NURSING NURSING LEADERSHIP AND LEADERSHIP AND

MANAGEMENTMANAGEMENT::

““A person in a position A person in a position of authority is not of authority is not automatically a automatically a

LEADER”LEADER”““Leadership and Leadership and positions are not positions are not

EQUIVALENT”EQUIVALENT”

““Not all Not all leaders are leaders are managers, managers,

nor all nor all managers are managers are

leaders.”leaders.”

Leadership and ManagementDefinition of Nursing Management:• The management process is universal. For

nurses, knowledge of this process assures them of the smooth functioning of the units to attain their goal of quality care through the judicious use of available human and material resources within specified periods.

• Focus on planning, organizing, staffing, directing or leading and controlling or evaluating all activities of the nursing system.

• Defined as a process of coordinating actions and allocating resources to achieve organization goals of the healthcare delivery system

Role of Manager

Developing Future Managers

Managerial development programs are very useful means of getting qualified managers. According to Katz, the necessary fundamental

skills of a manager are:

• Technical Skills• Human Skills

• Conceptual Skills

LEVELS OF SKILLS MANAGEMENT IN NURSING

• CONCEPTUAL – individual’s mental ability to coordinate a variety of interests and activities. Thinks critically and able to conceptualize how things could be. VISIONARY

• INTERPERSONAL – individuals’ preferred ways of using language, the degrees to which they listens, and their ways on responding to others.

• TECHNICAL- tools, procedures, and techniques that are unique to the nurse manager’s specialized situation. Master of the job-viewed as a source of help. AN EXPERT.

Top Management

Middle Management

First-Line Management

Conceptual Human Tech-nical

Conceptual

Con-ceptual

Human

Human

Technical

Technical

Proportions of Management skills needed atProportions of Management skills needed atDifferent levels of management Different levels of management

Concerned with broad-based, long-range decisions that affect the entire organization; therefore, conceptual skill is most important at that level

TopManagement

First-Line Management

Focuses basically on her or his group, Therefore, the need for conceptual skill is at a minimum

Human Skill

The need to be able to understand and work with people is important at all levels, but the first-line manager’s position places a premium on human skill requirements because of the great number of employee interactions required

Technical Skills relates to the proficiency in performing an activity in the correct manner with the right technique.

Human relationship skills pertain to dealing with people and how to “get along” with them.

Conceptual skills deals with the ability to see individual matters as they relate to the total picture and to develop creative ways of identifying pertinent factors, responding to the big problems and discarding irrelevant facts.

Another approach in developing managers is postulated by Summer in his early work which emphasize knowledge, attitude and ability

factors. Knowledge factors refer to ideas, concepts

or principles that can be expressed and are accepted because they have logical proofs.

Attitude factors relate to those beliefs, feelings and values that may be based on emotions and may not be subjected to conscious verbalization.

Ability factors include skills, art, judgment and wisdom.

Who Needs Nursing Who Needs Nursing Management?Management?

• All types of health-care organizations, including nursing homes, hospitals, home health-care agencies, ambulatory care centers, student infirmaries, and many others, need nursing management.

• Even the nurse working with one client and family needs management knowledge and skills to help people work together to accomplish a common goal.

• A primary nurse working with several clients prioritizes their care to assist time to improve health or, sometimes, peaceful death.

THE MANAGEMENT PROCESS

CONTROLLING assessing/regulating performance

DIRECTING actuating efforts to accomplish goals

ORGANIZING establishing formal authority

PLANNING thinking ahead, making projections to achieve

desired results

Top Management

Middle Management

First-Line Management

P O D S C

P

P

O

O

D

D S

S

C

C

P - PlanningO - Organizing

Amount of Emphasis on Management Function

D - DirectingC - ControllingS - Staffing

Universality of Management

Scenario:

A nurse –manager spent part of the day working on the budget(Planning) , meet with the staff about changing the patient care management delivery system from primary care to team nursing (Organizing), altered the staffing policy to include 12- hour shifts (staffing), held a meeting to resolve a conflict between nurses

and physicians (Directing), and gave an employee a job performance evaluation (Controlling).

Not only would the nurse-manager be performing all phases of the management process, but each function has a planning, implementing, and controlling phase.

LeadershipLeadership• Is defined as a process of influence• Is not limited to people in

traditional positions of authority.• A leader influence others to move

in the direction of achieving goals.• Leadership occurs in different

dynamics and settings

CORE values of LeadersCORE values of Leaders• A guiding VISIONA guiding VISION• PASSIONPASSION• IntegrityIntegrity• CuriosityCuriosity• FlexibilityFlexibility• IntelligenceIntelligence• Ability to support OthersAbility to support Others• Self ConfidenceSelf Confidence• DesireDesire

Leaders VS Managers

PLANNING is defined as pre-determined a course of action order to arrive at a desired result. It is a continuous process of assessing, establishing goals and objectives, implementing and evaluating them, and subjecting these to change as a new facts are known. While planning is largely conceptual, its results are clearly visible.

Importance of PlanningImportance of Planning Planning leads to the achievement of goals and Planning leads to the achievement of goals and

objectivesobjectives Planning gives meaning to work.Planning gives meaning to work. Planning provides for effective use of available Planning provides for effective use of available

resources and facilitiesresources and facilities Planning helps in coping with crises (disaster plans)Planning helps in coping with crises (disaster plans) Planning is cost effectivePlanning is cost effective Planning is based on past and future activitiesPlanning is based on past and future activities Planning leads to the realization of the need to Planning leads to the realization of the need to

changechange Planning provides the basis for controlPlanning provides the basis for control Planning is necessary for effective controlPlanning is necessary for effective control

4 -Types of Planner: Reactive- Reactive- planning occurs after a problem exists, planning occurs after a problem exists,

done in response to a crisis, lead to hasty decisions done in response to a crisis, lead to hasty decisions and mistakes.and mistakes.

Inactivist- Inactivist- consider status quo, spend a great deal consider status quo, spend a great deal of energy preventing change and maintaining of energy preventing change and maintaining conformityconformity

Preactive- Preactive- utilize technology to accelerate change, utilize technology to accelerate change, future orientedfuture oriented

Proactice/interactive- Proactice/interactive- consider the past, consider the past, present, and future, and attempt to plan the future of present, and future, and attempt to plan the future of their organization rather than react to it, dynamic and their organization rather than react to it, dynamic and adaptive to the environment adaptive to the environment

Types of PlanningTypes of Planning• Strategic/Long range- Strategic/Long range- forecasts the future success of an org. by matching

and aligning all its capabilities with its external opportunities (Marquis & Huston,2006).

• Tactical/Short-termTactical/Short-term

Elements of Planning

Time ManagementTime ManagementTime Management – is a technique foris a technique for

allocation of one’s time through theallocation of one’s time through the setting of goals, assigning priorities,setting of goals, assigning priorities,

identifying and eliminating time identifying and eliminating time wasteswastes

and use of managerial techniques to and use of managerial techniques to reach goals efficiently.reach goals efficiently.

““Work SMARTER, not Work SMARTER, not HARDER”HARDER”

How Do you Manage your Time???Planning anticipates the problemPlanning anticipates the problemTasks to be accomplished should be Tasks to be accomplished should be

done in sequence and should be done in sequence and should be prioritized to importanceprioritized to importance

Setting deadlines in one’s work and Setting deadlines in one’s work and adhering to them is excellentadhering to them is excellent

Delegates permits a manager to Delegates permits a manager to take authority for decision making take authority for decision making

• Is the process of determining the activities to be performed, arranging these activities to administrative units, as well as assigning managerial authority and responsibilities to people employed in the organization.

• This is a process of forming a system into an organic whole, giving it an orderly structure, framing and making arrangement for its working order. As an undertaking it involves cooperation.

• This is a process where personnel job description, qualifications and functions are distinctly defined and specified for work efficiency in the organization.

Classification CategoriesClassification Categories

Level I – Self Care or Minimal Care – Patient can bathe, feed and perform ADL. Level II – Moderate Care or Intermediate Care – Patient needs some assistance in ADL, ambulating up and about for short periods of time, Level III – Total, Complete or Intensive Care – Patients are completely dependent upon the nursing personnel.

Level IV – Highly Specialized Critical Care•Patients maximum nursing care, they need continuous treatment, observation, many medications, IV piggy backs, vital signs q 15-30 mins. hourly output; •Significant changes in doctor’s orders more than care hours / patient /day may range from 6-9 or more.