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Nursing Management



Management is creative problem solving.

Management is a generic function that includes similar basic tasks in every

discipline and in every society.

Management and administration sometimes appear to be synonymous, but

they are not synonymous terms.


Management may be defined as the art of securing maximum results with a

minimum of effort so as to secure maximum prosperity and happiness for
both employer and employee and give the public the best possible service
(John Mee, 1963)

Functions of management are:




Coordinating and Controlling

Reporting and Recording



Planning means to decide in advance what is to be done. It charts a course of

actions for the future. It is an intellectual process and it aims to achieve a
coordinated and consistent set of operations aimed at desired objectives.

Essentials of good planning

Yields reasonable organizational objectives

approaches to meet these objectives.



Helps to eliminate or reduce the future uncertainty and chance.

Helps to gain economical operations.

Lays the foundation for organizing.

Facilitates co-ordination.

Helps to facilitate control.


Dictates those activities to which employers are directed.


Once the objectives have been established through planning, management

concern must turn to developing an organization that is capable of carrying
them out. The management function of organizing can be defined
as ,relating people and things to each other in such a way that they are all
combined and interrelated into a unit capable of being directed toward the
organizational objectives.

Work activities required for the organizational performance are separated


Horizontal differentiation (i.e.. Dividing the organization into operational units

for more effective and efficient performance.)

Vertical differentiation (i.e.. Establishes the hierarchy and the number of

levels in the organization

The formal organization depends on two basic principles:

a) Responsibility: responsibility n an organization is divided among available

personnel by grouping the functions that are similar in objectives and
content. This should be done in a manner that avoids overlaps and gaps as
much as possible. Responsibility may be continuing or it may be terminated
by the accomplishment of a single action.

b) Authority: when responsibility is given to a person, he must also be given

the authority to make commitments, use resources and take the actions
necessary to carry out his responsibilities.


Staffing is the selection, training, motivating and retaining of a personnel in

the organization. Before selection we have to make analysis of the particular
job, which is required in the organization., then comes the selection of the
personnel. It involves manpower planning to have the right person in the
right place and avoid square peg in the round hole.

Manpower planning involves the following steps.

1. Scrutiny of present personnel strength.

2. Anticipation of manpower needs.

3. Investigation of turnover of personnel.

4. Planning job requirements and job descriptions.


Directing means the issuance of orders, assignments and instructions that

permit the subordinate to understand what is expected of him, and the
guidance and overseeing of the subordinate so that he can contribute
effectively and efficiently to the attainment of organizational objectives.

Directing includes the following activities

Giving orders

Making supervision




Giving orders: the central task in directing is giving orders. The order is the
technical means through which a subordinate understands what is to be
done. To facilitate this there are certain characteristics of good orders which
manager should be aware of:

The order should be clear, concise and consistent to give sufficient

information to ensure understanding

Order should be based on obvious demands of a particular situation, it seems

logical to the subordinates and not just an arbitrary whim of the manager.

The tone of the order is very important. The manner in which the manager
delivers the order has a great deal to do with its acceptance by the

Whenever possible, the reason for the order should be given. A subordinate
will accept an order more readily if he understands the need for it.

In some instances the manager uses delegation of authority instead of

issuance of orders for avoiding too many specific orders.


Supervision is the activity of the management that is concerned with the

training and discipline of the work force. It includes follow up to assure the
prompt and proper execution of orders.

Supervision is the art of overseeing, watching and directing with authority,

the work and behaviour of other.


Leadership is the ability to inspire and influence others to contribute to the

attainment of the objectives. Successful leadership is the result of interaction
between the leader and his subordinates in a particular organizational

There are number of styles of leadership that have been identified such as
autocratic, democratic participative leadership.

The continuum of leadership styles, ranges from the completely authoritarian

situation with no subordinate participation to a maximum degree of
democratic leadership, enabling the subordinate to participate in all phases
of the decision making process.


Motivation refers to the way in which the needs (urges, aspirations, desires)
control, direct or explain the behaviour of human beings. The manager must
motivate, or cause, the employee to follow directives.


Communication is the passing of information and understanding from a

sender to receiver.

Communication is vital to the directing function of the management, one way

to visualise this importance is to view the manager on one side of a barrier
and the work group on the other. Communication is the means the manager
has of reaching through the barrier to attain work group activity.


It is the act of synchronising people and activities so that they function

smoothly in the attainment of organization objectives. Coordination is more
important in the health services organization, because functionally they are
departmentalized. Different kinds of organization require different amount of

Basic approaches to coordination:

Corrective co ordinations are those coordinative activities that rectify the

present error or correct a dysfunction in the organization.

Preventive coordination comprises those coordinative activities that are

aimed at preventing the occurrence of anticipated problems of coordination,
or at least minimizing the impact of these problems.

Regulatory coordination comprises those coordinative activities that are

aimed at the maintenance of existing structural and functional arrangements
in the organizations.

Promotive coordination has those coordinative activities that are aimed at

attempting to improve the articulation of the parts of the organization, or to

improve the existing organizational arrangements without regard for specific



Controlling can be defined as the regulation of activities in accordance with

the requirements of plans.

Steps of control:

The control function, whether it is applied to cash, medical care, employee

morale or anything else, involves four steps.

1. Establishments of standards.

2. Measuring performance

3. Comparing the actual results with the standards.

4. Correcting deviations from standards.

Reporting and recording

Reports are oral or written exchanges of information shared between

caregivers or workers in a number of ways. A report summarizes the services
of the person, personnel and of the agency. Reports are written usually daily,
weekly, monthly or yearly.

Purposes of reporting:

To show the kind and amount of services rendered over a specified period.

To illustrate progress in reaching goals.

As an aid in studying health conditions.

As an aid in planning.

To interpret services to the public and to the other interested agencies.

Records and reports must be functional, accurate, complete, current

organized and confidential.


Budgeting, though primarily recognized as a device for controlling, becomes

a major part of the planning process in any organization. It is expressed in
financial terms and based on expected income and expenditure. Budget is
the heart of administrative management. It served as a powerful tool of
coordination and negatively an effective device of eliminating duplicating and

Features of budget:

Should be flexible.

Should be synthesis of past, present and future.

Should be product of joint venture & cooperation of executives/ department

heads at different levels of management.

It should be in the form of statistical standard laid down in specific numerical


It should have support of top management throughout the period of its

planning and supplementation


Managers address complex issues by planning, budgeting, and setting target

goals. They meet their goals by organizing, staffing, controlling and problem
solving. The nurse manager can assist the staff to think strategically about
what it is doing and what it should be doing for its clients , for example, in
todays world of cost containment, examining what clients pay for the care
they receive from the health care professionals.