PRAYER

Grant us peace O God, as we open our books and notes,

open our minds to Thy will and may we dedicate these
hours to Thy son, Jesus Christ.
Offer us insight, O Lord, that we may understand these
things and see them as a part of thy kingdom. May we
offer Thee our best in reading and learning that it may
be a part of our discipleship.
O Jesus, may this be a worthy time that is faithful to
thee and bring us closer to the goals we have in order to
serve thee. We offer this time and prayer in Thy holy
name. AMEN
It is not intelligence alone that
brings success, but rather the
drive to succeed, the
commitment to work hard and
the courage to believe in
yourself…=)
 LEADERSHIP
AND
MANAGEMENT

By Heneli S. Segura BSN, RN

Identify whether Leadership or Management
 May or may not be appointed
 Fulfilling organizational mission
 Towards Goal setting
 Risk Taker
 Officially Appointed
 Intuitive, empathic
 Do things right
 Challenge change
 Judgment based on performance
 Time frame based on present
 LEADERSHIP
 Leadership- process of influencing
the activities of an organized group
in its efforts toward goal setting and
goal achievement
 Leader-person who will show the
way, mark the way or guide a
course

 Nursing Leadership- process

whereby a nurse influences one or
more persons to achieve specific
goals in the provision of nursing
care
 THEORIES
Great man Theory
(Aristotelian Philosophy)
- argues that few people are
born with necessary
characteristics to be great
Charismatic Theory
- inspire others by obtaining
emotional commitment from
followers and by arousing
strong feeling of loyalty and
enthusiasm
Trait Theory
- maintains that traits are
inherited but later
suggested that traits
can be obtained
through learning
and experiences
Behavioral Theory
- highlights the understanding of
human behavior

Contingency Theory
- leadership style
will be effective or
ineffective
depending on
situation
 LEADERSHIP STYLES

Path Goal Leadership

- facilitates task accomplishment by
minimizing obstructions to
accomplish the goals and
reward the followers
for completion of the
tasks
Situational Leadership
- leader structures the tasks which
include planning, organizing, directing
and controlling; best leadership style;
posses FLEXIBILITY
5 Levels of Experience
-framework of situational leadership
 Novice
 Advance Beginner
 Competent
 Proficient
 Expert
Transactional Leadership
- exchange posture that identifies
needs of followers and provides
reward to meet those needs in
exchange for expected
performance
Transformational Leadership
- cooperative,
process-focused
networking

Servant Leadership
- servant as a leader,
put serving first and
take a holistic
approach
Result C-based Leadership
- recommends simplifying practices
and procedures; workers tell
manager what is wrong and make
suggestions for improvement
5. Pinoy Management ( Tomas Andres)

a) Management by Kayod (Realist)

• has gut feelings
• segurista
• mabilis/ action agad

b) Management by Libro (Idealist)

• palaisip
• perfectionist in a bookish way
c) Management by Lusot
(Opportunist)
 kung saan ang ihip ng hangin
 short acts
 mahilig sa ayusan

d) Management by Sugod (Reconciler)

 pambihira
 gifted
 LEADERSHIP STYLES
 Autocratic

 Democratic

 Laissez-faire
The nurse is concerned because she received
many time-off requests from her staff for the
coming holiday season. She has come up with
several possible solutions to the staffing
dilemma and has scheduled staff meeting to
present ideas to the staff. Which management
style is this manager demonstrating?
a.Participative
b.Bureaucratic
c. Autocratic
d.Laissez-faire
 MANAGEMENT
Process of working with and through
others to achieve organizational
objectives in a changing environment
 Match the following theorist to their theory:
 Father of scientific
a. Mary Follet
management
b. Max Weber
 Scheduling and Rewarding c. Elton Mayo
Theory d. Abraham
 Father of Management Maslow
Process e. Frederick
 Father of Organization Theory Herzberg
 Hawthorne Effect f. Douglas
 Hierarchy of Needs Theory McGregor
g. William Ouchi
 Theory X and Y Management
h. Henry Gantt
 Theory Z i. Frederick
 Conflict Resolution Taylor
 THEORISTS OF
MANAGEMENT
Frederick Taylor
- Father of Scientific
Management
- proposed a set of
techniques to increase the
efficiency and productivity of
each worker
Henri Fayol
- Father of Management
Process School/ Modern
Management Theory

- formulated the 14 principles of

management; believed that
management is universal and
that specialization increases
efficiency
Max Weber

- Father of
Organization Theory

- believed that
personnel
are selected for their
competence
Elton Mayo
- Hawthorne Effect
- discovered that when management
paid special attention to workers,
productivity was likely to increase,
regardless of environmental
condition
Abraham Maslow
- Hierarchy of Needs Theory
Frederick Herzberg
- Theory of Motivation

Douglas Mc Gregor
- Theory X and Theory Y Managers 
X = people dislike work and must be
directed and coerced
Y = people do not dislike work but
rather regard work as a source of
satisfaction
 POWER
the capacity to ensure the
outcome one wishes, and prevent
those one does not wish.
Identification: Determine what type of power
 Based on the position and organizational
policies
 Based on ones ability to inflict threat or
punishment
 Based on possession of valuable information
 Based on personality
 Based on knowledge of complex situation
 Based on ability to distribute anything
 Based on connection with authority
 TYPES OF POWER
 REWARD
 COERCIVE
 LEGITIMATE
 EXPERT
 REFERENT
 PERSONAL
 INFORMATIONAL
COMMUNICATION
Transfer of
information and
understanding
from one person
to another
COMMUNICATION PROCESS
 Ideation
 Encoding
 Transmission
 Receiving
 Decoding
 Response/feedback
 LINES OF
COMMUNICATION

Downward Communication
- flows from the people at the top
management levels in the
organizational hierarchy 
Upward Communication
- travels from staff and lower and middle
management personnel and continues up
the organizational hierarchy 

Horizontal Communication
- flows between departments and personnel in
the same level of hierarchy
Outward Communication
- deals with information that flows from
the caregiver to the patient, their family,
relatives, visitors and the community

Diagonal Communication
- occurs between individual or depart-
ments that are not on the same level of
hierarchy
Grapevine Communication
- informal method of communication
involving three or more person at a
time instead of one person to
another; rapid spread of information
 Knowing the lines of communication
 Letters
 Bulletin Boards
 Coordination Meeting
 Health teaching
 Feedbackaff
 “Chismis”
 Laboratory Request
 IR Report accomplished by the staff
 Operations Manual
 Job description shift
Communications ties people to their:
a.Social surroundings
b.Physical surroundings
c. Materialistic surroundings
d.Environmental surroundings

No. 59
The effectiveness of nurse-client communication
is best validated by:
a.Client feedback
b.Medical Assessment
c. Health team conferences
d.Client’s physiologic adaptations
Since people need some gratifying
communication to learn, to grow, and to
function in a group, all events that
significantly curtail communication will
produce:
a.Withdrawal
b.Severe disturbances
c. Some degree of mental deficiency
d.Further attempts to increase communication
 LEADER MANAGER
May or may
not have
Officially
APPOINTMENT official
appointmen appointed
t
As long as have power
the the and authority
POWER followers to enforce
are willing decision.
to follow.
 In intuitive and Relate to
empathetic people
RELATIONSHIP
manner according to
rule
Rewarded Fulfill
REWARD from personal organizational
achievement mission
May or may Managers as
not be long
POSITION
successful appointment
holds
 Interested in Carry out
risk taking predetermined
RULES
and exploring policies rules
new ideas and regulations
Influence Maintain an
others toward orderly,
goal setting controlled
OTHERS
national
equitable
structure
A staff nurse influences the behaviors of her
colleagues by guiding and encouraging them.
She’s an excellent role model but has no
formal authority over her peers. This nurse is
demonstrating characteristic of which of the
following roles?

a.Manager
b.Autocrat
c. Leader
d.Authority
 NURSING
MANAGEMENT
process where nurses
have smooth functioning
of their units to attain
their goals of quality care
through the judicious use
of available human and
material resources
 PLANNING
pre-determining the course
of action in order to arrive
at a desirable result
 TYPES OF PLANNING
Strategic Planning
- long range planning usually
takes 3 to 5 years into the
future
Operational Planning
- short range planning that
deals with day-to-day activities
 ELEMENTS OF
PLANNING
Forecasting
- looking into the future

Setting the Vision, Mission,

Philosophy, Goals and Objectives
Vision Statement
- outlines the organization’s future role
and function

Mission Statement
- outlines the agency reason for existing,
who the target clients are, and what
services will be provided
Philosophy
- statement of beliefs and values that
direct one’s life or one’s practice

Goals
- broad sentences of action
commitments through which an
organization’s mission and purpose will
be achieved
Objectives
- specific sentences of action
commitments through which an
organization’s mission and purpose
will be achieved
 A nurse manager notices that one of the
staff nurses is always 15 to 20 minutes late.
When the nurse manager discusses the
problem with her, the nurse says that she
has been late because her son’s nursery
school does not open until 7 am. The nurse
manager should respond by telling her to:

a. Ask one of the night nurses to cover for her

b. See if the neighbor can take the child to
school
c. Find out if other schools open earlier
d. Find some way to solve the problem and be
on time
Developing and Scheduling Programs
Time Management - technique for
allocating one’s time through the
setting of goals, assigning priorities,
identifying and eliminating wasted
time, and using managerial techniques
to reach goals efficiently

Preparing the budget

Which of the following activities demonstrates
application of budgeting by Erly’s
headnurse?

1. Working overtime
2. Requesting the assistance of others
3. Proper use of supplies and materials
4. Avoidance of waste

a. 1,4
b. 1,2
c. 3,4
d. 2,4
BUDGETING
allocation of a scarce
resources to meet
the basic needs
 TYPES OF BUDGET
Revenue Budget
- summarizes the income which
management expects to generate
during the planning period
Expense Budget
- describes the expected activity in
operational and financial terms for a
given period of time
Capital Budget
- outlines the programmed acquisitions,
disposals and improvements in an
institution’s physical capacity
The nurse manager of a busy pediatric unit
wants to purchase additional computers for
patient data collection and for online
continuing education programs. The total cost
is P10,000.00. She should include this
expense in what portion of her budget?

a.Personnel
b.Operating
c. Capital
d.Managerial
Establishing Nursing Standards, Policies and
Nursing Procedures
Nursing Standards- provide professionally desirable norms
against which the department’s performance can be
measured.

Policies- broad guidelines for managerial decisions that

govern the action of workers and supervisors at all levels 

Nursing Procedures- specific directions of implementing

written policies
ORGANIZING
process of grouping the
necessary
responsibilities and
activities for the
purpose of achieving
objectives
ORGANIZATIONAL CHART
• graphic
representations of the
organizing process

• distribute the
nursing
responsibilities and
lines connect the
positions
ORGANIZING PRINCIPLE
1. Chain of Command
 organizations are established with
hierarchal relationships
2. Unity of Command
 indicates one person has one boss

3. Span of Control
 a person should be a supervisor of a
group that he can effectively manage
4. Homogenous Assignment
 each person should perform a single leading
function

5. Exception Principle

6. Decentralization or Proper Delegation of

Authority
Limiting the number of people to those a
manager can effectively supervise is:

a. Unity of command
b. Span of control
c. Homogenous assignment
d. Delegation of responsibility with
authority
 TYPES OF ORGANIZATION
 Line Organization- simplest and most direct
type of organization in which each position has
general authority over the lower positions in
the hierarchy

 Informal Organization- horizontal relationships

rather than vertical.
• Staff Organization- purely advisory to
the line structure withy no authority to put
recommendations into action

• Functional Organization- each unit is

responsible for a given part of the
organization’s workload.
A registered nurse of the ICU is interviewing a RN for a
team leader position. The nurse appeared to be
qualified and has excellent references. She states that
she’s certified in critical care nursing but she misplaced
her verification card. Based on her knowledge of her
supervisory responsibility, the nurse manager should:
a. Contact the credentialing center and confirm the
nurse’s certification
b. Hire the nurse, but tell her that she must provide proof
of certification completing orientation
c. Avoid hiring the nurse
d. Trust that the nurse is telling the truth
ELEMENTS OF
ORGANIZING
1. Setting up the Organization Structure
2. Staffing- process of determining and
providing the acceptable number and
mix of nursing personnel to produce a
desired level of care to meet the
patient’s demand
 Staffing the Units
 Basic Staff – minimum number of
personnel needed to staff a unit and
includes fully oriented full and part-time
employees
 Complementary Personnel - scheduled
in addition to the basic group; provide
the flexibility needed to meet short-term
and unexpected changes
 Float personnel - not permanently
assigned to a station; provide
flexibility to meet increased patient
loads and unexpected personnel
absences
 STAFFING
Level of Nursing Nsg. Care Ratio of Prof.
Care Hours/ day to Non Prof
Level I 1.5 5:45

Level II 3.0 60:40

Level III 4.5 65:35

Level IV 6.0 70:30

 Hospital Minimal Moderate Intensive Highly
Class Specialized
Primary 70 25 5 -

Secondary 65 30 5 -

Tertiary 30 45 15 10

Specialized 10 25 45 20
Vacation Leave 15 15
Sick Leave 15 15
Legal Holidays 10 10
Special Holidays 2 2
Special Privileges 3 3
Off Duties 104 52
Continuing Ed 3 3
Total Non Working Days/yr 152 100
Total Working Days/yr 213 265
Total Working Hours 1704 2120
 STAFFING
COMPUTATIONS
 Categorized according to level of care
needed
 Find Nursing Care Hours needed per
patient
 Multiply everything with total working
Hours
 Find Total Nursing Care Hours Needed
per year
 Actual Working Hours /Person/year
 SCHEDULE
timetable showing planned work days
and shift for nursing personnel
TYPES OF SCHEDULING

 Centralized Schedule

 Decentralized Schedule

 Cyclical Schedule
 TYPES OF SCHEDULING
1. Self-Scheduling
 personnel are scheduled to work their
preferred shift

2. Flextime /Flexible Scheduling

 allows employees to select the time
schedule that best meet their personal
needs
•Developing Job Description

Job description- statement that

sets the duties and responsibilities of
a specific job
 DIRECTING
issuance of orders,
assignments and
instructions that enable
nursing personnel to
understand what are
expected from them
The Division Chief Nurse is often busy. She
is required to participate in several
committees and meetings. She brings her
assistant to some of these, assigns and
orients her to the committees task

Which of the following directing activities is

the chief nurse primarily performing?

a. Communicating
b. Delegating
c. Training
d. Motivating
ELEMENTS OF DIRECTING
1. Delegation- process by which a
manager assigns specific tasks/
duties to workers with
commensurate authority to perform
the job
 What cannot be delegated?
 Overall responsibility, authority and accountability
for satisfactory completion of all activities in the
unit.
 Authority to sign one’s name
 Responsibility for maintaining morale or the
opportunity to say few words of encouragement to
the staff especially the new ones.
 Evaluating the staff and or taking necessary
corrective or disciplinary action
 Jobs that are too technical and those that involve
trust and confidence
 COMMON DELEGATION
ERROR
 Underdelegating- false assumptions that
maybe interpreted as lack of ability
 Overdelegating- feel insecure in their
ability to perform a task
 Improper delegation- task and
responsibility that are beyond the
capability of the person
The nurse manager of an inpatient pediatric
unit is at home one evening when she
receives a call from a staff nurse informing
her of a serious medication error that just
occurred on the unit. The nurse manager was
notified because she assumes accountability
for what happens on the unit:
a.5 days a week
b.24 hours a day, 7 days a week
c. 8 hours a day, 7 days a week
d.24 hours a day, 5 days a week
A nursing team consists of an RN, an LPN/LVN, and
a nursing assistant. The nurse should assign which
of the following patients to the LPN/LVN?
a.A 72 year old patient with diabetes who requires a
dressing change for a stasis ulcer
b.A 42 year old patient with cancer of the bone
complaining of pain
c. A 55 year old patient with terminal cancer being
transferred to hospice home care
d.A 23 year old patient with a fracture of the right
leg who asks to use the urinal
A nurse plans for care of a patient with anemia
who is complaining of weakness. Which of the
following tasks should the nurse assign to the
nursing assistant?
a.Listen to the patient’s breath sounds.
b.Set up the patient’s lunch tray.
c. Obtain a diet history
d.Instruct the client on how to balance rest and
activity
 The nursing team consists of an RN, 2
LPNs/LVNs, and three nursing assistant. The
RN should care for which of the following
patients?
a.A patient with a chest tube who is ambulating
in the hall.
b.A patient with a colostomy who requires
assistance in colostomy irrigation
c. A patient a right-sided CVA who requires
assistance with bathing
d.A patient who is refusing medication to treat
cancer of the colon
 After receiving report, which of the following
patient should the nurse see FIRST?
a.A 14 year old patient in sickled-cell crisis with
an infiltrated IV
b.A 59 year old patient with leukemia who has
received half of a packed red cell transfusion
c. A 68 year old patient scheduled for a
bronchoscopy
d.A 74 year old patient complaining of a leaky
colostomy bag.
 MODALITIES OF CARE
 Functional Nursing- task-oriented in which a
particular nursing action is assigned to each
worker
 Total Care/ Case Nursing- assignment of one
nurse to one patient for the delivery of total
nursing care
 Team Nursing- decentralized system of care in
which a qualified professional nurse leads a
group of nursing personnel in providing for the
nursing needs of a group of patient/ client
through participative effort
 Primary nursing- nurse will be responsible for
patient care from admission to discharge

 Modular Method- modification of team and primary

nursing

 Case Management- system of patient care delivery

that focuses on the achievement of outcomes within
effective and appropriate time frames and resources
A nurse-manager of 30 bed surgical unit arrives at
work during a snowstorm. She finds that only the
LPN and 2 nursing assistants have been able to
make the journey to work. Each reporting staff
member has skills that can be used to provide care
for the patients in the unit. Which nursing care
delivery system would be most effective under
these circumstances?
a.Primary Nursing
b.Team Nursing
c. Functional Nursing
d.Case Management
2. Supervision- means to inspect, to guide, evaluate
and improve work performance of employees
through a criteria against which the quality and
quantity of work production are made

3. Coordination- synchronization of activities among

the various services and departments.

4. Decision Making
Decision- course of action that is consciously
chosen from available alternatives for the purpose
of achieving a desired result
PROCESS OF DECISION MAKING
 Definition of the Problem

 Analysis of the Problem

 Development of an alternative solution

 Selection of a solution

 Implementation and Follow-up

 CONFLICT
inevitable clash between two opposing
and oftentimes hostile parties
 Types of Conflict:
 Vertical- arise from difference of opinion
between superiors and subordinates

 Horizontal- arise as a common struggle

between departments or services wherein
the degree pf interdependence and
collaboration determine the success in
achieving shared goals and objectives
A nurse manager dealing with conflict should:

a. Establish the source of the problem

b. Redefine the problem to find new solution
c. Provide the solution to all problem
d. Ignore the problem and allow the staff to find
the solution
 CONFLICT MANAGEMENT
A. Avoiding- parties involved are aware
either consciously or unconsciously

B. Accommodating- person ignores his

own feelings about an issue in order
to agree with the other side

C. Competing- one side wins and the

other side losses
D. Compromising- each side gives up
something as well as gets something

E. Collaborating- both sides in conflict

work to develop the outcomes that is
best for both sides

F. Confronting- block the conflict from

the start; brings the parties together
 CONTROLLING/
EVALUATING
assessment and regulation of
performance in accordance
with the plans that have been
adopted, the instructions
issued and the principles
established.
It includes:

Management by Objectives-
determining objectives, measuring to
see if objectives are being met, and
comparing objectives with standards

Continuous Quality Improvement-

identify ways to improve processes or
programs and constantly enhance and
improve the quality of care
Performance Appraisal- control process in
which employees performance is evaluated
against standards

Methods of Measuring Performance

Informal Appraisal- consists of incidental
observation of performance while the worker
is engaged in performing nursing care

Formal Appraisal- regular and methodical

collection of objective facts that can
demonstrate the difference between what is
expected and what is done.
 METHODS OF
PERFORMANCE APPRAISAL
1. Anecdotal Records- objective
description of behavior; brief account
of incident
2. Rating Scale- methods of rating an
individual against a set standard
3. Checklist- assess presence or
absence of behavior or desired
characteristics
4. Essays- narrative description of
employee strengths and areas for
improvement

5. Peer Review- monitoring and

assessing work performance by peers

6. Coaching- manager's role in informal

day-to-day appraisals
 Assistants Evaluation Memo
Judy Smith, my assistant, can always be found
hard at work in her station. Judy works independently, without
wasting hospital time talking to colleagues. Judy never
thinks twice about assisting fellow employees, and she always
finishes given assignments on time. Often, Judy takes extended
measures to complete her work, sometimes skipping coffee
breaks. Judy is an individual who has absolutely no
vanity in spite of her high accomplishments and profound
knowledge in her field. I firmly believe that Judy can be
classed as a high-caliber employee, the type which cannot be
dispensed with. Consequently, I duly recommend that Judy be
promoted to executive management, and a proposal will be
executed as soon as possible.

Regards - Charge Nurse

Shortly thereafter, the HR department received the following memo from

the Charge Nurse:

Sorry, but that idiot (Judy) was reading over my shoulder while I
wrote the report sent to you earlier today. Kindly read only the odd
numbered lines for my true assessment of her...
 Quality Assurance- is the estimation of the
degree of excellence in patient health
outcomes and in activity and other resource
outcome
 Developing quality assurance criteria
 Nursing audit Committee
 Patient Care Audits
 Peer Review
 Quality Circles
 Utilization of Results
 Discipline- constructive and effective
means by which employees take personal
responsibility for their own performance and
behavior

Disciplinary Actions:
 Counseling and Oral Warning
 Written Warning or Memo
 Final Warning/ Suspension
 Dismissal
CBQ:
The headnurse is assign to do the following
in order of priority?
1. Ask Precy to write a report
2. Obtain explanation for non-
documentation of medicine
3. Ascertain from himself
4. Call Precy’s attention
a. 4132
b. 4123
c. 1423
d. 1234
“Reach for the moon,
even if you miss,
you’ll land among
the stars.”
Thank You…=)
GOD BLESS and ALWAYS keep your
FEET on the Ground!!!