n toward a decentralized model that emphasizes participation of staff and especially professional nurses" (p. 57). Decentralization recognizes the service nature of the U.S. economy, improved professionalism of nursing personnel, and the benefits of employee empowerment (Cohen and Wick, 1995, p. 18). The traditional hospital approach with its authoritarian hierarchies of management and labor is being displaced by a "delayered" organization in which managers function to facilitate the group's needs. Pay raises based on individual performance appraisals are being replaced with group evaluations by members of a team with the primary criterion being the satisfaction of patient care needs. Members of a team review patient care needs and allocate staff resources as opposed to the traditional method where a charge nurse makes all assignments. Under the modern approach to healthcare, nurses are hired into units or teams instead of "floated" to other units.
An important aspect in the trend toward decentralization of authority in the nursing profession is cross-training. Cross-training involves instructing nurses to perform the duties of more than one area of responsibility. Thus, for instance, registered nurses would be trained in delivering care in more than one specialty within a hospital. The realities of the mo
...