NURSING L E A D E R S H I P - Is the process of planning, organizing, leading

and M A N A G E M E N T and controlling the efforts of organizational

resources in order to achieve the organizational
Course Outline goals.

LEADERSHIP AND MANAGEMENT NURSING L E A D E R S H I P

 Definition of Leadership - Nursing leadership is the practice of leading
 Distinguishing characteristics initiatives that improve nursing practices and
 Leadership Theories outcomes.
 Leadership Styles - Nurse leaders rely on their ability to motivate and
 Management Process inspire nursing teams and staff in the
 Levels of Managers development of high-quality practices and patient
 Management Roles care methodologies. These professionals usually
 Management Skills work in higher-level nursing and leadership roles
 Management Performance and take a less hands-on approach to nursing
 Qualities of a Manager than nursing managers do.
 Management Theories - For instance, a nurse leader responsible for
overseeing and executing new care policies will
Learning Outcomes: focus on strategic planning and collaborating with
nursing staff, while a nurse manager will focus on
Demonstrate leadership and management skills in the carrying out the initiative and managing nursing
care of a group of clients in the community and teams and departments in implementing care
hospital setting strategies with patients.

At the end of the course, the students will be able to: Differences between Leader and Managers
 Define management.
 Describe the management process. COMPARISONS
 Distinguish roles that managers fulfill in an
organization. Leaders
 Explain management theories.  May not have delegated authority
 Discuss motivation theories.  Obtain power through influence
 Define leadership and explain its importance  Possess a wide variety of roles
for organizations.  May not be part of the formal organization
 Determine the importance of leadership in  Emphasize interpersonal relationship
nursing  Direct willing followers
 Infer pertinent facts on the different theories  Have goals that may or may not reflect the formal
of leadership organization
 Appreciate one’s capacity in becoming a  Focus on group process, information gathering,
nurse leader feedback and empowering others
 To identify the differences between a leader
and manager Managers
 Have assigned positions
 Obtain power through delegated authority
 Expected to carry out specific functions
 Part of the formal organization
 Manipulate people and resources to achieve
LEADERSHIP goals
- Occurs whenever one person influences another  Direct willing and unwilling subordinates
to work toward predetermined objective (Dessler)  Have greater formal responsibility and
- The process of influencing the activities of an accountability
organized group in its effort toward goal setting  Emphasize control, decision making,
and goal achievement (Stogdill) decision analysis and results

MANAGEMENT TRADITIONAL DEFINITION

- The art of getting things done through people - Leadership is an interpersonal influence directed
(Mary Parker Follet) toward the achievement of a goal or goals
  Influencer
Three key principles involved:  Creative problem solver
Interpersonal  Change agent
- Deals with more than one person  Diplomat
Influence  Role model
- The power to affect others THE ESSENCE OF GOOD LEADERSHIP IS THAT
Goals PEOPLE WILL FOLLOW YOU
- The end that one strives to attain
Evolution of
The process of influencing the actions of a person or Leadership Theory
group to attain desired objective - aim to understand, explain, and predict why some
leaders are more effective than others
CONTEMPORARY DEFINITION:
- Leadership is a dynamic relationship that is based on  Great Man Theory
mutual influence and common purpose between  Trait Theory
leaders and collaborators which leads both parties to  Behavior Theory
higher levels of motivation and moral development as  Contingency Theory
they evoke “real” change.  The Path-Goal Theory
 The Managerial Grid
3 Key Principles involved:
Relationship Leadership theories
- Connection between people - Leadership theories are the explanations of how
Mutual and why certain people become leaders.
- Something in common is shared - They focus on the traits and behaviors that
Collaborators people can adopt to increase their leadership
- work together capabilities. 

An individual induces a group to take action that is in Some of the top traits that leaders say are vital to
accordance with the leader’s purpose of all good leadership include:
 Strong ethics and high moral standards
Leadership  Great self-organizational skills
- is a dynamic, interactive process that involves  Efficient learner
three dimensions  Nurtures growth in employees
 the leader  Fosters connection and belonging
 the follower
 the situation The Great Man Theory
- involves people - Asserts that some people are born to lead,
- involves unequal distribution of power between whereas other are born to be lead
leaders and group members - Basis for most leadership research until mid-
1940’s
Leader’s role - Few people are born with necessary
 Decision maker characteristics to be great
 Communicator - Leaders are well-rounded and
 Evaluator simultaneously display instrumental and
 Facilitator supportive leadership behavior – considered
 Risk taker great men and supposedly effective leaders
 Mentor in any situation
 Energizer - Its assumption is that great leaders will arise
 Coach when there is a great need.
 Counselor - The idea of the Great Man also strayed into
 Teacher the mythic domain, with notions that in times
 Critical thinker of need, a Great Man would arise, almost by
 Buffer magic
 Advocate
 Visionary Trait Theory
 Forecaster
 - Assume that some people have certain 1. Accomplishing the task (task-oriented leader or
characteristics or personality traits that structure oriented)
make they better leaders than others - Concern for the task to be accomplished
- Personal qualities of an individual - Initiating structure, job centeredness, task
- This theory states that if someone had “true orientation
leadership traits” they could lead regardless - Emphasizes behaviors, set clear standards,
of the situation. high regard with production, set rules and
- It focused on “what a person is” and not on regulations for doing the job
what they could accomplish 2. Satisfying the needs of group members (people-
- Emphasizes that leaders are born not made oriented leader)
- People are born with inherited traits. Concern for the people doing the work
- Proposes that leadership is a function of - Consideration, employee centeredness and
these inborn traits. e.g. intelligence, relationship orientation
perception - There are people who become - Has social rapport to his subordinates,
good leaders because they have the right attention is focused to the individuals
combination of traits.
- Hold that possession of certain traits permit
certain individuals to gain position of
leadership - Some traits are particularly  Behavior of a leader who has a high regard
suited to leadership for task emphasizes
 Plan and define work to be done
Some common leadership traits  Assign talk responsibilities
1. Leaders need to be more intelligent than the  Set clear standards
group they lead  Job routines are established and deadlines
2. Leaders must possess initiative, the ability are set
to perceive and start courses of action not  Urge task completion and monitor results
considered by others  The task-oriented leader perceives his role
3. Creativity is an asset as accomplishing the operations of the unit
4. Emotional maturity with integrity  Warmth and social rapport with
5. Communication skills are important subordinates
6. Persuasion is used by leaders  Respect for the feelings of others
7. Leaders need to be perceptive enough  Sensitivity to other’s needs
8. Leaders participate in social activities  Leader’s role is to help operate as a unit by
Behavior Theory fostering social ties
- involves human skill aspect of a leader  Attention is on individual
 Studies leadership by looking at leaders in  Suggestions are encouraged, freedom is
terms of what they do. permitted in how work is done and
 Effectiveness is judged in terms of individual subordinates’ personal problems receive
subordinate outcome attention
 Attempts to explain leadership on the basis  Characterized by trust, mutual respect and
of what the leader does rather than what the emphasis on interpersonal relations
leader is
 It is not the characteristics of the leader but CONTEMPORARY THEORIES OF LEADERSHIP
rather the way the leader behaves towards
followers that determine effectiveness Contingency Theory/ Situational Theory
 Leadership capability can be learned, rather  States that an analysis of leadership involves not
than being inherent.- It is assumed that if only the individual traits and behavior but also a
success can be defined in terms of focus on the situation.
describable actions, then it should be  The effectiveness of the leader behavior is
relatively easy for other people to act in the contingent upon the demands imposed by the
same way situation.
 This opens the floodgates to leadership  Depends on the situation, different situations call
development for different behavior and approaches
 If the situation changes, the style changes
Basic assumptions  leader’s ability to lead is contingent upon various
2 major functions that leader perform situational factors, including the leader’s
 preferred style, the capabilities and behaviors of - Feelings and attitudes of followers regarding
followers and also other various situational acceptance, trust and credibility of the
factors. leader
 there is no one best way of leading and that a  Leadership is assessed by a group-
leadership style that is effective in some atmosphere scale
situations may not be successful in others  Developed a scale to identify different types
of leaders called the Least Preferred Co-
Situational Factors include: Worker Scale (LPC)
1. Needs and characteristics of followers
2. The nature of the task LPC
3. Environmental pressures and demands  reflects primarily the style of leadership
4. How much information is available to the leader  Assesses how favorable or unfavorable the
leader describes his least preferred co-
3 Major Component that are significant for leadership worker
effectiveness
1. Individual differences among leaders High LPC score leader
2. Differences among situations  One who sees even the least preferred co-
3. The manner in which these two variables worker in relatively favorable terms and is
are related more relationship-oriented

SITUATIONAL Leadership Approach Low LPC leader

developed by Hersey & Blanchard  more task oriented
 Emphasizes follower readiness as a factor
in determining leadership style Group-Atmosphere Scale
 Predicts the most appropriate leadership
style from the level of maturity of the Task Structure
followers - degree to which work is defined with specific
 Based upon the premise that different types procedures, explicit directions and goals
of situation demand different types of  High is it is easy to define and measure a
leadership task
 Focus is on the situation in which the  Low if it is difficult to define task and to
leadership is exercised and not upon the measure progress toward its completion
leader.
Four Criteria to determine degree of task structure
FIEDLER’S Contingency Theory 1. Goal clarity: extent to which a goal is
- leadership style will be effective or ineffective understood by followers
depending on the situation 2. Extent to which a decision can be verified:
knowing who is responsible for what
No leadership style is ideal for every situation 3. Multiplicity of goal paths: number of
solutions
Leader’s behavior is dependent upon the interaction of 4. Specificity of solution: number of correct
the leader’s personality and the needs of the situation. answers

Interrelationships between group’s leader and Position Power

members were influenced by manager’s ability to be a - refers to the authority inherent in a position,
good leader the power to use rewards and punishment
and the organization’s support of one’s
Three aspects of a situation that structure the leader’s decision
role
1. Leader – member relations High position Power
2. Task structure - right to hire and fire, promote and adjust salaries
3. Position power - directors of nursing, managers and patient care
coordinators
Leader-member relations
- involve the amount of confidence and loyalty Low position Power
the followers have with regard to their leader
 - may be elected, function in an acting  Contract for mutual benefits that has
position or be subject to removal by peers contingent rewards
and subordinates  view the leader-follower relationship as a
- elected committee chairpersons, team process of exchange.
leaders and staff nurses  The leaders use his or her position in in
order to encourage desired behaviors and
Path-Goal Theory tends to gain compliance by offering
(Robert J. House) rewards for performance and compliance or
 Describe the way that leaders encourage threatening punishment for non-
and support their followers in achieving the performance and non-compliance.
goals they have been set by making the  does not focus on the individual needs of
path that they should take clear and easy the follower, nor does the leader focus on
 Emphasizes that the leader behavior be the personal development of the follower.
such as complement the group work setting The leaders are influential because it is in
and aspirations the best interest of the follower to do what
 Based upon the expectancy theory of the leader asks
motivation and reflects the workers belief
that efforts will lead to successful results. TRANSFORMATIONAL THEORY
 Leaders set up clear path and clear - based on the idea of empowering others to engage
guidelines through which the subordinates in pursuing a collective purpose by working together to
can achieve both personal and work-related achieve a vision of a preferred future
goals and assist them in achieving these  The manager is committed, has a vision,
goals able to empower others with this vision
 Focuses on the leader and employee
Leaders would: working together for the greater good
a) Clarify the path so that subordinates may  Places strong emphasis on one individual
know their direction. engaging others and creating a connection
b) Remove obstructions that may hinder them that elevates the level of motivation and
to achieve their goal or goals. morality in both the leader and the follower
c) Increasing the rewards along the process.  Merges ideals and focuses to unite both the
employee and the nurse manager
In this leadership approach, the leader works to motivate  Promotes change.
followers and influence goal accomplishment.  The key to this kind of leadership is to
actively listen and come up with pertinent
 Directive style – provides structure through suggestions that not only promote patient
direction and authority; leader is focused on the outcomes, but also help build a base of
task and getting the job done leadership with the new nurse.
 Supportive style – is relationship-oriented; the  Vision is the essence; implies the ability to
leader provides encouragement, interest, and picture some future state and describe it to
attention. others so they will begin to “share the
 Participative style – focuses on involving dream”
followers in the decision-making process.
 Achievement-oriented style – provides high Comparison of Transactional and Transformational
structure and direction as well as high support Leadership
through considerations behavior.
Transactional
Two (2) types of leaders in management Focuses on management tasks
1. Transactional leader Is a caretaker
2. Transformational leader Uses trade-offs to meet goals
Shared values not identified
TRANSACTIONAL THEORY Examines causes
- exchange posture that identifies needs of followers Uses contingency reward
and provides rewards to meet those needs in
exchange for expected performance Transformational
 Concerned with day-to-day operations Identifies common values
Is committed
Inspires others with vision 30-35 Suggest some strength but
Has long term vision also some under- used
Looks at effects leadership abilities
Empowers others 29 or less Suggest unused leadership abilities
and room for improvement
Leadership Activities
 Effective leaders resolve disagreements Leaders are unique, and they can show their talent in
among members by arbitrating different ways. To further explore your leadership
 Leaders makes suggestions more often strengths, you might ask people whose opinions you
rather than giving orders value: “When you have seen me do really well as a
 Effective leaders supply objectives that are leader, which of these abilities am I using? If a number
common and acceptable to the group of people tell you that you are the same quality when
 Leaders provide security by maintaining doing well, you have likely identified a leadership
positive and optimistic attitude – even in the strength that should be appreciated and nurtured
face of problem
 Leader represents followers on various Approaches to Leadership
issues common to followers – acts as a - Focused on identifying qualities of a good leader and
symbol of unity of the followers styles of leadership managers use
 A leader through his attitude, behavior and
objectives inspire others TRAITS
 A leader acknowledges support of his - These are distinctive internal qualities or
followers and praises their effort and characteristics, personal factors that
contribution distinguish the leaders
 Physical characteristics
Leadership Skills  Social characteristics
Rate Yourself  Personality
 Intelligence characteristics
The best leaders have strengths in at least half-dozen  Work related characteristics
key emotional-intelligence competencies out of 20 or
so. To see how you rate on some of these abilities, These traits are not universal in nature
assess how the statements below apply to you. Not all these traits work all the time

While getting a precise profile of your strengths and “A person does not become a leader by virtue of
weaknesses requires a more rigorous assessment, these possession of traits, but the pattern of personal
this quiz can give you a rough rating. More important, characteristics of the leader must bear some relevant
we hope it get you thinking about how well you use relationship to the characteristics, activities and goals
leadership skills-and how you might get better at it. of the followers.” (Ralph Stogdill)

Total number of checks in each column Types of Leaders

Seldom _____ x1 = 1. Formal

_____  One who is appointed
Occasionally _____ x 2 = _____  Chosen by administration
Often _____  Given official or legitimate authority to act
x 3 = _____
Frequently _____ x4 =
_____
Total 2. Informal
_____  Do not have official sanction to direct
activities of others
Interpretation:  Chosen by the group
 Become leaders because of:
36+ An overall score of 36 or higher o Age
suggest you are using key leadership o Seniority
abilities well but ask a co-worker or o Special competencies
partner for his or her opinion, to be more certain o Inviting personality
 o Ability to communicate and
counsel other Disadvantages
 Results in low morale
Nurse Leader do not have to be in formal  Not as much opportunity for people to
management position with a management title develop their potential
 One-way communication does not lead to
Nurse leaders demonstrates leadership qualities and understanding
competencies  Results in hostility, alienation and inflexibility
 Little autonomy creativity and self-motivation
LEADERSHIP BEHAVIOR  Have little trust and confidence with
(STYLES) subordinates
- ways a leader behaves toward his followers  Subordinates fear the manager
influencing them to accomplish goals
 Autocratic Leaders Democratic or Participative or Consultative Leadership
 Democratic Leaders
 Laissez-faire Leaders - stable

Autocratic Leadership  Involve the group in decision making

- crisis, emergencies, startup of business  Let group determine work methods
 Make overall goals known
 Unilateral decisions  Use feedback as an opportunity for helpful
 Dictate work method coaching
 Limit worker knowledge about goals to justify the  They welcome suggestion and feedback and are
next step to be performed open to new ideas
 Give punitive feedback
Behaviors:
Behaviors:  Less control is maintained
 Strong control is maintained over the work  Economic and ego awards are used to
group motivate
 Other are motivated by coercion  Others are directed through suggestions
 Others are directed with commands and guidance
 Communication flows downward  Communications flows up and down
 Decision making does not involve others  Decision making involves others
 Emphasis is on difference in status (“I” and  Emphasis is on “we” rather than “I” and
“you”) “you”
 Criticism is punitive  Criticism is constructive

Results: Results:
 Well-defined group actions  Appropriate for groups who work together
 Productivity is high for extended periods
 Creativity, self-motivation and autonomy are  Promotes autonomy and growth
reduced  Effective when cooperation and coordination
between groups
Autocratic Leadership  Less efficient quantitatively than
authoritative leadership
Advantages
Results in central control and coordination Democratic or Participative or Consultative Leadership
More consistency in policy interpretation and
implementation Advantages
Quicker decisions.  Extremely motivational
Contributes to strong leadership that is important in  Makes better use of the skill and knowledge
generating change and meeting crises of the group
Good quantity and quality of output  Builds effective work groups
 People are more committed to an
organization and its activities
  Emphasizes the worth and importance of  Uses upward and downward communication
the individual between members of the group
 People are better informed. Develop  Disperses decision making throughout the group
personal skills  Places emphasis on the group
 Encourages open communication  Does not criticize

Disadvantages Results:
 Takes time to get others involved  Frustrating; group apathy and disinterest
 Results in compromise and watered-down can occur
decisions  Can result in creativity and productivity if
 Inaction can result from the diffused members are highly motivated and self-
responsibility directed
 Participation may hold down the innovative,  Appropriate when problems are poorly
far-sighted leader defined and brainstorming is needed to
 Participative styles are difficult to learn generate alternative solutions
 Works well only under certain conditions
Laissez-faire Leadership
Laissez-faire Leaders
(Free-reign) Advantages
 Give group complete freedom  Highly motivational to those people who
 Provide necessary materials seek freedom and independence
 Participate only to answer questions  Maximizes the potential of the individual
 Avoid giving feedback  Encourages a free-flowing adaptive
organization
Laissez-faire or Ultraliberal or Permissive Leadership
Disadvantages
- full stability  Can result in chaos because of lack of
 Shows low concern for both people and task central control and coordination
 Very permissive, nondirective, passive and  Personal rather than group goals may
inactive predominate
 Turn most decisions over to the group and  Easy for conditions to get out of hand before
show little interest in the work process or it corrective action is taken
results
 Absence of direct leadership Comparison of Leadership Styles (refer to ppt for
 Task is presented to the group, which picture
establish it own goals and works out it own
techniques for accomplishing goals within
the framework of organizational policy
 Leaves subordinates to freely set objectives
and work procedure
 Leader acts as liaison between outside
sources and the group and ascertain that
necessary resources are available to the
group
 Leader allows complete freedom in planning
activities and offers guidance in response to
direct questions
 Emphasis is on encouraging individual
performance by providing an unrestricted
environment

Behaviors:
 Permissive with little or no control
 Motivates by support when requested by group
or individual
 Provides little or no direction
Research has shown and indicated that 3 Elements involving controlling function
DEMOCRATIC LEADERSHIP could lead to both Steps must be taken to set work standards
quantity and good quality of work as well as satisfied To communicate them to the staff
workers A system of measures must be devised

Leadership style may vary from one situation to the Managerial Roles
other Role
An organized set of behavior that is associated with a
Leadership must promote high level of performance particular office or position
efficiently with little disruption Interpersonal Roles
Grow directly out of the authority of a manager’s
Factors affecting Leadership Styles position
Ability, skill and knowledge of the subordinates Involves developing and maintaining positive
relationships with significant others
Input + Management = Output Informational Roles
Manpower Pertains to receiving and transmitting information so
Money that managers can serve as nerve centers of the
Materials organizational units
Machinery Decisional Roles
Methods & Systems Making significant decisions that affect the
organization
(Resources)
Functions of Manager Managerial Skills
Planning Skills
Ability to engage in behavior that are functionally
Organizing related to one another and that lead to desired
performance level in a given area
Staffing Managerial Skills
Technical Skills
Leading/ Directing Management Performance
Effectiveness
Controlling ability to choose appropriate goals and
achieve them

Planning
defining the goals of the organization and determining
the activities and resources required to achieve them
requires information, judgment and decision-making Efficiency
– ability to make the best use of
Need to Plan available resources in the
Activities will be consistent with the organization’s process of achieving goals
goals Managerial Job Hierarchy
Correct type of amount of resources can be acquired First-Line Managers
Organizing Qualities of a Manager
Involves acquiring the resources that the organization Self-confidence
needs to achieve its aims Schools of Management Theory

Staffing CLASSICAL SCHOOL

Ensures all labor requirements are met
Directing Henry Fayol
provides direction and leadership to motivate staff to
perform task within the specified time frame and with
utmost efficient use of resources.
Controlling
to check or to regulate
 One of the pioneer of management of thought Controlling functions include performance appraisal,
fiscal accountability, quality control, legal and ethical
Founder of the Classical Organization control and professional and collegial control
Father of management process school
Postulate the 14 principles of management Management Process

Management process is similar in many ways to the

nursing process
14 Principles of Management Planning – Nurse manager spent part of day working
Division of labor on budget
Organizing – met with the staff about changing the
Management Functions identified patient care management delivery system from
Planning primary care to team nursing
Staffing- altered staffing policy to include 12-hour shift
Organization Directing – held a meeting to resolve a conflict
between nurses and physicians
Command Controlling – gave an employee a job performance
evaluation
Coordination
Contributions of the Classical School
Control Made planners aware that there are certain
Seven activities of management management principles that make for effective
- expanded by Luther Gulick management not only in business but in other fields as
POSDCORB well
Planning
Organizing Isolated some areas of practical concern to managers
Staffing that are still relevant today – division of labor and use
Directing of managerial authority
Coordination
Reporting BUREAUCRACY
Budgeting
Five functions of the management process Max Weber
Planning encompasses determining philosophy, goals, Saw the need for legalized, formal authority and
objectives, policies, procedures and rules, carrying out consistent rules and regulations for personnel in
long- and short-range projections, determining a fiscal different positions
course of action and managing planned change. Father of Organization Theory
Conceptualize Bureaucracy
Organizing includes establishing the structure to carry
out plans, determining the most appropriate type of Emphasized:
patient care delivery and grouping activities to meet Rule
unit goals. Other functions involve working within the s
structure of the organization and understanding and inste
using power and authority appropriately. ad
of
Staffing function consist of recruiting, interviewing, indiv
hiring and orienting staff. It also includes scheduling, idual
staff development, employee socialization and team s
building. Com
pete
Directing sometimes includes several staffing nce
functions, however, this phase’s functions usually over
entails human resources management responsibilities favo
such as motivating, managing conflict, delegating, ritis
communicating and facilitating collaboration m
3 Bases of Authority Studied effects of wage plans and fatigue on work
performance
Tradition Reduced number of motions in accomplishing task

Charisma Henry Gantt

Introduced the Gantt chart
Rational, Legal Authority Forerunner of the PERT chart
(Program
All personnel selected for competence Evaluation
and Review
Division of labor, authority and responsibility is clearly Technique)
defined Depicts the relationship of work planned or completed
on one axis to the amount of time needed or used on
Positions are organized into a hierarchy the other
SCIENTIFIC MANAGEMENT SCHOOL Developed task and bonus remuneration plan
workers guaranteed day’s wage
Frederick W. Taylor plus bonus for production above
standard to stimulate higher
production
Argued for a more humanitarian approach by
management
emphasized on service rather than
profit objectives
recognize non-monetary
incentives like job security and
staff development
Father of Scientific Management Human Relations Management
turned to scientific analysis to Behavioral School
better ways of managing Mary Parker Follett

Postulated the “if workers could be taught the one

best way to accomplish task, productivity would Suggested basic principles “participative decision
increase making or participative management”
Scientific Management School
Contribution of Scientific Management School “Managers should have authority with, rather than
led to the development of the efficient production line over, employees” – a need existed for collective
technique through time and motion studies decision making
Elton Mayo
the stress it places on the scientific selection of famous study of human behavior at the
workers has made us recognize the importance of Hawthorne Plant of western Electric
ability and training in increasing the effectiveness of company
worker
3 Phases of Hawthorne Experiment
development of work design has led managers to Test Room Studies
seek the “one best way” to get a job done Interviewing Studies
Observational Studies
Standardized to maximize profit
“Hawthorne Effect” – people respond to the fact that
Gilbreth they are being studied, attempting to increase
Frank Gilbreth whatever behavior they feel will continue to warrant
Lilian Gilbreth – first lady of management the attention
Results of the experiment
Emphasized When special attention is given to workers by
Benefits of job simplification management, productivity is likely to increase,
Establishment of work standards regardless of actual changes in the working conditions
 Managerial domination causes workers to become
Economic rewards by themselves have little effect in discouraged and passive
production level.
“if self-esteem and independence needs are not met,
leadership is a crucial element in the work situation employees will become discouraged and troublesome
and there is difference in formal and informal or may leave the organization
leadership
Stressed the need for flexibility within the organization
Recommends more employee participation in decision and employee participation in decision making
making The Managerial Grid
Contributions of the Behavioral School (Robert Blake/Jane Mouton)
discovered that a genuine concern for the individual Plays an important part in managerial behavior in
worker leads to increased productivity organizational development

teaching of people skills has become an important Shows managerial orientation is terms of two
aspect of management training variables

Douglas Mc Gregor
Theory X and Theory Y focuses on two contrasting Purpose of the Grid
attitudes A tool for identifying Management style
Back-up style, used when normal style fails to get
Theorized managerial attitudes about employees and results
directly correlated with employee satisfaction 5 coordinates are identified to reflect various styles of
leader behavior
Concludes how managers motivate and supervise (1.1) Impoverished Management. The manager makes
their workers depends on their assumption about their minimum effort or concern either for staff or to get
employees work done, the manager is lazy.
Theory X Assumptions
- managers take negative view of their (9.1) Task Management. Excellent work design. Well-
employees established procedures. Almost total concentration
Managers believed that employees on achieving results. People’s need are virtually
ignored and conditions of work are so arranged that
Employees are lazy people cannot interfere to any significant extents
Hate work and will avoid work if possible
Interested only in money and job security (1.9) Country club management. Personal
Do not like responsibility and meaningful relationship with people. Friendly
Needs constant supervision and direction atmosphere and high morale. Loosely structured work
Indifferent to organizational needs design. Manager is attentive to staff and has
Uncreative developed satisfying relationships. Little attention is
Must be coerced or threatened to get them to work paid to achieving results

Theory Y Assumptions (5.5) Middle of the road or the dampened pendulum.

- Managers have a positive perception of workers Satisfactory performance achieved by
Managers believed that workers equating the necessity for performance and
reasonable morale. Adequate performance
Like to work, enjoy work and see work as natural as through balancing the necessity to get out work wile
play maintaining morale of people at a satisfactory level
Committed, independent, self-motivated
Creative, exercise imagination and ingenuity (9.9) Team. High performance manager. Ultimate in
Willing to work hard to meet personal and managerial efficiency. Thoroughly dedicated people.
organizational goals Trustworthy and respectable atmosphere. Highly
Exhibit self-control and discipline organized task performances. Managers
Creative achieves high work accomplishment through leading
Chris Argyris committed people who identify themselves with
Supported McGregor and Mayo the organizational aims
The Managerial Grid
MANAGEMENT THEORY DEVELOPMENT Planning
Theorist Theory
The most basic and fundamental activity of
Taylor Scientific management process
management Planning
Weber Scope of Planning
Bureaucratic organization Top Management
Fayol
Management functions
Gulick Activities Middle Management
of management
Follett
Participative management Lower Management
Mayo
Hawthorne effect Types of Planning
McGregor Theory X and
Theory Y
Argyris Strategic Planning
Employee participation
Conceptual Process of the Nursing Service Operational Planning
Administration Strategic Planning
This course will discuss
PLANNING Determines long term objectives of the institution and
as it applies to the nursing profession the policies that will be used to achieve these
Course Outline objectives
PLANNING Done at the executive level of management
Introduction to Planning Future-oriented
Importance of Planning SWOT Analysis
Types of Planning - a tool used before making a strategic plan
Principles of Planning Weakness or Strength
Planning Process Expertise of nursing and medical personnel staff
Advantages of Planning Qualifications
Barriers to Planning Over or understaffed
Strategic Planning Process Financial Status
Decision Making Quality of patient care
Types of Decisions Abundance or scarcity of medical equipment and
Decision Making Process supplies
Group Decision Making Threats
Creative Decision Making Competition
Decision Making Tools Decrease in patient load
Time Management Low patient satisfaction
Budget Increase in charges
Types of Budget Legal threats
The Budget Process
Cost Containment Opportunities
Objective Improved or new facilities
At the end of the lecture, the students will be able to: Recruitment of medical and nursing personnel
Referrals
Gain basic knowledge of planning as a management New health care programs
function, its principles, theories and processes and
correlate the concepts with actual practice Operational planning
Explain the meaning of planning and importance to Deals with day to day maintenance of activities
nursing management Done in conjunction with the preparation of budget
Discuss nature and purpose of planning
Describe various phases of planning process
Define budget process Major Aspects of Planning
Planning should contribute to objective Purpose or Mission Statement
is a brief statement identifying the reason that an
Planning precedes all other aspects of management organization exist and its future aim or function.

Planning pervades all levels This identifies the organization’s constituency and
addresses its position regarding ethics, principles and
Planning should be efficient standards of practice.
Characteristics of a Good Plan
A well-developed plan should: Broad declaration of the basic, unique purpose and
Have clearly worded objectives scope of operations that distinguishes the organization
Be guided by policies and procedures from others of its type
Indicate priorities Mission Statement Components
Develop actions that are flexible and realistic Clients
Develop logical sequence of activities Products/ Services
Include the most practical methods for achieving each Location
objective Technology
Purpose / Importance of Planning Concern for survival
Leads to the achievement of goals and objectives Philosophy
Gives meaning to work Self-concept
Provides effective use of available resources and Concern for public-image
facilities Concern for employees
Helps cope in crisis situations Department of Health
Cost effective Vision
Based on past and future activities The leader of health for all in the Philippines
Leads to realization of need for change
Necessary for effective control Mission
Functions of Planning Guarantee equitable, sustainable and quality health
To focus attention on objectives for all Filipinos, especially the poor, and to lead the
To gain economic attention quest for excellence in health.
To facilitate control Vision/ Mission of FEU
To effect focus certainty and change Far Eastern University
Elements of Planning/ Steps in Planning aims to be
Forecasting a private university of choice in Asia.

Setting the Vision, Mission, Philosophy, Goals and Committed to the highest
Objectives intellectual, moral and cultural standards,
it strives to produce
Developing and Scheduling programs principled and competent graduates.

Preparing the budget It nurtures

a service-oriented community
that seeks to contribute
Forecasting to the advancement of global society.
Looks into the future including the environment in
which the plan will be executed Vision of the Institute of Nursing

Who will be the client The Institute of Nursing envisions that among the
Equipments schools offering Nursing courses, FEU-IN will be the
Facilities choice school in the next five (5) years because we
Supplies will produce graduates who can function/ practice
independently in any setting and not only looking at
The Planning Hierarchy employment as the sole career opportunity after
Vision graduation.
Outlines the organization’s future role and function Mission of the Institute of Nursing
The institute envisions competent graduates who are
Gives the institution something to strive for God-fearing, nationalistic and responsive to the
changing needs of society – local, national and health, prevent illness. Alleviate human sufferings and
international. assist in peaceful and dignified death
Goal
The institute is committed to the provision of quality The desired result toward which effort is directed.
education through a program of study that aims for
academic excellence and the development of nursing It is the aim of the philosophy.
student as a total person
It change with time and require periodic reevaluation
The educational program is given substance in a and prioritization.
competency based, community health-centered
curriculum complemented with co and extracurricular It is global in nature
activities on socio-cultural and spiritual aspects, in and
off campus It may direct and maintain the behavior of the
Philosophy organization.
flows from the purpose or mission statement and
delineates the set of values and beliefs that guide all Long- and short-term goals are usually set for services
actions of the organizations rendered, economics, use of people including people,
funds and facilities, innovations and social
Sense of purpose of the organization and the reason responsibilities.
behind its structure and goals Benefits of Goal
Increases performance
It is the basic foundation that directs all further Helps clarify expectations
planning toward the mission. Facilitates controlling function
Increases motivation
Provides parameter for decision making in Levels of Goals
determining what is critical to an organization. Strategic Goal
Tactical Goal
The Philosophy of the Institute of Nursing Operational Goal
The educational Program of the Institute of Nursing is Strategic Goal
found on the Faculty’s belief about Man, health, Official Goal
society, education and nursing
Broadly defined targets or future end results set by top
The faculty believes that: management
MAN is created in the image and likeness of God. He Tactical Goal
is a bio-psychosocial, spiritual, emotional, intellectual Targets or future end result usually set by middle
being capable of reasoning, seeking, attaining and management for specific department or units
enjoying truth
HEALTH is a basic right and personal responsibility of Spells out what must be done by various departments
every individual, family and community. It is a social to achieve the expected results
phenomenon and a dynamic state wherein Man is Operational Goals
able to function to his maximum and he adapts to the Targets or future end results set by lower
ever changing environment management that address specific measurable
SOCIETY is an open system composed of people who outcomes required from the lower levels
interact with one another and are affected by culture, How to set goals
creed, ideologies and economic conditions. A Specify the goal to be reached or tasks to be done
democratic dynamic society has the potential for Specify how the performance will be measured
continued development Specify the standard or target to be reached
NURSING EDUCATION is a continuous self realizing Specify the time span involved
process. It embraces all those experiences which Prioritize the goal
develops skills, attitudes and potentialities. It enables Determine coordination requirement
Man to have deeper understanding and appreciation Objectives
of the attainment of immediate and ultimate purposes are similar to goals in that they motivate people to a
of life and of national development goals specific end and are explicit, measurable, observable,
NURSING is a vital component of health system and retrievable and obtainable.
must be responsive to the needs of the society. Its
primary concern is to promote, maintain, and restore
Time frame in the completion of the objectives are wasted time and using managerial technique to reach
specified and the objectives should be stated in goals efficiently
behavioral terms, be objectively evaluated and identify 3 basic steps in time management
positive rather than negative outcomes.

Objectives:
In consonance with the Far Eastern University’s Priority Setting
Philosophy of developing of academic excellence, the Most critical skill in good time management
Institute of Nursing through the Baccalaureate 5 Priority setting traps
Program aims to provide for the maximum Whatever hits first
development of the student as a person, as a nurse Path of least resistance
and as a member of a dynamic society Squeaky wheel
Default
A Graduate of the Baccalaureate Program of the Far Inspiration
Eastern University Institute of Nursing who has been Whatever hits first
provided with and has participated in the intellectual, Occurs when an individual simply responds to things
physical, psychosocial, cultural and spiritual as they happen rather than thinking first and then
experiences is expected to: acting
Path of least resistance
Have an integrated personality Individual makes and erroneous assumption that it is
Function as a Professional Nurse in varied nursing always easier to do a task by himself or herself and
situations utilizing the nursing process and other fails to delegate appropriately
approaches in the care of the individual, the family Squeaky wheel
and the community and assumes accountability for his The individual falls prey to those who are most vocal
actions about their requests
Assume and initiate leadership and participate in Default
professional and community activities in consonance Individual feels obligated to take on tasks that no one
with the changing needs of the society else has come forward to do
Initiate and participate in research and advance Inspiration
studies to promote personal and professional growth Individuals wait until they become inspired to
and to contribute to the body of knowledge of health accomplish a task
and nursing 3 categories in prioritizing
Demonstrate critical thinking in varied situations don’t do
do later
Specific Level Objectives: do now
Level IV Don’t do
Problems that will take care of themselves
Projects an integrated personality Outdate
Utilizes readily the nursing process in varied situations Better accomplished by someone else
Assumes leadership responsibilities willingly with Manager removes unneeded clutter from his or her
minimum supervision work area
Conducts simple research studies relevant to nursing Do later
practice Reflect trivial problems
Seeks opportunities for personal and professional Those that do not have immediate deadline, thus
growth procrastinated

Developing and Scheduling Programs Procrastination

Programs to put off something until a future time, to postpone, or
Are determined, developed and targeted within a time to delay needlessly
frame to reach the set goals and objectives Do now
Reflects a unit’s day-to-day operational needs
Daily staffing needs
A technique to allocate one’s time through setting of Dealing with equipment shortages
goals, assigning priorities, identifying and eliminating Meeting schedules
Conducting hiring interviews
Giving performance appraisal possible consistent with judgment, facts and
List experience
Helpful in prioritizing all the do now list Time saving techniques, devices and
It is a plan, not a product and that the creation of the methods to better use of time
list is not the final goal Time Saving techniques
A planning tool Conduct an inventory of your activities
Managing time at work Set goals and objectives and write them down
Principles that may assist on planning work With the use of calendars, executive planners, logs or
Gather all the supplies/ equipment that will be needed journals, write what you expect to accomplish yearly,
before starting an activity monthly, weekly or daily
Group activities that are in the same location Break down large projects into smaller parts
Use time estimates Devote a few minutes at the beginning of each day for
Document nursing interventions as soon as possible planning
after an activity is completed Organize your work space so it is functional
Always strive to end the workday on time Close your door when you need to concentrate
Taking breaks Learn to delegate
Taking regularly scheduled breaks from work is In a meeting, define the purpose clearly before
important starting
Allow worker to refresh both physically and mentally Take or return calls during specified time
Dealing with interruptions Develop effective decision-making skills
Lower level managers experience more interruptions Take rest breaks and make good use of your spare
than higher-level managers time
External Time-wasters Decision Making Tool
Telephone interruption Program Evaluation and Review Technique (PERT)
Socializing Developed by Booz-Allen-Hamilton organization and
Meetings the US Navy in connection with the Polaris missile
Lack of information program
Poor communication PERT
Lack of feedback A popular tool to determine the time of decisions
Lack of adequately described policies and procedures A flowchart that predicts when events and activities
Incompetent co-workers must take place if a final event is to occur
Poor filing system Network system model for planning and control under
Paperwork and reading uncertain conditions
Dealing with time waster
Don’t make yourself overly accessible
Interrupt PERT
Avoid prompting socialization Recognizes that certain task must be completed
Be brief before the total project can be completed and subtask
Schedule long-winded pests must be completed before others can be started
If you would like to chat and have time to do so, use
coffee breaks and lunch hours Key events are identified, labeled or numbered on the
Anticipates problems that will rise from actions without flowchart
thoughts 3 projected time determined
Optimistic time (t0)
Task to be accomplished should be done in sequence Most likely time (tm)
and prioritized according to importance Pessimistic time (tp)

Setting deadlines in one’s work and adhering to them (t0) + 4(tm) + (tp)
(te) = -------------------------
Deferring, postponing or putting off decisions, actions 6
or activities can become a habit which oftentimes GANTT
cause lost opportunities and productivity Highly developed schedules that allow one to visualize
multiple tasks that have to be done
Delegation permits a manager to take authority for Henry L. Gantt
decision making and to assign task to the lowest level Graphic device which a manager can plan and
monitor work time for complex project
 Can be controlled or varied by the manager
It is a grid with columns labeled
Task Number of personnel working on a certain shift
Responsibilities Staffing mix
Time Frame (minutes, hours, days, weeks, months, Noncontrollable expenses
year or decades) Cannot be controlled by the manager

GANTT CHART Equipment depreciation

Responsibility Accounting Number and type of supplies needed by patient
Essential feature of fiscal planning Overtime
Organization’s revenues, expenses, assets and Types of Budget
liabilities is someone’s responsibility Cash Budget
Personnel Budget
Budget Operating Budget
Annual operating plan Capital Budget
Serves as an estimate of future cost Cash Budget
Plan for utilization of manpower, material and other Forecast the amount of money received
resources
Plan for future activities expressed in operational as Beginning cash balance, estimates of receipts and
well as financial monetary terms disbursements and the estimated balance for a given
period corresponding to that of the operating and
Factors in Budget Planning capital budget
Based on valid objectives to provide a product or Personnel Budget
service Work force budget
Ensure clients receive nursing services they want and Largest of the budget expenditures
need Calculating Nursing Care Hours (NCH) per patient-day
Simple, flexible and balance
Centralized Budgeting
Developed and imposed by comptroller, hospital Nursing hours worked in 24 hours
administrator and director of nursing NCH/PPD = -------------------------------------
No or little consultation with lower level managers in Patient
the preparation Census
Top-down approach in implementing of budget
Middle managers has no autonomy or right to control Operating Budget
the budget Reflects expenses that change in response to the
Decentralized Budgeting volume of service
Middle managers are actively involve in the planning
and budgeting process Cost of electricity
Unit managers have an intimate view of their needs Repairs and maintenance
Enhances morale and satisfaction of individuals who Medical/ surgical supplies
participated in the preparation of budget Capital Budget
Classification of budget Plan for the purchase of buildings or major
Fixed expenses equipments
Variable expenses Composed of long-term planning, major acquisitions
Controllable expenses component and short-term budgeting component
Noncontrollable expenses Four Budget Components in Health Care Institutions
Fixed expenses Revenue Budget
Do not vary with volume Summarizes income which management expects
during planning period
Building’s mortgage payment or manager’s salary Expense Budget
Variable expenses Expected activity in operational and financial terms for
Vary with volume a given period of time
Capital Budget
Payroll of hourly wage employees Outlines programmed acquisition, disposals and
Cost of supplies improvements in an institution’s physical capacity
Controllable expenses Cash Budget
Represents planned cash receipts and disbursement Administration of Meds
as well as cash balances expected during planning Performance Appraisal
period Patient Care
Forecast the amount of money received Continuing Education
Benefits from Budgetary Process Procedures
Planning are plans that establish customary or acceptable ways
Stimulates thinking in advance of accomplishing a specific task and delineate a
Leads to specific planning sequence of steps of required action.
Budget preparation stimulates action and interaction
Benefits from Budgetary Process It identifies the process or steps needed to implement
Coordination a policy and are generally found in manual in at the
Has a balancing effect on the total organization, the unit level of the organization.
quantity and quality of service to be given a patient
should closely equal the expected revenue Saves staff time
Encourages exchange information Facilitate delegation
Stimulates team play or team approach Reduce cost
Benefits from Budgetary Process Increase productivity
Control Means of control
Gives administration an opportunity to evaluate the
budget contributor Ward Administrative Manual
Comparisons between actual expenditures and Procedure Manuals
budgeted standards can be made with little or no effort Standard of Safe Nursing Care Manual
Define fixed and agreed upon goals Rules and regulations
Cost consciousness is enhanced are plans that define specific action or non-action in
Policies respect to a certain situation.
are plans reduced to general statements or
instructions that direct organizations actions in their Generally included as part of policy and procedure
decision making. statements, it describes situations that allow only one
choice of action.
Explain how goals will be met and guide the general
course and scope of organizational activities. Least flexible type of planning
There should be as few rules as possible
Direct individual behavior toward the organization’s Existing rules should be enforced to keep morale from
mission and define broad limits and desired outcomes breaking down and to allow organizational structure
of commonly recurring situations while leaving some End of Slides
discretion and initiative to those who must carry out
that policy
Personnel Policies
Absences
Assignments
Employee Benefits
Health Programs
Holidays
Hospitalization
Leaves
Promotion
Uniform
Performance Evaluation
Nursing Service Policies
Professional and Ethical Standards for Nursing
Practice
Staffing
Assignments
Job Descriptions
Nursing Audit
Infection Control and Fire Safety