ORGANIZING in Nursing Management Presentation subtitle

The Story of the Donkey Stuck in a Well

One day a farmer’s donkey fell down into a well. The donkey cried piteously for hours as the farmer tried to figure out what to do.

Finally, the farmer decided the animal was old, and the well needed to be covered up anyway; it just wasn’t worth it to retrieve the donkey.
He invited all his neighbors to come over and help him. They all grabbed a shovel and began to shovel dirt into the well. At first, the donkey realized what was happening and cried even more loudly in panic and fear.

Then, to everyone’s amazement the donkey quieted down.

As the farmer’s neighbors continued to shovel dirt on top of the donkey. He would shake off the dirt and take a step up. the donkey was doing something amazing.A few shovel loads later. Pretty soon. He was astonished at what he saw. With each shovel of dirt that hit his back. he would shake it off and take another step up. the farmer looked down the well. everyone was amazed as the donkey stepped up over the edge of the well and happily trotted off! .

Each of our troubles is a steppingstone. Remember the five simple rules to be happy: Free your heart from hatred – Forgive. The trick to getting out of the well is to shake it off and take a step up. Free your mind from worries – Most never happen. We can get out of the deepest wells just by not stopping. Expect less .Life is going to shovel dirt on you. all kinds of dirt. never giving up! Shake it off and take a step up. Live simply and appreciate what you have. Give more.

policies and procedures arranged in a systematic process through the delegation of function and responsibilities for the accomplishment of purpose. Consist of the structure and process which allows the agency to enact its philosophy and utilize its conceptual framework to achieve a goal. It is the process of establishing formal authority D.Organizing the Nursing Service All but which of the following does not define the process of organizing in nursing management? A. C. methods. . It helps the manager look into the future and decide in advance where the agency would like to be and what is to be done. B. It refers to a body of persons.

arranging these activities to administrative units. qualifications and functions are distinctly defined and specified for work efficiency in the organization.Organizing is. • This is a process of forming a system into an organic whole. as well as assigning managerial authority and responsibilities to people employed in the organization. • Is the process of determining the activities to be performed. giving it an orderly structure. As an undertaking it involves cooperation. • This is a process where personnel job description. framing and making arrangement for its working order. .

system or society where members harmoniously work together to achieve organization goals. including environment. that performs a task which has been differentiated into several distinct subsystem.What is an ORGANIZATION?  An organization is defined as a system of interrelated resources.  Planned groupings of people to accomplish a specific purpose  Is an organized body. materials. supplies and behavior of people. .

GOALS SUPERVISI ON PEOPLE ORGANIZATION JOB STRUCTUR E CULTURE .

4) Functional Organization – each unit is responsible for a given part of the organization’s workload.Types of Organization Classified by Nature of Authority 1) Line Organization.each position has general authority over the lower positions in the hierarchy.(Flat or horizontal organization) 3) Staff Organization. (also known as Bureaucratic/Pyramidal) 2) Informal Organization. .purely advisory to the line structure with no authority to put recommendations into action.refers to horizontal relationship rather than vertical.

.TYPES OF ORGANIZATIONAL STRUCTURE 1) Line Organization/ Bureaucratic/ Pyramidal . .shows that each position has general authority over the lower position of the hierarchy.Power are concentrated at the top.

.TYPES OF ORGANIZATIONAL STRUCTURE 2. Flat Organization .refers to an organizational structure with few or no levels of intervention between management and staff.

purely advisory to the line structure with no authority to place recommendations into action. .TYPES OF ORGANIZATIONAL STRUCTURE 3. Staff Organization .

TYPES OF ORGANIZATIONAL STRUCTURE 4.permits a specialist to aid line position within a limited and clearly defined scope authority. Functional Organization . .

Organizational Chart D.Is a line drawing which shows how the part of the organization are linked. A. Hierarchy C. Budgetary Chart B. areas of responsibility and person to whom one is accountable. It depicts the formal organizational relationship. Structural Plant .

The organization chart establishes the following: ■ Formal lines of authority—the official power to act ■ Responsibility—the duty or assignment ■ Accountability—the moral responsibility .ORGANIZATIONAL CHART Organizational chart is a line drawing that shows how the parts of an organization are linked.

ORGANIZATIONAL RELATIONSHIP 1. FORMAL RELATIONS 2. INFORMAL RELATIONS .

. through departmentalization and work division. . FORMAL RELATIONS Formal structure. provides a framework for defining managerial authority.ORGANIZATIONAL RELATIONSHIP 1. responsibility and accountability.

. INFORMAL RELATIONS Informal structure is generally social. with blurred or shifting lines of authority and accountability.ORGANIZATIONAL RELATIONSHIP 2.

4.5. All but which of the following activities is not included under Organizing? Budgeting Staffing Scheduling Developing Job description Organizational Structure Forecasting C. 5.4.3. 3.1. 6.4. 3.6 A. 1. 2. 4.2.3 only B.5 D. 2. 2.5 .

conceptual framework and goals of the organization. .SETTINGN UP THE ORGANIZATIONAL STRUCTURE: The creation of an organizational system compatible with the philosophy. Understanding the organizational structure as a whole facilitates the development of roles and relationships to enables the achievement of goals.

 Avoids overlapping of function because it pinpoints responsibilities.Importance of Organizational Structure  It enables members what their responsibilities  It frees the manager and the individual workers to concentrate on their respective roles and responsibilities  It Coordinates all organization activities so there is minimal duplication of effort or conflict.  Shows to whom and for whom they are responsible .

None of these D. 1. 4.2.2.The successful setting up of the organizational structure enables an organization to achieve.5. Shows to whom and for whom they are responsible 5. All of these C. 1.1 . Create an environment that raise friction A. Allowing the manager to concentrate on his/her role 3.3. Information of members of their responsibilities 2.4 B. Avoid overlapping of functions 4.

assist recommend and generally reduce the supervisors' responsibilities. Direct type of authority over the lower position. “Purely advisory” .  Staff Authority is the authority created to support.ORGANIZATIONAL TYPE OF AUTHORITIES  Line Authority entitles a supervisor to direct an individuals work.

Straight Line C. A.Mrs. Rectangle B. Chao’s relationship is indiacted in the organizational chart by. Mrs. Box D. Chao has recently been designated as adviser on nursing matters to the Secretary of the DOH. Broken Line .

D. Box Rectangle Broken Line Straight Line . One of the things that Nurse Mila noticed when she entered the office of the Chief Nurse is the Hospital’s Organizational Chart.A. C. Formal authority in an organizational chart is indicated by a. B.

2. Division of Work – each box represents an individual or sub-unit responsible for a given task of the organization’s workload.indicated labels or descriptions for the boxes. 4. which indicate individual & entire management hierarchy. .shown by the clusters of work groups 5.The level of Management. regardless of where an individual appears on the chart.Grouping of Work Segment. Type of work to be Performed . 3.Characteristics of Organizational Chart 1. Chain of Command – lines indicate who reports to whom & by what authority.

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of Levels Span of Control FLAT PYRAMIDAL Fewer Broad More Narrow Delegation Authority Control over Subordinates Greater Decentralized Lesser Lesser Centralized More Type Modern Traditional .Difference Between Flat and Pyramidal Structure. CATEGORY No.

Flat or Decentralized Structure Advantages • Communication patterns are simplified. problems tend to be addressed with ease and efficiency. • Employees have autonomy and increased job satisfaction within this type of structure Disadvantages • Supervisor spend less time with each worker • Supervisors may lack expertise in the variety of operations and may end up making inappropriate decisions .

Responsibility is the obligation to perform the assigned tasks Power is the ability to influence another to behave in accordance with one's wishes Status is the rank bestows on a person in accord with the groups estimation of the person value. Accountability mean taking full responsibility for the quality of work and behavior while engaged in the practice of the profession.Authority is the right to act or make decision without the approval of the higher administrator. Communication is the transmission of information between persons . significance to the group.

When responsibility for a particular job is delegated to a subordinate.Board Question Which of the following pertains to the principle of DELEGATION except. he is accountable for his actions to the person that bestowed him such. If a particular tasked has been delegated to a subordinate the superior’s own responsibility is no way diminished . d. When a particular task has been delegated to a subordinate the supervisors own authority is diminished to that of the subordinates c. a. When a person bestowed the authority for action. the latter should have authority over resources needed to accomplish the task b.

d. depending upon the pace and pattern of the working area b. Workers performing similar assignments are grouped together for a common purpose. while at the base of the organization a 1:10 ratio is common c. The number of workers that a supervisor can effectively manage should be limited. Conferring specified decision making to the lower levels of organization .Board Question Decentralization or proper delegation of authority is best describe by the following. At the top of the structure a ratio of 1:6 ratio of supervisor-worker is common. a.

Medical Center Chief MEDICAL DIVISION NURSING DIVISION ADMINISTRATIVE DIVISION BUDGET PERSONNEL ANXILLARY LABORATORY CLINICAL CLINICAL SPECIAL AREA PHARMACY DIETARY HOUSE KEEPING SURGERY EENT ORTHO RADIOLOGY OR ER ICU DR/NICU SUPPLY AUDIT MAINTENANCE DENTAL LAUNDRY SOCIAL SERVICE MEDICINE OB GYNE PEDIA/OPD COLLECTING TRANSPORT .

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ORGANIZATIONAL STRUCTURE OF A HOSPITAL NURSING DIVISION/SERVICES .

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Services Senior Nurses Supervising Nurse Clinical Services Senior Nurses Staff Nurses Nursing Attendants Staff Nurses Nursing Attendants . Chief Nurse Trng & Research Supervising Nurse Instructor Nurse Instructors Ass. Chief Nurse Clinical Service Supervising Nurse Spl.Chief of Hospital Chief Nurse Ass.

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Medical Center Chief Chief Nurse Dean of Affiliating Colleges

Ass. Chief Nurse
Supervising Nurses Supervising Nurse Ins Senior Nurses Staff Nurses Nurse Instructors Trainees

Clinical Coordinators
Clinical Instructors

Midwives
Nursing Attendants Institutional Workers

Nsg. & Midwifery Affiliates

Traditional Hierarchical Structure

CHIEF NURSE

SUPERVISING NURSE

STAFF NURSE

NURSING ATTENDANT

Staffing
 Process of determining and providing the acceptable number and mix the nursing personnel to produce desired level of care to meet the patients demand.  To provide each nursing unit with an appropriate and acceptable number of workers in each category to perform the nursing tasks required.

PRC ANSAPS Standards of Safe Nursing Practice) Layout of the various units Budget Expected hours of work per annum of each employee.Factors Affecting Staffing         The type. philosophy and objective of the hospital and the nursing The population serve or the kind of patient served whether pay or charity The number of patients and the severity of their illness-knowledge Administrative policies such as rotation. (40 hours week law)  Pattern of work schedule . weekends and holiday off duties Standards (ANSAP.

Employees working in agencies located in communities with less than one million population. will work 48 hours/week and therefore will get only one off-duty a week. .The Forty-Hour Week Law. Republic Act 5901. This also applies to employees working in agencies with at least one million population. provides that employees working in 100 bed capacity and up will work only 40 hours a week.

ratio 60:40 60:40 60:40 60:40 70:30 55:45 70:30 80:20 .6 2.Nursing Care Hour as per Patient Per Day According to Classification of Patients by Units Cases/ Patients General Medicine Medical Surgical Obstetrics Pediatrics Pathologic Nursery ER/ICU/RR CCU NCH/Pt.4 3.5 3.4 3./Day 3.0 4.8 6. to Non Prof.0 Prof.0 6.

generally within 24 hours. . of nursing time & skill they require.Patient Classification System (PCS) method of grouping patients according to the amount and complexity of their nursing care requirements. as well as the category of nursing personnel who should provide that care. serves in determining the amount of nursing care required.

5. Staffing. Tracking changes in patient care needs 4. Program costing & formulation of the nursing budget 3.Purposes for Classifying Patients 1. Determine quality . Perceived patient needs can be matched with available nursing resources 2. Determine values for the productivity equation: output divided by input.

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

 Significant changes in doctor’s orders more . Level IV – Highly Specialized Critical Care -  Patients maximum nursing care. they need continuous treatment. hourly output. IV piggy backs. observation. vital signs q 1530 mins. many medications.

5 55:45 3 60:40 Level III Total or Intensive Care Level IV Highly Specialized or Critical Care 4. to Non-Prof 1.Levels of Care Level I Self Care or Minimal Care Level II Moderate or Intermediate Care NCH Needed Per Patient/ Day Ratio of Prof.5 65:35 6 7 or higher 70:30 80:20 .

Percentage of Nursing Care Hours The percentage of nursing care hours at each level of care also depends on the setting in which the care is being given. .

Percentage of Patients in Various Levels of Care Types of Hospital Minimal Care 70 Moderate Care 25 Intensive Care 5 Highly Specialize Care - Primary Hospital Secondary Hospital Tertiary Hospital 65 30 30 45 5 15 10 Special Tertiary Hospital 10 25 45 20 .

Republic Act 5901. provides that employees working in 100 bed capacity and up will work only 40 hours a week. This also applies to employees working in agencies with at least one million population. .The Forty-Hour Week Law. Employees working in agencies located in communities with less than one million population. will work 48 hours/week and therefore will get only one off-duty a week.

Total Number of Working and Non Working Days and Hours of a Nursing Personnel Per Year Rights an d Privilege Given Each Personnel Per Year Working Hours Per Week 40 HOURS 48 HOURS 15 15 10 2 3 52 3 15 15 10 2 3 104 3 VACATION LEAVE SICK LEAVE LEGAL HOLIDAYS SPECIAL HOLIDAYS SPECIAL PRIVILEDGE OFF DUTIES (RA 5901) CEP TOTAL NON WORKING DAYS PER YEAR 152 100 .

Relievers Needed To determine the relievers needed use the following.15  Foe person working 48 Hours a week=0.  For person working 40 Hours a week =0.12 Distribution of Shift  45 percent for the AM shift  37 percent for the AFTERNOON shift .

250 patients in a tertiary hospital 40 Hours per week .Activity: Find the Nursing personnel needed for.

Multiply the total number of patient by the percentage of patient at each level of care. .  Find the total number of nursing care hour needed by the patient at each category level.The Formula  Categories the numbers of patient according to the levels of care needed. Find the number of patients at each level by the average number of nursing care hours per day Get the sum of the nursing care hours needed at the various levels  Find the actual number of nursing care hours needed by the given numbers of patients. Multiply the total nursing care hours needed per day by the total number of days in a year.

15 (40 hours). 0.The Formula  Find the actual number of working hours rendered by each nursing personnel per year. Multiply the number of hours on duty per day by the actual working days per year. Divide the total number of nursing care needed per year by the actual number of working hours rendered by an employee per year Find the number of relievers.12 (48 hours) Add the number of relievers to the number of nursing personnel needed . Multiply the numbers of nursing personnel needed by 0.

The Formula  Categorize the nursing personnel into professional and nonprofessional. Multiply the number of nursing personnel according to the ratio of professional to non professional. .  Distribute by shift.

The Story of the MULE .

"God created the mule. working constantly from dusk to dawn. . You will live for 50 years.' And it was so. give me no more than 20. Please. carrying heavy loads on your back. The mule answered: 'To live like this for 50 years is too much. and told him. 'You will be Mule. You will eat grass and you lack intelligence.

Then God created the dog. 'You will be Dog.' And it was so. 'Lord. to live 25 years as a dog is too much. and hold vigilance over the dwellings of Man. Please. . And the dog responded. You will eat his table scraps and live for 25 years. and told him. no more than 10 years. to whom you will be his greatest companion.

God then created the monkey. 'You are Monkey. 'Lord. And the monkey responded. acting like an idiot. . You will be funny. Please. give me no more than 10 years. and you shall swing from tree to tree.' And it was so. and you shall live for 20 years. Lord. to live 20 years as the clown of the world is too much. and told him.

and the 10 years the monkey rejected. . Lord. to be Man for only 20 years is too little. You will dominate the earth and live for 20 years.Finally. the 15 years the dog refused.' And it was so. give me the 20 years the mule refused. the only rational being that walks the earth.' And the man responded. God created Man and told him. Please. You will use your intelligence to have mastery over the creatures of the world. 'You are Man. 'Lord.

then marry and live 20 years like a mule working and carrying heavy loads on his back. Then.And so God made Man to live 20 years as a man. to live 10 years as a monkey. he is to have children and live 15 years as a dog. guarding his house and eating the leftovers after they empty the pantry. in his old age." . then. acting like a clown to amuse his grandchildren.

Centralized – done by the nursing director who develops a master plan for nursing personnel. an impersonal approach 2.Types of Staffing 1. Decentralized – the managers of individual nursing units have more control over the budget. .

Therefore. additional personal should be hired for those in supervisory and administrative position and for those in the special units. o Roomed in babies should be provided with additional staff . o Nursing Supervisors is provided . o Head Nurse should be provided for every nursing unit.NOTE: It should be noted that the personnel computed are only for those in patients.

provides a motivating climate for the employee. SCHEDULING o A timetable showing planned work days and shift for nursing personnel.PLACEMENT Placement is the assigning employees to a position or area. FACTORS CONSIDERED IN MAKING SCHEDULES: Different level of the nursing staff Adequate coverage for 24 hours Staggered vacations and holidays Weekends Long stretches of consecutive working days Evening and night shifts Floating        . Proper placement foster personal growth. maximizes productivity and organizational goals.

training and experience o Fairness to the staff o Stability o Flexibility Types of Scheduling: Centralized – Chief Nurse or designate do assigns the personnel to the hospital units Decentralized – Chief Nurse or designate assigns personnel but supervising Nurse/ Head or Senior arranged the shift and off duties Cyclical . (cycle length) .Covers designated number of wks.Assessing a Scheduling System: o Ability of the needs of the units o Quality to enhance the nursing personnel’s knowledge.

It saves time as the schedule does not have to be redone every week or two 3. It enables the employees to plan ahead for their personal needs preventing frequent changes in the schedule. holidays and sick leaves are more stable 5. Scheduled leave coverage such as vacation. Productivity is improved . It is fair to all 2. 4.Advantages of Cyclical Schedule 1.

Developing the Job Description Developing Job Description – a statement that sets the duties and responsibilities of a specific job. Qualification Requirements Job Relationship – source of workers Specific and Actual Functions and Activities . Contents of Job Description Identifying Data: Position Title: Department: Supervisor’s Title: Job Summary-essential features of the job that distinguish it from the others.

WHAT WOULD YOU DO FIRST IF YOU WERE IN A SITUATION WHERE: .

INTERPRETATION FAMILY SEX WEALTH CAREER & JOB FRIENDS & RELATIVES .

Test Your STRESS Levels .

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o Directing is the issuance of assignments. orders and instructions that help the nursing personnel to understand what are expected of them. . o Giving orders and directions to others to attain quality patient care. It is management of people which is the heart of the administrative process to be properly understood and practice by a nurse manager.DIRECTING o Directing is getting the work done through others.

Delegation Utilization of Policies and Procedures Supervision of Personnel Coordination of Service Communication Staff Development and Making of Decision . iii. iv. vi. ii.Elements of Directing i. v.

Principle of Delegation        Select the right person to whom the job is to be delegated Delegate both interesting and uninteresting tasks Provide subordinates with enough time to learn Delegate gradually Delegate in advance Consult before delegating Avoid gaps and overlaps .Delegation is the process of by which a manager assigns specific task/duties to workers with commensurate authority to perform the job.

Responsibility for maintaining morale or the opportunity to say a few words of encouragement to the staff especially the new ones 5. Evaluating the staff and or taking necessary corrective or disciplinary action 4. Jobs that are too technical and those that involve trust and confidence . authority and accountability 2. Overall responsibility. 1.Do you think that all matters be delegated? There are matters that cannot be delegated. Authority to sign one’s name 3.

. These may be due to lack of confidence in their staff  Feeling that only they could do the task better and faster  They may fear loss of control if some of their duties are delegated NURSING CARE ASSIGNMENT (sometimes called. ) Modalities of Nursing Care Systems of Nursing Care Patterns of Nursing Care Why Nurse Managers fails to DELEGATE? .

Four Basic Methods of Nursing Care • Functional Nursing • Total Care or Case Method • Team Nursing • Primary Nursing .

It allows most work to be accomplish in a short possible time 2.Functional Nursing  Task oriented in which particular nursing function is assigned to each workers  This method divides the work to be done with each person being responsible to the Head Nurse or Senior Nurse  The best system to use when there are many patients and professional nurses are few. Workers learn to work fast 3. Advantages' 1. They gain skills faster in the particular task .

Functional Nursing Disadvantages:  Holistic care is not achieved  Nurse's accountability are diminished  Patient cannot identify who their “real nurse”  Nurse patient is not fully developed  It is difficult to find a specific person who can answer the patient’s or relative’s questions .

Medication R. Attendant Hygienic Care Housekeeper Linen Attendant Patients Lines of Authority .N.N.Head / Senior Nurse R. Treatment Nsg.

Head / Senior Nurse Staff Nurse Patient Total Care / Case Nursing .

Ö He/she provides holistic care to the patients . evaluates and documents the nursing care Ö The nurse is accountable for his/her own actions. Ö The nurse plans.Ö In the Total Care or Case Method of nursing care one nurse is assigned to one patient for the delivery of total care. implements. coordinates.

Charge Nurse Team Leader Staff Nurse Clients Team Nursing .

TEAM NURSING • • • • Decentralized system giving care through participative effort Assigning patients and task according to job description Leader has the responsibility for coordinating the total care of a group of patient (Team Conference – the heart of team nursing) If not fully implemented. it can lead to fragmentation of care .

Physician Head Nurse Hospital and Community Resources Primary Nurse Patient/ Client Secondary/ Ass. Nurse PM Secondary/ Ass. Nurse Relief Lines of Authority in Primary Nursing . Nurse Nite Secondary/ Ass.

 Authority.  The primary nurse is responsible for in caring for 4 to 6 patients on a 24 hour basis throughout the hospitalization  Patient are provided with continuous care even when the primary nurse is off duty. night and on days when primary nurse is off duty. autonomy and accountability rest with the primary nurse. . secondary or associate nurse executes the nursing care during afternoon.  Since primary nurse assumes a 24 hours responsibility for nursing care. Each registered nurse is responsible for the total care of small group of patients from admission to discharge.

Modular Method  Modification of team and primary nursing RN provide direct nursing care with assistance of aides Case Management  The case manager is responsible for assessment of patient and family .

Supervis ion .

guiding and influencing the outcome of a person’s performance of an activity  It “appraises” Techniques in SUPERVISION:  OBSERVATION WHILE MAKING THE ROUNDS  SPOT CHECKING THE CHART  ASKING THE PATIENT ABOUT THE CARE THEY RECEIVE  LOOKING INTO THE GENERAL CONDITION OF THE UNITS  GETTING FEEDBACK FROM CO-WORKERS .  It is the active process of directing. “Supervide” which means to “Oversee or View Directly”  Providing guidelines for the completion of a task or activity with initial direction and periodic inspection.

What are the Good Qualities if Supervision? • Good Technical Skills • Ability to communicate • Firmness with flexibility to adjust to the needs of the situation • Fairness in dealing with the situation • Good decision making skills • Willingness to grow and develop • Pleasing personality • Ability the motivate employee • Advocacy for nurses and nursing .

that's amazing. greatly impressed. from hunger?" asked his doctor. you'll have lost at least five pounds. and repeat this procedure for two weeks. "I'll tell you what though. learn to be open to all possibilities. from all that skipping. "I want you to eat regularly for two days. Lesson: A different perspective can yield better results.Reginald was terribly overweight. When Reginald returned he shocked his doctor by having lost almost twenty pounds." his doctor assured him. "Why. The next time I see you. . "No. limited thinking. Therefore." the doctor said. Do not short-change potential results with narrow." "Why. I thought I was going to drop dead on the third day. so his doctor placed him on a strict diet." Reginald nodded. "You certainly must have followed my instructions. then skip a day.

Leadership is the act of developing people. WHAT IS THE DIFFERENCE BETWEEN LEADERS AND MANAGERS???? . What is that GOAL??? To provide quality nursing care to the patient. Leadership in nursing is necessary to guide nursing personnel to a specific goal.LEADING Leading ad defined by Webster means “to guide to go before and show the way”.

 Managers Demand Respect – Leaders Command Respect  Managers Have Subordinates – Leaders Have Followers  Managers administer .Leaders develop  Managers focus on systems – Leaders focus on people  Managers strive for control – Leaders inspire trust  Managers have short-term view – Leaders have a long-term goal  Managers are focused on the bottom line – Leaders are focused on potential  Managers imitate .Leaders innovate  Managers demand .Leaders command  Managers maintain .Leaders originate  Managers do things right – Leaders do the right thing .LEADERS AND MANAGERS  A manager is a title that can be given that signifies a position – a leader is a title that other people give you.

“All Managers are Leaders, but all Leaders are not Managers.”
What are the GOOD Qualities of a LEADER?
Leadership style:  Autocratic  Democratic  permissive

AUTOCRATIC LEADERSHIP
• This is all called directive or bureaucratic. In its most extreme form it implies a leader who uses coercion in the exercise of his/her power. • Autocratic leadership style is often considered the classical approach. It is one in which the manager retains as much power and decision-making authority as possible. The manager does not consult employees, nor are they allowed to give any input. Employees are expected to obey orders without receiving any explanations. The motivation environment is produced by creating a structured set of rewards and punishments. • This leadership style has been greatly criticized during the past 30 years. Some studies say that organizations with many autocratic leaders have higher turnover and absenteeism than other organizations.

Studies say that autocratic leaders:
--Rely on threats and punishment to influence employees --Do not trust employees --Do not allow for employee input Yet, autocratic leadership is not all bad. Sometimes it is the most effective style to use.

Autocratic leadership style is effective when:
--New, untrained employees who do not know which tasks to perform or which procedures to follow --Effective supervision can be provided only through detailed orders and instructions --Employees do not respond to any other leadership style --There are high-volume production needs on a daily basis

--There is limited time in which to make a decision
--A manager’s power is challenged by an employee --The area was poorly managed --Work needs to be coordinated with another department or organization

or resentful --Employees expect to have their opinions heard --Employees begin depending on their manager to make all their decisions --There is low employee morale.The autocratic leadership style should not be used when: --Employees become tense. high turnover and absenteeism and work stoppage . fearful.

The democratic manager keeps his or her employees informed about everything that affects their work and shares decision making and problem solving responsibilities. Interaction between the leader and the subordinate is open. Many employees like the trust they receive and respond with cooperation. but gathers information from staff members before making a decision.  Democratic leadership can produce high quality and high quantity work for long periods of time.  The democratic leadership style is also called the participative style as it encourages employees to be a part of the decision making. This style requires the leader to be a coach who has the final say. friendly and trusting. team spirit. and high morale.D e m o c r at I c  Democratic leadership is people oriented. It focuses on human aspects and builds effective teamwork. .

--The leader wants employees to share in decision-making and problem-solving duties. The democratic leadership style is most effective when: --The leader wants to keep employees informed about matters that affect them. It is most successful when used with highly skilled or experienced employees or when implementing operational changes or resolving individual or group problems. . --There is a large or complex problem that requires lots of input to solve. the democratic style is not always appropriate. Like the other styles. --You want to encourage team building and participation. --The leader wants to provide opportunities for employees to develop a high sense of personal growth and job satisfaction.Typically the democratic leader: --Develops plans to help employees evaluate their own performance --Allows employees to establish goals --Encourages employees to grow on the job and be promoted --Recognizes and encourages achievement. --Changes must be made or problems solved that affect employees or groups of employees.

and resolve problems on their own. make decisions. experienced. such as staff specialists or consultants are being used . --Employees have pride in their work and the drive to do it successfully on their own. This is an effective style to use when: --Employees are highly skilled. It is one in which the manager provides little or no direction and gives employees as much freedom as possible. All authority or power is given to the employees and they must determine goals. --Outside experts. and educated.Laissez-Faire Leadership Style The laissez-faire leadership style is also known as the “hands-off¨ style.

--The manager cannot provide regular feedback to let employees know how well they are doing. --Managers are unable to thank employees for their good work. .This style should not be used when: --It makes employees feel insecure at the unavailability of a manager. --The manager doesn’t understand his or her responsibilities and is hoping the employees can cover for him or her.

Leadership POWER An essential part of leadership or management is to influence the people you manage so that they do what you want them to do. The influence of a leader will depend on a variety of factors including their personality and of those around them. . For the purposes of this article we will refer to the people that the leader is managing or leading as followers. Below we will explore the different types of power a leader may have. The influence of a leader over his followers is often referred to as power.

gift vouchers and holidays to promotions. • This type of power needs to be used carefully to prevent followers becoming accustomed to rewards and refusing to complete routine tasks without a reward. commission and pay rises. . to follower employees to complete duties which are a normal part of their role. This is because as an employee they are under a contractual obligation to complete these tasks and they are already rewarded for this through their salary.Reward Power • This type of influence is created when the leader is able to offer a reward to his followers for completing tasks/behaving in a certain manner. Generally rewards should not be offered. Rewards in the workplace can take a variety of forms from chocolates.

job losses. Coercive powers should be used carefully. verbal abuse. • . and delayed or loss of promotion. Work to rule is where employees refuse to undertake any duties (or adopt working practices) that are not stated in their contract. In all cases the leader will need to choose the penalty carefully to prevent breaking the law or being the subject of an employment tribunal. they may resign or adopt a “work to rule” attitude. overuse can lead to unhappy employee followers. the leader will impose a penalty. If followers do not undertake the action required. Penalties take a variety of forms including withdrawal of privileges.Coercive Power • This is the opposite of reward power because this power is based on the leader having control over what happens if followers do not act as required. Unhappy followers can be negative or unmotivated.

combined with the follower’s belief that the job title gives the leader the right to give them orders. Often an experienced member of the team or staff in an organisation. or area manager). a leader will not have referent power over every follower they lead. As referent power is dependant on how the follower views the personality of their leader. whilst others such as Ghandi have lead millions through their personality and charisma. Expert Power As the title suggests a leader has expert power when the followers believe that the leader has “expert” knowledge or skills that are relevant to the job or tasks they have to complete. doctor. Referent Power This is created when the followers believe that the leader possess qualities that they admire and would like to possess. Some leaders will have referent power over just a few.Legitimate Power This is the power that a leader has when the followers believe that the leader has “a right” to instruct them and that they have an obligation to follow instructions. Sometimes legitimacy power is created by the leader’s job title (such as captain. The followers identify with their leader and attempt to copy their leader. . can have expert power even though they are not a supervisor or manager.

• Reward power needs follower to believe leader will reward them. • Expert power need follower to believe leader is an expert. • Legitimate power needs follower to believe leader has right to instruct them. • Referent power need follower to believe leader has desirable qualities. . • Coercive power needs follower to believe leader will punish them.

“Trust men and they will be true to you.” . treat them greatly and they will show themselves to be great.

MOST LIKELY OUTCOMES OF LEADER POWER & INFLUENCE • RESISTANCE COERCIVE • COMPLIANCE LEGITIMATE REWARD • COMMITMENT EXPERT REFERENT .

POLITE.EXPERT POWER – – – – ACT CONFIDENT AND DECISIVE KEEP INFORMED DON’T THREATEN SUBORDINATES’ SELF-ESTEEM – BE APPROACHABLE WILLING TO SHARE YOUR KNOWLEDGE WITH OTHERS REFERENT POWER – TREAT SUBORDINATES FAIRLY – DEFEND SUBORDINATES’ INTERESTS – BE SENSITIVE TO SUBORDINATES’ NEEDS & FEELINGS LEGITIMATE POWER – – – – BE CORDIAL. AND CONFIDENT MAKE APPROPRIATE REQUESTS FOLLOW PROPER CHANNELS EXERCISE POWER REGULARLY AND ENFORCE COMPLIANCE REWARD POWER – VERIFY COMPLIANCE AND ACCOMPLISHMENTS – OFFER REWARDS FOR DESIRED ACTIONS AND BEHAVIORS – OFFER CREDIBLE REWARDS THAT ARE DESIRED BY SUBORDINATES COERCIVE POWER – INFORM SUBORDINATES OF RULES AND PENALTIES – UNDERSTAND THE SITUATION BEFORE ACTING & WARN BEFORE PUNISHING – ADMINISTER PUNISHMENT CONSISTENTLY & PUNISH IN PRIVATE .

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Theories of Leadership
• Situational Leadership in this approach the leader behaves according to a given situation which may vary from one setting to the other. The theory considers a person’s qualities and motivation, the role expectations of the group, and the social forces at work such as the external factors that bring forth the leadership potentials. • “Contingency” leadership style is one in which the leader’s style matches the situation and its needs.

FIVE KINDS OF LEADERS
1. 2. 3. 4. 5. The natural leader who become a leader in spite of himself or herself The charismatic leader who is an authentic hero in the eyes of his followers The rational leader who is consistent and persistent in what he/she thinks is right The consensus leader who is perceived to be acceptable to all The leader by force who dominate by force and fear.

• The Trait Theory of Leadership describe the
personal and mental characteristics which are associated with successful leaders. Trait theory is based on the belief that leaders are born with certain qualities. • Leaders are gifted with certain qualities that are developed and show in their ability to get along with people, persuade them to course of action. • Similar in some ways to "Great Man" theories, trait theories assume that people inherit certain qualities and traits that make them better suited to leadership.

The GREAT MAN Theory
• assume that the capacity for leadership is inherent – that great leaders are born, not made.
• These theories often portray great leaders as heroic, mythic and destined to rise to leadership when needed. • The term "Great Man" was used because, at the time, leadership was thought of primarily as a male quality, especially in terms of military leadership. Learn more about the great man theory of leadership.

stewardship. trust. conceptualization. follower will reciprocate through increased teamwork. healing. servant leaders puts its emphasis on collaboration. empathy. • Ten Characteristics of SERVANT Leader: listening. awareness. empathy and ethics. which offer suggestions on how top-level leaders can influence and motivate those further down the hierarchy.Servant Leadership • Robert Greenleaf • Servant Leadership is a recent theory of leadership that argues that the most effective leaders are “servants of their people” • Servant leaders get results for their organization through whole-hearted attention to their followers and followers’ needs. The assumption is that if leaders focus on the needs and desires of followers. foresight. . persuasion. • The leader should be a servant first. leading from a desire to better serve others and not to attain more power. deeper engagement and better performance. Unlike many approaches to leadership.

Charismatic Leader • Charismatic leadership is leadership based on the leader's ability to communicate and behave in ways that reach followers on a basic. Many other characteristics are involved in leading effectively. but they certainly include the ability to communicate on a very powerful emotional level. • Developing "charisma" is difficult. and probably include some personality traits. and there is significant evidence to indicate that it simply is not necessary to have this elusive charisma to lead others well. to inspire and motivate • It's difficult to identify the characteristics that make a leader "charismatic". if not impossible for many people. but luckily charismatic leadership is not essential to be an effective leader. emotional way. .

• It helps promote trust between the health personnel . increase workers satisfaction and facilitates coordination.Co mmu ni c atI on • Communication is the transmission of information. optimizes patient care. • Communication facilitates work. increases motivation. opinions and interactions between and among individuals. effect change.

• A managers communication thrives best in a supportive environment which encourage positive value among its personnel. • Simple. • Feedback is essential to effective communication. • Adequate and timely communication of work related issues or . concise and exact messages ensures understanding of the message to be conveyed.Principles of Effective Communication • Clear lines of communication serve as the linking process by which parts of the organization is unified towards achievement. • A managers communication skills is vital to the attainment of the goal of the organization.

Family.UPWARD To Supervisor HORIZONTAL Peers and the Members of the Healthcare Team NURSE OUTWARD Patient. Community DOWNWARD Subordinates .

Downward Communication The traditional line of communication is from superior to subordinates which may pass through level of management. visitors and the community. Outward communication also involves how employee value their work. Outward Communication Deals with information that flows from the caregiver to the patients. Upward communication does not flow as easy as the downward communication. relatives. their families. personnel or departments on the same level. . Horizontal Communication Flows between peers. Upward Communication Upwards communication emanates from the subordinates and goes upward.

Coordination • Unites personnel and services towards a common objective. promotes good working relationship and work schedule are accomplished as targeted. Synchronization of activities among the various services or departments enhances collaborative efforts resulting in efficient. smooth and harmonious flow of work. . • Promotes overlapping of functions.

Other Institution and Civic Organization .Coordination • • • • • • • • • Coordination with the Medical service Coordination with the Administrative Service Coordination with the Laboratory Services Coordination with the Radiology Service Coordination with the Pharmacy Service Coordination with the Dietary Service Coordination with the Medical Social Services Coordination with the Medical Records Servives Coordination with the Community Agency.

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