1 nursing management

7/28/2019 1 Nursing Management

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NURSING

MANAGEMENT

GERARDO F. JOVEN, RN,

MAN,


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It is a process that involves the directionof a group of people towards

organizational goals and objectives.

Objectives of an organization are

accomplished by utilizing human and

physical resources and technology.


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Principles of Management


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1. Division of Work

each employee

has a specific job

to do

2. Authority

power to make

decisions andgive commands.


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3. Discipline

obedience and

respect of the

rules of the

organization.

4. Unity of

command each

employee receiveonly from one

superior.


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5. Subordination of

individual interests to

the general interestthe majority is superior

to the minority.

6. Unity of direction

objectives and

direction comesfrom one manager

using one plan.


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8. Centralization

degree to which

subordinates areinvolved in decision

making.

7. Remuneration

employees are

paid a fair wage

for their

services.


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9. Scalar chain refers

to the line of

authority from top

management to the

lowest rank. 10. Order People

and materials

are in the rightplace at the right

time.


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12. Stability of tenure

employees are

retained due totheir efficiency and

effectiveness.

11. Equity managers

observe kindnessand fairness to the

subordinates.


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13. Initiative

performing roles

without being

told to do so.

14. Esprit de corps

team spirit builds

harmony and unity

within the

organization.


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MANAGEMENT

PROCESSAND FUNCTIONS


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Four Basic Managerial Functions

Planning

Organizing

Directing

Controlling


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Planning

Forecasting ofevents based on

which decisionsare made, goalsare set andprioritized andpolicies andstandards aredeveloped.


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Top Managers: Director ofNursing Services, Chief

Nurses, Dean of the

College of Nursinga. Responsible for the

over-all operations

b. Establishes

objectives, policies,

strategies

Scope of Planning


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Middle Managers: Nurse

Supervisors, Clinical

Coordinatorsa. Coordinates nursing

activities of several

unitsb. Receives strategies and

policies from top

managers and translatethem into specific

programs.


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First-line Managers:

Head Nurses,

Primary Care

Nurses

a. Directlyresponsible for

the actual

production ofnursing services.


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1. Strategic Planning It extends

3 5 years in the future.Begins with in-depth analysis

of the SWOT so that goals can

be set for the future.


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2. Tactical Planning

Specified in one-

year incrementsinvolves allocating

available

resources tospecific purposes

expressed in

budget.


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3. Operational

Planning It

develops the day-to-day

departmental

activities andimprovement

goals for the year.


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Reasons for Planning

1. A good plan ensuresthat the neededresources are available

to carry out initiativesidentified for theorganization.

2. Everyone has the sameidea for where theorganization is headed.


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3. Increases the

chances of successon results.

4. Helps avoid crisis

and providesdecision making

flexibility.

5. Cost-effective


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1. Develop the mission,vision, philosophy, goals

and objectives.2. Collect and analyze data

on internal and externalforces.

3. Assess strength,weaknesses,opportunities and

threats.4. Formulate realistic goals

for the organization.


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5. Determine strategies to

achieve identified goals.

6. Develop time table for

each objectives set.

7. Provide guidelines forplans that are identified.

8. Implement plan.

9. Evaluate the plan.


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Elements

of Planning


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1. Forecasting is

the process of

estimation ofsituations in

order to

accomplish plans

of the

organization.


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2. Budgeting

operational

management planstated in terms of

income and expense,

covering all phases

of activity.


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Types of Budget

1. Operating Budget

goods and

services the unit

expects to use

during the budget

period.


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2. Capital Expenditure

Budgetbudgets

associated withoperating some

major capital assets


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3. Personnel Budget

compensation

and benefits to

nursing and

support personnel

required to

operate a unit.


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4. Cash Budget depicts where cash will

be spent over some near term in

order to know if the organization can

afford bills that must be paid soon.


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Purposes of Budgeting

1. Promotes proper allocationof resources.

2. Promotes smooth andefficient organizationaloperation.

3. Serves as a tool formodification and changesin the organization


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3. Schedulingdetailing what

activities to bedone, theorder in which

they arecompleted,who is to do

each and whenthey arecompleted.
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ORGANIZING

Grouping of activities forthe purpose of

achieving objectives,

the assignment foreach grouping to a

manager with

authority forsupervising the group.


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Elements of Organizing

1. Organizational

structure

2. Coordination3. Staffing

4. Job descriptions


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Organizational structurethe formal framework

by which job tasks are

divided, grouped andcoordinated.


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Forms of OrganizationalStructure


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1. Hierarchical/LineOrganization - associated

with principle of chain ofcommand, bureaucracyand vertical control andcoordination, levelsdifferentiated by functionand authority anddownward

communications.

h f


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Chief Nurse

Assistant Chief

Nurse

SupervisorNurse (PM)

SupervisorNurse (NT)

SupervisorNurse (AM)

Head Nurse Head Nurse Head Nurse

Charge Nurse Charge Nurse Charge Nurse

Staff Nurse Staff Nurse Staff Nurse


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2. Staff Organization

Assists the line inaccomplishing the

primary objectives of the

unit, provides advice andcounsel, includes clerical,

personnel, budgeting and

finance.


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Vice Presidentfor Finance

Legal Counsel

Resident Accountant

Bookkeeper

Purchaser

Executive Secretary

Messenger


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3. Free-form/Matrix

Personnel from

functionaldepartments are

assigned to a

specific program.Example: Task

Force, Ad Hoc

Committee.


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Over-All Chairman

Vice-Chairman

Chairman,

Committeeon Program

Chairman,Committee

on Invitation

Chairman,

Committee onArrangements

Chairman,Committee onRefreshments

Chairman,

Committee onDocumentation

Members Members Members Members Members


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Coordination it

refers to the quality

of collaborationacross various

departments in an

organization.
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Purpose: provides

access to

information and

enable

communication

among people in

different

departments at

different levels.
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1. Primary Nursing

The nurse has totalresponsibility for

the nursing care of

the patient 24hours a day from

admission to

discharge. It is

expensive.


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2. Team Nursing a group

of nurses work

together to fulfill the

full functions of

professional nurses.

The team leader has

the responsibility of

coordinating the total

care of a block of

patients.


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3. Case Method

provides for one-

to-one RN-to-

client ratio and

constant care for

a specified period

of time.

4 F ti l M th d


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4. Functional Method

task-oriented method

where nursing functionis assigned to each staff

nurse. One nurse is

giving medications, onefor VS, one managing for

IV. Gives professional

nursing low status interms of responsibility.


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Job Description - It is a

statement that setsthe duties and

responsibilities of a

specific job. Itincludes the needed

qualifications of the

individual to performsuch duties

successfully.


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DIRECTING

It refers to the

issuance of

assignments, orders

and instructions that

permit the worker to

understand what is

expected of him.


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Elements of Directing

1. Delegating

2. Supervision

3. Change Process4. Conflict Resolution

5. Decision Making

6. Communication
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Principles of Delegation

1. Right person

2. Right tasks

3. Right time

4. Right supervision


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Supervision to

oversee or view

directly andperiodic inspection

of the actual

accomplishment ofthe task or activity.


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Change Process

purposeful,designed effort to

bring about

improvements in asystem with

assistance of a

change agent.


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1. Competition and power

if the nurses primaryconcern is work withlittle regard topersonnel.

2. Smoothing nurse putsrelationship withpeople as a primary

concern rather thanwork accomplishment.


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5. Collaboration a

constructive

process where

parties recognize

the conflict and

confront the

issue openly.
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Guidelines for EffectiveCommunication


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5 Transmitting channel used


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5. Transmitting channel used

to communicate a message.

6. Decoding occurs when themessage is received (heard).

7. Action behavior taken by

the receiver as a result of themessage.

8. Feedback two-way

communication when senderand receiver exchange and

clarify information.


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Flow of Communication


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2. Upwardcommunication

comes from

subordinate totop

management.


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3. Lateral

communicationobserved

between

employees andpersonnel on

similar level.


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CO O G


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CONTROLLING

It refers to the process bywhich managers evaluating

to make sure that things are

done as intended.Nurse managers attempt to

see the actual activities

conform to planned

activities.


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Basic Components ofControlling

1 S tti t d d


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1. Setting standards

objectives and methods

for measuringperformance.

2. Measure actual

performance3. Compare performance

from standards.

4. Take corrective actions asnecessary.


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2. Process standards

refers to decisions and

actions of the nurse

relative to the nursing

process necessary toprovide good nursing

care.


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3. Outcome standards are

designed to measure theresults of care provided in

terms of changes in the

health status of clientsserved and satisfaction of

those served.


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Performance

Evaluation - It is a

method of

observation

through which the

individuals

efficiency is

evaluated over a

period of time.


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Quality Assurance - It is a means of

achieving accomplishment and

implies a guarantee of excellence.

Q lit A M th d


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Quality Assurance Methods

1. Nursing Audit isa qualitymeasurement

method throughevaluation ofnursing care done

in anunannouncedmanner.


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Discipline - It is rigidobedience to rules and

regulations, the

violations of which

results to punitive

actions.

Disciplinary Approaches


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Disciplinary Approaches

1. Counseling and OralWarning done in

private and in informal

manner. Employee iscounseled regarding

expectations of

improved performance.

2 Written Warning


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2. Written Warning

The employee is

told of his below

performance and

a written warning

is given.
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4. Dismissal when all

disciplinary efforts

have failed. It should

be in conformity of amajor violation as

contained in the

policy manual.


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Relevant Board Exam Questions

1. Jiggy, a registered nurse, worked with


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her staff to develop objectives for her

unit, which will establish priorities for

procedures. This is an example of

which of the following management

processes?

A. Controlling

B. Directing

C. Organizing

D. Planning

2. A document that describes the


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institutions purpose is:

A. The organizational chain of

command.

B. The organizational chart

C. The mission statementD. The strategic plan


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4. In anticipation of a nursing shortage, the


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nursing management in a facility is

investigating a nursing care delivery

model that involves the division of

tasks, with one nurse assuming the

responsibility for particular tasks. This

model is called:A. Total patient care

B. Functional nursing

C. Team nursing

D. Primary nursing

5. Nurses play an integral role in the

d l l d


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development, implementation, and

evaluation of a unit or department budget

in a nursing organization. An operational

budget accounts for:

A. The purchase of minor and major

equipment.

B. Construction and renovation.

C. Income and expenses associated with

daily activity in an organization.

D. Applications of new technology to

patient with chronic disorders.

6. A staff nurse made a medication error this

i d d i h h


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morning and reported it to you, the charge

nurse. Whats the best initial response for

you to make?

A. Inquire about the clients physiologic

response to the error

B. Remind the nurse about the

importance of medication safety

C. Write up an incident report

D. Discuss process changes with the

nurse manager

7. The nurse manager announces that the

emergency department (ED) will begin


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emergency department (ED) will begin

benchmarking results from client satisfaction

surveys. Which is the best understanding of thatconcept?

A. The ED will compare its current scores with

its previous scores

B. The ED will compare the ED nurses scores

with the ED physicians scores

C. The ED will compare its scores with the best

in the fieldD. The ED will compare its scores with other

departments scores.

8. Rapid changes in health care environment

h d d h d i i ki l f


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have expanded the decision-making role of

the nurse. Decision making is best

described as:

A. The process one uses to solve a

problem.

B. The process one uses to choose

between alternatives.

C. The process one uses to reflect on a

certain situation.

D. The process one uses to generate

ideas.

9. Before any memorandum or noticefrom the nurse director, Corazon and


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from the nurse director, Corazon andthe other staff were already aware ofthe new policy regarding properdecorum. They get the informationfrom the co-staff at the other station.This method of communication iscalled:

A. Lateral

B. Diagonal

C. Grapevine

D. Informal

10. A tall organizational structure is

fl ti f h t t f


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reflective of what type of

organization?

A. Centralized

B. Decentralized

C. WideD. Matrix


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And Finally
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Nurses who are managers play a critical

difference every day in the lives of their

patients families.By using their expert knowledge they

manage and meet patient care needs.


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Please text me when you

pass the Nurse LicensureExamination (NLE) !!!

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