ncm 107 complete
TRANSCRIPT
20 September 2011NCM 107: Nursing ManagementRey Ramirez
ORGANIZATION • What is an organization?
social entity (involves people) goal directed structured and coordinated activity system linked to the external environment open system
• Why organize? Man is a social animal
it is inherent in man (even nomads organize to get food)
no man is an island (early man form tribes to survive)
KEY ELEMENTS OF AN ORGANIZATIONInvolves people interacting with one another
People People
People
IMPORTANCE OF ORGANIZATIONSResource Management
to combine resources to make the desired goals and outcomes
4Ms/1T Money Machine Manpower Materials Time
Produce goods and services efficiently Facilitate innovation
Use modern manufacturing and computer-based technology
Adapt to the influence on changing environmentCreate value for owners, customersAccommodate ongoing challenges of diversity, ethics,
career patterns; and the motivation and coordination of people
CHARACTERISTICS OF AN ORGANIZATIONA purpose
People using Interacting knowledge and in groups and techniques
Working together in patterned relationships
5 BASIC PARTS OF AN ORGANIZATIONTop ManagerTechnical Support StaffMiddle ManagerAdministration Support StaffTechnical Core
Top Manager
Technical Middle Administration Support Staff Manager Support Staff
Technical Core
ORGANIZATIONAL EVOLUTIONEvolution:
One-man operation Father-son/assistant type Functional organization Functional organization plus a central headquarters Multi-diversonal firm Conglomerate
Tends toward increase in the ff: complexity size of organizations accelerating scientific knowledge and technological
developments government role customer needs new paradigms
*warranted the need for ORGANIZATIONAL THEORY
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ORGANIZATIONAL THEORYa way to see and analyze organizations more accurately
and deeply HOW?
based on patterns and regularities in organizational design and behavior
insights into organization functioningSIGNIFICANCE:
makes managers more competent and more influential (with theoretical background)
endless people will see and understand things other people around cannot see/understand
provide an appreciation of understanding of what is happening in organization
PRINCIPLES OF ORGANIZATIONCOMMUNICATION
formal; vertical; horizontalUNITY OF COMMAND
line of command; one superior; vertical lineSPAN OF CONTROL
number of subordinates that a supervisor can supervise effectively
DELEGATION OF AUTHORITY centralized; decentralized, delegate to competent
staff responsibility; accountability SIMILAR ASSIGNMENTS
departmentalization; specializationUNITY OF PURPOSE
all areas work towards a single purpose to achieve success
ORGANIZATION THAT THRIVE IN DYNAMIC ENVIRONMENTFLEXIBLE
Fast Speed Empowered Open in its communication Innovation Learning-oriented
DEVELOPMENT-FOCUSED Learn Energized Team-oriented Performance-based
VALUE-DRIVEN
ORGANIZATIONAL FUNCTIONSOperations ManagementAdministrationProduction ManagementMarketingSupplies ManagementHuman ResourcesSalesResearch and DevelopmentFinanceInformation Technology
ORGANIZATIONAL CLIMATEHealthy Unhealthy- Open and free- Seek help- Take risks- Challenged by job
- Frustrated- Threatened- Reluctant- Excuses for shortcomings
TYPES OF ORGANIZATIONUNITARY
DIVISIONALYZED (+) flexible (+) quick to respond to changes (+) innovative (-) duplication of resources (-) limit exchange of knowledge
CENTRALIZED Chief
Administrative division Investigative division Support service division Uniform division
DECENTRALIZEDMATRIX
(+) to combine functional and divisional (-) have 2 bosses (-) not easily to implement (-) ideal for multicompanies
PROCESS-BASED ORGANIZATION
ORGANIZATIONAL CHART
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ADVANTAGES map lines of decision-making authority helps people understand their assignments and
those of their co-workers reveals to managers and new personnel now they fit
into the organization contributes to sound organizational structures shows formal lines of organizations
LIMITATIONS shows only formal relationship does not indicate degrees of authority may show things as they are supposed to be/used to
be rather than as they are possibility exists of confusing authority with status
MAJOR CHARACTERISTICS THAT DIFFERENTIATE HEALTH CARE ORGANIZATIONservices offeredlength of direct service provisionownershipfinancial provisionteaching statusgeographical locationaccreditation and licensure status
ROLE OF ORGANIZATION Knowledge x Skill = Ability
Attitude x Situation = MotivationAbility x Motivation = Potential Human PerformanceHuman Performance x Resources = Organizational Productivity
MAJOR FORCES INFLUENCING PERSONALITY:
3 PERSPECTIVES OF EFFECTIVENESS Individual Group Organizational
CAUSES OF EFFECTIVENESS: Individual
effectivenessGroup
effectivenessOrganizational effectiveness
Causes:- ability- skill- knowledge- attitude- motivation- stress
Causes:- cohesiveness- leadership- structure- status- roles- norms
Causes:- environment- technologies- strategic choices- structures- processes- culture
SOURCES OF POWERCOERCIVE POWER – is the opposite of reward power and
is based on fear of punishment if one fails to confirmCONNECTION POWER – comes from formal or informal
coalition and interpersonal relations and links to prestigious and influential people within and outside the organization
REWARD POWER – something given in recompenseLEGITIMATE POWER – gives the leader or manager the
right to influence and the staff member an obligation to accept the influence
REFERENT POWER – is based on identification with a leader and what the leader symbolizes
INFORMATION POWER – comes from knowledge, access to information, and the sharing of information
EXPERT POWER– skillful, having knowledge and training
THE NURSE MANAGER INTRODUCTION TO MANAGEMENT
Definition of Management: deciding what to do doing through the effective use of resources coordination and integration of resources through:
P lanning O rganizing L eading C ontrolling
*to accomplish specific goals and objectives within an organization
science and art; a process involving mix of rational leading problem solving decision-making activities intuitive judgment
KEY PURPOSES OF MANAGEMENT AND LEADERSHIP: to provide direction to facilitate change to achieve results through the use of resources
(effective, responsible, creative)
MANAGEMENT THEORIESDIFFERENT THEORIES:
Scientific Management (F. Taylor, M. Weber) Administrative Management (H. Fayol) Human Relations (E. Mayo) Behavioral Science (A. Maslow, D. McGregor) Contemporary Management Theories (Ouchi)
TRADITIONAL MANAGEMENT METHOD: mid-19th century in pre-industrial times apprenticeship cottage industries Laissez-faire economies
SCIENTIFIC MANAGEMENT Taylor, Frederick
Father of Scientific Management frustrated with what he called, “systematic
soldiering”
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Principles: traditional “rule of thumb” means organizing
work must be replaced with scientific methods scientific personnel system must be established
so workers can be hired, trained, and promoted based on technical competencies and abilities
workers should be able to view how they “fit” into the organization and how they contribute to overall organizational
Nursing Implications: Work specialization Nurse staffing Staffing needs Supervisory tasks Departmentalization
BUREAUCRATIC ORGANIZATION Max Weber, a well-known German sociologist,
proposed bureaucracy as organization designed the need for legalized, formal authority and
consistent rules and regulations for personnel Characteristics of Bureaucracies:
there must be a clear division of labor a well-defined hierarchy of authority there must be impersonal rules and impersonality
of interpersonal relationships a system of procedures for dealing with work
situations must exist a system of rules covering rights and duties of
each position must be in place selection for employment and promotion is based
on technical competenceMANAGEMENT PROCESS THEORY
constitutes the body of knowledge that describes how managers conduct activities to keep the organization
why study? a theory provides criteria for determining what is
relevant provides stable focus for undertaking what
we experience enable us to communicate efficiently challenge us to keep learning about our
world Henri Fayol first identified the management
functions of: Planning
prevoyance (think ahead) examine the future and draw up plans of
action Organization
to organize build with the structure, material, and
human of the undertaking Command
to command (to direct) maintain activity among the personnel
Coordination to coordinate bind together, unify and harmonize activity
and effort Control
to control
see that everything occurs in conformity with policy
Fayol’s 14 Principles Specialization/Division of Labor
a principle of work allocation and specialization in order to concentrate activities to enable specialization of skills and understanding, more work focus, and efficiency
Authority with Corresponding Responsibility managers must be able to give orders and
authority gives this right if responsibilities are allocated then the
post holder needs the requisite authority to carry these out including the right to require others in the area of responsibility to undertake duties
delegation process− the job holder is assigned to act as the
agent of the high authority to whom they report
− allocation and permission to use the necessary resources needed (budgets, assets, staff) to carry out the responsibilities
the R = A correspondence is important to understand
Discipline employees must obey and respect the rules
that govern the organization good discipline is the result of effective
leadership discipline is essential for the smooth
running Unity of Command
an employee should receive instructions from one superior only
even where we are involved with team and matrix structures which one involve reporting to more than one boss—or being accountable to several clients
Unity of Direction unity of command idea of having one head
(chief executive, cabinet consensus) with agree purposes and objectives and one plan for a group of activities must be clear
Subordination of Individual Interest to the General Interest Fayol’s line was that one employee’s on
interests or those of one group should not prevail over the organization as a whole
this would spark a lively debate about who decides that the interests of the organization as a whole are
ethical dilemmas and matters of corporate risk and the behavior of individual “chancers” are involved here
shared set of values by people in the organization
− a unitarianism where the reasons for organization/activities and decisions
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are in some way neutral and reasonable
Renumeration of Staff price of services rendered general principle is that levels of
compensation should be “fair” and as far as possible afford satisfaction both to the staff and the firm (in terms of its cost structures and desire for profitability surplus)
Centralization process by which the act of an
organization, particularly regarding planning, decision –making, become concentrated within a particular location and/or group
decisions are made by the top executive/ on the basis of pre-set policies
difference between centralization and decentralization
− also called departmentalization
− there are: fewer ties in the organizational
structure wider span of control bottom to top flow of decision
making and flow of ideas Scalar Chain/Line of Authority
scalar chain of command of reporting relationship from top executive to the ordinary shop operative/driver needs to be sensible, clear and understood
straighten chain of command that extents unbroken from the ultimate officer to the lowest ranks
communication should follow this chain this chain creates delays
− cross communication can be allowed if agreed
Order people and materials should be in the right
place at the right time organization should provide an orderly
place policies, rules, instructions and activities
should be understandable one of the basic problem in management is
the balancing of an organization Equity
Fairness and sense of justice “should” pervade the organization in principle
Stability of Tenure
time is needed for the employee to adapt to his/her work and perform it effectively
stability and tenure promotes loyalty to the organization, it’s purposes and values
high employment is efficient if turnovers cannot be prevented,
management should provide orderly
personnel planning and ensure that replacement are available to fill vacancies
Initiative at all levels of the organizational structure,
zeal enthusiasm and energy enable people to have initiative
respect of employee empowerment employees who are allowed to originate
and carry out plans will exert high levels of effort
Espirit De Corps Need for building and maintaining of
harmony among the work force, teamwork and sand interpersonal relationships
This will also build unity within the organization
ACTIVITIES OF MANAGEMENT Luther Gulick expanded Fayol’s management
functions in his introduction of the 7 activities of management
PARTICIPATIVE MANAGEMENT Mary Parker Follet was one of the 1st theorist to
suggest basic principles of what they would be called “participative decision-making”
managers should have authority with rather than over employees
need for collective decision-makingHAWTHORNE MANAGEMENT
Elton Mayo discovered when the management paid special attention to workers, productivity was likely to increase, regardless of the environmental working conditions
“Hawthorne effect” indicated that people respond to the fact that they are being studied attempting
THEORY X AND Y Douglas McGregor, reinforced these ideas by
theorizing that managed vial attitudes about employees can be directly correlated with employee satisfaction
Theory X – lazy, needs constant supervision Theory Y – self-motivated and are willing to work
hard to meet personal and organizational goalsEMPLOYEE PARTICIPATION
Chris Argris self-esteem and independence not met to become
discouraged and trouble some
MANAGERIAL ROLESrole set is specific tasks a person performs because of the
position they holdroles are directed inside as well as outside the organizationTHREE BROAD ROLE CATEGORIES:
Interpersonal roles managers assume to coordinate and
interact with employees and provide direction to the organization Figurehead role : symbolizes the
organization and what it is trying to achieve
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Leader role : train, counsel, mentor and encourage high employee performance
Liaison role : link and coordinate people inside and outside the organization to help achieve goals
Informational associated with the tasks needed to obtain and
transmit information for management of the organization Monitor role : analyzes information from
both the internal and external environment Disseminator role : manager transmits
information to influence attitude and behavior of employees
Spokesperson role : use of information to positively influence the way people in and out of the organization respond to it
Decisional associated with the methods managers use to
plan strategy and utilize resources to achieve goals Enterpreneur role : deciding upon new
projects ot programs to initiate and invest Distubance handler role : assume
responsibility for handling an unexpected event or crisis
Resource allocator role : assign resources between functions and divisions, set budgets of lower managers
Negotiator role: seeks to negotiate solutions between other manager, unions, customers or shareholders
KEY MANAGEMENT COMPETENCIES: Promote personal and associated development and
empowerment Encourage risk taking innovation and organizational
development Demonstrate socially responsive and ethical behavior Solve problems and make decisions Engage strategic thinking Building partnership with external customers Build and utilize internal network and teams Communicate with others
3 GENERAL CATEGORIES OF MANAGERIAL SKILLS AND ABILITIES: Conceptual skills : ability to analyze and diagnose a
solution and find the cause and effect Human skills : ability to understand, alter, lead and
control people's behavior Technical skills : job specific knowledge required to
perform a task. Common example include marketing, accounting and manufacturing all 3 skills are enhanced through formal training,
reading and practice
NURSING MANAGEMENT LEVELSFIRST LEVEL MANAGER
responsible for supervising non-managerial staff day-to-day activities of a specific unit primarily responsibility for motivating the staff to
achieve the organization
MIDDLE MANAGER supervises a number of 1st level manager's usually in
related specialties or in a given geographical area responsible for people and activities within the
department supervise acts as liaison between upper and 1st level managers
TOP LEVEL executive managers chief nurse executive (CNE) it is to them that middle manager reports primarily responsible for establishing organizational
goals and strategic plans responsible for buffering the effects of the external
environment on nurses within the organization
MANAGERIAL QUALITIESATTRIBUTES OF SUCCESSFUL MANAGERS:
command of basic facts relevant professional knowledge self-knowledge mental agility proactive creative analytical, problem-solving and decision/judging-
making skills continuing sensitivity of events social skills and abilities emotional resilience balance learning habits
FUNCTIONS OF MANAGEMENT • PLANNING: deciding on course of action to achieve desired
results
• ORGANIZING: setting up and staffing the most appropriate organization to achieve the aim
• LEADING: exercising leadership to motivate people to work together smoothly to the best of their ability as part of the team
• CONTROLLING: measuring and monitoring the progress of work in related to the plan of and taking corrective action when required
PLANNING is a mental predisposition to do things in orderly way to think
before acting and to act in the light of factors rather than guesses
deciding for the best alternative among others to perform different managerial functions in order to achieve predetermined goals
PURPOSE: gives direction
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anticipate and offset change effective use of resources give meaning to work improve program and activities basis for control compels visualization of whole
CHARACTERISTICS: purposeful process not an act deliberate, rationale and objective futuristic flexible largely conceptual dimensional hierarchy in nature
PRINCIPLES: objectives - specific, clear and understood facilitates action coordination and communication maybe delegated constantly improved/re-planned tentative and interim
PLANNING HIERARCHYMission/Vision
Vision – mental image or the power of imagination to see something that is not actually visible
Mission – an aim to be accomplished Philosophy
articulate a vision and provide a statement of beliefs and values that direct one’s practice
Goals the end or outcome to be accomplished
Objectives something aimed at/or striven for; things done to
achieve the goalPolicies
a governing plan for accomplishing goals and objectives
Procedures chronological sequence of sets within a process
Roles set of responsibilities or expected results associated
with a job
KINDS OF ORGANIZATIONAL PLANS:STRATEGIC PLAN
a generalized plan outlining decisions of resource allocation, priorities and action steps to reach strategic goals
have long term focusTACTICAL PLAN
plan aimed at achieving tactical goals developed to implement parts of strategic plans concern more with activity getting things done that
deciding what to do have more specific and concrete focus
OPERATIONAL PLAN focuses on carrying out tactical to achieve
operational goals have short term focus and relatively narrow in scope
TIME FRAME FOR PLANNINGLONG-RANGE PLANS
covers many years any plan beyond 5 years
INTERMEDIATE PLANS less tentative and subject to change usually covers from 1 to 5 years specially important for meddle or first line managers parallel tactical plans
SHORT-RANGE PLANS covers 1 year or less generally affects managers day to day activities 2 KINDS OF SHORT-RANGE PLANS:
Action Plan Reaction Plan – develop to react to unforeseen
circumstances
BARRIERS TO GOAL SETTING AND PLANNING AND HOW TO OVERCOME:BARRIERS:
inappropriate goals improper reward system dynamic and complex environment reluctant to establish goals resistance to change constraints lack of resources government restrictions strong competition
OVERCOMING THE BARRIERS: understand purpose of goals and plans communication and participation consistency, revision and updating effective reward system contingency planning – determination of alternative
course of action to be taken if intended plan of action is unexpectedly disrupted/rendered inappropriate
PURPOSES OF GOALSprovide guidance and unified directionpromote good planning and facilitate future goal settingserve as source of motivation to employeesprovide an effective mechanism for evaluation and control
CORPORATE PLANNINGPHASE I – STRATEGICPHASE II – OPERATIONPHASE III – FEEDBACK AND CONTROL
PLANNING PROCESS
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STAGE 1: ANALYSIS OF OPPORTUNITIES SWOT Analysis – this is formal analysis of your
strengths and weaknesses, and if the opportunities and threats that you face
Risk Analysis – understanding pressures for changeSTAGE 2: IDENTIFYING THE AIM OF YOUR PLAN
What do I want the future to be? What benefits do I want to give my customers? What returns do I seek? What standards am I aiming at? What values do I and my organization believe in?
STAGE 3: EXPLORING OPTIONSSTAGE 4: SELECTING THE BEST OPTIONSTAGE 5: DETAILED PLANNINGSTAGE 6: EVALUATION OF THE PLAN AND ITS IMPACTSTAGE 7: IMPLEMENTING CHANGESTAGE 8: CLOSING PLAN
PLANNING CYCLE
STEPS IN PLANNING FUNCTIONS: Establishment of objectives Establishment of planning premises Choice of alternative course of action Formulation of derivative plans Securing Co-operation Follow-up/Aprraisal of plans
BUDGETa planning document used by a department or organization
that forecasts both receipts and expendituresa systematic programming of organizational activities
based on their cost and on the amount of resources available
BUDGET PROCESS
refers to those activities and steps needed to be taken for the manager to formulate a budget
BUDGET WORKSHEET a tool used for/by a manager to prepare their budget
VARIANCES a general term to describe the difference between a
budgeted number and an actual resultSTEPS IN BUDGETING:
Review past performances Review the organization's goals and projection Review the variance Actual preparation of budget
TYPES OF BUDGET: Operating (revenue, expense) Personnel Capital Expenditure Cash Flexible
NUMBERIZING PLANS BY BUDGET: developed such budget as volume and price of sales operating expenses necessary for plans expenditure for capital equipment
GANTT CHARTimplemented work over a perioda time-scale is given on the chart's horizontal axis and each
activity is shown as a separate horizontal rectangle (bar) whose length is proportional to the time required (or taken) for the activity's completion
in project planning, these charts show start and finish dates, critical and non-critical activities, slack time, and predecessor-successor relationship
also called CHRONOOGRAM, invented in 1917 by Henry L. Gantt (1861-1919)
PRINCIPLES OF THE GANTT CHART: measure activities by the amount of time needed to
complete them represent amount of activity that should have been
done in time
ORGANIZING the establishment of a formal structure of authority, through
which work subdivisions are arranged, defined and coordinated for the achievement of defined objectives
provide the relationships between people activities in such way as to organizational goals
occurs through interactional phenomena because of hierarchal arrangement of interdependent people
can be defined as: act of deploying the resources needed to achieve an
identified goal including human resources organizing is critical to success for any enterprise considers whether the resources at their disposal are
effectively deployed PURPOSE: best use of the organizations’ resources to achieve
organizational goals Special phenomenon:
power authority status process of delegation
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LEVELS OF ORGANIZING*Organizing take place in many levelsFIRST: ORGANIZE YOURSELF
get control of your desktop and work area at scheduled intervals
critically evaluate your daily routine at scheduled intervals
avoid time-wasting people and activities inventory your inbox contents organize your day so that your daily activities will
accomplish your plans do not over-schedule yourself
try to avoid scheduling more than half of any day if at all possible
leave time for the work that will have to be done as a result of the events that you have scheduled
examine your daily routine try to avoid scheduling more than half of any day if at
all possible practice the “first things, first” rule
always do first things never do second things
delegate, don’t abdicate inform other who need to know delegate only those things you should avoid procrastination
do the tasks you enjoy the least, firstORGANIZE YOUR DEPARTMENT TO MEET ITS GOALS AND
OBJECTIVES how many layers of management you are in? If there
is more than one why? is the span of control principle observed in your
department? do employees understand the department’s goals
and objectives? are you using the most effective means of
communication? do you have (or attend) too many meetings? do all meetings have a stated purpose and a written
agenda? Agenda item assigned a time limit?
STEPS IN ORGANIZING PROCESSReview plansList tasksGroup tasks into jobsGroup jobsAssign workDelegate authority
TERMINOLOGIESJOB – collection of tasks and responsibilities that an
employee is responsible to conduct; jobs have titlesFUNCTIONS – large number of tasks a complex positions in
the organizationTASK – typically defined as a unit of workROLES – set of responsibilities or expected results
associated with a job
TIME MANAGEMENT
set of skills, tools, systemswork togetherhelp you get more value out of your timewith the aim of improving the quality of your lifeTIME MANAGEMENT STRATEGIES:
Action Idea Logic People time styles Time analysis Daily planning Crisis control Problem analysis Time control Time evaluation
BARRIERS TO EFFECTIVE TIME MANAGEMENT: Habit Work expansion Oversuspension Underdelegation Losing sight of objectives
PRINCIPLES OF TIME MANAGEMENT: Communication Planning Delegating Prioritizing goals
SKILLS ASSOCIATED WITH TIME MANAGEMENT: Planning Prioritizing Goal setting Scheduling Managing your workload
KINDS OF TIME: Managerial Response Discretionary
TIME MANAGEMENT PROCESS: analyzing the present situation
where am I now? developing relevant assumptions
what conditions will most likely exist within the time span of the plan
establish objectives what do I want to achieve?
developing alternatives what ways might I attain objectives?
making a decision implementing the decision establishing review and control
TIME MANAGEMENT TECHNIQUES: personal commitment to improving deciding what not to do learning to say no recording how time is used planning use of time fire fighting vs fire prevention prime time programming blocks of time organizing the workspace memoitis – essential but use only when necessary
COMMON TIME WASTERS: overcommitment visitors
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telephone meetings indecision paperworks and readings lack of delegation lack of priorities
MANAGE MEETINGS: start on time end on time develop agenda only those needed must be present gather information prior to meeting
TECHNIQUES TO STOP PROCRASTINATION: break a large job down to smaller tasks do a start-up task take advantage of your moods consider the consequences of not doing the job consider hiring someone to do the job consider switching job with someone divide up the job to do what one likes to do make a commitment to someone/wager with
someone set goals set realistic time schedule gather necessary information avoid over-commitment give yourself a reward organize the department
functional product geographical process
BENEFITS OF TIME MANAGEMENT: efficient success healthy
OBSTACLES TO EFFECTIVE TIME MANAGEMENT: Obstacles
Unclear objectives Disorganization Inability to say “NO” Interruptions More interruptions Periods of inactivity Too many things at once Stress and fatigue All work and no play
What we can do? Recognize that obstacles exist Identify them Set goals (Specific, Measurable, Attainable,
Realistic, Time bound) Prioritize (Do, Delegate, Delay, Delete) Organize Learn to say “NO”
You can't do everything Don't undertake things you can't complete Remain consistent to your goals
Use your waiting time on public transportation at doctor's office waiting for your phone
on hold when you are early correspondence letter/memos book/tapes
Concentrate on the task at hand Focus on your goal
Consider personal time Morning? Evening? Late night?
Celebrate your success
DECISION-MAKINGis the skill to solve problems by selecting the one course of
action from several possible alternativesit is a key component of time management skills DECISION MAKING PROCESS:
identify the problem and analyze the situation explore the alternatives choose the most desirable alternative implement the decision evaluate the results
DECISION STRATEGIES: Optimizing : greatest possible gain Satisficing : good enough solution Mixed Scanning : satisfied to remove least promising
solutions than select best of remaining options Opportunistic : solution chosen by problem identifier Do Nothing : waiting for the storm to pass Eliminate Critical Limiting Factor : remove most
powerful obstacle to succeesPROBLEM SOLVING PRINCIPLES:
rely on policy for small problem: conserve time for large, unique problems
delegate recurring problems to subordinates trained to handle them
seek information for problem solving from internal and external experts
ensure adequate time and relaxed conditions for creative problem solving
after appropriate consideration, select and implement best solution without rumination
STAFFINGprovides the appropriate numbers and mix of nursing staff
and nursing care hoursto match the actual/projected patient care needsthat will lead to the delivery of effective and efficient
nursing careDETERMINING NURSING CARE HOURS
Nursing Hours Per Patient Day (NHPPD) calculated by dividing the total nursing care
hours by the total census (number of patient) there are no specific standards for nursing care
hours, it varies from the average of 5-7 hours in the medical/surgical units; 10-24 in CCU; 2428 for new, severely burned, selected clients
DETERMINING FULL-TIME EQUIVALENT (FTEs)
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one FTE = 40 hours of work/week for 52 weeks or 2080 hours/year
this is used to staff a unit 24 hours a day, 7 days a week
techniques in determining FTEs hours of week for the staff for 2 weeks, average
daily census and hours of care formula:
ave nsg care hrs x days of staffing period x ave px census hours of week/FTE in 2 weeks
data:− number of hours worked/FTE in 2
weeks = 80− number of days of coverage in 2 weeks
= 14− average daily census = *depends− average nursing care hours (based from
patient classification system) = 6.15 DETERMINING DISTRIBUTION OF STAFF
patient census – or average patient days (annual census/number of beds)
activities workload (care demands) skills of staff training and staff development exposures occupancy rate (average patient days/number of
days in a year) patient-related groups (DRGs)
SCHEDULING cyclic list of nurses working in a given week, in a
particular unit shows balance to work flow between nursing needs
and staff available it allows efficient giving of assignments and improve
staff utilization
PATIENT CLASSIFICATION SYSTEM (PCS)a scheme that groups patients according to the amount
and complexity of their nursing care requirements; it serves as a tool to reassure patient needs, caregivers interventions and the skill levels, required to meet those needs
developing a fair, objective, and reliable way to predict the required number and skill level of staff
to meet patient needsproviding appropriate staffing assignmentmeasured by standards of caredetermined by the number of hours of care neededto provide quality of care to the patientPURPOSES OF PCS:
determine the unit measure for: nursing time nursing hours per patient day (NHPPD)
time needed to provide patient care according to hospital department standards of care and practice
determine: number
monitor changes in patient care needs provide data on each patient care unit to project
staffing needs
ensure quality nursing care provided in a safe environment
PATIENT CLASSIFICATION SYSTEM: Category I – ambulatory; needs no assistance from
health professional Category II – with minimal assistance; with IV
tubings; NSD minor surgery, few days post-operative Category III – with moderate assistance; immediate
post-operative Category IV – full assistance with dependence on
health professional; comatose neurological patientUSES OF PCS:
improve patient satisfaction by providing required time to the patient according to his/her needs
enhance staff satisfaction monitor the provision of quality nursing care
PRIORITY SETTINGINVOLVES:
list the things that frequently get in the way identify aspects of your work that lies in and out of
your control keep a time log (set time frames) evaluate and analyze likely upcoming demands
SUGGESTED PRIORITY SETTING PRACTICES: set up a written priority matrix to analyze activities
that really merit higher priorities attach deadlines “To Do item” always allot a margin of time for interruption in your
plans clarify the time needed for the interruption; decide
whether you can handle it now when you become overloaded, ask for a meeting
with appropriate people: explain the competing demands suggest alternatives ask for additional ideas press for a decision about re-ordering priorities
and responsibilities when you take on a task, clarify scope and
expectations for its completion determine where the importance of this task file in
the “big picture” whenever delegating a task, explain set a specific task
CONSIDERATIONS IN PRIORITY SETTING: ABC of the ABC Maslow’s Hierarchy of Needs Professional ethics/laws Institutional safety rules/regulations
safety firstDELEGATION
it is handling of a task over to another person, usually a subordinate
it is assignment of authority and responsibility to another person
allows a subordinate to make decisions ensure that the delegate understands:
why the work is to be done why they are expected to do
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the date by which they are expected to do it the authority they have to make decision the problems they must refer back the progress or completion report they should
submit how you propose to guide and monitor them the resources and help they will have to complete
the workTIPS FOR DELEGATION:
competent employee reasons for selecting employees explain what and why guidance and support delegate, don’t abdicate inform other who need to know only those things you should
MODALITIES OF DELIVERING NURSING CAREFUNCTIONAL
Advantages The needs of a group of patient are broken down
into tasks Tasks are assigned to RNs/LPNs so the skill are
used to the best advantage Contribute to efficiency and effectiveness in doing
assigned tasks Disadvantages
Uneven continuity of care No holistic view of patient Time consuming Problem with follow-up
TEAM NURSING
a team of nurse provides total patient care to a group of patient A team of nurse to a group of patient Modular limit the team in a geographical area
Advantages Allows use of less prepared nurses Coordinated care
Disadvantages Requires much time for effective communication,
supervision and coordination Diminished continuity of care Fragmented care of client Role confusion
TOTAL PATIENT CARE
also called Case Method one RN is responsible for all aspects of care of one or
more patient Advantages
Continuous, holistic, expert Total accountability Continuity of communication
Disadvantages Too expensive Spends much time with tasks that can be
delegated Places the RN back to the patient bed side from
admission to discharge There is decentralized care RN designs, implements and evaluates patient
care
CASE MANAGEMENT
a model identifying, coordinating and monitoring the implementation of services needed to achieve desired patient care outcomes with a specified period of time
Advantages Reduced complications Reduced cost Increase collaborations Improved quality care
Disadvantages Case manager does not give direct nursing care Treatment focused High level of coordination, supervision and
communication Expensive
PROGRESSIVE DISCIPLINE APPROACH
No Discipline
Goal Warning
Written Warning
Supervision
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Charge Nurse
Med Nurse
TreatmentNurse
Bath duty Nurse(ADL)
Charge Nurse
Patient
Team/Module leader
Team/Module leader
Patient Patient
Charge Nurse
RN RN RN
RN / LPNs RN / LPNs RN / LPNs
Team/Module leader
Patient Patient Patient
Patient Caseload
Caregiver
Case Manager
Caregiver Caregiver
Improper Behavior
Termination
Steps in Progressive Discipline: Counsel the employee regarding the performance
problem and expectations for improvement. Timeless for improvement are given
Reprimand the employee for the first time if the unacceptable behavior continues. This may be oral/written, depending on policies/contacts
Reprimand the employee for the second time if the unaccepted behavior continues. This must be written
Suspend the employee for a given period of time if the unacceptable behavior continues
Terminate employee if the unacceptable behavior continues after return from suspension
Principles of Disciplinary Actions: Have a positive attitude Investigate carefully Be prompt Protect privacy Focus on the act Enforce on the act Enforce rules consistently Be flexible Advice the employee Take connective, constructive action Follow-up
Principles of Disciplinary Actions: Describe the situations and review previous
agreements Ask for explanation Listen and response with empathy Indicate what action you must take and why Agree on specific action Express confidence
Modification of Employee Behavior: Reinforcement Shaping Punishment Extinction
Components of a Disciplinary Action: Codes of conduct Authorized penalties Records of offense and corrective measures Right to appeal
LEADING the 3rd function of management ability to inspire and to influence others in order to attain the
objectives FIRST ACTIVITY
give directions − Clear− Concise− Consistent− Conforms to requirements
should conform with the requirements of the situation tone of directions (different situation requires different
emphasis)
DIRECTING
function of management that gets work done through others
5 SPECIFIC CONCEPTS OF DIRECTING: Giving directions Supervising Leading Motivating Communicating
REASONS WHY PEOPLE ARE DIFFICULT TO DIRECT: Fundamental disagreement Rivalry Different values Real or imagined sight Arrogant behavior or as perceived Feeling worthless Frustrated ambition Not being able to get own way Concern about impact of change Too much pressure – real/ perceived
SUPERVISINGconcern with training and discipline of the work forcefollow-up to ensure prompt execution of ordersSUPERVISOR’S ROLE AS LINE/MIDDLE MANAGER:
People management Managing managerial costs Providing technical expertise Organizing, such as planning work allocation,
monitoring work process Checking quality Dealing with customers/clients Measuring operational performance
SUPERVISOR’S ROLE IN TRAINING: Formulating training objectives Planning the training program Performing training program Evaluating effectiveness
SUPERVISOR’S ROLE DURING ON-THE-TRAINING: preparing the trainer: setting an atmospheres of
receptivity demonstrating the parts of the job; tell and show performance by the trainee; do not permit trainee to
learn in error follow-up and review
QUALITIES OF A SUCCESSFUL SUPERVISOR: Gives clear work orders, communicates well Praises others when deserved Is willing to take the time to listen Has confidence and self-assistance Gains the group’s respect through personal honesty Fair to everyone Demands good work for everyone Gains group trust by representing their view to
higher management Has appropriate technical knowledge of the work
being supervised Understands the group problems Goes “to bat” for the group Is approachable, friendly yet retains some distance
KEY POINTS TO SUPERVISOR’S ROLE IN TRAINING:
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efficiently trained employees will produce less waste and have fewer accidents
poorly trained employees have higher roles of absenteeism, tardiness and turnover
wait for competently trained employees; don’t rush the process
key part of training is the preparation of the trainee remember the 3 basic objective of training point out what the employees know, and do not
know and what they should know and do define what is considered acceptable performance real education should be directed to improve
competence beyond the job now held supervisor plays a critical role in the updating of
training programs and employees skills
CONFERENCEwidely used method of training in healthcareoffers participants the unusual opportunity to contribute
ideas, exchange experiences and solve problem by areas of pooled judgments
drawing together employees with varying skills, experiences and responsibilities in order for the group to learn from each other
success of the conference is dependent on its composition and the skill of the leader
SUPERVISOR AS CONFERENCE LEADER knows the topic planned for the conference fully aware of its goals
EFFECTIVE CONFERENCE MANAGEMENT CHECKLIST Make certain the subject is worth a meeting Plan carefully Work out a plan of action Inspect the meeting room Know the participants Review your responsibilities Don’t forget follow-up
THEORIES OF LEADERSHIPSituationalContingencyTransformation
LEADERSHIP STYLESAutocraticDemocraticLaissez-faire
MOTIVATINGset of skills manager uses to help employee to indentify
own needsfind ways within the organization to help satisfy themcaused behavior, a psychological process that gives
behavior purpose and directionTHEORIES OF MOTIVATION:
Need theorists (Maslow) Personality type
Dissatisfies – relate to pay, job security Satisfiers – content with work
Expectancy theory (Vroom) chance of high satisfaction rewards through
effort HOW TO MOTIVATE PEOPLE?
Take care Be optimistic Respect your employee Create an environment that has meaning for the
employee/his work Encourage new ideas and innovations Develop your employees professionally and
personality at all times Provide awards and rewards Total commitment Make efforts to retain talented and committed
employees
COMMUNICATINGinteractive process whereby the leader influence a groupthe medium by which leadership is conveyed to the groupinvolves the what, how, why the direction is necessarytransfer of information and understandingCOMPONENTS OF COMMUNICATION:
Message – the idea to be conveyed
Communication process – consists of 6 steps Ideation Encoding Transmission Receiving Decoding Response
Communication Climate Positive – enhances the message Negative – detracts from understanding the
message10 BASICS FOR GOOD COMMUNICATION:
Clarify your ideas before communicating to others Consider the physical setting Consider the psychological environment Consult with others when necessary to be sure your
communication is accurate Be mindful of the tome as well as the words of the
message Take the opportunity to convey something to help,
value or praise to the receiver Follow-up your communication Non-verbal communication should support
communication Be an active listener Be assertive when expressing your view
ACTIVE LISTENING Stop talking Put other person at ease Don’t interrupt Empathize Paraphrase Ask open minded questions Use silence
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Allow reflectionBLOCKS TO COMMUNICATION:
Poor listening habits Time and work demands Semantics Frame of reference
CONTROLLING a process comparing actual performance and taking corrective
action if needed to achieve desired objectives PRINCIPLES OF CONTROLLING:
Reflect the nature and needs of the activity Report deviations promptly Forward-looking Objective Flexible Point up exceptions at critical points Economical Understandable Lead to corrective action Reflect the organization pattern
PURPOSES OF CONTROLLING: Establish standards of performance Determine tools to measure performance
− 7 Ms to control: Manpower Mins (time) Money Machine Method (Policies) Materials
Evaluate and provide feedback of performance Improve productivity Provide quality management Institute necessary change
TYPES OF CONTROL: Feedforward – anticipating for the outcome or the
future Concurrent – continuous supervision Feedback
PRINCIPLES OF SUPERVISING CONTROL: Preventive control Management by exception Strategic control point
CONTROL PROCESSStep 1: Establish performance standardsStep 2: Measure actual performanceStep 3: Compare measured performanceStep 4: take corrective action
CHARACTERISTICS OF EFFECTIVE CONTROLProperly designedPrevent problems it was designed to detectSet appropriate standardsSpecify solutionsAccurate and timely
PERFORMANCE APPRAISAL
as a structured formal interaction between a subordinate and supervisor that usually takes the form of a periodic interview (annual or semi-annual) in which work performance of the subordinate is examined and discussed with a view to identifying weaknesses and strengths as well as opportunities for improvement and skill development
APPRAISAL METHODS: Rating Scales
offers a high degree of structure for appraisals traits relevant to appraises job are rated on a bipolar scale/points ranging from “poor” to
“excellent” Advantages :
Structured and standardized Same criteria, rating process for all Easy to use and understandable
Disadvantages : Trait relevance Systematic disadvantages Perceptual errors Perceived meanings Rating errors
Essay Method the appraiser prepares a written statement about
the employee being appraised statement usually:
concentrates on describing specific strengths and weaknesses in job performance
suggests causes of action to remedy the identified problem areas
statement maybe written and edited by the appraiser alone, or it be composed in collaboration with the appraise
Advantages: Less structured and confining Permits the appraiser to examine relevant
issue or attribute of performance Process is open-ended and very flexible
Disadvantages: Time-consuming Difficult to administer Demanding Writing skills of appraisers can
upset/distort the whole process Process is subjective
Rating Scales measure employee performance by examining
the extent to which predetermined work objectives have been met
objectives are established jointly by the supervisor and subordinate
once an objective is agreed, the employee is usually expected to self-audit
to identify the skills needed to achieve the objective they are expected to monitor their own progress and development
Advantages: Concentrates on actual outcomes Employees are judged according to real
outcomes Direct results can be observed
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Advocate that employees performance cannot be taken into constituent parts
Disadvantages: May lead to unrealistic expectations about
what can and cannot be reasonably accomplished
Need for a strong “reality checking” skills for supervisors
Tend to impose a certain rigidity Variable objectives may cause employee
confusionTECHNIQUES OF PERFORMANCE APPRAISAL:
Encourage discussions Constructive intervention Set performance goal Credibility of the appraiser Steps:
Do background work for the performance review Clarify job description and responsibilities Clarify employee development interests and
needs List specific development areas for concentration Review performance objectives and performance
standards Review progress toward objectives through
ongoing feedback and pre-discussions Decide on purpose (s) include giving employees
answers to: What am I expected to do? How well am I going? What are my strengths and weaknesses? How can I do a better job, how can I
contribute more?BENEFITS OF APPRAISAL:
Motivation and satisfaction Training and development Recruitment and in direction Employee evaluation
COMMON MISTAKES IN APPRAISAL: Fear factor Judgment aversion Feedback-seeking Appraiser preparation Employee participation Employee education
BIAS EFFECT OF APPRAISAL: “Matthew Effect”
suggests that no matter hard an employee strives, their past appraisal records will prejudice their future attempts to improve
CHARACTERISTICS OF EFFECTIVE APPRAISAL: Specific Descriptive Certain that feedback is not self-serving Directed towards behavior that can be changed Sensitive to time Feedback is clearly understood
MAINTAINING IMPROVED PERFORMANCE: Describe the improvement Explain the benefit of said improvement to you and
the group Listen with empathy to employee’s comments
Ask the employee if there is anything you can do to further improvement
If appropriate, indicate your intention to take such action
Thank the employee for the improvement
ALLOCATION OF RESOURCESAllocation – decision an organization makes regarding how
many of its resources will be devoted to a particular effortResource Allocation – distribution of organizational assets
to meet identified organizational goalsCONCERNS OF ALLOCATION:
Making staffing mix decisions Meeting regulations requirements Providing care to individual who are medically
indigent and have long-term care needs Providing needed patient care programs Compare values Learning to use finite resources efficiently Wise distribution of available resources Ensure cooperation of everyone
PROCESS OF ALLOCATION: Identify organizational goals Identify available organizational assets/resources Define constraints on decision maker Finding appropriate resources
COST CONTROLThe monitoring of costs, recording, and analysis of the data
to take correctiveCost control implies good cost management which must
include: Cost Estimating Cost Accounting Project Cash flow Earned value reporting
CONCEPT OF COST CONTROL: Cost control is designed
To put pressure on the project manager To perform exceptionally good project So that changes will be minimized
PHASES OF COST CONTROL:
*operating cycle from phase II – phase VPURPOSE OF COST CONTROL:
Derivation of output specifications (project – objectives)
Delineation of required activities (work) Coordination and communication between
organizational units
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Determination of type, amount and timing of necessary resources
Recognition of high-risk elements and assessment of uncertainties
Suggestion of alternative courses of action Realization of effect of resource level changes on
schedule and output performance Measurement and reporting of genuine progress Identification of potential problems Basis for problem solving, decision making and
corrective action Assurance of coupling between planning and control
QUALITY CONTROLRefers to quality related activities associated with the
creation of project deliverablesUsed to verify that deliverables are of acceptable quality
and that they are complete and correctExamples: Peer review; testing processInvolves performance management and maintenanceIncludes systematic method of ensuring conformance to a
desired standard or normQUALITY ASSURANCE (QA)
Refers to the process used to create the deliverables, and can be performed by a manager, client or even a third party reviewer
Examples: process checklist; project audits Process of establishing a target degree of excellence For nursing intervention and taking action to ensure
that each client receives that agreed on level of care Objectives of QA:
Set standard for nursing care delivery Establish as basis to evaluate this standard
Components of QA program: Clear and concise written statement of purpose,
philosophy, values and objectives Standards or indication for measuring quality of
care Policies and procedures for using such standards
in data gathering Analysis and reporting of the data gathered with
isolation of problems and variances Use of the results to prioritize and correct
problems and variances Monitoring of clinical and managerial
performance and ongoing feedback Evaluation of the Q.A. system
QUALITY IMPROVEMENT (QI) Concerned with performance development On going Involved with fixing NOW Preventing future costly mistakes Fostering breakthrough Continuous Quality Improvement (CQI):
Ongoing process of monitoring structure, process and outcome indicator in order to identify signal events, significant trends and opportunities for change
It integrates QA, QC, and QIDIFFERENCE BETWEEN QA AND CQI:
Q.A. – goals only air at maintaining care quality at a present level
C.Q.I. – ongoing process through which care standards and practice behaviors are progressively enhanced Current research findings Practice Patient and public welfare
NURSING CARE STANDARDSStandardThe desired quantity, quality or level of performance that is
established as a criterion against which worker performance will be measured
PURPOSES: Guide the provision of nursing care Provide the means by which nursing personnel are
evaluated in the provision care Provide the means by which to measure the end
results of nursing care through patient outcomesSTANDARDS OF CARE REFERS TO:
Nurses conducting themselves professionally according to generally accepted reasonable practice of nursing care
Conduct themselves with the degree of care, skill and knowledge that reasonably competent nurses would exhibit in any situation
Practice that avoid being found negligent Exercise good judgment, education and training to
the best of their ability under any circumstancesSOURCES OF STANDARD OF CARE:
Nursing Law Professional organizations Code of Ethics for Nurses Joint Communication Accreditation of Healthcare
Organization (JCAH) Case Law and Published opinions by judges State Statutes and Administrative Codes Hospital Policies Authoritative Nursing Journals
LEADERSHIP • NURSING LEADERSHIP:
- What is a leader?- Who is a good leader?- What are the characteristics of a good leader?
• LEADERSHIP:- the process of influencing people while operating to
meet organizational requirements and improving the organization through change
- use of personal traits to constructively and ethically influence organizational outcome are achieved through collective efforts
• LEADER: a person who demonstrates and exercises influence and power (charismatic) over others
• MANAGEMENT: activities need to plan, organize, motivate
• MANAGER: person who directs team of workers• DIFFERENCE BETWEEN MANAGERS AND LEADERS:
MANAGER LEADER- have an assigned position - often do not have delegated
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within the formal organization- have legitimate source of
power d/t delegated authority that accompanies their position- expected to carry out
specific functions, duties and responsibilities- emphasize control, decision
making, analysis, and result
- directs people
-manipulates people, the environment, money, time and other resources to achieve organizational goals- have greater formal
responsibility, accountability and control than leaders- directs willing and unwilling
subordinates
authority
- obtains power through other means such as influence
- has a wide variety of roles than managers do
- focuses on group process, informing, gathering, feedback and empowering others- emphasizes interpersonal
relationships- have goals that may/may not
reflect those of the organization
-may or may not be part of the organization
- directs willing followers
LEADERSHIP CONCEPTS People ask the difference between a leader and a boss… The
leader works in the open, and the boss in convert. The leader leads, and the boss drives. – Theodore Roosevelt
3 ESSENTIAL ROLES OF LEADERS: Define task Achieve the task Maintain effective relationships
PRINCIPLES OF LEADERSHIP: Leaders are made not born It can be learned It requires certain traits No one best style or leadership
PROCESS OF LEADERSHIP: Vision Mission Critical Success factors Goal Actions Steps Results!
FUNCTIONS OF A LEADER: Motivator Mentors Confessors Cheerleaders Coaches Role models Sounding boards
LEADER AND MANAGERLEADER
Facilitator Coordinator Peers or followers Inspiring and integrating Coaching and challenging
Macro Management Problem solving and quality management
MANAGER Director Controller Micro management Blaming Problem identifying Telling and selling Subordinates
THEORIES OF LEADERSHIPDEVELOPMENT OF LEADERSHIP THEORY (1900-PRESENT):
Management and leadership theory is dynamic What is known and believed about leadership Contributes to change overtime
LEADERSHIP THEORY: Describe the nature of leaders
Who are they? What are their unique accomplishments? What are the situations where leadership
intervention required?THEORIES OF LEADERSHIP:
Theories of Leadership (1900-1940) Great Man (1841)
Thomas Carlyle Born with the necessary characteristic to
be great
Trait (1940) C. Bird Inherited could be obtain through learning
and experience Behavioral Theory (1940-1980)
Leadership Style (Kurt Lewin) Authoritarian Leader – dependence
− Strong control is maintained− Motivated by coercion− Communication downward− “I”
Democratic Leader – Independence− Less control− Directed through suggestion and
guidance− Communication flows up and down
− Decision making involves others − “We”
Laissez-faire Leader – Chaos − No control− No direction
Humanistic (1960) Ability to manage “people” more than
organization resources Social environment
Theory X and Theory Y McGregor X – controlled, coerced with threaten Y – self-directed, self-control
Theory Z (1965) W.G. Ouchi Lifetime employment
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Slow promotion Self-Actualization (1965)
Abraham Maslow Contingency Approach (1960)
F.E. Fieldler Task structured Leader-maker Position power
Path Goal (1971) R.J. House Minimize obstruction
Situational (1950-1977) Hershey and Bianchard The follower become leader in some situation
Servant – Leadership (1977, 1991) Natural feeling that one wants to serve
Charismatic (1994) Max Weber Inspires by obtaining emotional commitment Strong beliefs, high, self confidence
Transformational (1994) Heinrich von Pierer Valuing Empowering Promoting quality
Visionary (1994) P. Senge To follow vision through self confidence Empathy
Ethical (1994) R. Heifets
QUALITIES OF A LEADER (MAXWELL)CharacterCharismaCommitmentCommunicationCompetencyCourageDiscernmentFocusPositive AttitudeProblem SolvingRelationship
ResponsibleGenerosityInitiativeListeningPassionSecurityServant hoodSelf DisciplineTeach abilityVision
ABC OF LEADERSHIPPositive Attitude – Self knowledgeEffective Behavior – Communication skillsPersonal Confidence – Transformative practice
PHASES OF LEADERSHIP GROWTHPhase 1 – I don’t know what I don’t knowPhase 2 – I know what I don’t knowPhase 3 – I grow and know and its starts to showPhase 4 – I simply go because of what I know
Ineffective – 1 and 2 Effective – 3 and 4
FORMAL AND INFORMAL LEADERS
Formal – those who are officially assigned leadership responsibilities within the organizationBasis for
ComparisonInformal Formal
General Unofficial OfficialMajor concepts
Power and politics
Authority and responsibility
Primary Focus Person PositionSource of power
Given by group
Delegated by management
Guidelines for behavior
Norms Rules
Sources of control
Sanctions Rewards and penalties
FACTORS OF LEADERSHIPSituationFollower – LeaderCommunication
HOW TO BECOME A GOOD LEADERKnow yourself and seek self improvementBe technically proficientKnow your people and look for their well-beingKeep your workers informedSeek responsibility and take responsibility for your actionsEnsure that the tasks are understood, supervised and
accomplishedDevelop a sense of responsibility in your workersTrain a teamUse the full capabilities of your organization
MORAL ASPECT OF LEADERSHIPRelease of human potentialMutual interdependence of individual and groupMaintain and review valuesFoster individual initiative and responsibilityVALUES:
Deeply held values and principles provide the road map for the way we lead and the way other people respond to us
Managers are people who do things right while leaders are people who do the right thing – Warren Bennis PhD
KNOW the four factors of leadership (follower, leader, communication, situation)
KNOW yourself KNOW human nature DO provide direction DO implement DO motivate BE a professional BE a professional who possesses good characteristics
PROFESSIONAL AND PERSONAL DEVELOPMENT
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ETHICO-MORAL ASPECTS OF NURSING PRACTICE ETHOS: meaning MORAL DUTY, the practical science of the
morality of human conduct MORALS: specific behaviors to accomplish ethical practices HEALTH ETHICS: division of ethics that relate to human health;
also termed as the ethics for the health profession PROFESSIONAL ETHICS: obligations of professional to the
general public BIOETHICS: moral issues in the field of health
NURSING ETHICS(Venzon, et. Al) – the interrelatedness of all principles of
right conduct as they apply to nursing profession(Johnson) – examination of all ethical and bioethical issues
from the prospective of nursingPURPOSES OF NURSING ETHICS:
it directs and teaches the professional nurse how they should act and how it should be
it pertains to the manner of acting and the means to do a certain act in the right way
IMPORTANCE OF BIOETHICS: Every health care provider is a moral agent The health care provider must make his decisions
responsibility through correct moral reasoning and well grounded judgment
PROFESSIONAL CODEBody of information that nurses confer or consult in
making decisions
2 TYPES: Code of Ethics – consists of declarations of faith and
ideas, which the profession upholds and the members conform and follow
Code of Conduct – consists of a paradigm of moral action or a framework of behavior, it is of guideline professional behavior
LAWA system of principles and practices by which people who
live in a society deal with their disputes and problems, seeking to solve or settle without resort to force
Serve as a guide to conductThe sum total of rules and regulations by which society is
governed; rule of conduct pronounced by controlling authorities
Rules of conduct, established and enforced by authority, which prohibit extremes in behavior so that one can live without fear for one self or one’s property
CLASSIFICATION OF LAW (in general): Divine Law – authority – GOD Human Law – authored by man
Public Law – applies generally to people of state enacting it Criminal Law – treats of the nature, extent
and degree of every crime
International Law – regulates the intercourse of nations
Political Law - defines the organization and operation of the government organs of the state and regulates relation between state and individual that compose it
Private Law – relates to private matters that do not concern public at large and administered between citizen and citizen Civil Law – has double purpose of
organizing the family and regulating property
Commercial Law – relates to the rights of property and the relations of persons engaged in commerce
Remedial Law- prescribes method of enforcing rights obtaining redress of their invasion
LEGAL RIGHT That which a man entitled to have or to do, or to
receive from others within the limits prescribed by law
That right to which the states gives sanction A claim which can be enforced by legal means
against persons or the community whose duty is respect it
PURPOSES OF STUDYING ETHICO-LEGAL AND LEGISLATIVE ISSUES: Serves as guide in the performance of nursing
functions and responsibilities addressed by the law Reflect certain concepts of the law in the day to day
functions and tasks Prevent/resolve conflict that may affect basic
societal and individual rights Appreciate nursing’s overall mission, its limits and
constraints Analyze impact of law/legislative issue on nursing
ESSENTIAL SOURCES OF LAW: Constitution Statutes/legislation Regulations issued by executive branch of
government Case decisions/judicial opinions Presidential decrees Letters if instructions
TYPES OF LAW: Tort – legal wrong committed against a person or
property, e.g. assault, battery Unintentional – negligent acts Intentional – presence of interest to harm
another person Liability – obligation incurred or might incurred due
to actions or failure to act Personal – individual person is liable for his/her
actions Vicarious – negligence is assumed due to
association with negligent person Corporate – the organization is responsible for
wrongful conduct of its subordinate
LEGAL ISSUES OF NURSING PATIENT CARE ISSUES:
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Patient’s rights Invasion of privacy Confidentiality Informed consent Sexual Harassment Occupational safety
MANAGEMENT ISSUES: Delegation and supervision Staffing Job reassignment (floating) Policies and procedures Incompetent practice Sexual Harassment Occupational safety
SCOPE OF NURSING: Provide nursing care utilizing nursing process Establish linkages with community resources and
coordination with health team Promote Health education Teach, guide and supervise students in nursing education
programs Undertake nursing and health human resource
development, training and research
CONTRACTAn agreement which creates an obligationAgreement upon sufficient consideration to do or not to do
a particular thingMeeting of minds of mind between 2 persons/parties
whereby one birds himself with respect to the other, to give something or to render some services (Civil Code)
TYPES: Express
Agreement is formal and stated either verbally or in writing
Terms of agreement are declared by the parties in writing or verbally at the time it is entered into
Implied Agreement is presumed or inferred from the acts
of the parties May also arise from mere consent
VALIDITY OF CONTRACT: Must be binding on both contracting parties Contracting parties may established such
stipulations, clauses terms and conditions deemed convenient provided not contrary to law, morals, good customs, public order or public policy
Obligations arising from contracts have the force of law between the contracting parties and should complied in good faith
STATUTORY REQUISITES OF A CONTRACT (ESSENTIAL REQUISITES WITHOUT THERE CAN BE NO CONTRACT): Consent of the contracting parties Object certain which is the subject matter of the
contract Cause of established obligation
OBJECT/SUBJECT MATTER OF A CONTRACT: All things which are not outside the commerce of
men, including future things All rights which are not in transmissible
Future inheritance in case expressly authorized by law
All services which are not contrary to law, morals, good customs, public order and public policy
CAUSE OF CONTRACT: Consideration of the contract that is the inducement
to it or the motive price, or impelling influence which induces a contracting party to enter into the contract
Contract to be valid must have sufficient cause or consideration
WILLAn act whereby a person is permitted the formalities
prescribed by law to control to a certain degree the disposition of his estate to take effect after his death
Making of a will is a strictly personal actNo one can lawfully substitute his intention and willMere mechanical work writing the testator’s work may be
done by a third personTESTATORY CAPACITIES:
Ability to comprehend the nature of the transaction in which the testator is engaged at the time
To recollect the property to be disposed of and the persons who would naturally be supported to have claims upon the testator
To comprehend the manner in which the instrument will distribute his property among the objects of his bounty
Testator must be of sound mind at time of executionHOLOGRAPHIC WILL:
With entirely written, dated, and singed by hand of the testator himself
Subject to no form and need not be witnessed The disposition of the testator written below his
signature must be dated and signed by him for validity
DISALLOWANCE OF WILL: If will was not executed and attested in accordance
with formalities required by law If testator at time of execution of will was in sense or
otherwise mentally incapable of making a will If testator executed will through force or under
duress or influence of fear/threats If will was procured through undue and improper
pressure and influence by the beneficiary or some other persons for the benefit of beneficiary
Of the signature of the testator was procured by fraud or trick
If testator acted by mistake or did not intend at the time he affixed his signature to the will that instrument he signed should be his will
NURSES AND CRIMINAL LIABILITYNurse may incur criminal liabilityPerforming an act offensive against persons or property Committing a felony
Acts or omissions punishable by law committed by: Deceit (dolo) – performed with deliberate intent
freedom intelligence elements essential in a criminal
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− Fault (Culpa) - wrongful act results from
imprudence, negligence, lack of foresight/ lack of still
CONSPIRACY: Exists when two or more persons come to an
agreement concerning the commission of a felony and decide to commit it
CLASSIFICATION OF PERSONS CRIMINALLY LIABLE: Principal
Those who take a direct part in execution of the act of
Those who take directly force/induce others to commit it
Those who cooperate in the commission of the offense of another act which the crime
Accomplices Persons not being principles by direct
participation inducement or cooperation through another act essential to the consummation of the crime cooperate in the execution of the offense by previous or simultaneous acts
Known also as accessory before the act Accessories
Those who having knowledge of the commission of the crime and without having participated therein either as principal or accomplice, take part subsequent to its commission in any of the following manners: By profiting themselves or assisting the
offenders to profit by the effects of the crime
By concealing or destroying the body of the crime, or the effects or instruments thereof, in order to prevent its discovery
By harboring, concealing or assisting in the escape of the principal of the crime
CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY: Justifying Circumstances
circumstances surrounding the commission of a crime may be justified by: Act in defense of oneself of his rights Act in fulfillment of a duty under order of a
superior Exempting Circumstances
imbecile, under 9 y/o, under 15 y/o, merely an accident without intention, under compulsion of an irresistible force, uncontrollable fear, prevented by lawful or insuperable cause
Mitigating Circumstances does not constitute justification but in fairness
and mercy may be considered extending or reducing the degree of moral capability
Aggravating Circumstances increase the criminal liability of the offender or
make his guilt more severe these includes taking advantage, committed with insult to public authority and abuse, committed in consideration of a reward, causing intentional damage
Alternative Circumstances
those which must be taken into consideration as aggravating or mitigating according to the nature and effect of the crime and other conditions attending its commission; these are usually relationship of intoxication to the degree of instruction
LEGAL DOCTRINESFORCE MAJEURE
an irresistible or superior force it is a fact or accident which human prudence can
neither foresee nor prevent extraordinary circumstances cause the act which is
independent of the actorHOLD-OVER DOCTRINE
the principle under which a public officer is permitted to continue in possession of an office and to continue to exercise the functions of the office after the end of his lawful term
JUS SOLIS the principle that the nationality of a person is
determined by the law of the place of his birthRES IPSA LOQUITOR
“the thing speaks for itself” under this doctrine the defendant is presumed to be
negligent where the instrumentality causing another’s injury was in the defendant’s control and where the accident was one which ordinarily does not happen in the absence of someone’s
RESPONDENT SUPERIOR “Let the superior answer, let the principal answer for
the acts of his agent” Under the legal maxim, the principal or master is
answerable for the acts of his agent or servantDOCTRINE OF NEGLIGENT CONDUCT
“the nurse is liable for negligent conduct”
DOCTRINE FOR DAMNUM ABSQUE INJURIA “although there was damage, there was no legal
injury”
INFORMED CONSENTRelated to the principle of autonomy and respect for
person Any procedure to be done on a person may only be
administered with his free and informed consent Gives valid permission for others to act in certain specific
ways ELEMENTS OF INFORMED CONSENT:
Knowledge Information disclosure by the health care
provider, truth of the proposed action, its nature, probable benefits, possible risks, and alternative options
comprehensive subject Consent
Subject competence (decisions based on the reasons)
Subject freedom (able to choose and act without undue pressure of time, emotional upset,
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confusion, persuasion, threat, deception, manipulation, fear)
LEGAL DOCTRINES OF NURSING PRACTICE: Malfeasance, Misfeasance, and Nonfeasance
Performance of action not to be done, improper performance of an action, omission of an action ought to be done
Doctrine of Informed consent The right to information and decide voluntarily
Doctor’s order rule It is legally safe to follow doctor’s order
Good Samaritan Law A nurse or any persons with proper knowledge
and skill may render first aid or treatment at the scene of an emergency and who does so within the standard of care, acting in good faith, is relieved of the consequences of the act
Negligence Refers to the commission or omission of an act,
pursuant to a duty, that a reasonable prudent person in the similar circumstance would or would not do and the acting or the non-acting of which is the proximate cause of injury to another person or his property
Elements of Professional Negligence: Existence of a duty on the part of the
person charged to use due care under circumstances
Failure to meet the standard of due care The foreseeability of harm resulting from
failure to meet the standard The fact that the breach of this standard
resulted in Malpractice
Improper or unskillful care of patient by a nurse, also may be considered as stepping beyond one’s authority with serious consequences
negligence or carelessness of professional personnel
negligent act committed in the course of professional performance
REPUBLIC ACT NO. 9173Philippine Nursing Act of 2002 (Changes in the new law):
Section 4 members of the board of examiners
Section 23 suspension of license not to exceed 4 years
Section 26 requirements for inactive nurse returnees
Section 28 scope of nursing practice, emphasizes code of
ethics, safe practice, APO-NPA Section 32
salary scale Section 34
funding for comprehensive nursing specialty program by PCSO
Section 35 incentive and benefits non-cash in nature standard nurse-patient ratio
PRC BOARD OF NURSING PD 223 – created the professional regulations commission
and prescribed its power and functionsJune 23, 1973Composition – Chairman and members representing 3
areas of nursing (NE, NS, CHN)QUALIFICATIONS:
Natural born citizen, permanent resident of the Philippines
Masters in Nursing, education or allied medical profession
At least 10 years of continuous practice of profession, last 5 years in the Philippines
Member of good standing of the accredited professional organization of nurses
Good moral characterPOWERS AND DUTIES OF THE BOARD OF NURSING:
Conduct licensure exam Issue, suspend or revoke Monitor and enforce quality standards of nursing
practice Ensure quality nursing education Conduct hearings/ investigations Promulgate Code of Ethics in coordination with
accredited professional organization Recognize nursing specialty organization Prescribe, adopt, issue and promulgate guidelines
and decisions for improvement of nursing practice and advancement of profession
QUALITIES OF NURSING EXAMINES: Filipino citizens BSN graduate from an accredited college/university good moral character
REGISTRATION OF RECIPROCITY: professional license issued without examination to
nurses registered under foreign laws Requirements:
Licensure in said country substantially the same as prescribed by Philippine Nursing Act
Laws of said state/country grant same privileges to registered nurses of the Philippines in sane basis as their citizens
From Foreign countries (Licensed nurses granted special/temporary permit): Internationally well-known specialists or
outstanding experts in any filed of nursing who renders service for free or not free
Those on a medical mission whose services shall be free in a particular hospital, center/clinic
Those employed as exchange professors in specially of nursing by school/colleges of nursing
Note: Permit maybe issued by the BON subject to approval of the commission and upon payment of prescribed fee. Permit effective only for duration of the project, medical,
Revocation or Suspension of Professional License and Certificate of Registration: Criminal offense involving moral turpitude
(unprofessional and unethical conduct) Gross impotence/ serious ignorance
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Malpractice/negligence Guilty of fraud, deceit or false statements to
obtain certification of registration Violation of Nursing Act, Code of Ethics for
Nurses, technical standards of nursing practice Practicing professional
TERMINOLOGIESREVOCATION
recall of a power or authority that was conferred of Elimination of the professional statue of a professional nurse
CANCELLATION to annul or to render void/invalid
SUSPENSION forced temporary withdrawal from the practice of
nursing. Stop temporarily privilegeCRIMINAL OFFENSE
violation of law with malicious intent or with intent to injure others
MORAL TURPTITUDE an act contrary to the accepted and customary rule
of right and duty between man and his fellow men or society in general
IMMORAL CONDUCT personal behavior contrary to good morals or
inconsistent with the rules and principles of morality behavior harmful to public welfare according to
standards of the communityDISHONORABLE CONDUCT
personal behavior that is disreputable, discreditable, disgraceful, shameful or scandalous
personal conduct which stains person’s character or lessens his reputation
UNPROFESSIONAL CONDUCT behavior that is unbecoming a member of a
profession in good standing behavior violates rules or ethical code of the
profession
PHILIPPINE NURSING ACT OF 2002ARTICLE I – TITLE
Section 1. Title. This Act shall be known as the "Philippine
Nursing Act of 2002."ARTICLE II – DECLARATION OF POLICY
Section 2. Declaration of Policy. It is hereby declared the policy of the State to
assume responsibility for the protection and improvement of the nursing profession by instituting measures that will result in relevant nursing education, humane working conditions, better career prospects and a dignified existence for our nurses.
The State hereby guarantees the delivery of quality basic health services through an adequate nursing personnel system throughout the country.
ARTICLE III – ORGANIZATION OF THE BOARD OF NURSING
Section 3. There shall be created a Professional Regulatory
Board of Nursing, hereinafter referred to as the Board, to be composed of a Chairperson and six (6) members. They shall be appointed by the president of the Republic of the Philippines from among two (2) recommendees, Per vacancy, of the Professional Regulation Commission, hereinafter referred to as the Commission, chosen and ranked from a list of three (3) nominees, per vacancy, of the accredited professional organization of nurses in the Philippines who possess the qualifications prescribed in Section 4 of this Act.
Section 4. Qualifications of the Chairperson and Members of the Board. The Chairperson and Members of the Board shall,
at the time of their appointment, possess the following qualifications:; Be a natural born citizen and resident of
the Philippines Be a member of good standing of the
accredited professional organization of nurses
Be a registered nurse and holder of a master's degree in nursing, education or other allied medical profession conferred by a college or university duly recognized by the Government: Provided, That the majority of the members of the Board shall be holders of a master's degree in nursing: Provided, further, That the Chairperson shall be a holder of a master's degree in nursing;
Have at least ten (10) years of continuous practice of the profession prior to appointment: Provided, however, That the last five (5) years of which shallbe in the Philippines; and
Not have been convicted of any offense involving moral turpitude; Provided, That the membership to the Board shall represent the three (3) areas of nursing, namely: nursing education, nursing service and community health nursing.
Section 5. Requirements Upon Qualification as Member of the Board of Nursing. Any person appointed as Chairperson or Member
of the Board shall immediately resign from any teaching position in any school, college, university or institution offering Bachelor of Science in Nursing and/or review program for the local nursing board examinations or in any office or employment in the government or any subdivision, agency or instrumentality thereof, including government-owned or controlled corporations or their subsidiaries as well as these employed in the private sector. He/she shall not have any pecuniary interest in or administrative supervision over any institution offering Bachelor of Science in Nursing including review classes.
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Section 6. Term of Office. The Chairperson and Members of the Board shall
hold office for a term of three (3) years and until their successors shall have been appointed and qualified: Provided, That the Chairperson and members of the Board may be reappointed for another term. Any vacancy in the Board occurring within the term of a Member shall be filled for the unexpired portion of the term only. Each Member of the Board shall take the proper oath of office prior to the performance of his/her duties. The incumbent Chairperson and Members of the Board shall continue to serve for the remainder of their term under Republic Act No. 7164 until their replacements have been appointed by the President and shall have been duly qualified.
Section 7. Compensation of the Board Members. The Chairperson and Members of the Board shall
receive compensation and allowances comparable to the compensation and allowances received by the Chairperson and members of other professional regulatory boards.
Section 8. Administrative Supervision of the Board, Custodian of its Records Secretariat and Support Services. The Board shall be under the administrative
supervision of the Commission. All records of the Board, including applications for examinations, administrative and other investigative cases conducted by the Board shall be under the custody of the Commission. The Commission shall designate the Secretary of the Board and shall provide the secretariat and other support services to implement the provisions of this Act.
Section 9. Powers and Duties of the Board. The Board shall supervise and regulate the
practice of the nursing profession and shall have the following powers, duties and functions: Conduct the licensure examination for
nurses Issue, suspend or revoke certificates of
registration for the practice of nursing Monitor and enforce quality standards of
nursing practice in the Philippines and exercise the powers necessary to ensure the maintenance of efficient, ethical and technical, moral and professional standards in the practice of nursing taking into account the health needs of the nation
Ensure quality nursing education by examining the prescribed facilities of universities or colleges of nursing or departments of nursing education and those seeking permission to open nursing courses to ensure that standards of nursing education are properly complied with and maintained at all times. The authority to open and close colleges of nursing and/or nursing education programs shall be vested on the Commission on Higher Education
upon the written recommendation of the Board
Conduct hearings and investigations to resolve complaints against nurse practitioners for unethical and unprofessional conduct and violations of this Act, or its rules and regulations and in connection therewith, issue subpoena ad testificandum (writ of summons to testify orally) but it includes clauses to bring in hand books, papers, etc. for the court). And subpoena duces tecum( "bring with you under penalty of punishment") is a court summons to appear and produce tangible evidence for use at a hearing or trial) to secure the appearance of respondents and witnesses and the production of documents and punish with contempt persons obstructing, impeding and/or otherwise interfering with the conduct of such proceedings, upon application with the court
Promulgate a Code of Ethics in coordination and consultation with the accredited professional organization of nurses within one (1) year from the effectivity of this Act
Recognize nursing specialty organizations in coordination with the accredited professional organization
REPUBLIC ACTSREPUBLIC ACTS TITLE
RA 6675 Generic Drugs Act of 1988RA 9165 Comprehensive Dangerous Drug Act of
2002RA 953 Narcotic Drug Act
RA 9262 Antiviolence against Women and their Children Act
RA 7610 Anti-child abuseRA 7658 Act prohibiting employment of children
below 15 y/oRA 6809 Emancipation LawRA 8172 Salt IodizationRA 3573 Providing Prevention and Supression of
dangerous communicable diseasesRA 7305 Magna Carta for Public Health WorkersRA 8749 Phil. Clean Air Act of 1999RA 6713 Code of Conduct and Ethical Standards for
Public Officials and employeesRA 8344 Act penalizing refusal of hospital/medical
clinic to administer emergency treatmentRA 7160 Local Gov’t CodeRA 2644 Phil Midwifery ActRA 2382 Practice of Medicine by NursesRA 9710 Magna Carta for WomenRA 7600 Rooming in and breast feeding Act of 1992RA 7432 Senior Citizen’s Act of 1992RA 9257 Senior citizens Act of 2004RA 9994 Expanded Senior citizens Act of 2010RA 8423 Establishment of traditional and alternative
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health careRA 877 Philippine Nursing Law 1953
RA 4704 Philippine Nursing Law 1966RA 7305 The Magna Carta of Public Health WorkersRA 8981 The PRC Modernization Act of 2000RA 9262 Anti Violence Against Women & Children
Act 2004RA 9439 Hospital Detention Bill 2007
BON Resolution #220
The Code of Ethics for the Registered Nurse
BON Resolution # 112
Competency Standards for Nursing Practice 2003 (11 Competencies)
CHED Memo Order # 30
Updated Policies and Standards for Nursing Education
EO 496 Procedures/criteria for Selection of Nominees for Vacant Positions in the PRC
HB 4110 Reproductive Health BillHB 5043 The Philippine Reproductive Health Bill and
Population Development Act of 2008HB 13 Providing for the Safety and Protection of
the Unborn Child and for other Purposes (R. Goilez)
HB 3667 The New Anti-Abortion Act of 2010 (A.S. Bagatsing)
SB 2497 Protection of the Unborn Child Act of 2010 (JP Enrile)
SB 1695 Mental Health Patient’s Bill of RightsPD 603 Child and Youth Welfare CodePD 651 Immediate registration of birth w/in 30
daysPD 996 Compulsory Basic ImmunizationPD 856 Sanitation Code of the Philippines
Administrative Order related to EINCPhil constitution
– Art. 3 Sec 1Bill of Rights
AO 2007-0026 Revitalization of the Mother-Baby Friendly Hospital Initiative in Health Facilities with Maternal and Newborn Care Services
AO 2008 – 0029 Implementing Health Reforms for the Rapid Reduction of Maternal and Neonatal Mortality
AO 2009 – 0025 Adopting New Policies and Protocol on Essential Newborn Care
AO 2010-0036 The Aquino Health Agenda: Achieving Universal Health Care for All Filipinos
WHO GUIDELINES: Baby Friendly Health Initiatives: Revised, Updated
and Expanded for Integrated Care : Section 4 - Hospital Self-appraisal and Monitoring (January 2006)
Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice (Integrated Management of Pregnancy and Childbirth, 2006)
WHO Recommendations for the Prevention of Postpartum Hemorrhage, 2006
Newborn Care until the First Week of Life Clinical Practice Pocket Guide, 2009
Philhealth Circular No. 011-2011 New Philhealth Care rates for Selected Medical Cases
and Surgical Procedures and the No Balance Billing Policy
PERSONAL/PROFESSIONAL STAFF DEVELOPMENT
The provision of creative and consistent high-quality education to adult learners who practice nursing in an environment of rapid advances in technology, budget constraints, and sophisticated performance improvement techniques
It is based on a philosophy of ADULT EDUCATION that utilizes teaching-learning principles and concepts that apply to people who have a combination of responsibilities (such as in the including family, financial obligations, employment commitment, and identified areas of interest or specialization)
Nurses who are adult learners combines many of these traditional adult responsibilities with the demands of increasingly complex societal and health care provider roles
AIM OF STAFF DEVELOPMENT PROGRAMS: to educate the whole person towards building
competencies for performing various roles in life (Malcolm Knowles, 1978)
ROLE OF MOTIVATION IN STAFF DEVELOPMENT: Motivation is the energy that causes adults to strive
toward competence that are importantSTAFF DEVELOPMENT PROCESS:
Focuses on developing nursing skills and knowledge within a comprehensive program that includes: Orientation
Introduces employees to new situations and includes content related to philosophies, goals, policies, procedures, personnel, benefits, role expectations, and physical facilities
Orientation is essential every time there is change in the roles responsibilities of a nurse
In-service Education Provides learning experiences in the work
setting for the purpose of:− Refining basic skills− Developing new skills and knowledge-
related to job performance− These learning experiences are aimed
at only one competency or knowledge area and are usually narrow in scope and conducted in a short period of time
Continuing Education Program are planned and organized around learning
experiences in a variety of settings that are intended to build on the educational and experiential bases of the nurse
it offers nurses new approaches to health care delivery and enhance practice, education, administration, research, and theory development
Example includes workshops, conferences, self-learning modules and seminars
Job-related Counseling
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Involves promoting the professional growth of employees by assisting them to deliver their best job performance
It may include counseling related to promotion possibilities and assistance in obtaining formal training in a specialized field
PHILOSOPHY OF STAFF DEVELOPMENT: it must reflect the vision-mission and philosophy of
the organization of which it is a part It needs to address the following:
How learning takes place Teaching methods Employees responsibility for their own learning Organizational responsibility for providing staff
development Client’s right to health care
MODELS OF STAFF DEVELOPMENT PROGRAM: Centralized Model
An agency with a wide staff development department
Composed of nursing and non-nursing multi departmental educators
All departments collaborate in determining and planning the job needs of their staff
Decentralized Model An in-service program managed by the nursing
department It addresses the specific needs of the department
that are solely nursing concerns Concerns may include the use and scheduling of
classrooms, potential duplication of efforts and the cost of providing multiply small programs
RESOURCES NEEDED FOR STAFF DEVELOPMENT: Personnel
Nursing service administrators are responsible for staff development to promote quality client care
The following are among their responsibilities: Providing financial and human resources Establishing policies for staff development Providing release time, finances, or both
for staff to attend continuing education offerings
Motivating employees to assume responsibility for their own professional development
Providing mechanisms to identified staff growth needs
Evaluating the effects of staff participation in continuing education offering on quality of client care
Advisory Committees An advisory committee identify needs and
resources and for planning programs. Member of the committee represent all fields of practice in the health care agencies
CONSIDERATION IN DESIGNING A STAFF DEVELOPMENT PROGRAM: Needs Assessment
Target population Development time Cost
Financial and human resources Analysis time Anonymity Objectivity
Teaching Methods To maximize learning, staff should be aware of
three important aspects involved in teaching adult learners: Collaboration between teacher and
student is essential for active learning to occur
Critical thinking may be seen as a basic principle of adult education
Self-directed learning has an important place in the educational activities of adults
Evaluation Evaluation is essential to provide staff with
information to improve programs or determine whether training programs should be done continued
Adult learners should have a sense of progress toward their goals and should be involved in evaluating their learning
When measuring learning, a before and after approach should be used so that learning can be related to the training programs
TECHNIQUES TO EVALUATE LEARNING: Observation of skills or behavior. Observation guides
need to be developed and observers need to be told specifically what they should be scrutinizing
Paper-and-pencil methods, such as true-false, multiple-choice, or fill-in-the blank tests
Unobtrusive measures, e.g. chart reviews, audits, wear of textbook pages, or numbers of staff using self-directed learning modules
PROGRAM EVALUATION: The content, process, and method of a program
should be evaluated: What the participants liked or disliked about the
program Whether the faculty and speakers were prepared Whether objectives were met How well the program was organized Whether the facilities were adequate Suggestion for improvement Suggestion for future programs
TRANSITIONING TO ROLE OF SKILLED CLINICIAN: Embedded within the transition from school to work
is the process of becoming a SKILLED CLINICIAN Dr. Patricia Benner studied the process of new nurse
skill acquisition and critical thinking and concluded that NEW GRADUATES’s perceptions of complex clinical situations were significantly different from those of nurses with more experience and skill
STAGES OF SKILL ACQUISITION: Novice
Applies theory learned in school Translates lessons into real-life patient care
environment Learns the rule and rule-based reasoning Begins the use of intuition related to patient care
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After successfully adjusting to numerous experiences with real patient care settings, the novice progresses to the advanced beginner stage
Advanced Beginner Begins to discern among situational elements of
clinical decision making Knows the rules that govern care in a situation
but begins to understand how and when the rules can be applied based upon the patient’s condition, desire, and needs
Feels overwhelmed “by the effort required to notice all relevant elements and to remember and increasing number of more complicated rules.”
Competent Begins to understand and adopt a hierarchical
perspective, i.e., to categorize the rules according to relevance and set priorities;
Determines which elements in a situation are deemed to be important in creating nursing care plans
Recognizes that decisions made has specific outcomes, and becomes emotionally involved in the outcome
Proficient Performs interventions with concern and full
involvement Has initiative and able to prioritize task at hand Performs required procedures with proficiency
speed, and confidence Actions become easier and less stressful
Expert Able to handle complex and unique situation Develops the ability to discriminate and choose
one priority over another that requires maturity and practice
Learns and gains experience in the new specialty Joins organizations where he/she can meet
his/her professional goal FIELDS OF SPECIALIZATION:
Institutional nursing (Staff Nursing) In-service Education
Public Health Nursing Occupational Health/Industrial Nursing School Health Clinical Nurse
Private Duty Nursing Military Nursing Advanced Practice Nursing Independent Nurse Practitioner Legal Nursing Consultant Nurse Informatician Nursing Education Flight Cruise Nursing
MIGRATION The movement of persons from one country or locality to
anotherA group of people migrating together (especially in some
given time period)WAVES OF MIGRATION:
First Wave Early 1900’s Filipinos served as plantation
workers of farmlands in Hawaii, Guam, and other US territories
Second Wave 1950’s Filipino nurses, doctors, engineers,
teachers and other professionals by thousands hurdled to the US Mainland and European continent
Third Wave 1980’s when petrodollar countries in the Middle
East required construction workers Fourth Wave
1990’s the verge of the feminization of migration high for women to serve as house helps, entertainers, teachers, nannies, caregivers, etc
CAUSES OF MIGRATION: Economic
Employment to a better job (Financial/ Professional growth)
Employees of: Transnational corporations International NGOs Diplomatic Corps “expatriates”
Non-economic Missionary work Education Retirement migration (migration from rich
countries to lower-cost countries with better climate)
Persecution Asylum
Personal Based on relationships Marriage Reunion with family
ACCULTURATION The process whereby the attitudes and or behaviors
of people from one culture are modified as a result of contract with a different culture
It implies a mutual influence in which elements of two cultures mingle and merge
Deals broadly with changes in cultural attitudes between two distinct cultures
Focus on the group rather than the individual and on how minority or immigrant groups relate to the dominant or host society
Ethnic identity as an aspect of acculturation is concern with individuals and how they relate to their own group as a subgroup of the larger society
Two Distinct Models of Acculturation: Linear Model
a strong ethnic identity is not possible among those who become involved in the mainstream society and that acculturation is inevitably accompanied by a weakening of ethnic identity
Two-dimensional Model Suggests that both the relationship with
the traditional or ethnic culture and the relationship with the new or dominant culture play important roles in the process
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Acculturation Process (JW Berry): Assimilation
Movement toward the dominant culture Integration
Synthesis of the two cultures Rejection
Reaffirmation of the traditional culture, or marginalization (alienation from both cultures)
Measures of Acculturation: All of the scales used to measure acculturation
include: SECOND-LANGUAGE PROFICIENCY
− because being able to communicate in the language of the host culture is a prerequisite to learning about it
PATTERNS − of language use, friendship choices,
food, music or movie preference, cultural awareness, ethnic pride, place of bitch, and contact with one’s homeland
PERCENTAGE− of one’s lifetime spent in the host
country
− One’s age at the time of immigration (have been shown to correlate with more extensive and detailed measures of acculturation and are therefore good indicators of an individual’s level of acculturation when more detailed information is unavailable)
AGING POPULATION: Demography
International UN (2000) 590 million, and by 2025 to over
1.1 billion, that is an increase of 224 percent since 1975
Constitute 13.7 percent of the world’s population
National The total population of the Philippines
stand at 73,130,885 The elderly population is equal to
4,280,364 or 5.8 percent of our population Issues on the Aging Population
Security in old age Occurrence of abuse committed Health status Policies and legislative for welfare Economic impact of aging
Complementary Therapy They go along with the medical care they receive
from their health care provider They are used alongside the more standard
medical care you receive (e.g. herbal teas with acupuncture)
They don’t fit into the mainstream of Western medicine and health care
Common Complimentary Therapies: Physical (body) therapies
− Yoga
− Massage− Acupuncture
Relaxation techniques such as meditation and visualization
Herbal medicine (organic plants)MEDICAL TOURISM
Medical Tourism Philippines Welcomes tourists from all over the world to visit
the Philippines for medical and leisure needs The most common procedure are cosmetic and
plastic surgery dermatology, weight loss surgery, ophthalmology and dentistry
PERSONAL DEVELOPMENTis our conscious self-improvement and self-transienceit is the aspiration to realize our higher self
NURSING AS A CALLING “is nursing just a good career where job prospects
are good?” or “Is nursing more than a job; it s a‟ calling.”
Calling Deep desire to devote oneself to serving people
according to the high values of the task or profession
Direct invitation or commissioning from God for a specific task or assignment that God wants us to do
NURSING AS A VOCATION Nursing is…
Doing good deeds People-oriented Character building
NURSING PROFESSION nursing is a profession focused on assisting
individuals, families, and communities in attaining, maintaining, and recovering optimal health and functioning
Profession is a calling wherein each member profess to have
acquired the knowledge, skills, and attitude necessary to guide others in that special field
PERSONAL DEVELOPMENT TIPS: identify own strengths, weaknesses, limitations determine personal and professional goals pursue continuing education support activities related to nursing and health issues adopt a positive attitude towards change and
criticismCAREER PLANNING
career choices are life choices, take them seriously, do it right
Jobs – paid occupation; something you do regularly for pay
Career – is a long-term of life time job, a profession you choose to spent the rest, or most, of your time in
Career Planning – to plan what job you would like to do for most, or rest of your life; is a lifelong process and it includes: choosing an occupation
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getting a job growing in your job possibly changing careers and eventually retiring
Career Planning Process: Knowing Yourself
Do self-assessment: Interests Values Roles Skills/aptitudes Preferred environment Developmental needs Your realities
Exploring your Options Know which occupations interest you Research the labor market Research on the institutions you wish to
work for When you have narrowed down your
options, you get specific information by: − Networking − Part time work − Internships − Volunteer opportunities − Written materials − Informational interviews
Making Decision/Match Try to identify possible occupations Evaluate these occupations Explore alternatives Choose both a short term and a long term
option Moving on/Action
Work towards goal by:
− Investigating sources of additional training and education, if needed
− Develop a job search strategy − Write a good resume − Gather information about the company − Learn to compose effective cover
letters − Prepare for job interviews − Learn to adopt to change
NURSING CAREER Getting started
Wrong idea: just to “get the first job” Correct idea: find the job that fits you and that is
a good first step on the path to a lifelong career in nursing
FOCUS: long-term career goals and the avenue by which they can be reached
SWOT: An in-depth look at what will make you truly happy in your work, use it for initial assessment of the job market Strengths
Relevant work experience Advanced education Additional product knowledge Good communication and people skills Computer skills Self-managed learning skills
Flexibility Weaknesses
Poor communication and people skills Inflexibility Lack of interest in further training Difficulty adapting to change Inability to see health care as a business
Opportunities Expanding markets in health care New applications of technology New products and diversification Increasing at risk populations
Threats Increased competition among health care
facilities Changes in government regulation
Beginning the Search Be psychologically self-employed
Your career belongs to you, not your employer
Security and advancement on the job are up to you
Security may be elusive, but opportunities for nurses are growing every day
Learn for employability Take personal responsibility for your career
success Learn for your current position but also for
your next position Technical, people skills, work in teams and
make presentations Plan for your financial future
Ask yourself, “How can I spend less, earn more, and manage better?”
Decisions based on financial matters makes one feel trapped and note secured
Develop multiple options Moving up is only one option Be aware of emerging trends in nursing,
adjacent fields, lateral moves, projects Build a safety net
Networking is extremely important Join professional organizations Take time to build long term nursing
relationships Interview Questions:
What is your philosophy of nursing? Relate it to the position you are seeking
What is your greatest weakness? Strengths? Start with weakness (make it sound like a
desirable characteristic); state the obvious (e.g. lack of experience)
End with a positive note (Strengths) Where do you see yourself in 5 years?
Do not employers think that you will use position as a brief stop on the path to another job
Answers should reflect the career plan in tune with the organization s needs (get‟ history of position.. investigate how long staff stays)
What are your educational goals? Be honest and specific
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RN, MAN, other trainings Foreign language, computers Indicate school
Describe your leadership style. How effectively you work with others Give examples of how you have
implemented your leadership in the past What can you contribute to this position?
Review SWOT and job description Be specific in relating your contributions to
the position What are your salary requirements?
You may be asked minimum salary range Investigate employer s salary range for this‟
position beforehand Be honest with your expectations, but
make it clear you are willing to negotiate “What if” questions
Competency-based reviews Be concise Focus on hospital’s philosophy and goals If you don’t know the answer, tell them
how you will go about getting the answer (You are a new graduate, you are not expected that you know everything)
Personal Questions: How would you describe yourself?
Repeat what is in resume/cover letter How would your peers interview
Say only strengths What would make you happy with this position
Discuss needs related to your work environment
Do you enjoy self-direction, flexible hours, and strong leadership support? cite specifics related to your ideal work
environment Describe your ideal work environment; Describe
hobbies, community activities, and recreation Brevity is important This is just used to gauge communication
and interpersonal skills You May Ask:
What is this position s key responsibility ‟ What kind of person are you looking for What are the challenges of the position Why is this position open To whom would I report directly Why did the previous person leave this position What is the salary for this position What are the opportunities for advancement What kind of opportunities are there for
continuing education CAREER MAPPING
Career maps contain detailed information to facilitate choices based on individual s talent and‟ organizational needs. Thus, they enable HR organizations and employees separately or together to choose development paths that build intersections between career aspirations and the needs of the business
“jobs come and go but people who are the „best at what they do and who have achieve the highest‟ recognition for their skills and knowledge in their profession are treasured forever.”
Career Maps: Like a GPS in your care Display alternative routes to build mastery in the
core professions Mastery is being the “best you can be” Those who achieve mastery of their profession or
trades are leaders, mentors, and innovators The knowledge, skills, and ability that mastery
requires is enduring and guides both simple day-to-day decisions as well as complex challenges
Other Desirable Skills: Oral and written communication Ability to assume responsibility Interpersonal skill Proficiency/technical competence Teamwork ability Willingness to work hard Leadership abilities Motivation, flexibility, initiative Critical thinking and analytical skills Computer knowledge Problem solving/decision making
Where to look for jobs: Public employment agencies Private employment agencies HR departments Information from friends/relatives Newspapers, professional journals College and university career centers Career and job fairs Internet websites Other professionals (networking)
CORE-COMPETENCY STANDARDS SIGNIFICANCE OF THE CORE COMPETENCY STANDARDS:
The core competency standards will serve as a unifying framework for nursing education, regulation and practice
Guide in developing curriculum in nursing framework in developing test syllabus for entrants into the nursing profession
Tool for performance, evaluation among nurses Basis for advance practice and specialization Framework for developing a training curriculum for
nurses Protect the public from incompetent practitioners Yardstick for unethical ad unprofessional practice for
nursing CORE COMPETENCIES FOR THE ENTRY-LEVEL:
11 core competencies areas for nursing practice that were identified which include the following:
− Safe and quality nursing care− Management of resources and environment− Health education− Legal responsibility− Ethico-moral responsibility− Personal and professional development
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− Quality improvement− Research− Record management− Communication− Collaboration and team work
APPLICATION OF CORE COMPETENCY IN NURSING PRACTICE:: Assessment of the individual patient needs for nursing:
− Establishes rapport and trust with the patient, family and significant others Welcomes the patient, family and
significant others on admission Greets patient by name, introduces self
and co-staff Communicates in a friendly, polite and
tactful manner Encourages verbalization of needs and
feelings through attentive listening Convey availability and willingness to help
by attending to needs at the soonest time possible
− Obtains a nursing history and does an initial and physical examination Applies the general principles of and
follows a logical sequence in history taking and physical examination
− Recognizes normal and abnormal findings from common laboratory and diagnostic examination results Compares results from a standard listing
of normal values/results of common laboratory and diagnostic examinations
− Defines health needs and problems from data gathered Identifies the significant findings from the
nursing history , physical examination and laboratory/diagnostic test results
Document all relevant information pertinent to patient care:
− Document all relevant information pertinent to patient care: Records where appropriate (kardex, flow
sheets and/or nurses notes) assessments results, treatments and medications, nursing and other health care interventions, and other pertinent information
Writes simply comprehensively and legibly
− Reports/endorses as appropriate Files reports relevant to patient care,
where appropriate (report book/ communication book/others)
Submits summary of endorsements of assigned patients to chare nurse or Nurse IV for inclusion in the endorsement report
− Records the disposition of dangerous drugs/narcotics Records in the disposition sheet the
name, of the patient, ward and bed number. Amount given, date and time administered, name and dangerous drug license number (S2) of the prescribing
physician name and signature of administering nurse
SAFE AND QUALITY NURSING CAREDemonstrate knowledge base on the health/ illness status
of individual/groups Indentifies the health needs of the patients/groups Explains the health status of the patient/groups
Provides sound decision making in the care of individuals/groups Identifies the problem Gathers data related to the problem Analyzes the data gathered Selects appropriate action Monitors the progress of the action taken
Promotes safety and comfort of patients Performs age specific safety measures in all aspects
of patient care Performs safe specific comfort measures in all
aspects of patient careSets priorities in nursing care based on patients’ needs
Identifies the priority needs of the patients Analyzes the needs of patients Determines appropriate nursing care to be provided
Ensures continuity of care Refers identified problem to appropriate individuals/
agencies Establishes means of providing continuous patient
careAdministers medications and other health therapeutics
Conforms to the ten(10) golden rules of medication, administration in health therapeutics
Utilizes nursing process framework for nursing. Performs comprehensive and systematic nursing assessment Obtains consent Complete appropriate assessment forms Performs effective assessment techniques Obtains comprehensive client information Maintains privacy and confidentiality Indentifies health needs
Formulates a plan of care in collaboration with patients and other members of the health team Includes patient and his family in care planning States expected outcomes of nursing interventions Develops comprehensive patient care plan Accomplishes patient centered discharge plan
Implements planned nursing care to achieve identified outcomes Explains intervention to patients and his family
before carrying them out Implements nursing intervention that is safe and
comfortable Acts according to client’s health condition and needs Performs nursing activities effectively and in a timely
mannerEvaluates progress toward expected outcomes
Monitors effectiveness of nursing interventions Revises care plan when necessary
Respond to the urgency of the patient’s condition Identifies sudden changes in the patient’s health
conditions Implements immediate and appropriate intervention
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MANAGEMENT OF RESOURCES AND ENVIRONMENTOrganizes workload to facilitate patient care
Identifies tasks or activities that need to be accomplished
Plans the performance of tasks or activities based on priorities
Finishes work assignment on timeUtilizes resources to support patient care
Determines the resources needed to deliver patient care
Controls the use of supplies and equipmentEnsures functioning of resources
Checks proper functioning of equipment Refers malfunctioning equipment to appropriate unit
Delegate functions to other members of the health team Determines tasks and procedures that can be safely
assigned to other member of the team Verifies the competencies of the staff prior to
delegating tasksMaintains a safe environment
Observes proper disposal of waste Adheres to policies, procedures and protocols on
prevention and control of infection Defines to follow in case of fire, earthquake and
other emergency situation
HEALTH EDUCATIONAssess the learning needs of the patient and family
Obtains learning information through interview, observation and validation
Defines relevant information Completes assessment records appropriately Identifies priority needs
Develops health education plan based on assessed and anticipated needs Considers nature of learner in relation to: social,
cultural, political, economic, educational and religious factors
Develops materials for health education Involves the patient, family, significant others and
other resources Formulates a comprehensive health education plan
with the following components: objectives, content, time allotment, teaching-learning resources and evaluation parameters
Provides for feedback to finalize the planImplements the health educational plan
Provides for a conductive learning situation in terms of time and place
Considers client and family’s preparedness Utilizes appropriate strategies Provides reassuring presents through active listening,
touch, facial expression and gestures Monitors client and family’s responses to health
educationEvaluates the outcome of health education
Utilizes evaluation parameters Documents outcome Revises health education plan when necessary
LEGAL RESPONSIBILITYCore Competency 1: Adheres to practices in accordance
with the nursing and other relevant legislation including contracts, informed consent Fulfills legal requirements in nursing practice Holds current professional license Acts in accordance with the terms of contract of
employment and other rules and recommendation Complies with required continuing professional
education Confirms information given by the doctor for
informed cont Secures waiver of responsibility for refusal to
undergo treatment of procedure Checks the completeness of informed consent and
other legal forms
Core Competency 2: Adheres to organizational policies and procedures, local and national Articulates the vision, mission of the institution
where one belongs Behaves in accordance with establish norms of
conduct of the institution/organization Shows membership of the accredited professional
organization and a professional organization releveant
Core Competency 3: Documents care rendered to patients: Utilizes appropriate patient care records and reports Accomplishes accurate documentation in all matters
concerning patient care in accordance to the standards of nursing practice
ETHICO-MORAL RESPONSIBILITYRespects the rights of individual/groups
Renders nursing care consistent with the patient’s bill of rights
Accepts responsibility and accountability for own decision and actions Meets nursing accountability requirements as
embodied in the job description Justifies basis for nursing actions and judgment Projects an positive image of the profession
Adhered to the national and international code of ethics for nurses Recites the code of ethics for nurses and abides by its
provision Reports unethical and immoral incidents to proper
authorities
PERSONAL AND PROFESSIONAL DEVELOPMENTIdentifies own learning needs
Verbalizes strengths, weaknesses limitations Determines personal and professional goals and
aspirationPursues continuing education
Attends formal and non-formal education Earns required continuing education units
Get involve in professional organization and civic activities
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Participates actively in professional, social, civic and religious activities
Maintains membership to professional organizations Support activities related to nursing and health
issuesProjects a professional image of the nurse
Demonstrate good manners and right conduct at all times
Dresses appropriately Demonstrates congruence of words and actions Behaves appropriately at all times
Possesses positive attitude towards change and criticism Listens to suggestions and recommendations Tries new strategies or approaches Adopts to changes willingly
Performs functions according to professional standards Assess own performance against standards of
practice Sets attainable objectives to enhance nursing
knowledge and skills Explains current nursing practices when situations
call for it
QUALITY IMPROVEMENTGathers data for quality improvement
Demonstrate knowledge of method appropriate for the clinical problems identified
Detects variation in the vital signs of the patient day to day
Reports necessary elements at the bedside to improve patient’s stay in the hospital solicits feedback from patient and significant others regarding care rendered
Participates in nursing adults and rounds Contributes relevant information about patient’s
condition as well as unit’s condition and patient current reactions
Shared with the team current information regarding particular patient’s condition
Speaks for the patient what is relevant to his condition
Documents and records all nursing care and actions Performs daily check up of patient’s
records/condition Completes patient’s records Actively contributes relevant information of patient
during rounds thru readings and sharing with othersIdentifies and reports variances
Documents observed variance regarding patient care and submits to appropriate group within 24 hours
Identifies actual and potential variance to patent care
Submits reports to appropriate groups within 24hours
Recommends solutions to identified problems Gives appropriate suggestions on corrective and
preventive measures Communicates and discusses with appropriate
groups Gives an objective and accurate report on what was
observed rather that an interpretation of the event
QUALITY IMPROVEMENTGather data using different methodologies
Able to identify researchable problems regarding patient care and community health
Identify appropriate methods of research for a particular patient/community problem
Combines quantitative and qualitative nursing design thru simple explanation on the phenomena observed
Analyzes data gatheredRecommends actions for implementation
Based on the analysis of the data gathered, recommends practical solutions appropriate for the problem
Disseminates results of research findings Able to talk about the results of findings to
colleagues/ patients/family and to others Endeavors to publish research Submits research findings to own agencies and
others as appropriate
RECORDS MANAGEMENTMaintains accurate and updated documentation of patent
care Completes updated documentation of patient care
Records outcome of patient care Utilizes a record system ex. Kardex of Hospital
Information SystemObserves legal imperatives in record keeping
Observes confidentiality and privacy of the patient’s records
Maintains an organize system of filing and keeping patient’s records in a designated area
Refrains from releasing records and other information without proper authority
COMMUNICATIONEstablishes rapport with patient
Creates all TRUST and CONFIDENCE Greets client in an open and respectful manner Asks client about themselves Tells client about choices depending on client’s
needs Helps client make an informed choice Explains fully how to choose options Returns visits for future consultation
Listen actively to clients queries and requests Spends time with the client to facilitate conversation
that allows client to express concernsIdentifies verbal and non-verbal cues
Interprets and validates client’s body language and facial expression (IEC materials)
Utilizes formal and informal channels Interprets and validates client’s body language and
facial expression (IEC materials)Responds to needs of individuals, family group and
community Provides reassurance through therapeutic, touch,
warmth and comforting words of encouragement Readily smiles
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Uses appropriate information technology to facilitate communication Utilizes telephone, cell phone email and internet for
disease information Identifies a significant other so that follow up care
can be obtained Provides “holding” or emergency numbers for
services
COLLABORATION AND TEAMWORKEstablishes collaborative relationship with colleagues and
other members of the health team Contributes to decision making regarding client’s
needs and concerns Participates actively in patient care management
including audit Recommends appropriate intervention to improve
patient care Respect the role of other members of the health
team Maintains good interpersonal relationship with
clients, colleagues, and other members of the health team
Collaborates plan of care with other members of the health team Refers clients to allied health team partners Acts as liaison/advocate of the client Prepares accurate documentation for efficient
communication of services
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