nursing leadership and management 2

8/6/2019 Nursing Leadership and Management 2

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Nursing Management


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1.MEN


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2.MONEY


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3. MATERIALS


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4.MACHINES


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LEADERSHIP

leading as defined in WEBSTERDICTIONARY means To Guide, togo before and show the wayLeadership in nursing isnecessary to guide nursingpersonnel to a specific goal, that

is the provision of quality nursingcare to their patientsLeadership is the art of developing people


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MANAGEMENT

Is a process by which cooperativegroup directs actions towardscommon goals.

It involves techniques by whichdistinguished group of peoplecoordinates the services of peopleIt includes moral and ethicalstandards in the selection of rightends towards which managersshould strive


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Behaviors of Leaders

PASSIVE AGGRESSIVE ASSERTIVESelf-denying Self-enhancing at

the expense of others

Self-enhancing(self & others)

Inhibited Expressive Expressive

Puts down self;low self-worth andconfidence

Puts down others Feels good aboutself

Allows others to Chooses forothers

Chooses for self

Does not achievegoal

Achieves desiredgoal by hurtingothers

Achieves desiredgoal


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Leadership Roles Management Functions

Acts as a role model,supporter and resourceperson

2. Knows legal liabilities of supervision

. Influences

subordinates to utilizedelegation to facilitateteam building and timemanagement strategies

. Aware of capabilities

and level of motivation of subordinates during task delegation

Guides subordinates indetermining appropriatesituations for delegation

4. Generates andimplements a periodicreview for each delegatedtask.

Ensures patient safety asminimum criteria indetermining most

appropriate person toaccomplish the delegated

Provides incentives andrecognition to showappreciation for the

delegated task completed.


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Leadership Roles Management Functions


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Why do we have to study

MANAGEMENT AND LEADERSHIP?

nurses must realizethat they have to keepup with the manychanges in the healthcare system and its

delivery of services tothe peopleNurses believe thatleaders are made andnot born!!!!!


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RA 7164 focused on threechanges in the effort toimprove the peoples healthfrom hospital or institutionalcare, emphasis shifted tocommunity health deliveryfrom emphasis on physicalcare, efforts are now directedtoward holistic approach to

the care of individuals,families and communitiesfrom being mere recipients of care, patients, individuals,

families and communities are


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the Philippine Nursing Law of 2002, RA 9173 still emphasizesthese concerns of Filipino nursesnurses must learn and adjust tothe complex interrelationshipsbetween and among serviceunits, departments, professionaldisciplines, community agenciesand administrationnurses have to know their placeand their specific roles in theorganizational hierarchynurses find at varying levels thatthey have to manage people,their clients or patients, their


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MANAGEMENT PROCESS

It is universalFor NURSES, knowledge of this processassures them of the smooth

functioning of their units to attain theirgoal of quality of care through the

judicious use of available human andmaterial resources within specifiedperiodsUniversal because it is used inbusiness, in the practice of onesprofession and even in running onesday to day personal affairs.


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HARBIZON and MYERS offers a threefold concept to emphasize a

broader scope of managementand MYERS offers a three fold concept to emphasize abroader scope of management

MANAGEMENT is:An EconomicResourceA System of Authority


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An Economic Resource

management is one of the factors of production together with land, laborand capital.

As industrialization increases,management is substituted for laborand capitalManagement resource of a firm

determines to a large extent, itsprofitability and productivityManagement is used more extensivelyin industries experiencing innovation


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As a System of Authority

management first develops withtop individuals determining thecourse of action for the rank andfilehumanitarian concepts have laterdeveloped paternalistic

approachesthe trend toward a democraticand participative approachfollows as employees receivehigher education


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As a Class and Status

SystemManagers have becomean elite group of brains

and education. Entranceto this class is based oneducation and knowledge

The new managerscontinue to expand theirhorizons in an effort toattain the ultimate in life


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ROLE OF MANAGERS

Mintsberg groups thebasic roles performed bymanagers as

INTERPERSONAL,

INFORMATIONAL,DECISIONAL


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1.INTERPERSONAL ROLEAs a symbol because of the positionhe/she occupies and consists of such duties as signing of papers/documents required by theorganization

As a leader who:HiresTrainsEncouragesFiresRemunerates

Judges


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as a LIASON officerbetween outsidecontracts such as the

community, suppliersand the organization


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2.INFORMATIONAL ROLE

One who monitors informationDisseminates information fromboth external and internal sourcesAs a spokesperson orrepresentative of the organization.He/she represents thesubordinates to superiors and theupper management to thesubordinates


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3.DECISIONAL ROLEAn Entrepreneur or innovator, problemdiscoverer, a designer to improveprojects that direct and control change

in the organizationA Trouble-shooter who handlesunexpected situations such asresignation of subordinates and lossesof clientsAs a Negotiator when conflicts arise


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DEVELOPING FUTUREMANAGERSManagerial development

programs are very usefulmeans of getting qualified

managers. According toKATZ, the necessaryfundamental skills of amanager are:


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a. TECHNICAL SKILLSrelate to the proficiency inperforming an activity in the correctmanner with the right technique

b. HUMAN RELATIONSHIP SKILLSPertains to dealing with people and

how to Get Along with themc. CONCEPTUAL SKILLS

deal with the ability to seeindividual matters as they relate to

the total picture and to developcreative ways of identifyingpertinent factors, responding to thebig problems, and discardingirrelevant facts


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A second approach indeveloping managers ispostulated by Summer in hisearly work whichemphasizes:


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a. ATTITUDE FACTORS

relate to those beliefs, feelings andvalues that may be based on emotionsand may not be subjected to conscious

verbalization.Interest in ones work Confidence in ones mentalcompetence

Desire to accept ones responsibilityRespect for the dignity of onesassociatesDesire for creative contribution

acquired by proper education


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b. KNOWLEDGE FACTORS

> refers to ideas, concepts orprinciples that can beexpressed and are acceptedbecause they have logicalproofs


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c. ABILITY FACTORS


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include skills, art, judgment and

wisdomin the Philippines, Nursing ServiceAdministrators are required to beacademically prepared

Chief Nurses or Nursing ServiceDirectors of hospitals with 100-bedcapacity are required to haveMASTERs DEGREE in NURSING witha major in Nursing AdministrationSupervising Nurses should have atleast 9 units of Graduate Studies inNursingprior to promotion or holding of managerial positions, nurses who


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LEVELS OF MANAGEMENT


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1. TOP MANAGEMENT


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2. MIDDLE MANAGEMENT


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3. FIRST LEVEL

MANAGEMENT


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LEADERSHIP ROLES

TOP ---------------------------ADMINISTRATOR

MIDDLE-----------------------SUPERVISORSFIRST LINE-----------HEADNURSES/SENIOR

NURSESOPERATIONAL LEVEL----------STAFF

NURSES/


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EARLY LEADERSHIP

THEORIES


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A. Trait/ Individual

Characteristic Theory

Some people have

certain characteristicsor personality traitsthat make thembetter leaders thanothers


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B. Great Man Theory

Some people are

born to lead,whereas others areborn to be led.


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C. Behavioral Theories


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1.Autocratic

sometimes called as DIRECTIVEor BUREAUCRATICa leader who uses coercion in

the exercise of his or her powershe or she has no confidence andtrust in his/her subordinateswhich in turn his/hersubordinates do not feel free todiscuss their job with theirsuperior.

Self-centered leader


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Pres. FERDINAND MARCOS


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AUTOCRATIC


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A type of leadership wherein obedienceto authority is strongly enforcedFavors strict rules and establishedauthorityWell-defined group actionsHigh productivity, low creativity, self-

motivation and autonomyIt is most effective in crisis situationswhen highly specialized skills arerequired and options for activities arelimitedIt is used to bring order out of chaosAlso called as Centric or Boss Centeredand THEORY X by MCGREGOR

Leaders thinks all workers are lazy, need


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2. Democratic

People-oriented leader (We)A type of leadership characterizedby free and equal participation indecision-makingPromotes autonomy and growthLess efficient quantitatively thanauthoritative leadership

Collaborative spirit and jointefforts exists and opencommunication prevails

It is a consultative style of


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DEMOCRATIC


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Pres. BARRACK OBAMA


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PRES. BILL CLINTON


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PRES. GEORGE BUSH


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3. Laissez-faire

Permissive leader (You)Let Alone style of leadershipThe style of leadership is highlyeffective in highly motivatedprofessionals like those in researchwhere independent thinking isrewarded

It is not used among health caredelivery systems


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Workers doesnt developsense of direction, supervisionor coordinationA type of leadership that ispermissive with little or nocontrol and motivates bysupport when requested bythe group of people

Frustrating due to overfreedomAppropriate when problems are

poorly defined


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D. Theory X and Theory Y byDouglas McGregor D.1. Theory X Assumptions:

1. The average individual has an inherentdislike for work and will avoid itwhenever possible.2. The average individual prefers to bedirected, hopes to avoid responsibility,and is more interested in financingincentives than in personal achievement.3. Because people dislike work, theymust be controlled, threatened andcoerced to put forth sufficient effort to


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D.2.Theory YAssumptions:1. The expenditure of physical and

mental effort is as natural as restor play.

2. Man will exercise self control and

self direction in the service of objectives to which he is personallycommitted.

3. The average person learns, under

proper conditions, both to seek and to accept responsibility.

4. The capacity to apply imaginationand creativity to the solution of or anizational roblems is widel


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D.3. Theory Z by OUCHI

enlarges upon Theory Y anddemocratic approach toleadershiphas humanistic viewpoint andfocuses on developing betterways of motivating people.


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II. NURSING MANAGEMENT

A. Frederick Winslow Taylor( Father of ScientificManagement)Taylors System for Work ImprovementConsisted of the following steps:Controlled observation of the workersperformance through time and motionstudyScientific selection of the best man toperform each jobTraining the selected worker to perform

job tasks


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4. Paying the worker according

to a differential piece rate5. Appointing a foreman for

each aspect of the work and

making the production workerresponsible for reporting to adifferent functional foremanfor each aspect of his job


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B. Lillian Gilbreth -

First Lady of Management

Benefits of job simplificationand the establishment of work standards

Effects of incentive wage plansand fatigue on work performance.Two of their children, frank andernestine, wrote Cheaper by the

Dozen


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C. Henry Gantt

Development of task and bonusremuneration planEmphasis on service rather thanprofit objects


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D. Henri Fayol - Father of theManagement Process School

First identified the managementfunctions of planning,organization, command,coordination, and control.


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Introduced the followingprinciples:

Principle of division of work Authority and responsibilityUnity of command

Remuneration of personnelEstablishment of tenureCommunication

CentralizationEquity and JusticeEsprit de corps


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E. Max Weber(1864-1920), known as the Fatherof Modern Sociology / Father of Organizational TheoryHe advocated that the ideal form of

organization is bureaucracy.Emphasis is on rules.Bureaucracies are founded on legal

or rational authority which is basedon law, procedures, rules, and soon. Positional authority of asuperior over a subordinate stems

from legal authority. Charismatic


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Efficiency in bureaucraciescomes from:

(1.) Clearly defined and specializedfunctions;(2.) Use of legal authority;(3.) Hierarchical form;(4.) Written rules and procedures;(5.) Technically trainedbureaucrats;(6.) Appointment to positionsbased on technical expertise;

(7.) Promotions based on


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F. James Mooney- he advocated that the

management is the technique indirecting people.

G. Lyndall Urwick - he advocated that the

managerial process consists of

planning, coordinating andcontrolling


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H. Mary Parker Follett

Keypoints:a successful leadership wasmore of a result of training inleadership skills than possessionof specific personality traitssuggested that a manager

should not give orders to anemployee, rather, the twoshould together analyze the

situation and then take orders


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I. Elton Mayo - HawthorneExperiments

concluded that much more thanthe physical environmentaffected worker productivityother factors which influenceproductivity by modifying theworkers social andpsychological satisfactions


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THE SETTING


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HOSPITAL

WHO (World Health Organization)defines Hospital as an integralpart of social and medicalorganization, the function of

which is to provide for thepopulation it serves, completehealth care, both curative andpreventive and whose outpatientservices reach out to the familyin its home and environmentIt is also a center for training of

health workers and for bio-social


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HOSPITAL LICENSURE LAW (

R.A 4226)Defines the term hospital as a place devoted primarily tothe maintenance andoperation of facilities for thediagnosis, treatment and careof individuals suffering fromillness, disease or deformity,or in need of obstetrical orother medical and nursing

care


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CLASSIFICATION OF

HOSPITALSAS CLINICAL, dependingon the type of patientstreatedaccording to ownership

and controlwhether it is a trainingor non-training hospital


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CLINICAL HOSPITALS

A. GENERAL HOSPITALprovide services for all kinds of illnesses, diseases, injuries and

deformitiesexamples are:PHILIPPINE GENERAL HOSPITALQUIRINO MEMORIAL MEDICALCENTER


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B. SPECIAL HOSPITALS

> provide services forparticular kinds of illness ordiseases and offer health and

medical care> EXAMPLE:Philippine Children

MedicalCenterPhilippine Orthopedic

Center


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ACCORDING TO OWNERSHIP

AND CONTROL1. GOVERNMENT HOSPITALAre operated and

controlled either partiallyor wholly by the national,provincial, municipal or

city government or otherpolitical subdivision,board or other agency

thereof


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Example:

National- those directly under theoffice of the president such as PGH,NCMH and POCRegional- Batangas RegionalHospitalProvincial-Bulacan IntegratedProvincial HospitalCity- Ospital ng Maynila, QuezonCity General Hospital, MandaluyongCity Medical CenterMunicipal or Rural- Don FormillezaMemorial Hospital


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2.PRIVATE OR NON-GOVERNMENTALHOSPITALS

are privately owned,established and

operated with funds,raised capitals or othermeans by privateindividuals,associations,

corporations religious Examples:


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Examples:

MISSIONARY MARYJOHNSTON HOSPITALOUR LADY OF LOURDES HOSPITALILOILO MISION HOSPITAL

CIVIC ORGANIZATIONSQUEZON INSTITUTE run by thePhilippine Tuberculosis Society

COMMUNITY ROMERO COMMUNITY HOSPITAL

PRIVATE1. ST. LUKES MEDICAL HOSPITAL


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TRAINING AND NON-TRAININGHOSPITAL

1. TRAINING HOSPITALIs a departmentalized hospitalaccredited Residency TrainingProgram in one or more specified

specialty or disciplineExamples are:

Jose Reyes Memorial Medical HospitalTondo Medical CenterQuirino Memorial Medical CenterSt. Lukes Medical Center


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2. NON-TRAINING HOSPITAL

May be departmentalized butwithout an accredited ResidencyTraining Program in one or morespecialty disciplines


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HOSPITAL CATEGORIES


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1. PRIMARY HOSPITALS

> are composed of municipal andmedicare hospitals which havefacilities and capabilities for first

contact emergency care andhospitalization of simple cases


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2. SECONDARY HOSPITALS

Consists of district hospitals withcapabilities and facilities formedical care of cases requiring

hospitalization. It has theexpertise of trained specialistsExamples are hospitals with 50up To 100 beds


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3. TERTIARY HOSPITALS

are specialized centers, regionalhospitals, medical centers,provincial or general hospitals.

Tertiary hospitals havecapabilities for providing medicalcare to cases requiringsophisticated diagnostic andtherapeutic equipment andexpertise of trained specialistsand subspecialties


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4. SPECIAL TERTIARY

HOSPITALare fully equipped withsophisticated diagnostic andtherapeutic facilities for specific

diagnostic and therapeuticfacilities for specific medicalproblem areas.Examples are:

LUNG CENTER OF THE PHILIPPINESPHILIPPINE HEART CENTERPHILIPPINE CHILDRENS MEDICAL

CENTER


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THE MANAGEMENT PROCESS


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I.PLANNINGis the first function, one mustrecognize that it permeates intoother functions which aredependent on itby FORECASTING one can estimate

the futureby setting OBJECTIVES, the resultsto be achieved can be determinedby DEVELOPING and SCHEDULING

programs, the activities neededwithin a set time frame can bedefinedby preparing the BUDGET, tools andresources can be allocated while


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PURPOSE OF PLANNING

DIREC

T


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TYPES OF PLANNING


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ELEMENTS OF

PLANNING:


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1 . Forecasting


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It Includes:

SETTING THE VISION MISSION


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SETTING THE VISION, MISSION,PHILOSOPHY, GOALS AND

OBJECTIVES1. VISION


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2. MISSION

3 PHILOSOPHY


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3. PHILOSOPHY

EDUCATION IS THELIBERATION FROM THEBONDAGE OF POVERTY

4. GOALS


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5. OBJECTIVES

2 E bli hi


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2. EstablishingObjectives (SMART)

3 S h d li


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3. Scheduling

K f l


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Krons formula:


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According to Davies the


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According to Davies,thefollowing symptoms of TimeMismanagement are:

TIME MANAGEMENT


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TIME MANAGEMENTPRINCIPLES

4 B dg t


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4. Budget


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a. NURSING BUDGET

b. Hospital Budget

4 components of B dget


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4 components of Budgetin an Health careInstitution. Revenue budget

2. Expense budget


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3. Capital Budget

4. Cash Budget


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Capital Expenditure


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Capital Expenditure

Personnel Budget


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Personnel Budget


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Operating budget

TYPES OF BUDGET:


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TYPES OF BUDGET:

Fixed-ceiling -O d d


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Open-ended -Flexible -

Sunset -Zero-based


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Zero-basedContingency

Performance -Program -

II ORGANIZING


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II.ORGANIZING

establishes formal authority


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it sets up the organizational

structure by identifyinggroupings, roles and relationshipwithin the agencythis is depicted on anorganizational chart

JOB DESCRIPTION defines thequalifications and scope of responsibilities, the relationshipsand authorities of personnelSTAFFING includes determiningthe staff needed, thus developing

and maintaining a staffing

Th


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The process

coversRECRUITINGSELECTING

ORIENTINGDEVELOPING PERSONNEL

Those selected personnel willthen be distributed in the various

areas of the agency where theyare qualified to belongSTAFFING SCHEDULES are madeto meet the needs of clients,

EFFECTS OF ORGANIZING


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EFFECTS OF ORGANIZING

ORGANIZATIONAL STRUCTURE


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ORGANIZATIONAL STRUCTURE

CHARACTERISTICS OF AN


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CHARACTERISTICS OF ANORGANIZATIONAL CHART


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Delegation of authority is guided


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by several key principles andconcepts:

a. Exception principle -b. Scalar chain of command -

c. Decentralization -


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d. Parity principle -

e. Span of control -


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pf. Unity principle

Responsibility -A h i


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Authority -

Accountability -Communication -

TYPE OF ORGANIZATIONAL


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TYPE OF ORGANIZATIONALSTRUCTURES1. Bureaucratic

Advantage:Disadvantages:

2. Ad hoc


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Advantage:Disadvantages:


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3. Matrix


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Advantages:

Disadvantage:


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III.DIRECTING/LEADING


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nursing leadership and management 2

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