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COLLEGE |
Transition
to Professional Nursing
GROUP PROCESS
To e-mail the instructor phillips@fiu.edu
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Read
Chapter 15 (Group Process) and Chapter 13 (Communication) in your textbook
Professional Nursing Practice: |
CLASS HANDOUT
DEFINITION OF GROUP
A group consists of two or more people who share needs and goals and
who take each other into account in their actions.
GROUP STRUCTURE AND ORGANIZATION
TYPES OF GROUPS
Primary
· Small intimate group in which the relationships among members are personal, spontaneous, cooperative and inclusive.
· Communication is face to face.
· Strong sense of group "oneness," “we,” and “our.”
· The primary group is the group people turn to for help and support with health problems.
· Examples: Family, friendship groups, play groups.
Secondary
· Larger, more impersonal and less sentimental.
· Group is means for getting things done.
· Group has impersonal controls and external constraints, such as rules or bylaws.
· Examples: Professional associations, task groups, ad hoc committees, political parties, business groups.
LEVELS OF GROUP
FORMALITY
Formal Groups
· Work organization (task) groups.
· Focus is completion of specific task.
· Characteristics of formal groups:
o Authority is imposed from above.
o Leadership selection (i.e. Chair) is often assigned from above.
o Leaders are often symbols of power and authority.
o Goals of group are often imposed at an even higher level than the Chair.
o The purpose of the group is kept rigid to protect the group’s objectives.
o Expected standards of behavior, regulations, and rules are superimposed on the group.
o Membership in the group is only partly voluntary.
o Interactions within the group are limited, but informal subgroups may be formed.
o Examples: Nursing/staff planning committees, service committees, team committees nursing care conference groups, hospital staff meetings.
Semi-Formal Groups
· Focus is on satisfying a person's social and ego needs.
· Characteristics of semi-formal groups:
o Structure is formal.
o A hierarchy is delineated.
o Membership is voluntary, but selective.
o Prestige and status often accrue with membership.
o Structured activities absorb a large part of group time.
o Objectives and goals are rigid.
o The leader often has control over the choice of a successor.
o Examples: Churches, social clubs, PTAs, lodges.
Informal Groups
· Provide much education and develop social values.
· Characteristics of informal groups:
o Not bound by rules or regulations.
o Interpersonal interactions are spontaneous.
o Usually has a set of unwritten laws and strong code of ethics.
o Has easily recognized basic objectives.
o Rotational leadership is common.
o Duties tend to be assigned by best qualifications.
o Leaders who make mistakes can be replaced quickly.
o Behavioral norms are developed by the group and/or group leader.
o Conformity and group solidarity are important. Deviance by a group member from behavioral norms can be threatening to group perpetuation.
o Group norms are enforced by sanctions (punishments) imposed by group. The leader often sets the tone as to whether a violation is sanctioned or accepted.
o Examples: Friendship, hobby, convenience, self-protective, work-related social groups.
· Work-related social groups (nurses often belong to these):
o Provides a technical challenge (“You can do what I do”).
o Shares social reality (“We all share same environment”).
o Provides an emotional challenge (“I’m OK, you’re OK”).
o Provides a means for active listening (“We all share the same experiences”).
TYPES OF HEALTH CARE GROUPS
· Teaching Groups--purpose is to impart information to participants.
· Self-Awareness/Growth Groups--purpose is to develop or use interpersonal strengths.
· Therapy Groups--purpose is self-understanding, handling stress, changing behaviors.
· Self-Help Groups
o Individuals share a similar health, social or daily living problem.
o Based on helper-therapy principle: Those who help are helped the most.
o Reasons to join a Self-Help Group:
§ Members can experience almost instant kinship, “You are not alone.”
§ Members can talk and listen to concerns and feelings since all share the experience.
§ Members can assist in self-reliance, independence, and role modeling.
§ The group atmosphere is generally one of acceptance, support, encouragement, and caring.
§ Value is placed on idea of mutual aid.
§ The group can provide power by collective action.
o Nurse's role in Self-Help Groups
§ Assist in forming group--find leaders.
§ Share expertise.
§ Give info on existing groups.
§ Participate as resource person.
§ Assist in times of crisis.
GROUP DEVELOPMENT
Orientation Phase
· Group members seek to be accepted.
· Anxiety, uncertainty and insecurity are often high.
· Safe topics are discussed.
Working Phase
· Group goals are established.
· Members feel more comfortable with each other.
· Decisions tend to be by consensus, not vote.
· Differences are handled by adapting and problem solving.
· Disagreements are dealt with openly.
Termination Phase
· Focus is on evaluating the group experience.
· Feelings range from satisfaction to frustration, depending on whether goals were met.
GROUP DYNAMICS
Forces within the group that determine the behavior of the group and
its members.
Factors of Group Dynamics
· Structure and organization—see above
· Commitment
· Leadership style
· Decision making methods
· Member behaviors
· Interaction patterns
· Cohesiveness
· Power
Commitment
· Membership agreement, pledge, obligation to the goals and output of the group.
· Characteristics of group commitment. Members:
o Feel a sense of belonging.
o Enjoy each other.
o Seek each other for counsel and support.
o Support each other in difficulty.
o Value the contributions of other members.
o Are motivated by working in the group and want to do their tasks well.
o Express good feelings opening and identify positive contributions.
o
Feel the goals of the group are achievable and important.
Leadership Style
· Typical ways in which a person takes on the leadership role within a group.
· Characteristics of effective leaders. Leaders:
o Use a leadership style that is natural to them.
o Use a leadership style appropriate to the task and members.
o Assess the effects of behavior on others and themselves.
o Are sensitive to forces acting for and against change.
o Express optimism about human nature.
o Are energetic.
o Are open and encourage openness, confronting the real issues.
o Facilitate personal relationships.
o Plan and organize activities of the group.
o Are consistent in behavior toward group members.
o Delegate tasks and responsibilities to develop members’ abilities.
o Represent the group with other groups.
o Involve members in all decisions.
o Value and use group members’ contributions.
o Encourage creativity.
o Encourage feedback about their leadership style.
Decision Making
· Traditional types of decision making:
o Authority-rule (individual)—one individual makes decision.
o Minority—one small or represented group makes decision (such as board members).
o Majority—the majority—50% plus one vote—makes decision.
o Consensus—the group agrees “in general,” no vote is taken.
o Unanimous—100% of group must agree (difficult).
· Other types of decision making:
o Brainstorming—rationale is that several people in a group can generate more ideas than a single person can.
o Nominal group technique—member responses are written, collected, then discussed.
o Delphi technique—data is gathered through a series of anonymous rounds of an initial question. Agreement is reached through consensus, voting, or statistical average.
· Effective decisions are made when the group members:
o Determine which decision method to adopt.
o Listen to all the ideas of members.
o Feel satisfied with their participation.
o Expertise is well used.
o Problem solving abilities are facilitated.
o Feel a positive group attitude.
o Feel time is well used.
o
Feel committed to the decision and responsible for its
implementation.
Member Behaviors
· Members' participation in the group.
· Each member assumes roles in a group (assigned or assumed). These member roles are:
o Task roles—related to the task of the group. Suggests ideas, evaluates ideas, pulls or links ideas together, seeks or offers information and opinions, summarizes decisions, maintains minutes, stimulates group action.
o Maintenance roles—aimed at maintaining or building the group’s continuity, cohesion, and stability. Offers praise and agreement, mediates conflicts and disagreements, identifies blocks and difficulties, seeks compromise, promotes open communication, relieves tensions by breaks or jokes.
o
Self-serving roles—aimed at satisfying the
individual’s needs and does not enhance group effectiveness. Expresses
negative points of view, calls attention to personal activities, attacks or
criticizes members, asserts authority or dominates, manipulates others,
interrupts or blocks or disrupts group activities/discussions, plays around
or is silly, doesn’t or refuses to participate.
Interaction Patterns
· Allows for analyzing strengths and weaknesses in a group’s interaction patterns.
· Verbal/nonverbal communication between group members during a specified period (such as 10-15 minutes).
·
Can be a visually diagrammed as a “sociogram” with each person
in the group visualized by seating arrangement as a box/circle and each
communication between members diagrammed as a line and arrow (can be a
one-way or two-way arrow).
Cohesiveness
· Amount of "oneness" and common purpose.
· Characteristics of cohesiveness in members. Members:
o Like and trust each other.
o Receive support and praise one another.
o Have similar attitudes and beliefs.
o Are loyal to the group.
o Readily accept assignments.
o Influence each other.
o Feel satisfied and secure.
o Stay in the group and value group goals.
· Characteristics of cohesiveness in the group. The group:
o Goals are valued and consistent with member values.
o Activities are handled by group action.
o Goals that are difficult to achieve are met by persistent efforts.
o Participation is high.
o Commitment is high.
o Communication in high.
o ”We” is heard frequently.
o Productivity is high.
o Norms are adhered to and protected.
Power
· Vital positive force that moves people toward the attainment of group goals.
· Sources of power
o Legitimate power—derived from one’s formal position.
o Reward power—perception of one’s abilities to bestow awards or favors.
o Coercive power—perception of one’s abilities to threaten or punish.
o Referent power—derived from an individual’s own vision, sense of self, and ability to communicate these so others who admire the person and are motivated to follow.
o Connection power—perception that one has important contacts or relationships.
o Expert power—derived from one’s expertise, talents, or skills.
GROUP EFFECTIVENESS
To be effective:
· Group goals are accomplished.
· Group cohesiveness is maintained.
·
Group has ability to modify structure to increase
effectiveness.
COMPARISON OF EFFECTIVE AND EFFECTIVE GROUPS
FACTOR |
EFFECTIVE GROUPS |
INEFFECTIVE GROUPS |
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Atmosphere |
Relaxed, comfortable, informal. |
Tense, boredom is evident. |
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Goal setting |
Clear, understood, modified as necessary. |
Unclear, misunderstood, or imposed. |
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Leadership |
Leadership shifts due to knowledge or experience. |
Leader delegated or based on authority. |
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Member participation |
Different members may assume leadership at different times. |
Participation is unequal, with high-authority members dominating. |
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Communication |
Open, two-way; ideas and feelings are encouraged. |
Closed, one-way; feelings are ignored; members have hidden agendas. |
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Decision making |
By consensus, although various procedures may be instituted. |
By the highest authority, with minimal involvement of members. |
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Cohesion |
Facilitated through inclusion, trust, liking, and support. |
Used as a means of controlling members, promoting rigid conformity. |
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Conflict tolerance |
High. Conflicts are examined and attempts are made to resolve them. Unresolvable conflicts are tolerated. |
Low. Conflicts are ignored, denied, avoided, suppressed, or overridden by group action. |
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Power |
Power is shared and determined by the members’ abilities and information they possess. |
Power is determined by the position in the group. Obedience to authority and control is strong. |
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Problem solving |
High. Constructive criticism is frequent, frank, and oriented toward removing an obstacle. |
Low. Criticism may be destructive, with personal covert or overt attacks. |
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Creativity |
Encouraged. |
Discouraged. People are afraid of appearing foolish if they put forth a creative thought. |