NURSING LEADERSHIP & MANAGEMENT

Michael Kenneth A. Desierto, R.N., M.A.N.

A. Leadership -Process of __________ in which the leader influences others toward goal achievement. -Effort to _______ and ________ changes. Leader - One who leads, conducts or guides the process. Types of Leaders 1. Informal leader 2. Formal or Appointed Theories of Leadership 1. Great Man Theory 2. Charismatic 3. Trait Theory 4. Situational Theory 5. Path-Goal Theory Types of Leadership 1. Transactional Leadership -Focused on ____________________________. 2. Transformational Leadership -Promotes employee ________________. 3. Connective Leadership -The leader promotes _________________ and ________________ within the organization and among other organizations. Leadership Styles 1. Autocratic

2. Democratic

3. Laissez-Faire or Permissive

Power & Authority a. Power b. Authority Types of power 1. Expert power 2. Legitimate power 3. Referent power 4. Reward power 5. Coercive power 6. Connection power 7. Personal power 8. Informational power B. Management Manager -A person that creates and maintains an internal environment in an enterprise in which individual work together as a group. MANAGEMENT LEVELS

1. FIRST LEVEL 2. MIDDLE LEVEL 3. TOP LEVEL Roles of Managers 1. INTERPERSONAL ROLE

2. INFORMATIONAL ROLE

3. DECISIONAL ROLE

Management Theories A. Scientific Management 1. FREDERICK TAYLOR Contributions: a. Reduced wasted effort. b. Set standard for performance. c. Encourage ________________. d. Stressed the selection of qualified workers who could be developed for a particular job. 2. Henry Fayol a. Management is _____________. b. Management is not a talent but a skill. c. Introduced the _____________________. 1. Division of Labor 2. Authority 3. Discipline 4. Unity of command 5. Unity of direction 6. Subordination of Individual Interest to the Common Good 7. Remuneration 8. Centralization 9. Hierarchy 10. Order 11. Equity 12. Stability of Staff 13. Initiative 14. Espirit de Corps B. Bureaucratic Organization 1. Max Weber a. Developed _________________. b. People are appointed by merit rather than favoritism c. Activities are routinized. C. Behavioral School 1. Elton Mayo Fayols 14 Management Principles

-Author of The Hawthorne Studies -_______ and not just physical work environment influence productivity. D. Motivational Theory 1. Douglas McGregor a. Theory X b. Theory Y

2. William Ouchi

Others: a. Abraham Maslos b. Frederick Herzberg c. Victor Vroom d. Operant Theory e. David McClelland f. Jo Stacy Adams Managerial Functions I. PLANNING Two Types of Planning 1. Strategic Planning 2. Operational Elements: a. Forecasting b. Vision, Mission, Philosophy c. Goals and Objectives d. Budgeting e. Nsg. Standards and Policies A. Forecasting -looking into the future and deciding in advance where the agency would like to be and what is to be done to get there. Components of Forecasting *PERC*

B. Mission -Vision -Philosophy Example: Vision: The Medical Center envisions itself to become the Center of Wellness and Excellence by providing holistic care. Mission: Our Tertiary facility provides holistic care that is accessible, affordable, available, and acceptable thru all aspects of health promotive, preventive, curative, rehabilitative. Philosophy: The Center of Wellness are guided by the ff beliefs: a. Loyalty to our clients IFC. b. Respect for individuals. c. Fair distribution of health services. d. Collaboration and teamwork with Clients, Colleagues, and other Personnel. e. The clients are the reason for the hospitals existence. C. Goals -Objectives D. Budget Types of Budget a. Capital Expenditure b. Operational c. Cash budget

E. Nursing Standards -Nursing Policies

II. ORGANIZING -Grouping of activities for the purpose of achieving objectives. Organizing Principles 1. Unity of Command 2. Scalar Chain or Hierarchy 3. Departmentation 4. Span of Control 5. Exception Principle 6. Decentralization/Centralization Elements of Organizing a. Organizational Structure b. Staffing c. Scheduling d. Job Descriptions

A. Organizational Structure -refers to the way in which a group is formed and provides a framework in which management processes are carried out. Types of Organizational Structure 1. Informal 2. Formal 1. Organizational Chart 3 General Types of Organizational Chart Vertical Chart

2.

Horizontal Chart

3. Concentric Chart

B. STAFFING -Is the process of determining and providing the acceptable number and mix of nursing personnel to produce a desired level of care to meet the patients demand. C. Schedule timetable showing planned workdays and shifts for nursing personnel. Types of Scheduling: a. Centralized b. Decentralized c. Cyclical d. Rotating e. Weekend Alternative f. Self-scheduling D. Job Description -a statement that sets the duties and responsibilities of a specific job. -an important tool to make sure that responsibilities are wisely delegated. Contents of JD: 1. Identifying Data 2. Job Summary 3. Qualification Requirements 4. Job Relationships 5. Specific and Actual Functions and Activities

III. DIRECTING -Issuance of assignments and instructions that permits the worker to understand what is expected of him. -Giving direction to others to attain quality client care.

 Elements of Directing 1. Delegation 2. Communication 3. Staff Development 4. Conflict Management

A. Delegating -is getting the work done through employees. - Process by which a manager assigns specific tasks to workers and holding them accountable and responsible for their performance. Principles of Delegation 1. Right person for the right job. 2. Delegate both interesting and non-interesting tasks. 3. Provide enough time to learn. 4. Gradual & advance delegation. 5. Consult before delegating. 6. Avoid gaps and ____________. 2 Important Criteria in Delegation 1. Ability of the worker to carry out the task. 2. Fairness not only to the employee but to the team as a whole. Modalities of Nursing Care 1. Primary Nursing Most _______ method _________ coverage for ________hospital stay Greater patient satisfaction Patient-oriented 2. Case Method _________ method; _____ nurse/Px ratio The nurse is responsible for the total care of the patient for the ______ 3. Functional Nursing Most _______________ method Best used if there are many _________ & _________ are few ______-oriented 4. Team Nursing Involves RNs leading other nursing and non-professional personnel. Team Conference B. Communication Lines of Communication 1. Upward 2. Downward 3. Horizontal or Lateral 4. Outward C. Staff Development 1. Orientation 2. In-service Education 3. Specialty Courses 4. Formal Education D. Conflict Management 1. Avoidance 2. Accommodation 3. Collaboration 4. Compromise 5. Competition IV. CONTROLLING -A process wherein the performance is measured and corrective action is taken to ensure the accomplishment of organization goal.

 Common Errors of Evaluation 1. Halo error 2. Horn error 3. Contrast error A. Performance Appraisal -a control process in which employees performance is evaluated against standards. Methods: a. Quality Circles b. Patient Care Audit c. Peer Review B. Quality Assurance -evaluation of health care system and the provision of health care services by health care workers. Framework Of Qa a. Structure b. Process c. Outcome

C. Disciplinary Action Steps: 1. Oral warning 2. Written Memo 3. Suspension 4. Dismissal V. Entreprenurse Primarily by: Collaboration with -BON-PRC, DOH, PNA, UPCN, OHNAP, Philhealth Objectives: Reduce cost of health care for the indigent pop. by bringing PHC services to poor rural communities. Maximize employment opportunities for unemployed RNs. Utilize unemployed HR for health for the delivery of public health services. Project Beneficiaries HMO PhilHealth members Self-paying Px, convalescent Px, Pxs needing long-term tx, Elderly Occupationally disabled Identified poor rural communities Unemployed nurses. God Bless Nurses!