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AIM:

At the end of the seminar the student will be better equipped to perform the directing function in nursing management, by using motivation. Objectives: At the end of the session the student will be able: To understand directing as a function of nursing management. Get an understanding of the roles and functions of various cadres in nursing management. To understand the characteristics/features of motivation. To know the need of motivation of employees. To know the steps in motivation process. How to create & implement a strategy for motivation To understand the model of motivation. To get knowledge about the theories of motivation.

To know the types of motivation. To know about the motivational approaches. To know about the motivational killer. To know the importance of motivation. To know the what is effective motivation. To understand the techniques to build motivational climate. To understand Role & functions of manager/administrator . To understand the methods of motivating employees. To know the advantages of motivation. Understand the role of motivation in directing the employees / subordinates.

Directing
Introduction Directing/Direction is a function of management performed by top level management in order to achieve organizational goals. It is very important and necessary function of management. Management has to undertake various activities like, guide people, inspired and lead them as well as supervision of their activity is required in order to achieve desired results. Meaning and Definition Direction consists of the process and techniques utilized in issuing instructions and making certain that operations are carried as originally planned. Directing involves determining the course, giving order and instruction and providing dynamic leadership Marshall Activating means and moving into action- supplying simulative power to the group- G.R Terry Directing is the process through which a manager communicates with and influences other members of the organization in the pursuit of company objectives. Directing is said to be a process in which the managers instruct, guide and oversee the performance of the workers to achieve predetermined goals.
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Directing is said to be the heart of management process. Directing initiates action and it is from here actual work starts. Direction is said to be consisting of human factors. In simple words, it can be described as providing guidance to workers is doing work. In field of management, direction is said to be all those activities which are designed to encourage the subordinates to work effectively and efficiently. According to Human, Directing consists of process or technique by which instruction can be issued and operations can be carried out as originally planned Therefore, Directing is the function of guiding, inspiring, overseeing and instructing people towards accomplishment of organizational goals. The managerial function of directing is like the activities of a teacher in a classroom. In order to teach, a teacher has to guide his students, maintain discipline, inspire them and lead them to the desired goal. It is a very important function in the management of any enterprise. It helps the managers in ensuring quality performance of jobs by the employees and achievement of organizational goals. The Three important skills that the nurse manager must possess when they are trying to influence the behaviour of other:1) Diagnose: The manager must first know the problem or the situation that needs direction.

2) Adapt: - As the situation demands, the manager must try to fit themselves into the situation & understand it before directing others to do so. 3) Communication:- Having understood , analysised & changed their behaviour according to the situation the managers shall communicate to other members to understand the situation & change their behaviour accordingly. Features of directing Ongoing process: - Directing is not an intermittent function of management. It is a process of continuously guiding the behaviour of individuals. Not supported by rules :- Since the behaviour of an individual cannot be predicted through any mathematical or statistical tool, the function of directing is purely based on possibilities of outcomes of application of behavioural sciences & is not supported by any rules or regulations. Directing is situational:- The force applied by the managers in influencing the individual behaviour changes from situation to situation. The environment, the nature of individuals the group behaviour to which an individual belongs, the attitude of individuals towards the working are some of the factors that the nursing manager must keep in mind while directing.
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 Behavioural science:- Since directing deals with the human behaviour, the managers should try to study the different aspects of human psychology to develop an understanding of how to influence this behaviour. Understanding of the group behaviour:- No individual can in isolation. While he is working in an organisation, he becomes the part of the informal groups.The behaviour of a person is different as an individual & a member of group it is therefore, essential that the managers understand the importance & nature of group behaviour to be able to direct effectively. Participative in nature:- The directions issued by managers initiate action on the part of individual to ensure greater participation of individual in carrying out the organisational activities, they should be made a part of the discussion & meeting where the various directive are being discussed. Importance of Directing Plans remain mere plans unless they are put into action. In the absence of direction, subordinates will have no idea as to what to do. They will probably not be inspired to complete the job satisfactorily. Implementation of plans is, thus, largely the concern of directing function. As a function of management, directing is useful in many ways.

Creation of a sound work environment:- Issuing directions in consultation with maximum potential, willingly & enthusiastically to contribute towards organisational goals. Development of managers:- The managers must be personally motivated to work in a given work environment & only thereafter should direct others to work. The managers thus try to develop their skills & competence to fit into a given situation & then direct others to follow. Working of managers & others organisational members with cooperation & harmony helps not only in prompting the skills of the members but also enables the managers to develop themselves as potential candidates for being promoted to higher levels of organisation structure. Behavioural satisfaction:- As the emphasis in farming directive is on the human behaviour & psychology, the individuals feel behaviourally satisfied & feel personally inspired to work towards the attainment of organisation goal. Increase the productivity:- Personally satisfied employees contribute towards increased output & overall efficiency of the organisation. Achieves coordination:- Directing, described as an ongoing process aims at continual supervision of the activities of the organisational members. This ensures that they are working according to the planned activities in a coordinated & an integrated manner.

Facilitates control:- Co ordination of individuals efforts aims at bringing the actual performance in conformity with the planned performance. The controlling function is also thus, facilitated through effective directing. Facilitate growth:- An organisation where the managers direct the individuals actions in a co ordinate & a balanced manner, is a stable & better condition to grow & adapt itself to environment changes than the one where direction is not effective. Principles of direction 1) Unity of command:- One boss for one subordinate that is all directions orders & instructions should come from only one boss, is the basic principles that must be followed to mark direction effective. If one subordinate receives instructions from more than one superior, there are chances that he would not be able carry out the instructions of either of the two. 2) Unity of direction:- One plan or related set of activities must have only one head. All activities related to personnel should be headed by the personnel manager. This helps in avoiding duplication of action & instructions, thereby economising on the use of scare resources. 3) Appropriate selection of employees:- The managers while selecting employees must ensure that the employees are capable of adjusting
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themselves to the organisation structure & are both willing & able to carry out the directions issued by their superior. 4) Participation: Since directing relates to influencing the behaviour of others, the managers should preferably follow the principle of participation of those who have to actually carry out the directions. 5) Communication:- To make direction effective, the managers must ensure that there is a two way flow of communication between managers & subordinates. 6) Counselling & guidance:- When the subordinate face problems in carrying out their task, the managers must provide them with necessary counselling & guidance. This will make direction more effective as the subordinates are free to approach their superiors for counselling. 7) Synthesis conflicting objective:- Each group of people, whether owners, managers, or labour has its own personal interest as supreme while carrying out the organisational activities. This can lead to conflicting interests which may hamper the overall organisational growth. Effective directions, motivation, guidance & counselling people about the need to consider their goals as subordinate to the overall goals shall enable the different group of people move towards the common directions. The conflicting objective are thus synthesized into one single plan, one objective, one direction & one goal & that is ,to achieve the overall organisational goals.
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8) Direct supervision:- Work by their superiors shall help them in knowing deviations in their work performance & the ways to remove them. This will increase their interest in the work & also their confidence & loyalty in their supervisors. Characteristics of Directing 1. Pervasive Function - Directing is required at all levels of organization. Every manager provides guidance and inspiration to his subordinates. 2. Continuous Activity - Direction is a continuous activity as it continuous throughout the life of organization. 3. Human Factor - Directing function is related to subordinates and therefore it is related to human factor. Since human factor is complex and behaviour is unpredictable, direction function becomes important. 4. Creative Activity - Direction function helps in converting plans into performance. Without this function, people become inactive and physical resources are meaningless. 5. Executive Function - Direction function is carried out by all managers and executives at all levels throughout the working of an enterprise; a subordinate receives instructions from his superior only.

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6. Delegate Function - Direction is supposed to be a function dealing with human beings. Human behaviour is unpredictable by nature and conditioning the peoples behaviour towards the goals of the enterprise is what the executive does in this function. Therefore, it is termed as having delicacy in it to tackle human behavior. Elements of Direction 1. Communication 2. Supervision 3. Motivation 4. Leadership These are the four essential elements of directing. We shall discuss about the nature and significance of each of these components.

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Communication
- Complex and multifaceted phenomenon. It is the process by which verbal and non-verbal symbols are sent, received and given meaning. Communication word has been derived from Latin word Communis which means common, thus communication stands for sharing of an idea in common. Communication is an exchange of facts, ideas, opinions or emotions by two or more persons Newman and Summer It is a sum of all the things one person does when he wants to create understanding in the minds of another. It is a bridge of meaning, it involve systematic telling, listening, and understanding Haimann

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Most Common Way to Communicate Speaking Writing Body Language Visual Images Elements of Communication People- minimum is 2; one will act as the sender and the other the receiver. Message the content or the substance of what is being communicated, could be an idea, feeling, instruction, fact or opinion. Channel the medium and the manner by which the message is conveyed ; could be verbal or non-verbal. Feedback the reaction of the receiver to the message as conveyed through a particular channel; measures the effectiveness of the communication. Noise anything that distorts the message conveyed.

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Communication Process (NOTE: EXPLAIN) The process by which a message, encoded by a sender, is transmitted through a medium to a receiver, who encodes the message and provides feedback. FOUR BASIC DIRECTIONS Downward Communication Communication which flows from the superiors to the subordinates is known as downward communication. In an organizational structure, the superiors utilize their abilities to attain the desired targets which mean that they may be engaged in issuing commands, directions and policy directives to the persons working under them. Under downward communication, the superiors anticipate instant recital of a job thats why it is highly directive. Katz and Kahn have identified five general purposes of superior-subordinate communication. a. To give specific task directives about job instruction b. To give information about organization procedures and practices c. To provide information about the rationale of the job d. To tell subordinates about their performance e. To provide ideological-type information to facilitate the indoctrination of goals

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Upward Communication Travels from subordinate to superior. The most common purpose of this communication is to provide feedback on how well things are going. It provides also the middle level managers the opportunity to represent their subordinates to the upper level managers. a. Open-Door Policy -(a communication policy in which a manager, CEO, president or supervisor leaves their office door "open" in order to encourage openness and transparency with the employees of that company.) b. Complaint program Lateral Communication Lateral communication refers to messages conversed between people on the same hierarchical level. For example, in terms of the workplace, if two supervisors have a discussion or two board members raise an issue this is known as lateral communication. The most common reason for this communication flow is to provide coordination and teamwork. Diagonal Communication Occurs between people who are neither in the same department nor in the same level of management hierarchy. In this case, someone communicate either downward or upward with someone in another functional area. In utilizing this

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flow of communication, protocol must be observed so as not to bypass the authority of the person concerned EFFECTIVE METHODS OF COMMUNICATION

Methods

Factors to consider

Electronics

these are highly effective means of quickly reaching those with whom you are communicating Interaction and participation are possible and often simple for all involved parties Their ease of use means that they pose a possible risk of communications overload The seemingly endless possible combinations of words, images and color are very powerful

Meetings

If used properly; meetings can build relationships and mutual trust Meetings enable instant feedback Meetings facilitate mutual understanding Reponses can often be gauged through eye contact Preparation, planning and openness are required

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Journalism

In-house publications enable a wide range of msgs and editorial techniques It is possible to facilitate some interaction through reader letters and contributions. The content of most organizations journals tends to be bland, resulting in low leadership

Internal marketing

This is a powerful method of selling change to the organizations own staff Detailed written documents and colorful posters help to explain and simplify complex msgs These techniques are able to elicit very strong, immediate motivational responses

Noticeboards

Can be either official information givers, or for general use by employees Provide a central location in which to make information accessible to all employees. There is no real possibility of interactive response, and employees may feel uninvolved.

Telephone

The telephone is not suitable for lengthy or complicated discussions The lack of physical presence may lessen the speakers

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understanding of each other

BARRIERS TO EFFECTIVE COMMUNICATION Too much information people suffers from what we call sensory overload The message is poorly organized communicating also involves planning Inaudible voice when talking in front of a crowd be sure that you have loud and clear voice so that everybody will be able to hear what you are saying Mannerisms distract attention Lack of understanding Inconsistent verbal and non-verbal communication Noise any factors that disturbs, confuses or interferes with communication Differing perceptions people who have different backgrounds of knowledge and experience often perceive the same phenomenon from different perspective

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 Too many links in the communication process Symbol with different meaning a symbol that may mean something to the sender might mean another to the receiver. Badly expresses message The message is not clearly expressed by the sender thats why the real message is not received by the receiver. Faulty Translation Mistranslation from other language may affect the real meaning of a message Language differences the words used must mean the same thing to sender and receiver OVERCOMING BARRIERS TO COMMUNICATION Use feedback to facilitate understanding and increase the potential for appropriate action Repeat message in order to provide assurance that they are properly received Use multiple channels so that the accuracy of the information may be enhanced Use simplified language that are easily understandable and which eliminates the possibility of people getting mixed-up with meanings.

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TO ATTAIN EFFECTIVE MANAGERIAL COMMUNICATION 1. Humanize understand, appreciate and elevate the importance of humans above other concerns 2. Harmonize establish a climate of cooperation, trust, helpfulness, confidence, belongingness and openness 3. Habitualize put into a habit such positive practices 4. Institutionalize put into practice good communication habits at the individual level until these practices are introduced to the company or organization as standard operating procedure 5. Acclimatize adjust, be flexible and extra tolerant 6. Modernize learn the modern ways of communicating 7. Symbolize if words will not do, use symbols 8. Empathize to understand intimately the other peoples feelings ,thoughts, motives and aspirations 9. Dualize make your communication dual 10.Minimize Keep It short!!!!

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INFORMAL COMMUNICATION IN THE ORGANIZATION Grapevine is an informal channel of business communication. It is called so because it stretches throughout the organization in all directions irrespective of the authority levels. a. Grapevine networks 1. Gossip chain happens when one person passes informal communication to all others in the informal organization 2. Single strand each person receives information from one individual and passes it to another 3. Probability chain people randomly pass information to the other members of the organization 4. Cluster chain people pass information to other members of the informal organization selectively b. Grapevine activity. People tend to engage in grapevine when: 1. People lack information 2. There is insecurity in a situation 3. People have personal interest in the situation 4. They have new information

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LEADERSHIP
- Art of getting someone else to do something that you want done because he wants to do it (Dwight D. Eisenhower) - Process of directing the behavior of others toward the accomplishments of objectives. - is one of the important parts of direction. Leadership is the ability to secure desirable action from a group of followers voluntarily, without the use of coercion- Alford and Beatly

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Leadership refers to the quality of the behaviour of the individual whereby they guide people on their activities in organized efforts- Chester Barnard LEADING IN TIMES OF CRISIS 1. Stay calm 2. Be visible 3. Put people before business 4. Tell the truth 5. Know when to get back to business

LEADERSHIP STYLES 1. Autocratic Leadership Under the autocratic leadership style, all decision-making powers are centralized in the leader, as with dictators. Leaders do not entertain any suggestions or initiatives from subordinates. The autocratic management has been successful as it provides strong motivation to the manager. It permits quick decision-making, as only one person decides for the whole group and keeps each decision to him/herself until he/she feels it needs to be shared with the rest of the group.

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2. Participative Leadership Consists of the leader sharing the decision-making abilities with group members by promoting the interests of the group members and by practicing social equality. Consultative Leaders This style focuses on using the skills, experiences, and ideas of others. However, the leader or manager using this style still retains the final decision-making power. To his or her credit, they will not make major decisions without first getting the input from those that will be affected. Consensus Leaders For leadership to occur one party must follow another party. An exception being which requires the leader influence the followers to aid in a common task, which would seem to eliminate the possibility of leading people to do nothing. Which is kind of amusing when one considers to "do nothing" is usually the decision reached by process of consensus in the first place. Democratic Leaders democratic leader A leader who maintains an egalitarian atmosphere within the group and who is prepared to delegate planning, decision making, and other responsibilities to followers.

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3. Free- rein Leadership A person may be in a leadership position without providing leadership, leaving the group to fend for itself. Subordinates are given a free hand in deciding their own policies and methods. 4. Narcissistic leadership The narcissism may be healthy or destructive although there is a continuum between the two. To critics, "narcissistic leadership (preferably destructive) is driven by unyielding arrogance, selfabsorption, and a personal egotistic need for power and admiration. 5. Toxic leadership A toxic leader is someone who has responsibility over a group of people or an organization, and who abuses the leader-follower relationship by leaving the group or organization in a worse-off condition than when he/she first found them. Importance of Leadership Initiates action- Leader is a person who starts the work by communicating the policies and plans to the subordinates from where the work actually starts. Motivation- He motivates the employees with economic and noneconomic rewards and thereby gets the work from the subordinates.

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Providing guidance- A leader has to not only supervise but also play a guiding role for the subordinates. Guidance here means instructing the subordinates the way they have to perform their work effectively and efficiently. Creating confidence- Confidence is an important factor which can be achieved through expressing the work efforts to the subordinates, explaining them clearly their role and giving them guidelines to achieve the goals effectively. It is also important to hear the employees with regards to their complaints and problems. Building morale- Morale denotes willing co-operation of the employees towards their work and getting them into confidence and winning their trust. A leader can be a morale booster by achieving full co-operation so that they perform with best of their abilities as they work to achieve goals. Builds work environment- Management is getting things done from people. An efficient work environment helps in sound and stable growth. Therefore, human relations should be kept into mind by a leader. He should have personal contacts with employees and should listen to their problems and solve them. He should treat employees on humanitarian terms. Co-ordination- Co-ordination can be achieved through reconciling personal interests with organizational goals. This synchronization can be
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achieved through proper and effective co-ordination which should be primary motive of a leader.

THEORIES OF LEADERSHIP a. Fielders Contingency Theory it hypothesizes that, in any given leadership situation success is

determined primarily by; 1) The degree to which the task being performed by the followers is structured 2) The degree of position power possess by the leader 3) The type of relationship that exists between the leader and the followers.

b. Theory X and Y Assumptions c. Theory Z

MANAGEMENT STYLES 1. Management by crisis 2. Management by exception 3. Management by objectives 4. Management by coaching and development
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5. Management by competitive edge 6. Management by consensus 7. Management by styles 8. Management by walking around 9. Words simplifications

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SUPERVISION AND MANAGEMENT Supervision is defined as An art or a process by which designated individual or group of individuals oversee the work of others and establish controls to improve the work as well as the worker. Supervision is generally termed as an educational process in which a person with better training or more experience takes the responsibility of training a person with less training or less experience, and in this educational process the leadership of the supervisor and the growth of the supervised combine to achieve and maintain progressively the highest level of performance of which the worker is capable. Supervision is observation and providing feedback to ensure the quality of the program and to enable the staff to perform to their maximum potential. Traditional approaches to
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supervision emphasized on inspecting facilities and controlling individual performance.

OBJECTIVES OF SUPERVISION 1. To help subordinate to do their job skilfully and efficiently. 2. To develop subordinates capacity to the fullest extent. 3. To promote team work 4. To promote moral and motivation among workers. 5. To bridge the gap between personal goal and organizational goal.

PURPOSE OF SUPERVISION:

To improve the quality of work / performance.

Helping the person doing the work and develop the highest possible standard

PRINCIPLES OF SUPERVISION 1. Supervision should aim at growth in knowledge and improvement of skill of the person.

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2. Supervision should improve the ability in thinking and adjusting to the new situation. 3. It should help to formulate objects. 4. Good supervision stimulates their interest and effectors. 5. No undue pressure for achievement 6. Autonomy to subordinate preferred 7. Supervision should have competence 8. Supervision should have receive training 9. Decision making is encouraged 10. Free communication to required 11. No over burdening to staff 12. Good leadership by supervisor 13. Suitable climate for work 14. Give guidance 15. Supervision should encourage innovation allowing free flow of ideas and share positive experiences of personnel
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COMMON SUPERVISORY METHODS

1.Individual conference 2.Group conference 3.Training 5.Evaluation sessions sessions 4.Review of 6.Direct records observation

PRINCIPLES APPLIED TO NURSING: Supervision should be focused on the attainment of one goal, the giving of a high quality of nursing care. Strives to make the ward a good learning situation. Supervision is well planned. It should posters the ability to think and act herself. Helps her to attain objectives stimulates interest and effort. Encourages and challenges her to greater endeavour through adequate approval commendation and by recognition of work well done. To make pattern for analysis and to analyze continuously her success in reaching the objectives.
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WHO IS SUPERVISOR? A supervisor is a person who is primarily incharge of a section & is responsible for both quality & quantity of production, for the efficient performance of the equipment, & for the employees in his charge & their efficiency, training & morale A supervisor drives authority from the departmental head for getting work done from the workers by using the resources of the enterprises. He issues instructions to the workers, directs their activities & reports to the department head on the performance of his section.

QUALITIES OF A GOOD SUPERVISOR: Trained person Understand the training background and ability of the supervised. Good knowledge, the local practice Good in health, skills in T.G & PR/t have pleasing manner. Good listener. Supervisor should have leads examplenory life

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 Creative enthusiasm Just impartial human, tolerant and tactful Helpful Good power of judgment.

Functions of Supervision:

A. Administrative

B.Education

C. Communication

D. Evaluative

A. Administrative: Assignment of the work loads of individual and groups according to the level of physical and mental competence (or) preparing the duty roaster. Identify the needs for supplies and equipment and providing materials and supplies to facilitate the staff performance. Identify the problem and helps to solve.

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B. Educative: Orientation Teaching subordinates Plan and conduct in service education program Ensuring staff developments C. Communicative The supervision act as a communicator between the staff and authorities and other health team members. She facilitates communication She should encourage free communication among persons between worker and community representatives and members of health team. D. Evaluative:

include identify the cause of difficulty. .

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OTHER FUNCTIONS ARE:

Co-ordinates there of subordinates and agents and promote team worker. Promote social contact with in the team to bring staff together and increases group cohesiveness. Develops mutual confidence Raises level of motivation Develops good IPR Maintains R & R Establish control over the subordinates

AS A MANAGER SUPERVISOR HAS TO PERFORM THE FOLLOWING FUNCTIONS

performance of the worker

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STEPS IN SUPERVISION: When supervision is needed the supr has to make plan for supervision by using certain steps to follow. 1. Defining of the job to be done 2. Selection and organization of supervisor activities based on available resources. 3. Anticipation of difficulties 4. Establishment of criterion for evaluation determining what extent the programme has met problem / objectives acc to plan.

Types of supervision: (1) Direct supervision Face to face talk with worker Points to be considered: - Do not loose temper - Use democratic approach and avoid autographic - Give workers chance to reply
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- Do not talk too much and too fast - Be human in behavior - Do not give instructions haphazard way

(2) Indirect supervision: With the help of record and reports of the worker and through written instructions. This includes: - Ensuring carrying out allotted work - Analysis of monthly progress input efforts and achievement - Analyzing amount of work allotted - Support and guidance.

Methods of supervision: (1) Technical vs. creative supervision (2) Co-operative vs. authoritarian (3) Scientific vs. institutive (4) Task oriented vs. employee oriented I. Technical These are basic supervisory skills and which need to be trained group discussion and conference
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For example: techniques of service study, record construction, time study etc. Creative provides maximum adaptation to the situ Ex. Instead of orientation period of two week for each new staff member, a variable plan in both contents and time according to the needs of each individual should formulated. II. Cooperative full participation of each member of the group in planning, action and decision. Authorization: supervision responsibility centers entirely on the supervisor, with the staff following his / her orders. Both are needed all to situation. III. Scientific supervision Relies on objective study and measurement than personal judgment / opinion. Intitutive supervision :It needs to maintain IPR IV. Task oriented supervision emphasize the task more than performer. Employee oriented: Supervisors are more concerned about worker staff their needs and welfare than assigned tasks. TOOLS FOR SUPERVISION Checklist Rating scales Nurses reports Nursing rounds
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 Job descriptions Personnel policies Staff educations Problem solving approach

TECHNIQUES OF SUPERVISION A technique is a way of doing something. Techniques vary with the personality and ability of the individuals who are being supervised, the activities that are being performed under supervision and the immediate circumstances. Any technique used for supervision must be based on sound democratic psychological principles which takes account the nurses individuality.

THE PROCESS OF SUPERVISION: Stage 1: Preparation for supervision 1. A supervisor should focus on specific issue. - Efficacy of service provided to the - Relevant problems - Efficacy problem utilization management of limited resources.
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2. Study of document 3. Identification of priorities 4. Preparation of a supervision schedule Stage 2: supervision Use tools: - Job description - Task description - Weekly time table - Check list / rating for each work As a supervisor the following duties has to be performed. Establish contact Review the objectives, targets and norms Review job descriptions Note actual / potential conflict Observe the actual performance. Observe the individual nursing staff carries out his/her tasks. Identify the gaps & needs for follow up action based on feed back data attained through the observation.

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Stage 3: Follow up of supervision Unless actions to follow-up the gaps and needs identified during stage are taken, supervision remains incomplete. Each supervisor must prepare a report on the observations made during supervision. The follow-up action may include: Organizing in-service training programmes/continuing education programmes for the nursing personnel. Reorganization of time table / work plan/ duty roaster. Initiating changes in logistic support or supply system. Initiating actions for organizing staff welfare activities. Counseling and guidance regarding career development and professional growth

THE EFFECTIVENESS OF SUPERVISION DEPENDS ON: 1. Human relations skill 2. Technical and Managerial knowledge 3. Leadership position 4. Improved upward relations 5. Relief from non-supervisory duties

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6. General and lose supervision

1. Human relations skill:

Supervision is mainly concerned with instructing, guiding and inspiring human beings towards greater performance. For purpose of direction, the supervisor has to rely on leadership, counseling, communication and other determinants of human relations 2. Technical and Managerial knowledge: Guidance implies a complete understanding of all work problems, for which supervisor should have good knowledge about technical aspect of job and also the managerial aspect 3. Leadership position The authority of supervisor must be made commensurate with their duty so as to make the job of supervision a satisfying, rewarding and challenging one

4. Improved upward relations To ensure god quality of supervisors, the supervisors should be regularly allowed to present their views and suggestions to top executive in regard to the personnel and their works performance.

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5. Relief from non-supervisory duties To make the supervisory duties purposeful, the supervisors are to be relieved of many routine activities that divert their attention from the real job.

6. General and lose supervision According to some experience, the general and loose supervision is more productive than close supervision. Here the leader must allow freedom and initiative to his followers for pursuing a common course of action.

PROBLEMS OF SUPERVISION PROBLEMS IN NURSING SERVICE: There are no perfect nursing service programs/situations without any problems 1. Shortage of nursing personnel. 2. Individual differences among personnel in interests, capacities and abilities. 3. Lack of information, insight and understanding of changes and developments in the interest of the continuance and improvement of nursing. 4. Lack of clearly defined assignments, multiple responsibility and lack of planning on the part of those to whom personnel is responsible 5. Outdated policies, procedures and guides to workmanship which cause them to be disregarded and unused.
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6. Inadequate, unsafe, and defective equipment. 7. Ill health in the part of personnel 8. Undesirable personnel characteristics with special attention to attitudes.

COMMON PROBLEMS IN COMMUNITY HEALTH NURSING SUPERVISION: 1. Problems inherent to budgeting, planning and timing. 2. Personnel problems including problems of poor performance. 3. Grievances 4. Lack of financial resources. 5. Lack administrative support 6. Staff members who are inflexible and resist any type of change 7. Assignment to projects other than those committed to perform 8. Lack of political support 9. . Staff members who do not accept or support the program goals. 10. Conflict within the nursing unit itself.

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11. Inability to proceed (for many reasons) because the timing is wrong 12. Inability to hire qualified personnel. 13. .Changes in program priorities. 14. Other issues can include anything from car rental, uniform allowance, security of the staff within the community, need for supplies and equipment, duplication of services provided by another organization.

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MOTIVATION INTRODUCTION Motivation is an action that stimulates an individual to take a course of action, which will result in an attainment of goals, or satisfaction of certain material or psychological needs of the individual. Motivation is a powerful tool in the hands of leaders. It can persuade convince and propel people to act. DEFINITION:Motivation is defined as Motivation is an inner impulse or an internal force that initiates and directs the individual to act in a certain manner to satisfy a need.
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Motivating force is a need that comes from within an individual, e.g. to make a living, gain status and respect or to remove a source of frustration (Review of Maslows Hierarchy of Needs). Motivation refers to the way in which urges, drives, desires, aspirations, striving or needs direct, control or explain the behavior of human beings. -Dalton E. McFurland

NEED FOR MOTIVATION:The nurse manager must realize that nurses have different personalities, work habits, and what motivates one nurse may not motivate others. Meanwhile, some nurses are skilled, confident, and capable of self-direction and seem to motivate themselves, while other nurses lack self-confidence; they do their jobs poorly and have little motivation. The nurse manager is responsible to motivate the second group and to improve their performance. Researchers have revealed that job performance is the result of the interaction of two variables; the ability to perform the task and the amount of motivation. Job Performance = Ability + Motivation. Job dissatisfaction: Job dissatisfaction contributes to higher turnover rates and decreased productivity and considerable time and money are required to recruit and select a replacement for someone who leaves the organization, it also takes time to socialize new employee to the organizational culture, which is expensive time,

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beside that, other employees will need to carry more load to cover the needs, and at last the kind of interruptions that results from the loss of this employee. For all those reasons the manager should be concerned about job satisfaction of employee, and to do that there is a need to look at the different theories.

TYPES OF MOTIVATORS 1) Intrinsic motivation: Refers to motivation that comes from within the person, driving him or her to be productive. It is related to a persons level of inspiration. The motivation comes from the pleasure one gets from the task itself or from the sense of satisfaction in completing or even working on the task rather than from external rewards.

2) Extrinsic motivation: It refers to motivation that comes from outside an individual, i.e. enhanced by the work environment or external rewards such as money or grades. The rewards provide a satisfaction and pleasure that the task itself may not provide. An extrinsically motivated person will work on a task even when they have little interest in it because of the anticipated satisfaction they will get from the reward. e.g.- reward for a student would obtain good grade on an assignment or in the class.

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TYPES OF MOTIVATION 1) Achievement motivation It is the drive to peruse and attain goals. An individual with achievement motivation wishes to achieve objectives and advance up the ladder of success. Hence, accomplishment is important for his/her own sake and not for the rewards that accompany it. 2) Affiliation motivation It is a drive to relate to people on a social basis. Individuals with affiliation motivation perform work better when they are complimented for their favourable attitude and co-operation.

3) Competence motivation It is the drive to be good at something, allowing the individual to perform high quality work. Competence/skill motivated individuals seek job mastery, take pride in developing and in using their problem solving skills and strive to be creative when confronted with obstacles. They learn from their experiences. 4) Power motivation It is the drive to influence people and change situations. Power motivated people wish to create an impact on their organisation and are willing to take risks.

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5) Attitude motivation Attitude motivation is how people think and feel. It is their self-confidence, their belief in themselves and their attitude to life. It is how they feel about the future and how they react to the past. 6) Incentive motivation It is where the people are motivated through external rewards. Here, a person or team reaps a reward from an activity. It is the type of rewards that drive people to work harder. 7) Fear motivation Fear motivation coercions a person to act against will. It is instantaneous and gets the job done more quickly. Fear motivation is helpful in the short run.

Methods of motivating employees / Motivational factors: There are different methods which can be used for motivating employees .There can also be treated as motivational factors/ forces/stimulators. They include monetary & non monetary factors. Monetary factors: 1) Salaries/wages: Money happens to be the most important motivation factor. While determining salaries, management must give to employees

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security of income along with ability to lead respectable life. Salary should be revised periodically to meet the cost of living. 2) Bonus: Under the bonus payment Act,1965 a company has to declare bonus whenever it earns profit. Bonus adds to annual income of the employees & it becomes monetary incentive. 3) Incentives: When employees are paid over & above their salary, an additional payment in recognition of better work, it is called incentive. When incentive payment is offered, employees work hard to earn more & they remain motivated. 4) Allowances: Management providers to employees both statutory & non statutory types of allowances such as medical allowance, educational allowance, house rent allowance, recreation allowance, education allowance & so on .These allowance act as motivators. 5) Special incentives : There are certain monetary incentives offered only to deserving employees e.g. performance bonus, attendance etc. It has a positive impact on others because they also work hard to earn these special incentives.

Non Monetary factors: 1) Job Security & job enrichment: Job security is useful the motivation of employees. Such security keeps the employee away from the tension of becoming unemployed. Job enrichment provides an opportunity for
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greater recognition & advancement, job enrichment refers to redesign of jobs. 2) Fair treatment to employees: Employer should give attention to the needs, difficulties & grievance of employees. Small work groups & effective communication are useful for solving the problems of workers. Employees must be given decent treatment. They will be co- operative only when they are treated with sympathy & love, affection & dignity. Employees should also be given help in personal matters. 3) Recognition of good work: Recognition of good work at an appropriate time gives encouragement to the employees to show better performance in future. As an appreciation of good work, prizes rewards, promotions etc. should be given. 4) Encouragement to self-development & career development : Employees should be given varied training facilities self- development & also provides opportunities for career development. Every employee has a desire to grow, develop & rise higher. This desire should be exploited fully for motivating employees. For this, training as well as management development programme should be introduced. 5) Delegation of authority: Due to delegation of authority, a subordinate employee fells that superior has faith in him & also in his ability to use authority in a proper manner. Employees get mental satisfaction when authority is given to them. They take interest & indicative in work & try
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to prove that they are competent to work at the higher levels. Thus delegation of authority becomes a motivating factor. 6) Congenial working condition: It is a non-functional incentive for motivation. Employees should be given various facilities & conveniences at the work place. The work environment should be pleasant, safe & reasonably comfortable. This creates desire to work efficiently. 7) Helpful attitude of management: The helpful attitude towards its employees creates a sense of affinity for the organisation. Fair treatment to workers. Cordial industrial relations also motivate employees. Thus ,enlightened & pro-employee attitude of management acts as a motivating factor. 8) Fair opportunity of promotion: Fair opportunity of promotion to all eligible workers is one more method useful for motivating employees. They take interest in the work as they feel that they will be rewarded in the form of promotions. Training facility should be provided to employees in order to make them eligible for promotion. 9) Labour participation in management: Labour participation is useful for the motivation of employees. Workers get higher status & better scope for expressing their views through such participation. Even the formation of quality circles or joint management council is useful for motivating employees.

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10)

Designation & status: When an employee is provided with a

better designation, it adds to his status. Employees are proud to reveal their attractive & high-sounding designations. Characteristics/Features of motivation:1) Psychological process: Motivation is a psychological process useful encouraging employees to take more interest & initiative in the work assigned. It relates to human relations. 2) Initiative by manager: The initiative for motivation is to be taken by the manager by offering guidance & also by other methods like appreciation of good work or offering incentives. 3) Continuous activity: It is a continuous & circular process. Subordinates need motivation in a continuous manner as their needs & expectations change from time to time. A manager has to study the needs of the worker & use the technique of motivation accordingly. The process of motivation must be made a regular & continuous one. 4) Goal- oriented & action- oriented:- Motivation diverts human behaviour towards certain goals. Attainment of organisational & individual goals depends on the motivational plans. 5) Broad concept:- motivation is a comprehensive concept &cover needs, human relations & satisfaction of employees. For employee motivation

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monetary & other incentives need to be offered. Job satisfaction is one need of subordinates & is useful for motivation. 6) Essence of management process:- Motivation is an essential function of a manager. He has to motivate his subordinates for achieving organisational objectives. Motivated force is an asset of business unit. Motivation employees bring success, stability & prosperity to a business unit. 7) Beneficial to employees & management:- Motivation offers benefits to employees & organisation. It avoids clashes & encourages cooperative outlook among employees. Motivation leads to cordial labourmanagement relations. It provides more profit to management & better welfare to employees. 8) Varied measures available for motivation: For motivation various monetary & non monetary incentives can be offered to employees by the management. Attractive wages, welfare facilities, job security & fair treatment are some measures of motivating employees. Importance of motivation of employees:Nature of motivation Unending process: human wants keep changing & increasing. A psychological concept: deals with the human mind.

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Whole individual is motivated: as it is based on psychology of the individual. Motivation may be financial or non-financial: Financial includes increasing wages, allowance, bonus, etc. Motivation can be positive or negative: positive motivation means use of incentives - financial or non-financial. E.g. of positive motivation: confirmation, pay rise, praise etc. Negative motivation means emphasizing penalties. It is based on force of fear. Eg. demotion, termination. Motivation is goal-oriented behaviour. Motivation is an internal feeling of an individual. It cant be observed directly; we can observe an individuals action and interpret his behaviour in terms of underlying motives. This leaves a wide margin of error. Our interpretation may not reveal the individuals true behaviour. Motivation is a continuous process that produces goal directed behaviour. The individual tries to find alternatives to satisfy his needs. Motivation is a complex process. Individual may differ in their motivation even though they are performing the same type of job. For example, if two men are engaged in cutting stones for constructing a temple, one may be motivated by the amount of wages he gets and the other by the satisfaction he gets by performing the job.
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COMPONENTS OF MOTIVATION Motivation comprises of three main components:

We start off by deciding what we want, which is our direction as we know where we want to go and what we have to achieve. Then we make an effort towards our goal. We start to do things and we continue our making the efforts for some time and give it everything that we have. Now comes the part where we have to be persistent with our efforts and keep doing them. SOURCES OF MOTIVATION 1) Internal or push forces:

-esteem

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2) External or pull forces: a. Characteristics of the job

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b. Characteristics of the work situation

REQUISITES TO MOTIVATE We have to be Motivated to Motivate Motivation requires a goal Motivation once established, does not last if not repeated Motivation requires Recognition Participation has motivating effect Seeing ourselves progressing Motivates us Challenge only motivates if you can win Everybody has a motivational fuse i.e. everybody can be motivated Group belonging motivates .

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In the initiation, a person starts feeling lacknesses. There is an arousal of need so urgent, that the bearer has to venture in search to satisfy it. This leads to creation of tension, which urges the person to forget everything else and cater to the aroused need first. This tension also creates drives and attitudes regarding the type of satisfaction that is desired. This leads a person to venture into the search of information. This ultimately leads to evaluation of alternatives where the best alternative is chosen. After choosing the alternative, an action is taken. Because of the performance of the activity satisfaction is achieved which than relieves the tension in the individual. CREATING A MOTIVATING CLIMATE As the organization has an impact on intrinsic and extrinsic motivation, it is important to examine organizational climates or attitudes that influence workers morale and motivation. Employees want achievement, recognition and

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feedback, the opportunity to assume responsibility, a chance for advancement, fairness, good leadership, job security and acceptance and adequate monetary compensation. All these create a motivating climate and lead to satisfaction in the work place. e.g. nurses who experience satisfaction stay where they are, contributing to organizations retention. STRATEGIES TO CREATE A MOTIVATING CLIMATE 1. Have a clear expectation for workers and communicate effectively. 2. Be fair and consistent when dealing with all employees. 3. Be a firm decision maker. 4. Develop a team work/team spirit. 5. Integrate the staffs needs and wants with the organizations interest and purpose. 6. Know the uniqueness of each employee. 7. Remove traditional blocks between the employee and the work to be done. 8. Provide opportunities for growth. 9. Encourage participation in decision-making. 10. Give recognition and credit. 11. Be certain that employees understand the reason behind decisions and actions. 12. Reward desirable behaviour.

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13. Allow employees exercise individual judgement as much as possible. 14. Create a trustful and helping relation with employees. 15. Let employees exercise as much control as possible over their work environment.

Leadership Roles and Management Function Associated With Creating A Motivating Work Climate:- Leadership Roles: 1. Recognize each worker as unique individual who is motivated by different things. 2. Identifies the individuals and collective value system of the unit and implements a reward system that is consistent with those values. 3. Listen attentively to individual and collective work values and attitudes to identify unmet collective needs that can cause dissatisfaction 4. Encourage workers to stretch themselves in an effort to promote self growth and self actualization. 5. Maintains a positive and enthusiastic image as a role model to subordinates in the clinical setting 6. Encourage mentoring, sponsorship and coaching with subordinates. 7. Develop time and energy to create an environment that is supportive and encouraging to the discouraging individual.

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8. Develop a unit philosophy that recognizes the unique worth of each employee and promote reward systems that make each employee feel like a winner.

9. Demonstrates through actions and words a belief in subordinates that they desire to meet organizational goals. 10. Is self- aware regarding own enthusiasm for work and takes steps to motivate self as necessary. MEASURES TAKEN BY THE NURSE MANAGER TO FACILITATE NURSES MOTIVATION: - The nurse manager while managing the nursing unit will have to choose a combination of the following measures to facilitate nurses motivation. 1) Act as a Role model (Set a good example):a) Set high standards in the units. b) Maintain a positive attitude towards the work and staff. c) Be optimistic; in other words, be aware of how difficult the job is and how it can be done. d) Ask for help when in need. e) Admit mistakes. 2) Develop and maintain Good Personal Relations:a) Use two-way communication. b) Be friendly, not to criticize staff in front of others and be fair.
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c) Keep a sense of humor and avoid getting angry. d) Try to understand nurses attitudes, likes, dislike their experience, previous training, problems in their work and needs.

These measures will help in understanding nurses behavior. Understanding is the first step toward motivating nurses. Trust comes with understanding and it develops slowly based on the respect and acceptance of the manager. Motivation is based on understanding and trust. Some guidelines for developing trust:a) Apply rules equally and consistently. b) Avoid favoring some nurses over others, be fair. c) Share information show respect for ideas and opinions and confidentiality. d) Be supportive at all times.

3) Post Each Nurse where she can work best:The nurse is more likely to succeed and be motivated if her/his interests and skills are considered in the assignment. Success is the best motivator.

4) Use a participative style:-

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Participation and sharing information will motivate nurses since they feel they are taking part in decisions. Motivation requires more than physical involvement in a job. It also demands mental and emotional involvement.

5) Guide, encourage and support continuously:Guidance means helping nurses in planning, evaluating their work and in solving work and personal problems.. Encouragement means helping and reassuring nurses regardless of the type of problems. Develop a supportive environment by reducing physical stresses associated with the job. Support means removing obstructions and providing nurses with satisfying work environment which include personnel and facilities and suitable learning materials needed to do their job. Reward Good work:a) Give recognition for successful achievement of the job. Praise frequently and informally. It can be in front of other staff. b) Reward includes: Pay increase, promotion, training for advancement to a higher level within a job. c) Thank you is a type of reward that helps to increase self-confidence.

6) Build team work (Team spirit) a) Schedule regular meetings.

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b) Make nurses feel that their job is important to the success of the team. c) Integrate the needs and wants of the staff nurses with those of the nursing unit. d) Think of nurses in the unit as a group and do what is best for them.

7) Provide continuing education:Nurses enjoy learning new knowledge and skills or updating the existing knowledge and skills or taking new responsibilities through continuing education.

SYMPTOMS OF MOTIVATED NURSES:1. Show interest, enthusiasm and have a positive attitude. 2. Believe their work is important and work hard. 3. Work well with their supervisors and others. 4. Take part willingly in planning, implementing and evaluating their work. 5. Show responsible behaviour. Strive to find the best way to produce optimal job performance.

THEORIES OF MOTIVATION The word motivation theory is concerned with the processes that describe why and how the human behaviour is activated and directed. It is considered as one of the most important areas of study in the
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field of organizational behaviour. There are two different categories of motivation theories- the content theories and the process theories.

A) Content theories of motivation This is also called as the Need theory. It mainly focuses on the internal factors that energize and direct human behaviour. Some of the need theories are-

1) Abraham Maslow (1943) Maslows theory included 5 basic needs in his theory, namely the- The physiological needs, Safety and security needs, Love needs, self-esteem needs and self-actualization needs. Maslow suggested that human needs are ordered in a hierarchy from simplex to complex. Higher level needs do not emerge as motivators until lower needs are satisfied and a satisfied need no longer motivates behaviour.

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Physiological needs: Food, water, warmth, shelter, sleep, medicine and education, etc. Once the physiological needs are met, the next level becomes predominant.

Safety and security needs: These are the needs to be free of physical danger and of the fear of losing a job, property, food or shelter. It also includes protection against any emotional harm.

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Social needs: Since people are social beings, they need to belong and be accepted by others. People try to satisfy their need for affection, acceptance and friendship. After the lower needs are well satisfied, affiliation or acceptance will emerge as dominant and the person strives for meaningful social relationship.

Esteem needs: According to Maslow, once people begin to satisfy their need to belong, they tend to want to be held in esteem both by themselves and
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by others. This kind of need produces such satisfaction as power, prestige status and self-confidence.

Need for self-actualization: Maslow regards this as the highest need in his hierarchy. It is the drive to become what one is capable of becoming; it includes growth, achieving ones potential and self-fulfilment. It is to maximize ones potential and to accomplish something.

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2) Alderfer ERG theory ERG theory is similar to Maslows hierarchy of needs. The existence (E) needs are equivalent to physiological and safety needs; relatedness (R) needs to belongingness, social and love needs. The growth (G) needs to self-esteem and self actualization- personal achievement and self-actualization. The major conclusions of this theory are:

satisfied than the desire to satisfy a lower need intensifies.

satisfaction of the lower-level needs. This phenomenon is known as frustrationregression process

3) Frederick Herzberg Two Factor need theory (1966) Herzberg felt that job satisfaction and dissatisfaction exists on dual scales. Workers are motivated by two types of needs/factorsintrinsic/motivation factors (satisfiers): challenging aspects of the work, achievement, added responsibility, opportunities for growth and opportunities for advancement

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extrinsic/hygiene factors (dissatisfiers): salary, status, working conditions, quality of supervision, job security and agency policies.

According to Herzberg, the hygiene factors must be maintained in quantity and quality to prevent dissatisfaction. They become dissatisfiers when not equitably administered, causing low performance and negative attitudes. The motivation factors create opportunities for high satisfaction, high motivation and high performance. Absence of motivation factors causes a lack of job satisfaction.

4) David McClelland(1961) David McClelland has developed a theory on three types of motivating needs:

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People with high need for power are inclined towards influence and control. They like to be at the center and are good orators. They are demanding in nature, forceful in manners and ambitious in life. They can be motivated to perform if they are given key positions or power positions. In the second category are the people who are social in nature. They try to affiliate themselves with individuals and groups. They are driven by love and faith. They like to build a friendly environment around themselves. Social recognition and affiliation with others provides them motivation. People in the third category are driven by the challenge of success and the fear of failure. Their need for achievement is moderate and they set for themselves moderately difficult tasks. They are analytical in nature and take calculated risks. Such people are motivated to perform when they see atleast some chances of success. McClelland observed that with the advancement in hierarchy the need for power

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and achievement increased rather than Affiliation. He also observed that people who were at the top, later ceased to be motivated by this drives. 5) McGregors Theory X and Theory Y Douglas McGregor proposed two different motivational theories- theory X and theory Y. He states that people inside the organization can be managed in two ways. The first is basically negative, which falls under the category X and the other is positive, which falls under the category Y. Assumptions of theory X: er possible, will attempt to avoid it.

threatened with punishment to achieve goals.

issued. s place a greater importance on security over all other factors and display little ambition.

Assumptions of theory Y:

-control and self-direction and if they are committed to those goals.

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imagination, ingenuity and creativity in solving the problems of the organization. power is only partly used.

On analysis of the assumptions it can be detected that theory X assumes that lower-order needs dominate individuals and theory Y assumes that higher-order needs dominate individuals. An organization that is run on Theory X lines tends to be authoritarian in nature- power to enforce obedience and the right to command. In contrast Theory Y organizations can be described as participative, where the aims of the organization and of the individuals in it are integrated; individuals can achieve their own goals best by directing their efforts towards the success of the organization B) Process theories of motivation Process theories of motivation provide an opportunity to understand thought processes that influence behaviour. The major process theories are- Vrooms expectancy theory, goal-setting theory and reinforcement theory.

1) Reinforcement theory B.F. Skinners theory (1969) suggests that an employees work motivation is controlled by conditions in the external environment, that is, by designing the
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environment properly, individuals can be motivated. Instead of considering internal factors like impressions, feelings, attitudes and other cognitive behaviour, individuals are directed by what happens in the environment external to them. Skinner states that work environment should be made suitable to the individuals and that punishment actually leads to frustration and de- motivation. Hence, the only way to motivate is to keep on making positive changes in the external environment of the organization. Positive behaviour should be reinforced or rewarded as this increase the strength of a response or induces its repetition. Reinforcers tend to weaken over time and new ones have to be developed. Negative reinforcement occurs when desired behaviour occurs to avoid negative consequences of punishment. Punishment creates negative attitude and can increase costs.

Expectancy theory of Vroom

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This theory postulates that most behaviours are voluntarily controlled by a person and are therefore motivated. It focuses on peoples effort-performance expectancy, or a persons belief that a chance exists for a certain effort to lead to a particular level of performance. This theory states that motivation depends on three variablesAttractiveness: the person sees the outcome as desirable. Performance-reward linkage: the person perceives that a desired outcome will result from a certain degree of performance. Effort-performance: the person believes that a certain amount of effort will lead to performance.

3) J. Stacy Adams Equity theory Third process theory and focuses on fair treatment. Persons believe that they are being treated with equity when the ratio of their efforts to rewards equals those of others. Equity can be achieved or restored by changing outputs, attitudes, the reference person, inputs or outputs of the reference person or the situation. People have a tendency to use subjective judgment to balance the outcomes and inputs in the relationship for comparisons between different individuals. Accordingly,

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4) Jeremy Benthams The Carrot and the Stick Approach English philosopher, Jeremy Bentham ideas developed his ideas in the early years of the Industrial Revolution, around 1800. Benthams view was that all people are self-interested and are motivated by the desire to avoid pain and find pleasure. Any worker will work only if the reward is big enough, or the punishment sufficiently unpleasant. With this view, the carrot and stick approach was built into the philosophies of the age. This metaphor relates to the use of rewards and penalties in order to induce desired behaviour. It came from the old story that to make a donkey move, one must put a carrot in front of him or dab him with a stick from behind. Despite all the research on the theories of motivation, reward and punishment are still considered strong motivators. In
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almost all theories of motivation, the inducements of some kind of carrot are recognized. Often this is money in the form of pay or bonuses. Even though money is not the only motivating force, it has been and will continue to be an important one. The trouble with the money carrot approach is that too often everyone gets a carrot, regardless of performance through such practices as salary increase and promotion by seniority, automatic merit increases, and executive bonuses not based on individual manager performance. The stick, in the form of fearfear of loss of job, loss of income, reduction of bonus, demotion, or some other penalty has been and continues to be a strong motivator. It often gives rise to defensive or retaliatory behaviour, such as union organization, poor-quality work, executive indifferences, and failure of a manager to take any risks in decision-making or even dishonesty. However, fear of penalty cannot be overlooked. Whether managers are first-level supervisors or chief executives, the power of their position to give or with hold rewards or impose penalties of various kinds gives them an ability to control, to a very great extent, the economic and social well-being of their subordinates .

5) Goal-setting theory of Edwin Locke :This theory is based on goals as determinants of behaviour. The theory states that when the goals to be achieved are set at a higher standard than, employees are motivated to perform better and put in maximum effort. The more specific the goals, the better the results produced. The goals must be achievable, and
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their difficulty level must be increased only to the ceiling to which the person will commit. Goal clarity and accurate feedback increases security. It revolves around the concept of Self-efficacy i.e. individuals belief that he or she is capable of performing a hard task.

6) Arousal/ Cognitive Evaluation theory:Focuses on internal processes that mediate the effects of conditions of work on performance. This theory states, a shift from external rewards to internal rewards results into motivation. It believes that even after the stoppage of external stimulus, internal stimulus survives. It relates to the pay structure in the organization. Instead of treating external factors like pay, incentives, promotion etc and internal factors like interests, drives, responsibility etc, separately, they should be treated as contemporary to each other. The cognition is to be such that even when external motivators are not there the internal motivation continues.

7) Attitude theory Focuses on favorable attitudes of job satisfaction and job involvement leading to high performance.

8) Attrition/self-efficacy theory Focuses on explanations for events or behaviour. Perceptions of self efficacy and self esteem affect performance.
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Motivational theories for Better Nursing Management The needs of an individual are important motivators. These make the person work with enthusiasm & interest. The significant individual needs are: * Need for Power: Which results in a strong desire to influence staff, stimulate them to work, making them achieve positions of leadership e.g. making the nursing supervisor wholly responsible to take care of whole ward. The need for achievement results in a desire to do something better or more efficiently than others. People with a high need of achievement have an intense desire for success & equally intense fear of failure. They want to be challenged, prefer to assume personal responsibility to get work done and like to work for long hours. Training and orientation (refresher) course increase this need. All the staff working in a particular area should be given equal chance to attend the refresher courses related to that particular area. * Need for affiliation: - Some people derive pleasure from being loved and tend to avoid the pain of being rejected by social group. They enjoy social relationships, intimacy, empathise and help others in trouble. There is close intimacy when a staff nurse is allowed to plan and decide patient care along with ward supervisor. In order to satisfy the employees, a manger can also use Maslow's Motivation Theory in these ways:

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* Improving physical working conditions to satisfy needs e.g. grilled door and escorts to secure the nursing staff at night, providing rest rooms for lunch and dinner. * Increasing the level of training, development and skill in order to meet the self esteem needs e.g. uniform, leave facilities, vacation to nursing students. If these facilities are inadequate it harms their self esteem. * Having congenial social group and peer group interaction to fulfill affiliation needs. * Placing the person in position which match their self concept to fulfill the self actualization need. Job Design Job design is another motivator to satisfy, signify and give value to employees encouraging them to perform well. Koul Jyoti conducted a study on job satisfaction of 126 staff nurses of different hospitals in J&K State and showed that only 8% were highly satisfied. Maximum satisfaction was found for the work itself and with the competency of supervision. The areas of best satisfaction were concerned with material rewards and individual agency. The older age group and experienced persons were found more satisfied. Work Environment There are many conditions in the environment which could possibly effect the motivation of staff. It is seen by Behaviour Modification Theorist that employees perform positively if environment is favourable which is made by pay/ reward policies, democratic leadership style, peer group interaction etc. To effect the performance of employees, their input (e.g. efforts, training, experience, skill, education,
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seniority) should be equitable to their output e.g. pay, rights, benefits, jobstatus, status symbol's (vacation, clothing, satisfactory superior). The employees feel inequity if unrewarded or if given undesirable placement. The employees always respond to the environment & these responses influence their behaviour. A nursing Manager can accomplish this by using following motivational techniques. * Positive Reinforcement: Annual reward for better performance in the form of money, recognition, praise, promotion etc. Give reward to the most clean and best patient care ward on Annual days. * Avoidance Learning: Some staff nurses improve their behaviour in order to avoid criticism of Nursing. Superintendent or to avoid any disciplinary action against her. * Punishment: Nursing Superintendent, for example, can withhold reward or promotion so as to change the behaviour of staff. Scolding in front of others or humiliating should be avoided. * Be sure to tell a person she / he is doing wrong and what type of behaviour is desired e.g. RT feeding given with force by use of piston should be corrected and demonstrated so that goes with gravity. * Making the staff participate in different activities which give them affiliation, acceptance and recognition, e.g. in conferences, Nurses'-Day, Hospital Annual Day etc.

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* Giving feeling of personal responsibility or keeping interactions. The newly appointed staff should be left independent but be observed closely. * Warmth, support and identity motivate the staff to perform better. Every staff member has her own potential. Respect their individual capabilities. Don't scold if she is performing badly in other field. Let her develop potential gradually.

PROBLEMS IN APPLYING MOTIVATION THEORIES This article presents a non-exhaustive account of some problems in applying motivational theories to the actual conditions of the workplace. It should give readers a general idea of some of the less effective and more effective methods for motivating employees.

Reward vs. Punishment It is generally conceded that while rewards can offer workers a variety of incentives which can not only motivate them to work harder but also produce feelings of good-will towards management, punishment often functions only to cultivate feelings of hostility between managers and workers, which can directly and negatively effect productivity.

Personal Satisfaction vs. Financial Satisfaction One of the most successful ways of fostering a productive and motivated workforce is to ensure that workers are satisfied with their jobs, not just with
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their pay. It is interesting to note that people are quite often more concerned with how much they like their job than they are with how much money they actually make. Making employees feel important in the workplace can make them feel like part of the team, which makes them feel personally invested in the health of a business.

Persuasion vs. Coersion By appealing to a worker's sentiments and reason a manager can persuade a worker to take initiative and build their morale, which are internal drivers of motivation. However, by appealing to fear and coercion a manager may actually cause a decline in internal motivation, leaving instead feelings of hostility or anxiety which can negatively affect production.

Knowing Your Workers Understanding what is important to an individual is endemic for understanding how to motivate that person effectively. Is an individual motivated by the opportunity to develop professionally or by the possibility of making more money? Does he or she want more responsibility or more clearly defined responsibilities? Is it important that he or she see the end-product of their work or not? Usually, employees are not motivated by just one thing, which can make it difficult to determine the best strategy for motivation.

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Involvement One of the top things leading workers to feel productive and motivated in the workplace knows that they have a good management team. When people feel close to their managers they oftentimes do not want to disappoint, and may even feel the desire to win approval. By being invested in workers, managers can get workers to feel reciprocally invested in their workplace and their work. Fostering motivation in the workplace is first and foremost about fostering good management practices.

METHODS FOR MOTIVATING EMPLOYEES 1. Job rotation: This is also known as cross training. It can be effective for employees that perform repetitive tasks in the job. This allows the employees to learn new skills by shifting them from one task to another.

2. Job enlargement: is a motivation technique used for employees that perform a very few and simple tasks. It increases the number and variety of tasks that the employee performs, resulting in a feeling of importance

3. Job enrichment: this method increases the employees control over the work being performed. It allows the employees to control the planning, execution and

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evaluation of their own work, resulting in freedom, independence and added responsibility.

4. Flexible time: this allows the employees to choose their own work schedule to a certain extend. 5. Job sharing: a less common method but very effective in preventing boredom. It allows employees to share two different jobs 6. Employee involvement: people want to feel like they are a part of something. Letting the employees to be more active in decision-making related to their job makes them feel valued and important to the company and increases job motivation.

7. Variable pay programs: merit based pay, bonuses, gain sharing, and stock ownership plans are some good motivators for employees. They should be offered as an incentive or reward for outstanding performance.

The six commonly used motivational approaches:

The motivational approach are the means by which administration attempt to influence the employee to accomplish the work of an organisation.

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There are six commonly used motivational approaches: Directiveness Paternalisim Compromise Competition Participation Path-need motivation

Directiveness: Directiveness is based on authority & economic rewards. The leadership is autocratic & the motivator usually is fear. In shortterms, directiveness may produce beneficial result, but in most situation its principal outcome is organisational mediocrity specially seen in the long run. Paternalism: Paternalism is a motivational approach based on fatherly treatment of an employee. It is based on two beliefs, i.e., be good to employees & they will be grateful & loyal in turn,& make them happy to become part of the organisation or work group, so that they will work harder. Paternalism can make people happy, but it is not likely to provide through job satisfaction. Compromise:

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BOOK REFERENCES A. G. Chandorkar. Management for Health care professional. Paras medical publisher, page no.583-621 Neelam kumari. Management of Nsg. Services and education, 3rd edition 2011. p. v. books editors page no.293-300. Dr. S. R. Pandya. Administration and management of education, 4th revised edition 2011. page no. 263-278. Basavanthappa B T, Nursing administration. 2nd edition. Jaypee Brothers Medical Publishers; St Louis USA;2009.page no. 109-134 Barriet J. Ward management and Teaching. 2nd ed. Delhi: EBS Publishers; 1967 Ward MJ, Price SA .Issues in nursing administration. St. Louis: Mosby; 1991. Marquis B. L. ,Hutson C.J . Leadership roles and management functions in nursing Theory and application. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2006. Douglass L M. The effective nurse- leader and manager. 5th ed. Mosby: St. Louis; 1996.

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