1 introduction to nursing management (1).pdf

Nursing

1. MANAGEMENT AND
LEADERSHIP IN NURSING
Dr Ahmad Al-Nawafleh
RN, MPA, CI, PhD
[email protected]
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2. House Rules
◼Come on time
◼Come in complete uniform to practice setting
◼All cell phones must be in your bags and in
silent mode
◼No gum during the class
◼Strictly conforms to break time
◼Come prepared (meaning read…read…read)
◼Submit written assignment on time, late
papers will lose 10% credit / day late
◼Participate during discussion
◼Talk when you have been recognized already
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3. Contents
◼Definitions
◼Definitions of Nursing Leadership and Management
◼Management Theories
◼Types and styles of Management Levels of
Management
◼Leadership and Management Skills and Behaviors
◼Management Functions
◼Roles of the Nurse Manager
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4. What comes into mind when
you talk about management?
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5. What comes into mind when
you talk about management?
People Processes Structure
Function Policies Authority
OrganizationProcedures Responsibility
Communication Resources
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6. Key Concepts in Management
Planning
Organizing
Directing
Controlling
Staffing
Budgeting
Productivity
Leadership
Power
Delegation
Efficiency
Effectiveness
❖Structure
❖Function
❖Authority
❖Accountability
❖Hierarchy
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7. -came from the word “to manage” (Henri
Fayol)
-to manage is to forecast and plan, to
organize, to command, and to control
Management is……
“getting things done in right way in right
time by right persons with right amount
of resources and with effective use of
resources”.
process of working with and through
others to achieve organizational
objectives in a changing environment
Management
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8. Importance of Management
in nursing
◼to facilitate the act
◼to achieve certain objective and
goal
◼to deliver quality nursing care to
our patients
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9. What is Nursing Management?
Relates to planning , organizing,
staffing, directing and controlling the
activities of a nursing enterprise or
division of nursing departments and
of the subunits of the departments
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10. Management Defined
Management -
◼coordinates people, time, and supplies
to achieve desired outcomes,
◼involves problem-solving and decision-
making processes.
Managers responsibility:
◼maintain control of the day-to-day
operations,
◼achieve established goals and
objectives.
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11. 11
Management Theories
Frederick Taylor
Lillian and Frank Gilbreth
Henry Gantt
Scientific Management
Henri Fayol
Max Weber
Classic Organization
Mary Parker Follett
Elton Mayo
Kurt Lewin
Human Relation
Abraham Maslow
Frederick Herzberg
Douglas McGregor
William Ouchi
Chris Argyris
RensisLikert
Peter Drucker
Behavioral Science

12. 12
Human Relations
•focused on the effect individuals have on the success or failure of organization
•stresses the social environment
•chief concerns are individuals, group process, interpersonal relations, leadership, and
communication
Scientific Management Theory
•scientific procedures to solve managerial problems
•focus on productivity and profit
Behavioral Science
•Emphasized a positive attitude towards people, training managers, meeting employees’
needs, and obtaining commitment through participation in planning and decision
making
Classic Organization
oviews the organization as a whole rather than focusing solely on production
omanagerial activities are classified as planning, organizing, and controlling

13. Functions of
Management
◼Planning
◼Organizing
◼Staffing
◼Directing
◼Controlling
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14. ◼Planningincludes defining goals and objectives,
developing policies and procedures; determining
resource allocation; and developing evaluation
methods.
◼Organizingincludes identifying the management
structure to accomplish work, determining
communication processes, and coordinating people,
time and work.
◼Staffingincludes those activities required to have
qualified people accomplish work such as
recruiting, hiring, training, scheduling and ongoing
staff development.
◼Directing encourages employees to accomplish
goals and objectives and involves communicating,
delegating, motivating, and managing conflict.
◼Controllinganalyzes results to evaluate
accomplishments and includes evaluating employee
performance, analyzing financial activities, and
monitoring quality of care.
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15. Roles of the Nurse Manager
❑Customer Service Provider
❑create an environment of caring
❑Team Builder
❑Resource Manager
❑Decision Maker and
❑Problem Solver
❑Change Agent
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16. Customer Service Provider
◼Providing service or care to customers
(patient or clients).
◼Nurse must keep customer service first
and foremost as the motivator of all plans
and activities.
◼Without customers, the organization will
go out of business.
◼The most importantrole is to create an
environment of caring-caring for staff
members as well as for patients and families.
Staff members who believe that their
manager sincerely cares about them and
the work they do are able to pass that
feeling of caring on to their patients and
other customers.
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17. Caring for the staff members can be
demonstrated through (McNeese-Smith,
1997):
◼Offering sincere positive recognition for both
individuals and teams.
◼Praising and giving thanks for a job well done.
◼Spending time with staff members to reinforce
positive work behaviors.
◼Meeting the staff member's personal needs
whenever possible, such as accommodating
scheduling needs for family events and being
flexible in times of illness.
◼Providing guidance and support for
professional and personal growth.
◼Maintaining a positive, confident attitude and a
pleasant work environment.
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18. Team Builder
◼A team is a group of people organized to
accomplish the necessary work of an organization.
◼Teams have become important in the changing
health care environment.
◼Teams bring together a range of people with
different knowledge, skills, and experiences to meet
customer.
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19. Resource Manager
◼Resources include the personnel, time, and supplies
needed to accomplish the goals of the organization.
◼Nurse manager has the responsibility -effectively
manage resources in providing safe, effective patient
care in an economic manner.
The nurse is managing resources using three types of
Budgets:
1. Personnel
Allocates funds for salaries, overtime, benefits, staff
development and training, and employee turnover costs
2. Operating budget
Allocates funds for daily expenses such as utilities, repairs,
maintenance, and patient care supplies
3. Capital budget
Allocates funds for construction projects and/or long-life
equipment such as cardiac monitors, defibrillators, and
computer hardware; capital budget items are generally
more expensive than operating supplies.
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20. Decision Maker and Problem Solver
◼components of effective leadership and management
in clinical patient care.
◼Problem solving is focused on solving an immediate
problem and
◼decision maker includes a decision-making
step.
Nursing process = problem-solving
process includes :
◼assessment,
◼analysis and diagnosis,
◼planning,
◼implementation,
◼evaluation;
◼has proven to be effective to manage the complex
decisions.
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21. The nurse -change agent
◼is responsible for guiding people
◼through the change process and
needs
◼to develop an understanding about
the nature of change and effective
change strategies.
1. Change should be implemented only for good
reason.
2. Change should always be planned and implemented
gradually.
3. Change should never be unexpected or abrupt.
4. All people who may be affected by the change
should be involved in planning for the change.
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22. Manager
plans organizes
what is to be done who is to do it
how it is to be done
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23. Nurse manager will have:
an appointed management position within
the organization with responsibilities to
perform administrative tasks:
◼planning staffing requirements,
◼performing employee performance
appraisals,
◼controlling use of supplies and time,
◼meeting budget and productivity goals.
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24. Leadership Defined
Leadershipis the ability to persuade others to
follow your direction, to motivate, to inspire, and
to instill vision and purpose.
Leadership combines:
◼intrinsic personality traits,
◼learned leadership skills,
◼characteristics of the situation.
Leader -
◼guides people and groups to
accomplish common goals,
◼influences the beliefs, opinions, or
behaviors of a person, group, or
groups of people.
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25. Nurse leader
◼is able to inspire others on the health
care team to make patient education an
important aspect of all care activities.
Leadership qualities:
◼unique personality characteristics,
◼exceptional clinical expertise,
◼relationships with others in the
organization.
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26. Leaders Managers
◼May or may not have official
appointment to the position
◼Have power and authority
enforce decisions only so long
as followers are willing to be
led
◼Influence others toward goal
setting, either formally or
informally
◼Interested in risk-taking and
exploring new ideas
◼Relate to people personally in
an intuitive and empathetic
manner
◼Feel rewarded from personal
achievements
◼May or may not be successful
as managers
◼Appointed officially to the
position
◼Have power and authority to
enforce decisions
◼Carry out predetermined
policies, rules and regulation
◼Maintain an orderly,
controlled, rational and
equitable structure
◼Relate people according to
their roles
◼Feel rewarded when fulfilling
organizational mission or goals
◼Are managers as long as
appointment holds
Similarities and Differences
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27. LEADERSHIP AND MANAGEMENT
SKILLS AND BEHAVIORS
Hersey and Blanchard (1988) have identified that
effective leadership and management requiresskills in
three major areas:
1.Technical skills—such as clinical expertise
and nursing knowledge.
2.Human skills—the ability and judgment to
work with people in an effective leadership
role.
3.Conceptual skills—the ability to understand
the complexities of the overall organization
and where one's own area of management
fits into the overall organization.
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28. ◼MANAGEMENT SKILLS IN
NURSING
◼1. Conceptual
◼2. Interpersonal
◼3. Diagnostic
◼4. Technical Skills
◼5. Coach and Mentor Skills
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29. Types and styles of Management
◼Authoritarian management style
◼Democratic management style
◼Laissez-Faire management style
◼Multicratic leadership
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30. Types of Management
Authoritarian management style
◼Autocratic
◼Manager makes most of the decisions in isolation
◼Found in bureaucratic organizations that reinforce
centrality of authority and reliance upon formal rules
◼Managers issue orders and expect to be obeyed
◼Authority derives from position power tied to official
hierarchical title
◼Authoritarian managers will have subordinate support if
they are involved in overall goals and process
◼Strong control is maintained
◼Others are motivated by coercion
◼Others are directed with command
◼Communication is downwards
◼“I” and “You”
◼Punitive criticism
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31. Types of Management
Authoritarian management style
Advantages
◼Results to well-defined group actions
◼Decision making can be done expeditiously
◼Appropriate when immediate action is needed
◼Authoritarian managers will have subordinate support if they
are involved in overall goals and process
Disadvantages
◼Subordinates don’t have stake in achievement/failure of
management goals
◼Employee may subvert goals
◼Managers issue orders and expect to be obeyed
◼Authority derives from position power tied to official
hierarchical title
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32. Types of Management
Democratic Management Style
◼Involves subordinates in decision making
◼Democratic managers see themselves as
coworkers
◼Stresses importance of communication and
consensus
◼Promotes autonomy and growth
◼Manager leads by providing information,
suggesting direction and being supportive of
coworkers
◼Function best in less centralized and where
there is less reliance on formal rules and
policies
◼Emphasis “We”
◼Constructive criticism
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33. Types of Management
Democratic management style
Advantages
◼Coworkers are consulted
◼Coworkers have input on decision making
◼Employees are involved in all the processes prior to
decision making
◼It is appropriate if decision at hand does not require
urgent action
Disadvantages
◼Decision becomes lengthy process
◼Coworkers not confident in participating in decision
making
◼Employees may think manager is not capable to DM
◼Employees think they are made to do something they are
not paid for
◼If decision not implemented employees think their time is
wasted
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34. Types of Management
Laissez-Faire
◼Permissive management
◼Least structure and control
◼Requires coworkers to make own goals,
decisions
◼Managers provide maximum support and
freedom for workers
◼Provision of little or no direction
◼Communication upward and downward
◼DM is dispersed throughout group
◼Criticism withheld
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35. Types of Management
Laissez-Faire
Advantages
◼Providing maximum support and freedom
◼Allows practice of high levels of
independence
Disadvantages
◼Not possible to let workers arrive at an
individual decisions about patient care
◼Because of multidisciplinary care, decision
must be centralized
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36. Types of Management
Multicratic
◼One skill of a manager is
identifying which style a
particular situation requires
◼Combines the best of all
approaches
◼Provides maximum structure
when the situation requires
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37. Levels of Management
◼Top level managers
◼Middle-level managers
◼First-level managers
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38. Levels of Management
Top level managers
◼Looks at the whole organization
◼Coordinate internal and external
influences
◼Makes decisions with few
guidelines
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39. Levels of Management
Responsibilities of top-level
managers
◼Determining philosophy
◼Setting policies
◼Creating goals and priorities for
resource allocation
◼Need great leadership, not part
of day-to-day operation
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40. Levels of Management
Middle-level managers
◼Coordinates effort of lower levels of
the hierarchy
◼Conduit between lower and top-level
managers
◼Carry out day-to-day operation
◼Involved in long term planning
◼Establishing unit policies
◼Nurse supervisors, head nurse, unit
managers
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41. Levels of Management
First-level managers
◼Concerned with specific unit
workflow
◼Deal with immediate problems in
daily operations
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