification and evaluation Voting individually on priority ideas, with the group solution being derived mathematically through rank ordering or rating the groups decision rule.

DELPHI TECHNIQUE Here judgments on a particular topic are systematically gathered from participants who do not meet face to face. Ideas are collected through a set of carefully designed sequence of questionnaires of information and opinions derived from previous questionnaires. The process may involve many interactions but normally does not exceed three. This technique can rely on the input of experts widely dispersed geographically. It can be used to evaluate the quality of research proposals or to make predictions about the future based on current scientific knowledge. This technique is useful when expert opinions are needed and expense would prohibit bringing them together. STATISTICAL AGGREGATION Here individuals are polled regarding a specific problem, and their responses are tallied. It is a very efficient technique, but is limited to problems for which a quantifiable answer can be obtained. One disadvantage of this is that no opportunity exists for group members to strengthen their interpersonal ties or for the generative effect of group decision. BRAIN STORMING Here group members meet together and generate many diverse ideas about the nature, cause, definition or solution to a problem without consideration of their relative valve. A premium is placed on generating lots of ideas as quickly as possible and on coming up with unusual ideas. Most importantly, members do not critique ideas as they are proposed. Evaluation takes place after all the ideas have been generated. Members are encouraged to improve on each others ideas. These sessions are very enjoyable but are often unsuccessful because members inevitably begin to critique ideas, and as a result, meetings shift to the ordinary interacting group format. Criticisms of this approach are the high cost- factor, the time consumed, and the superficiality of many solutions. SYNECTICS Whereas brainstorming concentrates on generating a greater number of ideas, synectics tries to identify one different new idea. To avoid eliciting obvious or common solutions, the group leader does not provide the group with a detailed analysis of the problem. Instead, the leader tries to be general as possible in giving background information. The first is personal analogy in which the manager asks group members to identify with the problem. In direct analogy, the second method, comparisons are made with parallel concepts; the human brain and a computer are examples of such parallel concepts. The third method is symbolic analogy, which attempts to describe the problem using interpersonal images. Eg: pain has been described in colour equivalents such as orange or red. The final method is fantasy. Members break conventional thinking patterns and suspend judgement to evoke highly fanciful and imaginative ideas.

3) Normative or prescriptive model:This is most appropriately used when the information is objective when routine decisions are involved and when problem is structured. This approach involves comparing the solutions to the objectives and selecting solutions that will best meet the objective, taking into account the cost against the benefits and the positive and negative consequenences for each option, even though it is not easy to implement, it may yield the highest probability of achieving the desired outcome. 4) Descriptive or Behavioral model: - With this approach, all options outcomes or consequences are not known, here goal is to select an acceptable option. This selects the solution that minimally meets the objective or standard for a decision, the approaches used are use of past experience, gathering more data, use creative approaches etc, advantages of this model is that it is more creative, disadvantage of this models that it will not end in best decision. STEPS IN DECISION MAKING PROCESS 1. Identify the problem and analyze the situation 2. Explore the alternatives 3. Choose the most desirable alternative 4. Evaluate the result 1) Identify the problem and analyze the situation The first step is defining the problem. What is wrong? Where improvement is needed / defines the factors that are causing the problem? Identify the problem by analyzing the situation. The manager should have a questioning attitude. What is the desirable situation/ what are the presenting symptoms? What are the discrepancies? Who is involved? When? Where? With answers to these question managers can develop tentative hypothesis and test them against what they know possible elimination of hypothesis that fail to confirm to the facts reduces the number of causes of to be considered if care able hypothesis should be further tested for causal validity when managers believe they have identified the cause of problem, they should begin exploring possible solutions. 2) Explore the alternatives There are usually a number of ways to solve a problem. Some may be quick and economical but less effective other may be effective but less economical. When solving the problem the manager determines first whether the situation is covered by policy, one most ones experience to solve problem and also learn how others are solving similar problem. This can be done through continuing education, professional meetings, review of literature, correspondence brainstorming with staff. 3) Choose the most desirable alternative:The number and quality of alternative depend largely on the creativity and productivity of managers and their staff. Leadership that prevents immediate acceptance of an apparently obvious solution and facilitates group exploration of decision making opportunities usually increases the number of alternative and the quality of problem solving, avoidance of real problem lack of clear problem definition, insufficient data, early statement of attitude by a status figure, mixing of idea generation, idea evaluation, lack of staff commitment and decision made by large groups also interfere with reaching effective solutions. The following questions are asked will this accomplish the stated

objective/ Does it maximize effectiveness and efficiency, one should use available resources before seeking outside assistance. 4) Implement the decision: After a decision has been made it must be implemented. A decision that is not put into action is useless. The manager needs to communicate the decision to appropriate staff in a manner that does not arouse antagonism. The decision and procedure for its implementations can be explained in an effort to win co-operation, manager selects the staff who has to implement the action and provide direction to initiate the action manager need to control the environment so that function as planned 5) Evaluate the result: - Evaluative criteria is developed for which audits, checklist ratings, rankings can be used FACTORS AFFECTINGS DECISION MAKING The perception of problem can be influenced by internal and external factors 1) Internal factors include variables like decision makers physical and emotional state , personal characteristics, culture, social and philosophical background, past experience, interest, knowledge and attitude 2) External factors include environmental condition and time Decision making tools:1) Decision grids - Decision girds facilitate the visualization of the options under consideration and allow comparison of options using common criteria. 2) Pay off tool- This requires the manager to establish the cost versus benefit relationships and the probabilities of certain outcomes using current information and historical data 3) PERT charts - The programme evaluation and review technique. Decision making in nursing As health care becomes increasingly customer oriented nurses are responding by establishing close patient care advocated relationships. Sound decision making is the foundation needed to advance professional practice. As stated earlier decision making is a process as choosing between alternatives. The decision maker must; 1) Assess the situation Define the situation that has given rise to the opportunities for decision making 2) Plan the process Set the criteria for the decision to satisfy personal, professional, and institutional values. Determine who can make the decision Recognize the possible strategies and screen them for acceptability Predict the possible outcomes of strategies and the positive and negative impact of each

Weigh the risk involved Select the most satisfactory strategy

3) Implement the decision. 4) Evaluate the outcome of the decision Ethical aspects of decision making Ethics is a moral philosophy, a science of judging the relationship of means to ends, and the art of controlling means so they will serve human ends. It involves conflict, choice, and conscience. When there is a conflict, there is a choice between conflicting alternatives. The choice is influenced by values. Values are learned first from important adults and are modified by association with people of different values. Value modification and reinforcement are lifelong processes. A value is consciously prized and cherished, freely chosen from alternatives, and acted on in a variety of ways. There are several ethical positions that do not solve dilemmas. However, they do provide ways to structure and clarify them. Utilitarianism is a community oriented position that focuses on the consequences and prefers the greatest amount of good and happiness for the most people, or the least amount of harm. In contrast, egoism seeks solutions that are best for oneself without regard for others. Ones own pleasure is the concern. Formalism considers the nature of the act and the related principles without thought to personal position or consequences of the actions: be honest; remember the golden rule. Rule ethics expects obedience to laws, rules, professional codes, and authority. Fairness considers distribution of benefits and liabilities from the viewpoint of the least advantaged. Benefit to the least advantaged is the norm in this type of decision making There are also models for ethical relationships. The contractual model provides a contract that identifies general obligations and benefits for two or more people. It deals with the model of both parties and is appropriate for superior- subordinate relationships. In the collegial model, individuals share mutual goals and reach decisions through discussion and consensus. When there are shared values, this model helps build teams and minimize conflict. To make an ethical decision, one must first consider what is intended to be a means and an end and then determine what good or evil is found in he means and the end. If a major evil is intended either as a means or an end, it is an unethical decision. CONCLUSION The decision making style of a nurse is similar to the leadership style that the manager is likely to use BIBLIOGRAPHY 1) Basavanthappa.BT, Nursing Administration, 1st Edition, New Delhi; Jaypee brothers, 2003. 2) Patrica Yonder Wise, leadership and Management in Nursing, St. Louis; Mosby; 1995 3) Tomey Marriner Ann, Guide to Nursing Management and Leadership, 5th Edition, St. Louis; Mosby, 1992.