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The Essential Guide to Thinking for Management Success Effective Decision Making is the definitive guide to the crucial managerial skill of creative thinking.
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The human rationality, however, operates within the limits of a psychological environment that requires a selection of factors in which the individual should base his decisions. In this context, there is the influence of the behavior of decision-makers and the hierarchical structure of the decision-making The results show the need that nurses feel for having autonomy and deliberative spaces in practice. This brings to the surface the importance of organizations appeasing the decision maker, with a psychological environment that favors that decisions made are in line with organizational objectives The problems are composed of elements of valuation value judgments for the purposes of choice when decisions lead to selection of the most current, factual goals factual judgment , when the decisions are implied in implementing these purposes.

This condition demonstrates a hierarchy for the decision-maker in the decisions regarding these elements, as steps toward achieving the objectives will be taken, according to the degree of importance, in descending order Thus, the ability, values and knowledge employed by the decision-maker focus on the administrative efficiency of organizations.

These elements are denominated limits of rationality and behave like moving boundaries bounded which move depending on the situation, making it impossible to apply all of its capacity to the decisions, becoming ineffective. The system is one of stimulus-response, namely, the mechanism of continuity: The approach proposed by Simon 10 - 13 , the theory of rationality, brings issues that can lead to better understanding of how decisions happen to the field of discussions of the decision-making process. Another contribution of rationality theory 13 is the understanding of mechanisms used by human rationality to deal with the complexity of problems, such as: The decision- making model presented in seminars to guide the discussions on the subject is formed by standardized steps, beginning with problem identification, selection of two or more alternatives for resolution, and further evaluation However, this research showed two important results, the first was ignorance, on the part of these nurses, of a process of systematic decision-making; and the second - the model designed for them - showing characteristics of sequential model of decision-making.

Although this model seems to be capable of meeting the needs of the reality of their work, important aspects related to the context and actors participants in the decision-making process were neglected. Nurse managers expressed the need to evaluate the external and internal interference of the problem and define the actors involved in its resolution Figure 1.

However, the classical conception of order in decision-making is formed by ideas closely related to the single reality of the objective world, structured by a chain of causes and effects, with intentionality guided by the preference of each individual. The situations and individuals are constantly changing, which obscures the interpretations of reality The confusing world of ideas that decision-makers face is not systematically organized, but is rather ambiguous and symbolic.

This effect is explained by the characteristics of ambivalent decision-makers who express their preferences, identities, experiences and meanings.

Effective Decision Making

Therefore, when some groups of decision-makers are gathered, common meanings as a basis for decision-making should be established, and not only to group information about the issue. With this precaution, disconnected and ineffective decisions can be avoided As the criteria for problem analysis are multiple and ambiguous in nature, the concepts portrayed by the sequential model theory seem to underestimate the complexity of the decision-making process in the present.

Nurses and mid-level managers are responsible for managing human resources, materials, equipment, and cost information. Currently, these professional participate in the management committee, at the moment of decision-making related to the sectors they manage. In this space, strategic decisions are shared with upper management. Since this is the only deliberating space, these nurses propose a moment of intermediate discussion for maturation of proposals as they are made in an internal council. The political strategies of the decision-making process indicate that the central aspects of decision-making are rational processes, however, the exponents political models of decision- making reject the idea that members of the organization make rational decisions.

Organizations are composed of different groups, driven by actors with varied interests who practice political tactics to influence decisions that affect their positions in the organization. The political behavior of actors increases the uncertainty of decision-making, as it is contrary to its formal rules and may even subvert them The major forms of political intervention in decision-making arise from hierarchical power, financial control needed to implement the strategic decisions, and the influence on and the power of veto. The group of decision-makers is influenced in the decisions they make by public policies and domestic interests.

Therefore, decision-makers need skills and technical knowledge to combine divergent interests and appropriate solutions. In these cases, open discussions on political issues have more effect on the results than an attempt to force the decision through the use of power, or to make a decision based on misinformation due to political artifice The use of power contributes to conflicting situations in the processes and working relationships.

Although there is a formal discourse that nurse managers have autonomy to make decisions related to their work, in the professional practice, nurses confront organizational barriers, a portrait of a political system in which senior managers have partially conflicting goals.

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In this environment, decision-making appears as interlaced processes restricted by rationality and politics, in which the decision-maker that holds more power interferes with and determines the decision 1. Thus, the context for the use of the sequential model of problem-solving cannot meet the work needs of nurses working in a public institution.

Under the perspective of the garbage can 9 , anarchic organizational models can be found in public and educational organizations. As characteristics of this model, decisions are inconsistent and poorly defined preferences; the actors vary in the amount of time and effort they devote to situations that are not in their domain area, the participation is fluid; production processes are not well understood by members of organization, the work is done based on trial and error.

To meet the environment with this degree of uncertainty, the garbage can model indicates flows to deal with problems; the decisions result from multiple events rather than an orderly process. Organizations tend to produce solutions discarded in the "garbage can" by the absence of problems; when problems arise, it is in the "garbage can" that solutions are sought until one fits the needs of the situation 9.

However, a decision can be good or bad for the organization, depending on the facts and the ethical elements that compose it. A good decision carries a moral sense to the decision-maker, who shall select one alternative rather than another. The chosen alternative does not fully satisfy the desired objectives, as it represents only the best solution found in that circumstance.

Selectively, the decision-maker chooses according to his beliefs and values, evidence that decisions are relative. The decision may not represent the ideal solution. In these cases, it is recommended that the rules and regulations of the organization not ethical character , are clear and well defined by upper management, as they will be the limitations necessary for decisions The existence of cognitive limits in the rationality paradigm was identified in a study on decision-making. The basic cycle that decisions follow to solve the problem begin with identifying, advance to development, and alternative choice is broken according to the complexity of the problem.

The conflict between decision-makers influence the manner of decision-making. From the analysis of the study, the authors concluded that the decision-makers are rational in some respects, but not in their entirety, a result that contrasts with the classical view of rationality The decision-making process is a phenomenon with multiple facets, that in addition to the decision-makers involves the decision type, and the method by which the decision is processed, the characteristics of defined actions, the context or environment of choice, and the desired results 5.

Given the complexity of the decision-making process, the decision-maker needs some preparation for confronting it.


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Therefore, another result of this research refers to reflections on management education for nurses. The third category shows that the management instruments used to support the decision-making process are: A study, published in , revealed that nurses have difficulties making decisions in a systematic manner 3.

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The development of skills for professional practice in health and nursing starts in academic life. Efforts of educational institutions and training courses are conducted so that the construction of this knowledge interacts with the daily work, and promotes reflection based on the experienced reality. It is clear, however, that there is a mismatch between the training received and what is expected of the professional in terms of hospital management performance Nurses reported difficulty in articulating the knowledge of the decision-making process and its application in practice 3.

In this situation, one subject scholars reviewed was that universities do not instruct the student in ethical and effective practice. In this process, two questionable assumptions are used by universities to develop their credibility and legitimacy. One, already stated, refers to the idea that students are not prepared for professional practice; the other is the fact that academic research does not provide useful knowledge.

The author proposes a practice epistemology, structured to promote reflective learning, resulting from the interaction between teacher and student, developed through dialogue, counseling, criticism, explanations and teacher performance.

How do smart people make smart decisions?

As a result, learning is replaced by a direction in which the professional acquires substantive understanding of the process that focuses on developing reflective behavior, consistent with the practice, regardless of the organizational context into which the professional is integrated This study aimed to analyze the decision-making model developed by nurse managers, with the methodological guidance of action research. Action research, and participatory construction of the logical framework, proved to be suitable as they allowed the identification of the model adopted as a support for nurses' decision-making, which neglects the limitations of rationality and interferes with the effectiveness of decisions.

Nurses showed a lack of clarity of decision-making as a resource that, when perceived, facilitates and contributes to the achievement of organizational objectives. The results suggest the need to apply management theory models to support the decisions of nurse managers, and thus achieve effectiveness in the results of their decisions. Development of research with other groups of nurse managers to improve the proposed model is necessary.

The discussions and reflections on the decision-making process and decision-making in the hospital setting need to be achieved by the educational institutions so that there is better preparation of professionals regarding the decision-making process. J Nurs Adm [Internet]. Rio de Janeiro RJ: The new science of management decision. Harper and Row; Making decision-making research matter: Management Research Review [Internet]. A garbage can model of organizational choice. Adm Sci Q [Internet]. A Behavioral model of rational choice.

Q J Econ [Internet]. The Free Press; Prediction and prescription in systems modeling.


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  • A primer on decision making how decision happen. Educando o Profissional Reflexivo: Sistemas de apoio e seu impacto. Strategic Management Journal [Internet]. The political aspects of strategic decision making. Nutt PC, Wilson D, editors. The handbook of decision making. Services on Demand Journal.

    METHOD Based on the phenomenon studied and the proposed objective, a qualitative approach was used, with the mode of action research.

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    RESULTS Nurse managers were young, aged between years old, with little management experience, with the time in this activity between one and three years. I just make some things in a non-structured manner. I try to analyze the data, think about what outcome I want to achieve, but I just decide intuitively, in an amateur way. Be the first to ask a question about Effective Decision Making.

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