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 goal
achievement.
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
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
Good Communicator Visionary
Mentor Problem Solver
Critical Thinker Role Model
Concepts of Nursing Leadership
Leadership Roles and Management Function Associated with Delegation
Leadership Roles and Function Related to Preliminary Staffing Function
LEADERSHIP
Persons ability to move people to act.
L LEAD, LOVE, LISTEN
E ENTHUSIASTIC, ENERGETIC
A ASSERTIVE, ACHIEVER
D DEDICATED, DESIROUS
E EFFECTIVE, EFFICIENT
R RESPONSIBLE, 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
Reccognition
POWER
Ability to efficiently and effectively exercise authority and control through organizational and social strength.
LEADERSHIP
AUTHORITY, RESPONSIBILITY, ACCOUNTABILITY
A Authority, the right to decide
R responsibility, ability to respond
A accountability, 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:
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.
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
Bureaucratic Max Weber
Rule-centered (THEY)
An institutional method for applying general rules to specific cases, making actions of management air and
predictable
Management Process Henri 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
Communication
Centralization
Equity and justice
Esprit de corps
Leadership Theories
Theory X and Theory Y -- Douglas Mc Gregor, 1960
Theory X
Assumes that people dislike work and must be directed and controlled
Organizational goals are emphasized
Theory Y
Assumes that people are self directed and will accept responsibility under favorable conditions
Individual goals are emphasized
Leadership Theories
Theory Z -- William Ouchi, 1981
Promotes a relationship-oriented, democratic leadership style
Collective decision making
Long term employment
Indirect supervision
Slower promotion
Holistic concern
Leadership Theories
CHARISMATIC THEORY
Leader inspires others by obtaining emotional commitment from followers and by arousing strong feelings of
loyalty and enthusiasm.
NURSING MANAGEMENT
Management
Is a tasks
Is a discipline
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
D directing (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 command 1 boss
5. Unity of direction single plan
6. Subordinate of individual interest to general interest
7. Renumeration fair payment
8. Centralization of authority top decision
9. Scalar change interconnectedness fr top to bottom
10. Order line of authority
11. Equity & justice fair 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
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 Gilbreth First Lady of Management
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 Fayol Father 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
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 Mayo Hawthorne 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 structure of the
primary 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
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 (19211970)
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 Manager Henry Mintzberg
Interpersonal (3)
Figurehead
Leader
Liason
Informational (3)
Monitor
Disseminator
Spokesperson
Decisional (4)
Enterpreneur
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 pagtitimpi resignation to or acceptance of failures and shortcomings
Suerte relating 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
Pagtitiis to endure a hard life without complaint and with complete resignation to such fate
Manyana Habits putting off for late appointments
Ningas-kugon tendency for sudden outburst of enthusiasm at the start of any endeavor followed equally abrupt
loss of interest
come what may attitude- one can leave matters as they are; no need to exert effort because supernatural spirits or
Bathala 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 the
threat 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 be
repaid 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 Power becomes very evident in Filipino organizations
4. Application of Bureaucracy constitute an essential part of Filipino life because the chief functions is
reinterpreted is to strengthen the traditional norms of society through the evolution of a unique synthesis of
theretional and traditional.
5. Personalism identifies leadership with benevolences; focuses not so much on what a person does as in who he
is; 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
Process of Mgt: Fayol
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
Process of Mgt: Fayol
Types of Planning
Strategic Plan defines 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 Plans focuses 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.
- 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
Forecasting estimating the future mission, vision, objectives
Establishing Objectives (SMART)
Specific
Measurable
Attainable
Realistic
Time- bound
Elements of Planning
Scheduling setting a timeframe
Budget numerical description of expected income and planned expenditures for an organization for a specific
period 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
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
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 utilities gas, 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
Assignment Patterns for Delivery of Nursing Care
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
A group of care providers with the leadership of a professional nurse can provide better patient care than those same
people working as individuals
Assignment Patterns for Delivery of Nursing Care
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 I Minimal care
Level II Intermediate or Moderate care
Level III Intensive care
Level IV Highly 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
Process of Mgt: Types of Planning
Scope of Planning:
Forecasting / estimating the future
- 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 first
thing 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
Budgeting systematic financial translation of a plan.
- the allocation of resources on forecast needs
Process of Mgt: Types of Planning
Budget Plan is designed to meet future service expectations, to provide quality care at minimum cost.
4 components:
Revenue Budget summarizing income mgt.
Expense Budget describe expected activity
Capital Budget outlines programmed acquisition, disposal & improvements
Cash Budget money received, cash receipts, disbursement.
Process of Mgt: Types of Planning
Types of Budgeting:
Centralized Budget imposed by comptroler, adminstrator with no consultation to the lower level managers.
Decentralized Budget middle manager involved in planning & budgeting
Components of Institutional Budget:
1. Manpower Budget wages & salaries, fees to be paid outside registry.
2. Capital Expenditure Budget large expense: lands, building, equipments or long term use.
3. Operating Budget cost of supplies, minor repair and maintenance, overhead expenses
Process of Mgt: Types of Planning
Factors in Budget Planning
Patient
Health care facility/ hospital
Personnel
Standard of nursing care and supervision
Policies, procedures and standard
Process of Mgt: Types of Planning
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
Process of Mgt: Types of Planning
STEPS IN DECISION MAKING
Define the problem
Assess all options
Weight all options against a set of criteria or standards
Test possible options
Consider consequences of the decision
Make a final decision
Process of Mgt: Types of Planning
Kinds of decision:
Whether Decision deciion made before the selection of one of several alternatives, where selection is made after
weighing the pros and cons.
Ex: Whether or not to buy a car.
Process of Mgt: Types of Planning
Kinds of decision:
2. Which Decision choosing from among several alternatives, which are measured based on set of pre-defined
criteria.
Ex: Among the car presented, which one will i buy.
Process of Mgt: Types of Planning
Kinds of decision:
3. Contigent Decision decisions 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
Process of Mgt: Types of Planning
Decision Making Models:
Win Win mutual willingness in the group to come up with solutions that are acceptable to all.
Win Loose some interest are advanced at the expense of others.
Decision Making Models:
3. Disagreement and Collaboration decisions resulting in the following elements when conflicts and disagreements
are openly explored.
High quality decisions
Creative decisions
Decisions that are understood
Decisions that are accepted and owned

Decision Making Models:
4. Solution Shaping focused on how to modify or amend proposed solution rather than attempt to pressure people
into changing their minds about the solution.
Process of Mgt: Types of Planning
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 making
decisions
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. Formal system 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
Principles of Organizational Design
Division of labor departmentalization / specialization
2. Unity of command line of command
3. Authority and responsibility distribution of power
ORGANISING: Principles of organizational design
4. Span of control centralized or decentralized

5. Contingency factors deals 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
Formal uninterrupted lines
Informal broken 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.
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
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 patients capable of ADL
Intermediate or moderate care needs some help.
Ex: pt. With IVF, Catheter, respirator
ORGANISING: Patient classification system
3. Total Care patient bedridden
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 5901 Forty 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%
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
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
6. Find the nursing personnel needed
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
6. Find the nursing personnel needed
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.
6. Find the nursing personnel needed
44 nursing personnel + 4 relievers = 48 nursing employees
36 nursing personnel + 3 relievers = 39 nursing employees
7. Categories into Professional and Non Professional
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
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
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. Competitive occurs when 1 or more groups attain same goal & only one group can attain goal
2. Disruptive an environment filled with fear, anger and stress. Goal is elimination of its opponent.
3. Conflict Resolution
Dominance and Suppression (win lose strategy)
Restriction autocratic, coercive
Smoothing Behavior one persuade the other to give in to other side
4. Avoidance Behavior
5. Majority rules
6. Compromise or consensus each side agreed upon solution
7. Integrative Problem solving both parties tries to solve the conflict
8. A Win Win strategy focuses on goals and attempts to meet the need of both parties
9. Loose Loose strategy neither side wins, settlement reached is unsatisfactory to both sides.
10. Confrontation most effective means, attempts are made to resolve it through knowledge and reason
11. Negotiation conflicting 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
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 control prevent anticipated problem
2. Concurrent control enacted while work is being performed
3. Feedback control focus 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