Transitioning From Closed to Open Systems: How Effective Nurse Leaders Approach Problem Solving and Decision Making in Organizations The objective of this study is to examine transitioning from closed to open systems and how effective nurse leaders approach problem solving and decision making in organizations. This study will utilize systems theory in identifying an issue or process that could be improved and apply knowledge and strategies related to systems theory.

The problem addressed in this study is the excessive trust vested in unlicensed personnel resulting in some to make decisions reserved to licensed health professionals.

Responsibilities of the Nurse Manager

It is reported that the licensed nurse manager or supervising nurse has the responsibility to "delegate professional responsibilities only to persons who are qualified by education, experience or licensure to carry out the responsibility." (New York Office of the Professions, Division of Professional Licensing Services, 2009, p.27) It is additionally reported that it is the responsibility of the State Education Department to investigate any charges relating to whether "administrative and supervisory personnel have made adequate provision for staffing…to ensure necessary patient care in all situations." (New York Office of the Professions, Division of Professional Licensing Services, 2009, p. 27)

II. Specific Nurse-Administrator Duties

Included in the responsibilities and duties of the nurse manager or administrator in patient care are the following: (1) making sure that the personnel's qualifications and capabilities are appropriate to the needs of the patient; (2) accepting the reasonable notice of a nurse to terminate the nurse-patient relationship and locate a qualified replacement; (3) addressing any known vacancies in a timely manner; (4) ensuring that every effort is taken to acquire additional staff that is qualified; (5) assign assistance periodically from another area for the delivery of specific services; (6) prioritize the activities of care that will be given during...

(New York Office of the Professions, Division of Professional Licensing Services, 2009, pp. 27-8)
III. Licensed Professionals and Duties

It is reported that licensed professionals should "in general…must provide only services that they are competent to perform." (New York Office of the Professions, Division of Professional Licensing Services, 2009, p. 28) It is reported that Registered Professional Nurses are authorized to execute medical orders "from select authorized health providers." (New York Office of the Professions, Division of Professional Licensing Services, 2009, p. 30) Additionally, Registered Nurses may functioning independently in the provision of nursing care in the following areas: (1) Case finding: this includes but is not limited to: (a) identification of epidemiological trends; (b) client abuse assessment; and (c) early identification of emergent complications; (2) Health teaching: this includes but is not limited to: (a) patient teaching; (b) patient teaching in relation to disease process and management regarding life factors including health and ethnicity; and (3) Health care promotion: this includes disease and accident preventing as well as teaching normal child growth and development; (4) Health counseling: this includes but is not limited to: (a) mental health counseling; (b) Addiction counseling; and (c) health counseling related to management of chronic diseases; (5) Care Restorative of Life and Well-Being: this includes: (a) rehabilitation services; (b) triage and ongoing assessment; (c) and ongoing surveillance and nursing intervention; (6) Care that is supportive of life and well being including: (a) hospice and palliative care; (b) management of chronic pain through non-pharmacological measures of nursing; and (c) public health care. (New York Office of the Professions, Division of Professional Licensing Services, 2009, pp. 30-1)

IV. Systems Theory

A system is defined…