(Leadership & Mngt.)

8/11/2019 (Leadership & Mngt.)

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Leadership

is a learned behavior involving influence and role modeling that inspires people to achieve personal and group goals.

Leadership

Is the process of influencing the activities of an organized group in its effort towards goal setting and goalachievement.

It involves inspiring, enlivening, and encouraging others to follow willingly, voluntarily, and cooperatively to meet

this goal with zeal and confidence and to their greatest potential

VARIOUS DEFINITION OF LEADERSHIP

It is a process of persuasion and example by which an individual induces group to take work and action that is

accord to the leaders purposes or shared purposes of all (Gardner)

It is a process by which a person inspires a group of constituents to work together using appropriate mean to a

common mission and goal (Hollowman)

It is a process of directing and influencing the task-related activities of group members (Stoner)

It is a process of social transaction in which the person influences others.(Merton)

It is a process of stimulating to strive willingly to attain organizational objectives giving them the experience to

attain the common objectives and satisfactions with the type of leadership provided (Flores)

It s a process of empowering beliefs and teaching others to top their full capabilities by shifting the beliefs that have

been limiting them (Robbins)

It is a process of influence in which leader influences, inspires, enlivens, or encourages others toward goal

achievement(yuki)

It is a process in which leaders make vision so palpable and seductive that everybody is willing to sign on (Bennis)

Attributes of a good leader

1. Self awareness

2. Self confidence

3. Advocacy

4. Accountability

Characteristics of A Leader

Intelligence

knowledge

judgment


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decisiveness

oral fluency

emotional intelligence

independence

personable

adaptability

creativity

cooperativeness

alertness

self-confidence

Become a leader who embodies:

PURPOSE Operating from a place of connection to your own deep wisdom, standards, and values so you move n

into effective action and realized vision

ACTION Translating your purpose and intention into effective action and realized vision

AFFILIATION Engaging with others in a way that honors differences and harvests the fruits of diversity to produce

collaborative, quality outcomes

ACCOUNTABILITY Stewarding your commitments on behalf of the human community and our common future

RENEWAL Recognizing the essential nature of renewal, for yourself and others, and adopting robust practices of

play, pleasure, and well being

RESILIENCE Rising to the occasions life presents you with curiosity, conviction, resilience, and a continual

openness to learning to produce collaborative, quality outcomes

Effective Leadership Satisfies 4 Primary Conditions :

a person receiving a communication understands it

this person has the resources to do what is being asked of him/her

the person believes the behavior being asked of him o her is consistent with personal interests and values

the person believes the request is consistent with the purposes and values of the organization

LEADERS ROLES

Risk Taker Good Listener

Influencer Forecaster

Change Agent Energizer


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Good Communicator Visionary

Mentor Problem Solver

Critical Thinker Role Model

Concepts of Nursing LeadershipLeadership Roles and Management Function Associated with Delegation

Leadership Roles and Function Related to Preliminary Staffing Function

LEADERSHIP

Persons ability to move people to act.

LLEAD, LOVE, LISTEN

EENTHUSIASTIC, ENERGETIC

AASSERTIVE, ACHIEVER

DDEDICATED, DESIROUS

EEFFECTIVE, EFFICIENT

RRESPONSIBLE, RESPECTFUL

LEADERSHIP Elements:

Vision

Influence

Power

Authority

Responsibility

accountability

LEADERSHIP

VISION

Essence of leadership

Provides direction to the influence process.

INFLUENCE

Ability to obtain follower

Communication


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Reccognition

POWER

Ability to efficiently and effectively exercise authority and control through organizational and social strength.

LEADERSHIP

AUTHORITY, RESPONSIBILITY, ACCOUNTABILITY

AAuthority, the right to decide

Rresponsibility, ability to respond

Aaccountability, ability to account

5 LEVELS OF LEADERSHIP

NURSING LEADERSHIP

Leadership Theories

GREAT MAN THEORY

People who use instrumental and supportive leadership behaviour are considered effective leaders in any situation

Some people are born to lead whereas others are born to be led

Holds that some people are born to lead, while others are born to be led

Indicates that few people are born with the necessary characteristics to be great and effective leaders in any situation

possess both instrumental and supportive leadership behavior.

INSTRUMENTAL ACTIVITIES: planning, organizing, and controlling the activities of subordinate to achieve goal

SUPPORTIVE LEADERSHIP: socially-oriented, and allows for participation and consultation from subordinates

for decisions that concerns them

TRAIT THEORY

Believes that a leader must possess certain traits to be effective

This earlier thought to be inherited but later research indicates that trait could be obtained through learning

experience

Some people have certain personality traits that make them better leaders than others

Leadership traits are:

energy, drive, enthusiasm, Ambition, Aggressiveness, decisiveness, self-assurance. Self-confidence, friendliness,

affection, honesty, fairness, loyalty, dependability, technical mastery, and teaching skills

Some common leadership traits:


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Leaders need to be more intelligent than the group they lead

Most possess initiative, ability to perceive, and start the courses of action not conceived by others

Creativity and originality

Emotional maturity and integrity

Adequate communication skills persuasive to gain consent of followers

Perceptive to distinguish from opponents and place subordinates in suitable positions

Participative in social activities

Believes that a leader must possess certain traits to be effective

Some people have certain personality traits that make them better leaders than others

Leadership Theories

Behavioral Theories

Autocratic

Focus is on productivity

Self-centered Leaders

Well-defined group actions

Obedience to authority is strongly enforced

Favors strict rules and established authority

Leaders exert total control over members

Low creativity, self-motivation and autonomy

Democratic/ Participative

People-oriented leader (WE)

Promotes autonomy and growth

Leader shares control with group members

Free and equal participation in decision-making

Less efficient quantitatively than authoritative leadership

Laissez-faire/Permissive

Permissive Leader (YOU)

Leader relinquishes control to group members.


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There is total freedom in a highly permissive atmosphere.

Frustrating due to over freedom

Creativity and productivity will result if members are highly motivated and self-directed

STYLES OF LEadership

Leadership Theories

Situational and Contingency Theories

Leader utilizes varying styles depending on the situation

Requires the performance of both the leader and the followers

Requirements of the leaders differs according to varying situations

A person may be a leader at one time and a follower in another

Contemporary Leadership Theories

BureaucraticMax Weber

Rule-centered (THEY)

An institutional method for applying general rules to specific cases, making actions of management air and

predictable

Management ProcessHenri Fayol

First identified management functions of

Planning

Organizing

Command

Coordination

Control

Management Process using the following principles:

Principle of division of work

Authority and responsibility

Unity of command

Remuneration of personnel

Establishment of tenure


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Is people

It is a practice

GOAL: Achivement & performance

Management

Taking place with structured organizational setting and with prescribed roles.

Directed towards the attainment and objective

Achieved through the efforts of other people

Using system & procedure

Process of Mgt: Fayol

P - planning

O - Organizing

Ddirecting (Command & Coordination)

C - controlling

Famous THEORISTS

Frederict Taylor (Scientific Management)

Steps:

Observation of workers performance

Scientific selection of best man to perform task

Training the chosen ones

Paying worker according to rate

Appointing few to managerial position

Appointing a foreman for each aspect of work

MANAGEMENT THEORISTS

HENRI FAYOL (14 Principles of Mgt.)

1. Division of work

2.

Autority & responsibility

3.

Discipline

4.

Unity of command1 boss5. Unity of directionsingle plan6. Subordinate of individual interest to general interest


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7. Renumerationfair payment

8. Centralization of authoritytop decision

9. Scalar changeinterconnectedness fr top to bottom

10. Orderline of authority

11. Equity & justicefair just treatment

12. Stability of tenure

13. Initiative

14. Esprit de corps - harmony

MAX WEBER

Form of bureaucracy based on hierarchy of authority,

division of work based on specialization of function

Impersonality in interpersonal relationships

Selection for employment and promotion on basis of technical competence

MARY FOLLETT

Management focus on the motivation of individual and groups in the achievement of goal.

Manager should not just give orders to employees but rather work together

ELTON MAYO AND FRITZ ROETHKISBERGER

(Hawthorne Effect)

A momentary change of behavior or performance in response to change in a workers environment, result being an

improvement

KURT LEWIN ( THEORY OF HUMAN BEHAVIOR)

Workers behavior is influenced by interaction between the personality, structure of primary work group and the

socio-technical climate of the workplace.

Leadership styles: authoritarian, democratic, laissez-faire

Theory X: an individual has

Inherent dislike for work & will avoid it if possible

Prefers to be directed

Hopes to avoid responsibility

More interested in financial incentives than in personal achievement


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Must be controlled, coerced, threatened

DOUGLAS MCGREGORS THEORY X & Y

Theory Y: an individual

Has expenditure in mental & physical effort

Is responsible

Is creative

Is self possessed

Has a good sense of of self direction

Is a problem solver

ABRAHAM MASLOWS HIERARCHY OF NEEDS

Physiologic Needs

Safety & security

Love and belongingness

Self Esteem

Self Actualization

FERDINAND HERZBERGS

MOTIVATION HYGIENE THEORY

2 Factors that influence people

MANAGERS VS LEADERS

Scientific Management

Frederick Winslow Taylor

System for Work Improvement consisted of the following steps:

Controlled observation of the workers performance through time and motion study

Scientific selection of the best man to perform job task

Paying the worker accordingly to a differential piece rate

Appointing a foreman for each aspect of the work

Making the production worker responsible for reporting to a different functional foreman for each aspect of the job

Lilibeth GilbrethFirst Lady of Management


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Benefits of job simplification and the establishment of work standards

Effects of incentive wage plans and fatigue on work performance

Henry Gantt

Development of task and bonus remuneration plan

Emphasis on service rather than profit objects

Classic Organization

Henri FayolFather of Management Process School

Developed the following management principles:

Division of work and task specialization

Authority commensurate with the degree of his responsibility

Each employee should receive orders from only one supervisor

A single person should direct the activities that are directed towards a single objective

he interest of the individual worker should be subordinated to the interest of the whole group

There should be unbroken scalar chain of authority and communication

All employees of the organization should be treated with equity and justice

Efforts should be made to develop teamwork and esprit de corps among workers in the organization

Max Weber

Father of Modern Sociology

Father of Organizational Theory

Advocated that the ideal form of organization is bureaucracy

Emphasis is on rules

Bureaucracies are founded on legal or rational authority which is based on laws, procedures, rules.

Positional authority of a superior over a subordinate stems from legal authority

Charismatic authority stems from the personal qualities of an individual

Efficiency in the bureaucracies comes from:

Clearly defined and specialized functions

Use of legal authority

Hierarchical form


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Written rules and procedures

Technically trained bureaucrats

Appointment to positions based on competence

Clearly defined career paths

James Mooney

Advocated that management is the technique in directing people

Lyndall Urwick

Advocated that the managerial process consists of planning, coordinating and controlling

Human Relation

Mary Parker Follett

A successful leadership was more of a result of training in leadership skills than possession of specific personality

traits

Suggested that a manager should not give orders to an employee, rather, the two should together analyze the

situation and then take orders from the situation

Elton MayoHawthorne Experiments

studied the relationship between employee productivity and physical working conditions

concluded that much more than the physical environment affected worker productivity\

other factors which influence productivity by modifying the workers social and psychological satisfaction

Kurt Lewin

revived the study of group dynamics

developed the field theory of human behavior

proposed that a workers behavior is influenced by interactions between the workers personality, the st ructure of theprimary working group and the socio-technical climate of the workplace

Jacob Moreno

Developed sociometry, psychodrama, socio drama and role playing

Chester Bernard

Cooperation depends on non-financial inducements

Behavioral Science

Douglas Mc Gregor


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Theory X and Theory Y

Frederick Herzberg

Factors associated with dissatisfaction are different from factors which causes satisfaction

Chris Argyris

During maturation, the individual moves to a condition of greater independence, increased productivity, more varied

activity, longer time prospective and increased self-control

Proposed that rigid structure and stringent rules of the typical bureaucracy block normal maturational changes

Flexibility within the organization

Employee participation in decision-making

Abraham Maslow (1921

1970)

Hierarch of Mans Needs

Other Management Theories

Herbert Simon

Views business and service institutions as network of decision making

Alvin Toffler

Suggests that the only way that people will be able to maintain a sense of equilibrium is for them to design personal

and social change

Ten Roles of a ManagerHenry Mintzberg

Interpersonal (3)

Figurehead

Leader

Liason

Informational (3)

Monitor

Disseminator

Spokesperson

Decisional (4)

Enterpreneur


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Disturbance handler

Resource allocator

Negotiator

Rensis Likert

Superiors and subordinates demonstrate trust in each other

Information is solicited in setting goals

Decisions are made at all levels using democratic process

Training is provided

Filipino Style of Leadership

Impact of values and behavior on Filipino leadership

Frank Lynch 1964 informed that three basic aims that motivate and control an immense amount of Filipino behavior

are social acceptance and economic security.

Filipino behavior patterns

Amor Propio or self-esteem

Hiya or embarrassment

Utang na loob or obligation

Pakikisama or getting along together

FILIPINO BEHAVIOR PATTERN AND VALUES SYSTEM AFFECTING THE FILIPINO LEADERSHIP

STYLE

1. Bahala na or pagsawalang Bahala

Pasensya o pagtitimpiresignation to or acceptance of failures and shortcomings

Suerterelating everything to fate

Overdependence on authority

Resiliency or capacity to adapt to misfortunate with tendency to return to old ways and forget lessons of past

misfortunes

Pagtitiisto endure a hard life without complaint and with complete resignation to such fate

Manyana Habits putting off for late appointments

Ningas-kugontendency for sudden outburst of enthusiasm at the start of any endeavor followed equally abruptloss of interest


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come what may attitude- one can leave matters as they are; no need to exert effort because supernatural spirits orBathala will take care of everything for anybody

Mixing pleasure with work leading to failure to distinguished one from another

Talagang ganyan ang kapalaran (Thats life) eats up ones sense of responsibility and personal accountability; gives

ones false sense of self confidence to proceed even unsoundly in the belief somehow one will manage to get by

Segurista- demands demonstration of assured success

2. Person Oriented

Hiya (shame or embarassment)development of the capacity for this feeding is encouraged by family since thethreat of experiencing it is considered an effective means of obtaining appropriate behavior

Utang Na Loob (obligation)feeling which develops when someone has received a favor from another; cannot berepaid by money. Repayment is expected by the donor in a form decided at some future time by the donor.

3. High-Respect and Regard for women the Pinay Powerbecomes very evident in Filipino organizations

4. Application of Bureaucracyconstitute an essential part of Filipino life because the chief functions isreinterpreted isto strengthen the traditional norms of society through the evolution of a unique synthesis oftheretional and traditional.

5. Personalismidentifies leadership with benevolences; focuses not so much on what a person does as in who heis; not o much on what the person knows as whom he knows and who knows him not as much on the objective

reality of things as on the way things are actually perceived.

6. Dangal (honor), puri (modesty), utang na loob (sense of gratitude) considers moral dimensions of his actions,solutions, and decisions. Sense of gratitude to the people who supported the company at the early stage may make

him / her decide to retain an employee even if his / her knowledge are no longer needed.

The

Nursing Management Process

The Nursing Management Process

Planning

Organizing

Staffing

Directing

Controlling

PLANNING



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Examining the future

Deciding what needs to be achieved, how to achieved it, who is to do it

Developing a plan of action

Failing to plan is planning to fail

A pre-determining course of action in order to arrive at a desired result

Characteristic of a Good Plan

Have a clearly worded objectives, including desired results and methods for evaluation

Be guided by policies and / or procedures affecting the planned action

Indicate priorities

Develop actions that are flexible and realistic in terms of available personnel, equipment, facilities and time

Develop logical sequence of activities

Include the most practical methods for achieving each objective


Types of Planning

Strategic Plandefines direction & growth of the organization

- 3 to 5 years plan

- long term in nature

- based on the strengths & weaknesses of the organization

- involves the upper management

Process of Mgt: Types of Planning

2. Operating Plansfocuses on timetables, target qualities, specifies persons tasks.

- deals with techniques for accomplishment

- short term (1 year)

- involves, middle & lower managers

3. Continous or Rolling Plan

- involves mapping out day to day activities.


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- tasks of a staff nurse in modifying NCP depending on the needs of a client

Reasons for planning:

Leads to success in achievement of goals and objectives.

Provides for the effective use of available personnel & resources

It helps to cope with crises efficiently

Reduces the element of change

Necessary for effective control

Elements of Planning

Forecastingestimating the future mission, vision, objectives

Establishing Objectives (SMART)

Specific

Measurable

Attainable

Realistic

Time- bound

Elements of Planning

Schedulingsetting a timeframe

Budgetnumerical description of expected income and planned expenditures for an organization for a specificperiod of time

Approaches

- Centralized

- De-centralized

Components of an Institutional Budget

- Capital Expenditure

- Personnel Budget

- Operating Budget

Capital Expenditure

A large capital outlay for buildings or equipment that commits the institution to a particular path for someone in the

future


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Includes physical changes such as replacement or expansion, major equipment and inventories

Personnel Budget

Estimates the cost of direct labor necessary to meet the agencys objectives

Determines recruitment, hiring, assignment, lay off and discharge of personnel

Operating Budget

Input-output analysis of expected revenues and expenses

Includes personnel salaries, employees benefits and insurance, medical-surgical supplies, office supplies, rent, heat,

light, housekeeping, laundry service, drugs, pharmaceuticals, repairs, maintenance, in-service trainings, books etc

Types of Budget

Fixed-ceiling

Uppermost spending limit is fixed by the organization before subordinate managers are asked to develop budget

proposals for their individual units

Open-ended

Operating managers presents a single cost estimate for what she considers the optimal activity level, without

indicating how that plan should be scaled down if less funding is available

Flexible

Can be adjusted or manipulated, consists of several financial plans, each for a different level of activity of different

operating conditions

Sunset

Designed to self-destruct within a prescribed period to ensure cessation of the funded program by the pre -determined date

Zero-based

Expenses have to be justified to determine profit loss, forces managers to set priorities and justify resources, based

on previous years expenditure

Contingency

Can be used in case of emergency; if not used, can be a part of savings

Performance

Based on functions, such as direct nursing care, supervision, in-service education, quality control, nursing audit,

procedure revision and development, nursing research etc

Program


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Costs are computed for an entire program, as for ambulatory surgery program, both old and new, with every annual

budget preparation

Direct and Indirect Expenses

Direct: Directly associated with patient care such as medical and surgical supplies, medicines, etc

Indirect: for items like utilitiesgas, electricity, communication facilities etc

Fixed and Variable Costs

Fixed

Expenses that are constant and are not related to productivity and volume

Ex. Building and equipment depreciation, utilities, fringe benefits, admin salaries

Variable

Fluctuates depending upon the volume or the census or the types of care

Ex. Medical-surgical supplies, medicines, laundry and food costs

Assignment Patterns for Delivery of Nursing Care

Functional Nursing

Emphasis is on getting the job done, assignments are divided among staff members according to job descriptions

and much work must be completed

Total Care

Giving of all direct care to the patient by an RN

Maybe task-centered or patient-centered

The nurse provides all the care her patients need while she is on duty


Team Nursing

Devised to be used when teams would be composed of care providers who had adversity in education and abilities

Based on:

Every patient has the right to receive the best care possible with the available staff and time

Planning nursing care is basic in providing this care

All nursing personnel have the right to receive help in doing their job


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A group of care providers with the leadership of a professional nurse can provide better patient care than those same

people working as individuals


Primary Nursing

RN is responsible and accountable for the care of the patient 24 hours a day

Responsibility includes assessing, planning, implementing and evaluating nursing care from the time the patient was

admitted to the nursing unit until the patient is discharged from the unit

Designed to return the RN to their original role of giving direct patient care, which would improve the quality of

care given

Patient care classification system

Level IMinimal care

Level IIIntermediate or Moderate care

Level IIIIntensive care

Level IVHighly specialized Intensive care

Time Management

Basic Steps in Time Management

Time for planning & establishing priorities

Completion of the task with the highest priority & ensuring that a task is finished before beginning with another

Reprioritization according to task left and new found information

Time Management

Managing time at work

Gather all equipment and supplies needed beforehand

Group activities with similar locations

Use time wisely

Record all nursing interventions immediately after each activity is finished

Finish all work on the designated time


Scope of Planning:

Forecasting / estimating the future


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- the agency, community affected & goals of care

- must be supported by facts & policies, plans

2. Set objectives/ Goals and determine results desired.

3. Develop and schedule strategies, programs / projects / activites; Set the Time Frame

- Time Mgt.

- Multitasking

- PERT (Performance Evaluation Review Technique)

TIME MANAGEMENT

To plan effective use of time, nurses must understand the big picture, decide on desired outcomes, and do firstthing first Kelly (2008)

TIME WASTERS

Procrastination

Inability to delegate

Inability to say no

Management by crisis, haste and indecisiveness

Interrupting telephone calls

Complaining

Perfectionism

Disorganization

4. Prepare the Budget and Allocation of Resources

Budgetingsystematic financial translation of a plan.

- the allocation of resources on forecast needs


Budget Planis designed to meet future service expectations, to provide quality care at minimum cost.

4 components:

Revenue Budgetsummarizing income mgt.


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Expense Budgetdescribe expected activity

Capital Budgetoutlines programmed acquisition, disposal & improvements

Cash Budgetmoney received, cash receipts, disbursement.


Types of Budgeting:

Centralized Budgetimposed by comptroler, adminstrator with no consultation to the lower level managers.

Decentralized Budgetmiddle manager involved in planning & budgeting

Components of Institutional Budget:

1. Manpower Budgetwages & salaries, fees to be paid outside registry.

2. Capital Expenditure Budgetlarge expense: lands, building, equipments or long term use.

3. Operating Budgetcost of supplies, minor repair and maintenance, overhead expenses


Factors in Budget Planning

Patient

Health care facility/ hospital

Personnel

Standard of nursing care and supervision

Policies, procedures and standard


DECISION MAKING

- Process of identifying and choosing an action from among several possible choices.

This is influenced by values and preferences of the decision maker.

IS an end point of critical thinking


STEPS IN DECISION MAKING

Define the problem

Assess all options


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Weight all options against a set of criteria or standards

Test possible options

Consider consequences of the decision

Make a final decision


Kinds of decision:

Whether Decisiondeciion made before the selection of one of several alternatives, where selection is made afterweighing the pros and cons.

Ex: Whether or not to buy a car.


Kinds of decision:

2. Which Decisionchoosing from among several alternatives, which are measured based on set of pre-definedcriteria.

Ex: Among the car presented, which one will i buy.


Kinds of decision:

3. Contigent Decisiondecisions that have been made but put on hold until some conditions are met like time,energy, price, availability, opportunity, encouragement.

Ex: I have decided to buy the car if I can get it for the discount price


Decision Making Models:

WinWinmutual willingness in the group to come up with solutions that are acceptable to all.

WinLoosesome interest are advanced at the expense of others.


3. Disagreement and Collaborationdecisions resulting in the following elements when conflicts and disagreementsare openly explored.

High quality decisions

Creative decisions

Decisions that are understood

Decisions that are accepted and owned


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4. Solution Shapingfocused on how to modify or amend proposed solution rather than attempt to pressure peopleinto changing their minds about the solution.


CRITICAL THINKING

A cognitive process of examining underlying assumptions, interpreting and evaluating arguments, imagining and

exploring alternatives and developing reflective criticism for the purpose of reaching justifiable reasoned

conclusion and correct judgement.

ORGANIZATION

Organizing

The way a group is formed, including lines of communication, channeling of authority, span of control, and makingdecisions

Formal structure of the organization which reflects official arrangement of position & working relationship

Providing the material and human resources and building the structure to carry out the activities of the organization.

Determines what tasks are to be done, who is to do these, how the tasks are to be grouped, who reports to whom, and

what decisions are to be made.

It is the backbone of management.

Process:

Identification and definition of basic task

Delegation

Establishing relationships

Categories of organization:

1. Formalsystem of well defined job, each with a measure of asuthority and responsibility and accountability.

2. Informal - do their actions in terms of needs and relationships not in terms of procedure and regulations.

CHARACTERISTIC OF ORGANIZATION

Division of work

Chain of command

Types of work segments

Levels of management


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Principles of Organizational Design

Division of labordepartmentalization / specialization

2. Unity of commandline of command

3. Authority and responsibilitydistribution of power

ORGANISING: Principles of organizational design

4. Span of controlcentralized or decentralized

5. Contingency factorsdeals with task variablity and problem analyzability

Patterns of Organizational Structure

Tall or Centralized

Patterns of Organizational Structure

Flat or Decentralized

3. Staff Organization

Functional Organization

5. Ad Hoc organization

Organizational Relationships

Formaluninterrupted lines

Informalbroken or dotted line

TYPES OF ORGANIZATIONAL STRUCTURE

LINE ORGANIZATION

General authority over the lower positions in the hierarchy

INFORMAL ORGANIZATION

Horizontal relationships, among workers with similar interests.

TYPES OF ORGANIZATIONAL STRUCTURE

STAFF ORGANIZATION

advisory to the line structure with no authority to put recommendations.

FUNCTIONAL ORGANIZATION

clear delineation of roles and responsibilities.


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Management principles

Unity of command

Chain of command/ command responsibility

Span of control

Channel of communication

Delegation of authority

STAFFING

Refers to the required number and mix of nursing personnel in a nursing unit with in a 24 hour period.

Main purpose of Staffing:

to provide safe, quality care.

Start with Self-assessment

STAFFING

Process of assigning competent people to fill the roles designated for the organizational structure through

recruitment, selection & development:

STAFFING PROCESS DEVELOPING AND RETAINING STAFF

STEPS IN STAFFING

1. Determine the number and types of personnel needed.

2. Recruit personnel

3. Interview

4. Induct or orient the personnel

5. Job offer

Factors affecting Time Requirement of Nursing Care

Acuity of the patients illness

Degree of dependence of the patient to care givers

Communicability of the patient

Rehabilitation needs and special treatments and procedures


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Patient Classification System

measurement tool used to articulate the nursing workload for a specific patient or group over a period of time.

Patient Classification System

Self care or minimal care patientscapable of ADL

Intermediate or moderate careneeds some help.

Ex: pt. With IVF, Catheter, respirator

ORGANISING: Patient classification system

3. Total Care patientbedridden

4. Intensive Care patients

STAFFING FORMULA

1. Full Time Equivalent (FTE)

Works 5 days, 40 hours/ week x 52 weeks /yr

2,080 hours of work time

Total nursing care hours x days in year

-------------------------------------------------------

Total annual hours per 1 FTE

2. 40 hrs/week law

R.A 5901Forty Hour Week law

ABO X NCH

--------------------------- = Total # of personnel in 24hrs

No. Of working hours

ABO = Average Bed Capacity

NCH = Nursing Care Hours

Standard Value for NCH

B. % OF PROFESSIONAL AND NON PROFESSIONAL IN RATIO

C. DISTRIBUTION PER SHIFT

A.M = 45%


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P.M = 37%

NIGHT = 18%

D. 40 HOURS / WEEK

For personnel working in a hospitals with 100 bed capacity or over over or which are located in 1 M population

E. 48 hours / week

For personnel who work in agencies with lesser bed capacity or which are located in communities with less than 1

M population

Guidelines for Determining the nursing personnel needed

1. Determine type of hospital wheter it is primary, secondary or tertiary.

Hospital A is a 100 bed capacity secondary level hospital

ORGANISING: Staffing formula; nursing personnel

2. Categorize patients according to levels of care

100 pts x 65% = 65 pts needs minimal care

100 pts. X 30% = 30 pts needs intermediate care

100 pts. X 5% = 5 pts needs intensive care

3. Find the NCH needed by patients / day and get the SUM

Minimal Care = 1.5 hours

Intermediate care = 3 hours

Intensive care = 4.5 hours

Minimal care = 65 x 1.5 hrs = 97.5 NCH

Intermidiate care = 30 x 3 hours = 90 NCH

Intensive Care = 5 X 4.5 hours = 22.5 NCH

Total = 210 NCH / day

4. Find the Total NCH X 365 days

210 NCH / day X 365 days = 76,650 NCH

5. Find number of working hours per year

40 hours/wk

216 x 8 hours = 1,728 working hrs/year


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48 hours/wk

268 x 8 hours = 2,144 working hours/yr

6. Find the nursing personnel needed

Number of personnel needed

NCH per year

-------------------------------

Working hours / year

Number of relievers needed

Number of personnel x 0.95

ORGANISING: Staffing formula


Nursing personnel

76,650 NCH/year

------------------------ = 44 nursing personnel (40hrs/wk)

1,728 work hrs/yr

76,650 NCH/yr

---------------------- = 36 nursing personnel (48hrs/wk)

2,144 wrk hrs/yr


Nursing Relievers

44 nursing personnel x 0.95 = 4 nursing relievers

36 nursing personnel x 0.95 = 3 nursing relievers

* Average yearly absence of an employee 35 days. Divide 35 by 365 days is 0.95. This includes mandatory leaves

and other absences.


44 nursing personnel + 4 relievers = 48 nursing employees

36 nursing personnel + 3 relievers = 39 nursing employees

7. Categories into Professional and Non Professional


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Primary = 55:45

Secondary = 60:40

Tertiary = 65:35

8. Distribute by shifts

AM = 45%

PM = 37%

Night = 18%

Determinants of Staffing

Number of personnel

Mix of personnel

Number of patients

Type of patient care delivery system

Classification of patients

Types of Staffing

Centralized staffing - chief nurse

assignment of personnel is made by the nurse manager at the organizational level.

Decentralized staffing - head nurse

allocation of nursing personnel at the unit level.

Cyclical Staffing

covers a designated number of weeks called the cycle length and is repeated thereon.

Process Increasing the Chance of Hiring Success

Determine the business labor and management needs

Develop a current job description

Build a pool of applicants

Review application and select those to be intervied

Interview

Check references

Make a selection


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Hire

DIRECTING

Is the issuance of assignment, orders and instructions that permit the worker to understand what is expected of him

or her

Delegation

Transferring of responsibility from higher to lower authority

Policy utilization, revision & updating

Supervision

Guides, directs, motivates, teaches and facilitates

Act of issuing orders, assignments, instructions to accomplish the goals / objectives

Command

Co-ordination

CHARACTERISTICS:

Must be clear, concise, consistent and complete

Must explain the rationale well & makes sure that it is understood

ELEMENTS:

Delegation

Supervision

Staff development

Coordination

Collaboration

Communication

evaluation

DIRECTING: delegation

We cannot delegate:

Assessment

Health teachings

evaluation


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DIRECTING: communication

Barriers to effective communication

Physical barriers

Social/ psychological (stress, fear, trust)

Semantics

Interpretations

DIRECTING: evaluation

Purpose of Evaluation:

Get feedback

Determine progress

Basis for promotion

Recognize weakness; develop strengths

Develop fair employment practice and performance

Conflict

Is a natural, inevitable condition in organization

Consequence of real or perceived differences in goals, vakues and ideas, attitudes, beliefs, feelings and acgtions

Types of conflict

1. Competitiveoccurs when 1 or more groups attain same goal & only one group can attain goal2.

Disruptivean environment filled with fear, anger and stress. Goal is elimination of its opponent.3.

Conflict Resolution

Dominance and Suppression (winlose strategy)

Restrictionautocratic, coercive

Smoothing Behaviorone persuade the other to give in to other side

4. Avoidance Behavior

5. Majority rules

6. Compromise or consensuseach side agreed upon solution

7. Integrative Problem solvingboth parties tries to solve the conflict

8. A WinWin strategyfocuses on goals and attempts to meet the need of both parties


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9. LooseLoose strategyneither side wins, settlement reached is unsatisfactory to both sides.

10. Confrontationmost effective means, attempts are made to resolve it through knowledge and reason

11. Negotiationconflicting parties give and take on various issues.

Frequent Mistakes in Delegation

Under delegation

Over Delegation

Improper delegation

POWER - the ability to impose the will of one person or group to bring about certain behaviors in other persons or

groups.

AUTHORITY - is the legitimate right to give commands.

Different forms of Power

Legitimate power

Given to a manager by virtue of his position in the organization.

Ex. head nurse

Reward power

Based on the ability of the manager to administer rewards to others

Different forms of Power

Coercive Power

Founded on the managers ability to use punishment on others for non compliance with order.

Expert Power

Derived from some special ability, skill or knowledge demonstrated by the individual

Referent power

Based on attractiveness or appeal of one person to another

CONTROLLING

Process of checking to make sure that things are done as intended.

Process by which managers attempt to see that actual activities conform to planned activities.

Performance appraisals, fiscal accountability, quality control, legal and ethical control and professional and collegial

control

Verifying that everything occurs in accordance with plans, instructions, established principles and express command


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Functions: serve as means and an end. cyclical

Principles:

A critical few

Point of control or centralization of authority

Self control or discipline

Types of control

Feedforward controlprevent anticipated problem

2. Concurrent controlenacted while work is being performed

3. Feedback controlfocus on result of operation as guide in future planning

Performance Appraisal

Types of Rating Scale

Trait Rating Scale

Job Dimension Scale

Behaviorally-anchored Rating Scale

Checklist

Peer Review

Self-appraisal

Accreditation

Evaluation of quality of nursing education provided

Development of Standards

Pre-determined level of excellence that serves as a guide to practice

Audit

Measurement tools used to provide quality care

Goal-Setting

Consider the availability of resources

(Leadership & Mngt.)

Documents

Transcript of (Leadership & Mngt.)