Mr. Channabasappa. K.

UNIT-II
MANGEMENT
1. Steps in management process

Introduction

A process is a series of steps or actions which lead to achieve a goal.and it is dynamic.

Nurses are familiar with the application of nursing process such as assessing, diagnosing,
planning, implementing and evaluating the patient care in the health care management of
their patients/clients in any setting .Similarly nurse leaders must also be aware of various
steps involved in the management process.

Generally the students are aware of managing their learning activities during their
professional carrier, and in their work in professional practice .Some of the individuals
basically organized but some will learn through exposure to certain situations during their
practice. The effective nurses are those who really understand and consciously apply the
principles of management to practice.

What is management process?

The management process is like nursing process which include;

 gathering data from different sources,

 diagnosing the problems by analyzing the data carefully,
 plan appropriate actions according to priorities,
 carry out the interventions suitable
 evaluate the outcomes of interventions and
 re plan until the problems identified are resolved.
As said in the previous lesson the management is the process of getting work done through
others.

Nursing management:

It is the process of working through nursing personnel to promote and maintain health
, prevent illness and suffering.The role of nurse manager is to plan, organize, direct, and
control available resources in order to provide effective economic care to groups of clients.

In reality the management process is more complex than nursing process as it directly deals
with the management of working with human beings, physical resources, organizational and
psychological process within a creative and innovative climate for the realization of
organizational goals.

So management is a dynamic process which is universal and can be used in variety of settings
and situations.

1
Henry Fayol (1925) first identified the functions of management.

They are;

 Planning
 Organization,
 Command,
 Co-ordination and
 Control
Later Luther Gullick (1937) expanded these activities by introducing two more activities in
addition. (POSDECORB)

Planning, Organizing, Staffing, Directing, Co-ordinating, Reporting and Budgeting.

All these are again reorganized by clubbing reporting and coordinating under the component
of control and classified as five major elements or steps in the management process

The Major FIVE elements of Management process as follows;

Elements of
management
process
1.Planning

5.Controlling 2.Organizing

3.Staffing
4.Directing

1. Planning:
Planning is Preparing a blue print.

It is a continuous , Intellectual process of determining philosophy ,Objectives,

Policies, procedures and rules and standards, long and short term projected out comes
and fiscal course of actions and managing planned change. This is the preliminary and
most important step of management process.
 Mr. Channabasappa. K.M

2. Organizing:

It is establishing the structure to carry out plans. Determining the most appropriate
type of patient care delivery in a health agency. Or educational programs in an
institution. Grouping the activities to meet its goals,

Other functions involve;

 working within the structure of an organization and

 understanding and
 using power and authority appropriately.

3 .Staffing:

It is a process of assigning competent people to fill the appropriate nursing roles in a an

institution , designated for the organizational structure through;

 Recruitment & Selection of staff

 Hiring and Orienting staff ,
 Staff scheduling and
 Staff development activities,.
staffing often becomes part of organizing. Example : Appointment of a Dean for the college
of nursing, nursing superintendent for a hospital or a head nurse for a surgical unit etc.

3.Directing:

Is a process of involving many human resource management responsibilities such as ;

 Motivating
 Managing a conflict,
 Communicating and
 Facilitating Collaboration and Coordination.
4. Controlling:

It is an ongoing process to ensure that activities of an institution or organization adhere to

the plan .It includes

 Quality assurance,
 Performance appraisal
 Fiscal accountability.
 Legal & ethical and professional control.
An effective manager uses the management process to achieve agency goals through
group efforts .In directing employees, manager follows a predetermined plan.

The overall plan for the nursing department is developed jointly by nurses from all
highrarchial levels. They specify what needs to be done, how and by whom the
responsibilities to be carried out considering the available resources like material ,money
and man power resources.
 2. Functions of administration
Introduction
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. If we consider the administration as one
side of the coin, the management is the other side of the same coin. To translate any policy
into action people need structure, that is organization, when structure is there, there are
some functions to be performed to accomplish goals, that functional aspect of organization
is dealt by management.

Definition
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:
Usually the actions of the manager (planning, organizing, directing, coordinating
and controlling) are referred to in the management literature as the functions of the
management process.
1. Planning:
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:
 Good planning
 Yields reasonable organizational objectives and develops alternative 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.
The main activities in the planning are the formulation of strategies and setting the
objectives. Strategy is the set of decisions that determine the character (size, scope and
mix of services) of a health services organization and give it the direction in the market
place. In a real sense objectives are the key to the entire management process.
 Mr. Channabasappa. K.M

2. Organizing:
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.‖
The most basic premise of organization is
 Division of work (is essential for efficiency)
 Work activities required for the organizational performance are separated through
 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.
3. Staffing
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.

4. Directing
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
 Leading
 Motivating
 Communicating
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 subordinate.
 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:
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.
Leading:
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 situation.
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.
 Mr. Channabasappa. K.M

Motivating:
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.
Communicating:
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.
5. Coordinating:
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 coordination.
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 problems.
6. Controlling:
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.
 7. 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.

8. Budgeting:
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 wastage.
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 terms.
 It should have support of top management throughout the period of its planning and
supplementation
In a nutshell the functions of a manager by Drucker include:
1. Establishes and communicates goals and objectives.
2. Organizes, analyzes and divides work into tasks.
3. Motivates and communicates.
4. Analyzes, appraises and interprets performance and measurements.
5. Develops people including self.
Research Input
1. Nurse executives, perspectives on succession planning
Six nursing executives from 5 settings were interviewed to learn more about
how succession planning is being applied in today‘s practice. Their experiences,
presented in this article provide a snapshot of ways succession planning can be
 Mr. Channabasappa. K.M

applied in different organizations. Interviewees share their personal philosophy,

concepts, and approaches to succession planning. Although these nurse executives
approach succession planning differently they share a belief that succession
planning is key to sustaining quality nursing practice.
2. Leadership and nurse retention: the pivotal role of nurse managers
This article describes the views of 32 nurse managers regarding their roles
and the characteristics they need to promote retention. The purpose of the study
was to describe the roles and skills of nurse managers, whether they posses these
skills, the characteristics of the nurse managers that facilitate or serve as a barrier to
nurse retention. A sample of 39 nurse managers was selected for the study. Data
was collected by using 4 focus group discussions. First line managers are in the
best position to impact retention because they have firsthand knowledge of issues
and challenges important nurses and care delivery.

Conclusion:
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 today‘s world of cost containment, examining
what clients pay for the care they receive from the health care professionals.
3. Concept of management

Introduction

One of the human activities is managing ever since people began forming groups to
accomplish aims they could not achieve as individuals, managing has been essential to ensure
the coordination of individual efforts concepts are building blocks of they and principles. The
concept of management must be clear to those who use them.

Definition of management

Management is the process of designing and maintaining an environment in which

individuals, working together in groups, efficiently accomplish selected items.

Management has been defined as the creation and maintenance of internal

environment in an enterprise where individuals working together in groups, can perform
efficiently and towards the attainment of group goals.

- Koontzand O’Donell
Management may be defined as the art of applying the environment principles that
underline the control of men and material in the enterprise under consideration.

- Kimball and Kimball

Important reasons for management concepts

To

1) Increase managerial efficiency

2) Develop a science of management and to crystallize the nature of management
3) prepare and study research projects every year
4) acquire social achievement

To increase managerial efficiency

The establishment rules, principles and techniques of management increase

managerial efficiency as they provide managers the important guidelines as how they should
operate and work in different situations.

To develop a science of management and to crystallize the nature of management

Lack of understanding of the management concepts, principles and techniques make it

difficult to analyze job and to design programmes to train and develop managers. Therefore,
it‘s essential to develop a science of management.

To prepare and study research projects every year

Research work must undertake to expand and improve the horizons of management
knowledge if structural frameworks of management theory exist. Major research projects
must be pursued every year by the students of management to test various aspects of the
validity of management.
 Mr. Channabasappa. K.M

To acquire social achievement

Broadly speaking, a management function is to co-ordinate the efforts of the people so

that individual objectives may be translated into social achievements.

Management, organization and administration:

At the very outset it should be made clear that the three works are neither
synonymous nor interchangeable. They have their own field of operation. All convey
different meanings. In common language they are taken as one and the same. In practice
however they have different meanings.

According to G.E Millswork all three defined as

Administration is primarily the process and the agency used to establish the object or
purpose which an understanding and its staff are to achieve, secondly, administration has to
plan and stabilize the broad lines of principles which will govern action. The broad lines are
called polices.

Management is the process the agency through which the execution of policy is
planned and supervised.

Organization is the process of dividing work into convenient tasks and duties, of
grouping such duties in the form of posts of delegating authority to each post and of
appointing staff to be responsible that work carried out as planned.

Distinction between administration, management and organization

Administration Management Organization

i) It is the process of It is the process of It is the process of dividing
determining the object to planning the work as per tasks and duties as planned by
be achieved the object laid down by the management within the
administration. objectives.
ii) It lay down the polices It executes the polices and It organize the work
and principles programmes

iii) It prepares the It supervise and controls It draw out the line and
framework under which the execution of assigned determines the line of action.
one is asked to work and work
execute.
vi) It provides It controls activities It delegates the authority and
 Direction determine the line of action.
 Guidance Fixes responsibility therefore.
 Leadership
V) Thus it is the first and It comes second follows It occupies the third place and
provides to the the administration and solely responsible for what the
management and derives strength from management has planned and
organization administration administration has set.
Stages of management

i) Top management
ii) Middle order management
iii) Lowest level management
i) Top management

Responsible for planning. It lays down the polices and programmes for the enterprise.
It thus, provides a framework within which the entire enterprise works. Top management is
responsible for providing leadership, guidance and supervision.

ii) The middle order management

Responsible for executive work at the second tier which certainly functions as the
second order to the top management.

iii) The lowest level management

Like the middle order responsible for the execution for the plans, polices and
programmes. This level is directly involved in the operation of job while the middle order
management, the second tier, is indirectly responsible for execution.

The term management is used in three alternative ways

1. Management as a discipline
2. Management as a group of people
3. Management as a process
1. Management as a discipline

Discipline refers to a field of study having well-defined concepts and principles.

When we refer to management as a discipline, we include in it the various relevant concepts
and principles, the knowledge of which aides in managing. From this point of view,
management can be treated either as an art or science.

2. Management as a group of people

Sometimes, we refer to management as a group of people in which we include all

those personnel who perform managerial functions in organizations.

E.g When we talk about relationship between management and labour in an organization, we
refer to two distinct classes or group of personnel in the organization. In the first category, we
include all those person who are responsible for managerial functions and in the second
category, we include non-managerial personnel.

3. Management as a process

A process can simply defined as systematic method of handling activities. How ever
the management process can be treated as a complex one which can be referred to as an
identifiable flow of information through interrelated stages of analysis directed towards the
achievement of an objective or set of objectives.
 Mr. Channabasappa. K.M

Principles and importance of management

Management id a living science. From time to time various thinkers of the subject
have expressed their opinion on the principles.

According to Urwick, Keith and fayol there are 15 principles

1) Principles of policy making

An effective management needs, clear and well thought out policy. The evolved
polices should be such which may be acceptable to all and may be able to arouse the interest
of the workers and provide incentives to all those who are responsible giving the polices a
practical shape.

2) Principles of Improvement and adjustment

An enterprise is a going concern, it grows step by step steadily but surely. The
management has, therefore, to prove itself a living science. It should be flexible, able to
accept improvement and adjust itself according to the dictate of the situation.

3) Principles of balance

In order to develop on proper lines with high degree of efficiency and economy the
enterprise is required to have a balanced structure. Here, at least for this purpose the chief
executives is required to go through all the details minutely and he is also to ensure that a
proper balance between the duties, responsibilities rights and authority is well established.

4) Principle of Individual effectiveness

According to Henri Fayol proper training on scientific lines for increasing the
individual effectiveness. Proper training, good wages policy, human relations, and healthy
surroundings also help the enterprise in increasing the effectiveness of an individual.

5) Principles of relationship of task and accomplishment

Everyone should be placed in his assigned job according to his skill, knowledge,
aptitude and experience so as to ensure efficiency and understanding. The scientific selection
of workers helps the management in placing the workers at places where they are fitted
suitably.

6) Principles of simplicity

Working of any organization should be as simple as possible. From principle of

simplicity we mean that plants used in production, procedure followed in routine jobs and the
way in which materials and of course the mean are put to use should be simple enough.

7) Principles of specialization

Standardization is a focal point of scientific management and it comes through

specialization. Specialization increases the productivity. Quality of product improves due to
specialization.
8) Principles of standardization

Specialization makes standardization possible. Standardization helps in marketing the

product. Quota and quality production is ensured with the help of standardization. Cost
calculation becomes easy. The principle of standardization is of utmost importance to the
management from the point of view of production, marketing, supervision and best utilization
of available resources.

9) Principles of financial Incentives

Sound wages policy based on financial incentives elicits maximum co-operation of

the workers. This obviously ensures growth and prosperity to the enterprise. Serving the
society is best possible manner in another goal of management which it can attain if the
workers are satisfied and interested in serving the enterprise to their fullest capacity. 10)
Principles of planning

Planned work ensures smooth running of an enterprise. Plans decide as to what, when,
how and of course whom a work is to be accomplished. Pre-determined objectives and
thought give the point of achievement and success.

11) Principle of control

However reasonable, discipline efficient and responsible worker might be needs a

supervision and proper control. Effective control decides the future of the organization,
standardization of jobs and product helps in better control over both men and materials.

12) Principles of leadership

Supervision and control precedes the leadership, guidance and direction. Unless these
are provided properly and as per the requirement of the enterprise no amount of supervision
and control can vouch safe the smooth running of the enterprise. A good leadership, better
direction, required direction also ensure co-operation and good human velocities.

13) Principle of co-operation

Co-operation begets confidence and ensures mutual respect. Both of them are a must
for proper and smooth working hence the principle and need for co-operation among all of
the confidence.

14) Principle of responsibility and authority

Duties and responsibilities, rights and authority go together. Rights and authority
cannot be exercised, unless they are clearly spelled out. It necessary that each workman and
each section of the enterprise must be supplied a list of their duties and responsibilities which
is to be performed and rights and authority they would enjoy while shouldering the burden of
their duties and fulfilling their responsibilities.

15) Principe of exception

According to this principle top management should be made free from routine nature
of jobs so that it may devote its time in studying the problems and solutions to solve them.
 Mr. Channabasappa. K.M

4. PLANNING AND CONTROL

Planning

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 and develops alternative 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.

Controlling

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.

Controlling formula

Ss+Sa+F+C I

SS- Setting the standards I- Improvement

SA – Applying the standards

F - Feed back
 C – Correction

5. CO-ORDINATION AND DELEGATION

INTRODUCTION

In every organization and harmonization of the various departmental-activities are

indispensable to achieve the desired objectives. The ensure harmonious and smooth
functioning of an enterprise, the activities in all areas, departments, decisions of an enterprise
are required to be pulled tighter. At the same time, it is necessary to avoid the splintering
efforts that may destroy the unit of action through their cross-purpose working or inter-
departmental conflicts. All this requires effective co-ordination. Co-ordination is the
integration, synchronization, or orderly pattern of individual and group efforts to achieve the
organizational objectives.co-ordination affects the people, groups, organizational units, and
all activities with in every enterprise. Lack of co-ordination causes tremendous waste of time,
effort, and money.

DEFINITIONS

Co-ordination is defined in different ways as follows.

It is the adjustment of the parts of each others and of the movement and operation of party in
time. So that each can make into maximum contribution to the product of the whole.
(TERRY)

Co-ordination is the integrating process in an orderly pattern of group efforts in an

organization toward the accomplishment of a common objective.

Co-ordination is the orderly arrangement of group efforts to provide unity of an action in

pursuit of common purpose.

Co-ordination is the orderly synchronization of efforts to provide the proper amount, timing
and directing of execution resulting in harmonious and unified actions to a stated objective.
(NEW MAN,1953)

CHARACTERSTICS

Group effort

Organization is not a haphazard collection of people, material, machnines, equipment

and other financial and physical resources. The financial, human and technical resources are
properly organized and co-ordinate.co-ordination transcends and permeates all managerial
functions. It is the orderly synchronization of efforts of the sub-ordinates to provide the
proper amount and quality of execution, so that their unified efforts lead to the stated
objectives of a group of people to achieve organizational objectives

Unity of action

Co-ordination applies to the group effort,not individual effort, co-ordination stress

the unity of effort and unity of action. It is an ongoing process where managers develop and
integrated, orderly and synchronization pattern of group effort among his sub-ordinates and
try to attain unity of effort in the pursuit of some common objective.
 Mr. Channabasappa. K.M

Common purpose

Effective co-ordination is good management. Co-ordination is not a one-shot deal. It

is a never ending process of ensuring the achievement of organizational goals effectively.
When the individual and group as well as organization are interrelated the in congruency
between personal goals and organizational objectives gets resolved automatically.co-
ordination involves a reciprocal relationship i.e. willingness to take and give among the
people and activities concerned. Each tries to serve his own goals, perceptions, attitudes,
beliefs, values ect. Each tries to serve his own goals and ends. Conflicts between individual
goals and organizational objectives are inevitable in every firm, such conflicts and in
congruencies demand co-ordination of efforts to achieve common goals.

IMPORTANT FEATURES OF CO-ORDINATION

 Co-ordination is a integrity process.

 If subdivision of work is in escapable, co-ordinationbecomes mandatory.
 Undue confusion is a symptom of poor co-ordination.
 Co-ordination is a process. It is a process of achieving integration among different
organizational units.
 Unity of effort is the heart of co-ordination problem. By unity of effort means that the
managersarrange the nature and timing of activities so that individual efforts blend
into a harmonious
 stream of productive action.
 The idea that co-ordination is a fixed entity that either exists or does not exist is
totally
 unrealistic.co-ordination is present in all organizations but in varying degrees.
 The chief objective of co-ordination is a common purpose.
 Co-ordination cannot be achieved automatically. It must be won by intelligent,
vigorous,persistent and organized effort.

PRINCIPLES OF CO-ORDINATION

Co-ordination is a process where by an executive develops an orderly pattern of

group effort among his subordinates and secures unity of action in the pursuit of common
objectives. Co-ordination is the continuous and dynamic process and emphasizes unity of
efforts of achieve the desired objectives. Co-ordination the managerial responsibility.

1.Principle of direct contact: co-ordination can be achieves by direct contact among the
responsible people concerned. Co-ordination can be easily obtained by direct interpersonal
relationships and direct personal communications. Such personal contacts bring about
agreement on methods, actions and ultimate achievement of objectives. Direct contacts also
help with away the controversies and misunderstanding among organizational participants. It
is based on the principle that co-ordination is better achieved through understanding,not by
force or order.
2. Principle of early stages: co-ordination should start from the very beginning of planning
process. At the time of policy formulation and objective setting. Co-ordination problem is
90% solved. it is because participative goal setting enables agreement and commitment to
orgazational goals and there is no question of conflict and in congruency, if not initiated in
the early stages of planning process and policy formulation, becomes difficult to exercise in
the later stages of the execution of plans.

3.Reciprocal relationships: as the third principle: all factors in a situation are reciprocally
related.in other words all the parts influence and are influenced by other parts. For example
when A works with B and he is turn works withC and D,each of the four finds himself
influenced by others influenced by the people in the total situation.

4.Principles of self co-ordination: in this when a particular department affects other

function or department or function in turn affected, may not have direct control over the
other department that is influencing the said department. However, if other departments are
modified in such a fashion that this affects a particular department favorably then self co-
ordination is achieved. this principle is rarely practiced in day-to-day life.

IMPORTANCE OF CO-ORDINATION

Co-ordination is crucial factor in the survival of any enterprise. The need for co-
ordination arises from the diversity of tasks to be undertaken and of persons to carry them
out. It emerges as soon as the operation to be multiple or complex, by reason of the fact that
more than one person is concerned with it.co-ordination is essential as:

 It resolves conflicts between line and staff inter-department,intraa-

departmental conflicts and
 restores harmony in operations.
 It results in the accomplishment of organizational goals
 It helps to increase the effectiveness of management

CO-ORDINATION HELPS TO INCREASE THE EFFECTIVENESS OF

MANAGEMENT IN THE FOLLOWING WAYS

Co-ordination pulls all the function and activities together. In the absence of co-
ordination the energies, resources, skills, and intelligence of people, materials and
financial resources cannot follow a specific direction. it is quiet likely that the
resources and people will be misused and misutilized.
Co-ordination brings unity of action and direction. it resolves effectively the
dangerous conflicts between individual and organizational goals. The managerial
function of co-ordination strives for unity of action in a setting characterized by
baffling diversity of goals,perceptions,attitudes,personality,skills,intelligence,ect
without the desired degree of unity organization will not be in a position to attain the
specified objectives.
Activities are dividing and sub-divide in organizations. such differentiation requires
effective integration of activities. The integration is brought about by co-ordination
in terms of fusion among differentiated work units and authority centers.
 Mr. Channabasappa. K.M

Modern organizations are considered as open system these open systems are
characterized by information flows, resource flows, and the flow of activities.co-
ordination ensures the smooth flow of resources into productive units and brings
required quality output.

TECHNIQUES TO ACHIEVE CO-ORDINATION

1. co-ordination by rules or procedures

In the work that need to be accomplished is highly predictable and hence can be
planned in advance, a manager can specify a head of time what actions his subordinating the
routine rescuing activities, rules and procedures are helpful which specify in detail a head of
time, what courses of action the subordinates should take if some situation should a rise.

2. Co-ordination by targets or goals

Most of the managers assign specific goals/ targets to their subordinates facilitate co-
ordination.

3. Co-ordination through hierarchy

Rules, regulations and procedures as well as the goals apart, managers also use the
chain of command to achieve co-ordination. When situations arise the specified rules or
targets do not cover that, subordinates are trained to bring the problem to their concerned
manager. Co-ordination through the hierarchy works well as long as the number of problems
that must be brought to the boss is not great.

4. co-ordinationthrough departmentalization

Departmentalization also serves as a technique to bring about effective co-ordination.

some forms of departmentalization also facilitate co-ordination better than do others. a matrix
approach means each project has the continuous and undivided attention of its own project
manager and the project team. Therefore in the case of matrix organization co-ordination is
automatically ensured

5. Using a staff assistant for co-ordination

To make his job of coordinatinating easier, a manager may hire an assistant. When
subordinate brings a problem to him, the assistant can comic the information on the problem,
research the problem, provide alternative solutions available. This increases, undoubtedly, the
manager‘s ability to handle the problems and coordinate the work of his subordinates.

6. Using a liaison for coordination

In some big organizations where the volume of contacts between two departments
grows, many managers appoint a special liaison person to facilitate coordination.

7. Using committee for coordination

 Another sound technique of coordination is to from committee for understanding
various functions and problems. Committees are increasingly useful for coordinating,
planning and executing programs and controlling the various activities. Committees also
establish face-to-face contacts and personal relationships and promote voluntary
cooperation.further, to coordinate the overlapping and conflicting functions committees need
to be established.

8. Using independent integrators for coordination

In some special circumstances, independent integrator may be recruited by

organizations. An independent integrator‗s job is to coordinate the activities of several
interdependent departments. They are not attached to the departments they coordinate. The
independent integrators will be either individuals or departments. Using independent
integrators for achieving coordination has to be useful in high-technology companies.

9. Conferences

Conferences at regular intervals also ensure better coordination. Conferences provide

adequate platform for discussion of various problems being encountered by different
departments.

10. The techniques of communication

To promote coordination, communication system must be perfect. It must be well designed.

Communication is an artery through which the decisions flow top to bottom and reports flow
from bottom to top. With out proper communication coordination is almost impossible.

11. Miscellaneous

Other coordinating techniques include :grouping the similar activities, reorganization of

departments to ensure coordination, cross functioning of the departments, project
management organization hierarchy, planning techniques, creation of certain staff positions,
periodical staff meetings ect.

TYPES OF CO-ORDINATION

Coordination can be classified into two broad categories, one on the basis of its shape in the
organization and other on the basis of its scope and coverage. On the former basis, it can be
classified into vertical and horizontal coordination and on, the latter basis, into internal and
external coordination.

1. Vertical and horizontal coordination

The term vertical coordination is used when coordination is to be achieved between

various links or different levels of the organization vertical coordination is needed to ensure
that all the levels in the organization act in harmony and in accordance with organizational
policies and programmers. It is the function of the top executives to bring about this co-
 Mr. Channabasappa. K.M

ordination. Vertical coordination is secured through delegation of authority and with the help
of directing and controlling.

The term ―horizontal coordination‖ is used when coordination has to be

achieved between departments on the same level in the management hierarchy. Thus, when
coordination is brought between production department, sales department, personnel
department etc it is said to be horizontal coordination.

2. Internal and external coordination

Coordination may be internal or external to be organization. Coordination is internal when it

is achieved between different departments, sections, and units of an enterprise. It is both
vertical and horizontal.

The various factors with whom it has interaction include government, customs, supplies and
competitors. An enterprise has to keep proper coordination with these. Such type of
coordination is known as external co-ordination and it is essential for the survival of the
enterprise. External coordination also involves interaction with other business, economic and
research institutions to have the benefits of latest information and technological advances.

DIFFICULTIES OF CO-ORDINATION

Lack of coordination and understanding between and among individuals, groups, and
departments.
lack of good interpersonal relations
failure in accomplishing objectives according to time and work
schedule Lack of direction and consequently aimless individual efforts.
Functioning of departments in the organization as watertight compartments.
Lack of initiative and loyalty towards the organization

DELEGATION
Delegation is defined as transferring of responsibility to subordinates on behalf of the
manager. It is an act through which a manager gives authority to others to attain certain
assignments.

Definition

 "Delegation is defined as the transfer of responsibility for the performance of a task

from one person to another"
 "Transferring to a competent individual the authority to perform a selected nursing
task in a selected nursing situation . The nurse retains accountability for delegation"

Salient Features:
1. Not to delegate total authority
2. Not to delegate authority which he himself does not possess
3. Should be only for organisational purpose and not personal purpose
4. It does not imply reduction in power
Characteristics:
1. Delegation of authority can be exercised only by higher authority
2. Delegation can be of any kind
3. Delegation does not mean transfer of final authority
4. Does not involve surrender of power

5 Rights to delegation

National Council of State Board of Nursing in the US presented 5 rights to delegation from
the perspectives of both nursing service administrator and staff nurse. Nursing service
administrator is responsible for job description, role delineation, development of
organisational policies, procedures and standards an assurance of adequate human resources.
Staff nurse is responsible for assessing client, delegating appropriately, communicate clearly,
providing monitoring and supervision.

1. Right task
2. Right circumstance
3. Right person
4. Right direction/communication
5. Right supervision/evaluation

Strategies for effective delegating

 Plan ahead
 Identify necessary skill and levels
 Select most capable person
 Communicate goal clearly
 Empower the delegate
 Set deadlines and monitor progress
 Model the role: provide guidance
 Evaluate performance
 Reward accomplishment

Kinds of delegation:
1. Full delegation
2. Partial delegation
3. Conditional delegation
4. Formal delegation
5. Informal delegation

Principles of delegation:
1. Should be written and specific
2. Authority and responsibility should be equal
3. Should be properly planned and exercised
4. Right person should be chosen
5. Good reporting system should be established
 Mr. Channabasappa. K.M

6. Should have certain objectives to get certain results

7. Superiors should be ready to give support and guidance
8. Overall responsibility lies with the superior

Symptoms of poor delegation

1. Dissatisfied subordinates
2. Disorganized effort
3. Long queue in front of boss office
4. Boss always busy
5. Boss carrying big suitcase
6. Work never completed in time
7. Constant time pressure
8. Hold up of activities due to pending orders from boss

Common delegation errors

 Under delegating-frequently occurs from managers false assumption is that it may be

interpreted as a lack of ability on his part to do the job correctly or completely.
Another cause is manager‘s desire to complete the whole job personally due to lack of
trust in sub-ordinates.
 Over delegating- some managers over delegate burdening their subordinates. Others
do so because they feel insecure in their ability to perform a task, and due to lack of
organisation time. It can decrease the productivity.
 Improperly delegating- it includes delegating the things at wrong time, to the wrong
person or for the wrong reason. Also delegating the yaks and responsibilities that are
beyond the capability of the person to whom they are being delegated or that should
be done by the manager.

Barriers to delegation

 The belief that ―i can do it better myself‖

 Lack of confidence and trust in workers
 Low self confidence, insecurity
 Vague job description
 Inadequate training
 Lack of adequate recruitment and selection
 Time involved in explaining the task
 Reluctance to take the risks involved in depending on others.
 Fear of loss of power

Delegation as a function of professional nursing

With the restructuring of care delivery models registered nurse at all levels are
expected to make assignments for and supervise the work of different levels of employees.
Registered nurses should perform role of supervisor and delegator need preparation to assume
these leadership tasks. Nursing schools and health care organisations have to prepare
professionals for the delegator role. This includes basic principles of delegating to right
person, at a right time and for the right reason, and an action that must be undertaken when
work is delegated in an appropriate or unsafe manner.

Subordinate resistance to delegation

Common cause of this can be:

 Failure of the delegator to see the subordinates perspectives

 Workload assigned are highly challenging both physically and mentally
 Belief of employees that they are incapable of completing the delegated task.
 Inherent resistance to authority
 Due to over delegatio

Delegating to a transcultural work team-factors which may affect here include

 Communication
 Space
 Social organisation
 Time
 Environmental control
 Biological variations

Integrating leadership roles and management functions in delegation

Delegation provides a means for increasing productivities . It is also a managerial tool

for subordinate accomplishment and enrichment. It also requires highly developed leadership
skills such as sensitivity to subordinate capabilities and needs, and the ability to communicate
clearly and directly , the willingness to support and encourage subordinates in carrying out
delegated tasks and the vision to see how delegation might result in increased personal
growth for subordinates.

Conclusion

For the effective administration of any organisation co-ordination and delegation are
essential. Without these two functions it will be difficult to achieve the organisational goals .
The right to delegate and the ability to provide formal reward for successful completion of
delegated tasks reflect the legitimate authority inherent in the management role.
 Mr. Channabasappa. K.M

6. DECISION MAKING-DECENTRALIZATION

INTRODUCTION:

Decision making lies deeply embedded in the management process, and is the
only vehicle for carrying managerial workload. Managers see decision as their central job
because they constantly choose what is to be done, which is to do, where to do, and how to
do. William Moore has equated it with management when he sys that management means
decision making.

DEFINITION:

Decision & Decision Making:

A decision is a choice made between two or more available alternatives. Decision

making is the process of choosing the best alternative for reaching objectives.

(Samuel C. Certo, 2003)

Decision making can be defined as a process of choosing between alternatives to

achieve a goal. It is the process by which an individual chooses one alternative from several
to achieve a desired objective.

(Manmohan Prasad, 2003)

Types of decisions:

1. Basic Decision or Strategic Decisions:

All basic decision is strategic decisions involving large range commitments and large
investments. They are unique in nature. Slight or small mistakes in these decisions
would seriously injure the entire organizations.

2. Administrate Decisions:

Administrative decisions are mainly related with structuring of the firm and
how finance can be obtained for the development of the firm smoothly and effectively.

Herbert Simon had classified all decisions in two classes; these are
Programmed and non – programmed decisions.

Programmed decision:

It involves organizations which an develop specific process for handling these

decision.
 E.g. standing operating procedures and policies.

Non – Programmed Decisions:

They relate to general problem solving process. They involve judgment, intuition and
creativity.

3. Organizational and Personal Decisions:

According to Barnard organizational decisions reflect company policy.theycan be
delegated of transferred to others.
While personal decisions refer to those made by a manager as an individual and these can‘t
be delegated.

4. Policy of Operating Decisions:

Policy decisions are taken by the top, management. They are of vital importance and
they affect the entire enterprise.

e.g. the declaration of bonus in a company is a policy matter which is to be decided by

the top ,management, while calculation and distribution of bonus is an operating
decision which is taken as the lower levels.

5. Individual and Group Decisions:

The decisions taken by the an individual in the organization is known as individual

decisions.Group decisions refer it the decisions which are taken by a group of organizational
members (board of directors, committer of experts)

Characteristic of Decision Making Process:

1. From various courses of action, it is a process of choosing a particular course of

action.
2. It is a human process which involves the application intellectual abilities.
3. It is a rational process which is proceeded by deliberation and reasoning. It may also
be called as end process.
4. It is always related to situation in which a manger may take one decision in a
particular set of circumstances and another in a different set of circumstances.
5. This involves certain specific purpose in which these may just be decisions not to
decide.
 Mr. Channabasappa. K.M

Principles of Decision Making

1. Principles of autonomy
This principle is form of personal liberty also referred to as freedom of choice or
accepting the responsibility for one‘s choice.

2. Principle of beneficence
The principle status that the actions one takes should be done in an effort to promote
good.

3. Principle of paternalism
This principle is related to positive beneficence in that one individual assumes the
authority to make a decision for another individual.

4. Principle of utility
This principle reflects a belief in utilitarianism on the belief that what is best for the
common good outweighs what is best for individuals.

5. Principle of justice
This principle states that equals should be treated and unequal should be treated according to
their differences

TECHNIQUES OF DECISION MAKING

In order to evaluate the alternatives, certain quantitative techniques have been
developed which facilitate in making objective decisions. Some of the techniques are:
1. Marginal cost analysis
2. Cost benefit analysis
3. Operational research
4. Linear programming
5. Network analysis

1. Marginal cost analysis

Here additional revenues from additional costs are compared. The profits are
maximum at the level where marginal revenues and marginal costs are equal. For instance in
order to find the optimum output of a machine, one can vary inputs against output until the
additional inputs equal the additional output.

2. Cost benefit analysis

 This analysis may be used for choosing among alternatives to identify a preferred
choice when objectives are far less specific than those expresses by such clear quantities as
sales, costs or profile. ―Cost models may be developed to show cost estimates for
each alternative and its effectiveness.

3. Operational research
This is a scientific method of analysis of decision problems to provide the executive
the needed quantitative information in making these decisions.
This seek to replace the process by an analytic, objective and quantitative basis based
on information supplied by the system in operation and possibly without disturbing the
operation.

4. Linear programming
Linear programming is a technique devised for determining the optimum combination
of limited resources to achieve a given objectives. It is applicable in areas like production
planning, transportation, ware house location and utilization of production and ware housing
facilities at an overall minimum cost.

5. Network analysis
It is used for planning and controlling the project activities. Under this a project is
broken-down to small operations which are engaged in a logical cycle. A network diagram
may be drawn to present the relationship between all the operations involved.
Decision Making Process: OR Stages of Decision Making Process

Objectives
X

Problem Data Alternatives Evaluation

s
collection
Y

Z
Information Testing Selection

Implementation

Feed back
 information
Decision making involves all the following stages.
1. Diagnosis and defining the problems.
 Mr. Channabasappa. K.M

2. Analysis the problem

3. Collection of data
4. Developing alternatives
5. Review of key factors
6. Selecting the best alternatives
7. Putting the decision into practice
8. Follow-up

1. Diagnosing and defining the problem

It is first and the most important task before taking the decisions. Eminent authors of
the subjects are of this opinion that a problem well defined is half solved and a good decision
can‘t be taken up unless the decision taker had a good grasp of the problem.

2. Analyzing the problem

It involves classifying the problem and gathering information. Classification of
problem is based on:
 The nature of the decision
 Impact of the decision
 Futurity of the decision
 Periodicity of the decision; and
 The limiting or strategic factor relevant to the decision.

3. Collection of data
A lot of information is required to classify any problem. The collection of right type
of information is very important in decision making. Before gathering information one must
be clear as to how much time and money he can spend in gathering information he needs.

4. Developing alternatives
Without resorting to the process of developing alternatives, a manager is likely to be
guided by his limited imagination. Once the manager starts developing alternatives, various
assumptions come to his mind which he can bring to the conscious level.

5. Reviewing of key factors

While developing alternatives, the principle of limiting factor has to be taken care of.
A limiting factor is one which stands in the way of accomplished the desired goal. It is a key
factor in decision making. If such factors are properly identified, manager can confine his
search for alternative to those which will overcome the limiting factors.
6. Selecting best alternative
There are various methods to evaluate the alternatives, common method is:
 Intuition – Choosing a solution that seems to be good at that time.
 Weigh the consequences of one against those of the others.

7. Putting the decision into practice

The manager should try to ensure that systematic steps are taken to implement the
decision. In order to make the decision acceptable, it is necessary for the manager to make
the people understand what the decision involves, what is expected of them and what they
should except from the management.
In order to make subordinates committed to the decision, it is essential that they
should be allowed to participate in the decision making process.

8. Follow-up
It is better to check the results after putting the decision into practice. The reasons for
following up of decisions are as follows:
 If the decision is a good one, one will know what to do if faced with the
similar problem again.
 It the decision is bad one, one will know what not to do the next time.
 If the decision is a bad and one follows up soon enough, corrective action may
still be possible.
In order to achieve proper follow-up, the management should device an efficient
system of feedback information.

MODELS OF DECISION MAKING PROCESS

List of decision making models are:
1. Normative model
2. Descriptive model
3. Decision tree model
4. Strategic model
5. Nursing process model
6. Intuitive decision making model
7. Econological model
8. Moral model
 Mr. Channabasappa. K.M

9. Ethical decision model

10. Bounded rationality model or administrative man
11. problem solving model

1. Normative Model
It is assumed to maximize satisfaction and fulfill the ―perfect knowledge assumption‖
that ―in any given calling for a decision, all possible choices and the consequences
and potential outcome of each are known‖. Seven steps are identified in the analytical precise
model.
Predetermined goal (or) desired value

Define and analyze problem

Identify all alternatives

Evaluate each alternative

Rank order of alternatives

Select maximizing alternative

Implement decision

Implement decision

Follow-up
 Lancaster, 2000

2. Descriptive model
Herbert Simon developed the descriptive model based on the assumption that the
decision maker is a rational person looking for acceptable solutions based on know
information. The following are the steps in the descriptive model.
1. Establish a satisfactory or acceptable goal
2. Define the subjective perceptions of the problem
3. Identify acceptable alternatives (the decision maker may either identify several
alternatives before proceeding to the next step or identify and evaluate the
alternative sequentially).
4. Evaluate each alternative in terms of its ability to solve the problem
satisfactorily.
5. Select a satisfactory alternative (This may be the first one encountered or the
one that produces the most favorable outcome).
6. Implement the decision
7. Follow-up.

Descriptive model of decision making

Establish satisfactory goal or value

Define subjective perception of problem

Identify acceptable alternatives

Evaluate alternatives

Select satisfactory alternatives

Implement decision

Follow up

Lancaster & Lancaster, 2002

32
 Mr. Channabasappa. K.M

3. Decision tree model

Possible
Possible events
events Alternative events

Increased demand
Increased for procedures
demand
for procedures

Hire regular staff

Decreased demand for procedures

Decreased
demand for
procedures
Increased demand
Increased staff
demand Decision point
staff

Decreased demand for staff

Decreased Pay over time and on call wages
demand for staff
Marquis and Huston, 2002

Magee and Brown made decision trees as starting with a basic problem and using
branches to represent ‗event forks‘ and ‗action forks‘. The number of branches of each fork
corresponds to the number of identified alternatives.
Every path through the tree corresponds to a possible sequence of actions and events,
each with its own distinct consequences. Probabilities of both positive and negative
consequences of each action and event are estimated and recorded on the appropriate branch.
Additional options and consequences of each action event sequence can be depicted on the
decision tree.
Normal analysis of the tree is conducted by computing predicted consequences of all
event forks (the right hand edge of the tree), substituting that value for the actual event fork
with the best expected consequences.

4. Strategic model

33
 The three crucial elements in decision making are represented by three inter-
connected circles.
 Identify the problem
 Developing a solution that are reasonable alternatives; and
 Selecting a single best solution.
Each circle is intercepted with a broken-line triangle to indicate the potential
supporting activities. The two directional arrows represent the non linear, dynamic nature of
decision making.

Identifying
the problems

Supporting activities Developing potential

Selecting the single best in decision making solutions
choice

Swansburga 2002

i. Identifying the complex problems

Mintzberg discovered two essential activities of successful managers before
developing a statement of the problem.
 First, they listed to employees concerns and prodded them to describe details.
 Second, they diagnosed the causes of problems using data gathered through
intensive discussions with peers and securitization of organizational records.
Good mangers analyze facts, evaluate the need for a decision based on their
perception of the situation and then make a diagnosis.

ii. Developing solutions

 Mr. Channabasappa. K.M

Once the problem has been identified, the nurse must then evaluate the potential for a
solution and determine the priority of the problem.
Reitz suggests three approaches to setting the priorities for problems.
 Deal with problems ion the order in which they appear.
 Solve the easiest problem first
 Solve the crisis problems before all others. A decision will depend on the time
and energy that can be devoted at that time. When a high priority problem
with limited potential for resolution is identified, the decision maker may be
forced to give it lower priority until more information is collected and
acceptable alternatives can be found.

iii. Selecting single best solution

According to Mintzberg founded three major activities characterize the final decision.
 Screening solutions using predetermined criteria
 Evaluating the costs and benefits as nearly as possible; and
 Selecting the single best solution.

iv. Supporting activities

Includes extensive planning, communicating and politicking takes place in the course
of making good choices.
 Planning may be informal and flexible and may involve developing a
schedule, deciding on the best choice and obtaining co-operation.
 Communicating involves sharing information and selling the best solution to
other by the use of formal channels, such as committees and informal
networks.
 Political involves understanding organization key stake holders, their
personality authority and range of influence.

Successful strategies for decision making

The participant described decision strategies that were essential for accomplishing
their plan and included:
 Building extensive networks of individuals and groups who could provide
them with resources at local, state and national levels.
 Searching the nursing, hospital and business literature.
 Being knowledgeable and involved in the politics of their organization and
professional associations.
 Communicating regularly and repeatedly about decision activities to
organization members, especially t hose in the hospitals dominant coalision –
 usually the chief executive officer, finance manager and chief of the medical
health.
Nursing Process Model
The nursing process provides problem solving approach and decision making.

Marwuis&Huston, 2002
As a decision making model, the nursing process has a strength that is feed back
mechanisms. The arrows in figure show constant input into the process. When the decision
point has been identified, initial decision making occurs and continues throughout the process
by using a feedback mechanism. This model can be easily be adapted as a theoretical model
for problem solving leadership and management.

v. Intuitive decision making model

1. Assess 2. Recall

Gather patient data Possible nursing

diagnosis and
intervention

4. Implement/evaluate 3. Plan

Implement Analyze

Follow through Synthesize

Marquis and Huston, 2002

 Mr. Channabasappa. K.M

Romiszowski built on the nursing process in creating the intuitive decision making
model. In this model, the decision maker consciously incorporates recall or cumulative
knowledge that comes from education, both formal and informal as well as experience, in
planning the decision. Inexperienced or notice decision makers spend more time in the
assessment, recall and planning phases, whereas experienced decision makers gather
information because planning has become automatic (that notice nurses and experienced
nurses process information differently has been supported by.

vi. Econological model

It is an ideal view of economic man, in which a manager who is faced with a problem
weighs the economic aspects of all possible courses of actions and chooses the action that is
expected by the yield, the greatest net gain or the least loss.
Simon observed the following steps of this model.
 Discover the symptoms of the problem or difficulty.
 Determine the goal to be achieved or define the problem to the solved.
 Develop a criterion against which alternative solution can be evaluated.
 Identify the alternative course of action.
 Consider the consequences of each alternative as well as the likelihood of
occurrence of each.
 Choose the beast alternative by comparing the consequences of each
alternative.
 Act or implement the decision.
Discover symptoms

Set goal or define the

Develop criterion
problem

Develop alternatives

Determine all outcomes Select alternatives

Act or implement
decision
Basavanthappa .B.T, 2006
vii. Moral Model
According to Crisham Moral representing:
M - Massage the dilemma, collect data about the ethical problem and who shows be
involved in the decision making process.
O - Outline options, identify alternatives and analyze the causes and consequences.
R - Review criteria and resolve, weigh the options against the values of those
involved in the decision. This may be done through a weighting system.
A - Affirm position and act, develop strategy for implementation.
L - Look back, evaluate the decision making.

viii. Ethical decision making

According to Murphy and Murphy, this model is specifically geared for ethical
decision making as it helps the individual clarify the basic beliefs and values of those
involved.
The steps of this model include:
 Identify the problem
 Determine why the problem is an ethical one.
 Identify the people involved in the ultimate decision.
 Define the role of decision maker.
 Consider the short and 1mg term consequences of each alternative.
 Make the decision.
 Compare the decision with the philosophy of the decision makers ethics.
 Follow-up on the results of the decision in order to establish a baseline for
future decision making.
ix. Bounded rationality model
The problem A single All Preferences Preferences No time or Final
is clear and well alternatives and clear and clear cost choice
unambiguou defined and constant constraints will
s goal is consequences and stable exist maximize
to be are known economic
achieved pay off

Lead to

Rational decision making

Robbins and Decenzo, 2006
 Mr. Channabasappa. K.M

Managerial decision making is assumed to be rational in the managers make

consistent, value – maximizing choices within specified constraints.
A decision maker who was perfectly rational would be fully objective and logical.
Remember that the assumptions of rationality often do not hold true, because the level of
certainty that the rational model demands rarely exists. That is certainty implies that a
manager can make an accurate decision because the outcome of every alternative is known.
Most managers then must try to assign probabilities to outcomes that may result. We
call this process dealing with risk. When decision makers do not have full knowledge of the
problem and cannot determine even a reasonable probability of alternative outcomes, they
must make their decisions under a condition of uncertainty.

x. Problem solving model

Problem solving and decision making are vital abilities for nursing practice. Nurses at
all levels must posses the basic knowledge and skills required for effective problem solving
and decision making. Problem solving and decision making skills require critical thinking
which is a higher cognitive process and both can be improved upon with practice.

Decision Problem
solving

Critical
thinking

Creativity

Decision making
It is a purposeful and goal directed effort using a systematic process to choose
directed effort using a systematic process to choose among options. The hallmark of decision
making is the identification and selection of options.
Problem solving
Problem solving is focused on trying to solve an immediate problem.

Creativity

It is essential for generation of options or solutions. Creativity individuals are able to

conceptualize new and innovatic approaches to a problem by being more flexible and
independent in their thinking.

DECENTRALIZATION

Introduction

Decentralization is the division of activities by forming departments. In nursing

service, departmentalization aims on attaining a better quality of patient care through benefits
derived from specialist nurses. Departmentalization aims to provide better arrangements,
control of facilities, equipments and materials required to perform the necessary service.

The nursing service administrator should explicitly define the standards, policies, and
scope of decision to be undertaken by top administration and those to be handled by
departments and their subunits.

Decentralization versus Centralization

The term centralized and decentralized refer to the degree to which an organization
has spread its lines of authority, power, and communication.

The centralization tends to concentrate decision making at the top level of the
organization, whereas decentralization disperses decision making and authority throughout
decision making and authority throughout and further down the organizational hierarchy. The
centralization and decentralization can be thought of as two theoretical extremes of one
continuum. In other words the decentralization is the extent of authority is passed down to
lower levels in the organization. The centralization is the extent to which authority is retained
at the top of the organization.

Complete centralization complete decentralization

Authority decentralization

Authority not delegated

 Mr. Channabasappa. K.M

Definition of decentralization

Decentralization is the dispersion or delegation of responsibilities and the authority to

lower levels of an organization. Institution makes use of both centralization &
decentralization. Top management needs a positive attitude towards decentralization and they
need competent personal to whom they can delegate authority.

Decentralized structure

The decentralized structure is flat in nature and organizational power is spread out
throughout the structure. These are few layers in the reporting structure, and managers have a
broad span of control. Communication patterns are simplified and problems tend to be
addressed with ease and efficiency at the level at which they occur. Employees have
autonomy and increased job satisfaction
Nursingwithin this type of structure.
Administrator

Maternity Paediatric Surgery

supervisor supervisor supervisor

Nurse Nurse Nurse Nurse Nurse Nurse

Dec

Decentralization (Flat, Horizontal, Participatory) Structure

Flat organizational structures are characteristic of decentralized management.

Decentralization refers to the degree of which authority is shifted downward within an
organization to its divisions, services, and units. Decentralisation is delegating decision
making responsibilities to the ones doing the work participatory management.

Implementation of philosophy of decentralized decision making by top management

sets the stage for involving more people perhaps even the entire staff in making decisions at
the level at which an action occurs. Both decentralized management and participatory
management delegate authority from top managers downward to the people who report to
them. In doing so, objectives or duties are assigned, authority is granted, and an obligation or
responsibility is created by acceptance the employee is accountable for results.
 In nursing, as in other organizations, delegation fosters participation, teamwork, and
accountability. A first line manger with delegated authority will contact another department
to solve a problem in providing a service. The first line manager does not need to go to his or
her department head of the other service, creating a communication bottleneck. The people
closest to the problem solve it, resulting in efficient and cost effective management.

Research conducted on Magnet hospitals found the most of the hospitals has a
decentralized structure in which nurses had a feeling of control over their unit work
environment. Porter O‘Grady identified the following conditions as essential for effective
decentralization:

 Freedom to function effectively

 Support from Peers and leaders

 Concise and clear expectations of the work environment

 Appropriate resources

ADVANTAGES AND LIMITATIONS OF DECENTRALIZATION

Advantages

The advantages of decentralization are as follows:

1. Relieves top manager from burden of managing.

2. Encourages subordinates to undertake responsibility.

3. More freedom to managers.

4. Increases motivation of subordinates.

5. Enhances competition among various departments/units.

6. Helps setting up of profit centres.

7. Promotes development of general managers.

8. Prepares mangers for rapid change in the organization.

Limitations

The limitations of decentralization are as follows:

1. Maintenance of uniform policy throughout organization becomes difficult.

2. Increases complexity of coordination.

3. May lead to loss of control by superior level managers.

 Mr. Channabasappa. K.M

4. May be limited by inadequate control techniques.

5. May be constrained by inadequate planning.

6. Limited by inadequate training.

7. Limited by inadequate number of qualified personnel at lower level.

8. It may be limited by external factors like; government regulations, taxation policy of

government, etc.

CONCLUSION

Decision making lies deeply embedded in the management process and is the only vehicle
for carrying managerial work load. Nurses should actively involve in decision making in all
levels rather than simply obeying the decisions. It is effective only when it is timely done. It
needs courage as well as creative thinking from the part of the nurse administrator.

The size of the organization is also a key factor in determining the extent of
centralization or decentralization. As the scope and amount of work of manager increasers,
the trend is towards decentralization. There are distinct advantages of both the systems.

I. BIBLIOGRAPHY

Text Books

1. Petricia S Yoder-Wise. Leading and managing in Nursing. 2nd edition. Mosby

publication; 1999

2. Mary Lucita. Nursing: Practice and Public Health Administration. 2 nd edition. India:
Elsevier publication; 2007

3. BT Basavanthappa. Nursing Administration. 2nd edition. New Delhi: Jaypee brothers‘

publication; 2009

4. Bessie L. Marquis and Carol J. Huston. Leadership Roles and Management Functions
in Nursing – Theory and Application. 5th edition. New York: Lippincott Williams &
Wilkins; 2006

5. Linda Roussel. Management & Leadership for nurse administrators. 4 th edition. USA:
Jones & Bartlett publication; 2006
 7. VISION AND MISSION STATEMENT

INTRODUCTION

Setting of organizational objectives is the starting point of managerial actions. An

organisation‘s end results for which an organization strives is termed as ―mission‖, purpose,
objective, goal, target etc. Many times these terms are used interchangeably as all these
denote end results.

MISSION STATEMENTS

A Mission Statement defines the organization's purpose and primary objectives. Its
prime function is internal – to define the key measure or measures of the organization‘s
success – and its prime audience is the leadership team and stockholders. Mission statements
are the starting points of an organisation‘s strategic planning and goal setting process. They
focus attention and assure that internal and external stakeholders understand what the
organization is attempting to accomplish.

MISSION AND PURPOSE

Mission and purpose are used interchangeably, though at theoretical level, there is a
difference between two. Mission has external orientation and relates the organization to the
society in which it operates. A mission statement helps the organization to link its activities to
the needs of the society and legitimize its existence. Purpose is also externally focused but it
relates to that segment of the society to which it serves; it defines the business which the
institution will undertake.

Dimensions of Mission statements:

According to Bart, the strongest organizational impact occurs when mission statements
contain 7 essential dimensions.

 Key values and beliefs

 Distinctive competence
 Desired competitive position
 Competitive strategy
 Compelling goal/vision
 Specific customers served and products or services offered
 Concern for satisfying multiple

stakeholders According to Vern McGinis, a

mission should:

 Define what the company is

 Define what the company aspires to be
 Limited to exclude some ventures
 Broad enough to allow for creative growth
 Distinguish the company from all others
 Serve as framework to evaluate current activities
 Stated clearly so that it is understood by all
 Mr. Channabasappa. K.M

Developing a Mission Statement

Structure of a mission statement

The following elements can be included in a mission statement. Their sequence can be
different. It is important, however, that some elements supporting the accomplishment of the
mission be present and not just the mission as a "wish" or dream.

 Purpose and values of the organization (products or services, market) or who are the
organization's primary "clients" (stakeholders)
 What are the responsibilities of the organization towards these "clients"
 What are the main objectives supporting the company in accomplishing its mission

A mission statement explains the company's core purpose and values.

1. At is most basic, the mission statement describes the overall purpose of the organization.

2. If the organization elects to develop a vision statement before developing the mission
statement, ask ―Why does the image, the vision exist -- what is it‘s purpose?‖ This purpose is
often the same as the mission.

3. Developing a mission statement can be quick culture-specific, i.e., participants may use
methods ranging from highly analytical and rational to highly creative and divergent, e.g.,
focused discussions, divergent experiences around daydreams, sharing stories, etc. Therefore,
visit with the participants how they might like to arrive at description of their organizational
mission.

4. When wording the mission statement, consider the organization's products, services,
markets, values, and concern for public image, and maybe priorities of activities for survival.

5. Consider any changes that may be needed in wording of the mission statement because of
any new suggested strategies during a recent strategic planning process.

6. Ensure that wording of the mission is to the extent that management and employees can
infer some order of priorities in how products and services are delivered.

7. When refining the mission, a useful exercise is to add or delete a word from the mission to
realize the change in scope of the mission statement and assess how concise is its wording.

8. Does the mission statement include sufficient description that the statement clearly
separates the mission of the organization from other organizations?

Mission Statements of Well Known Enterprises

"To solve unsolved problems innovatively" -Mary Kay Cosmetics

"To make people happy.‖ –

Walt Disney
VISION STATEMENTS

Vision statements reflect the ideal image of the organization in the future. They create
a focal point for strategic planning and are time bound, with most vision statements projected
for a period of 5 to 10 years. The vision statement communicates both the purpose and
values of the organization. For employees, it gives direction about how they are expected to
behave and inspires them to give their best. Shared with customers, it shapes customers‘
understanding of why they should work with the organization.

Developing a Vision Statement

1. The vision statement includes vivid description of the organization as it effectively carries
out its operations.

2. Developing a vision statement can be quick culture-specific, i.e., participants may use
methods ranging from highly analytical and rational to highly creative and divergent, e.g.,
focused discussions, divergent experiences around daydreams, sharing stories, etc. Therefore,
visit with the participants how they might like to arrive at description of their organizational
vision.

3. Developing the vision can be the most enjoyable part of planning, but the part where time
easily gets away from you.

4. Note that originally, the vision was a compelling description of the state and function of
the organization once it had implemented the strategic plan, i.e., a very attractive image
toward which the organization was attracted and guided by the strategic plan. Recently, the
vision has become more of a motivational tool, too often including highly idealistic phrasing
and activities which the organization cannot realistically aspire.

VALUE STATEMENTS

Value statements define the organisation‘s basic philosophy, principles and ideals.
They also set the ethical tone for the institution. An organisation‘s values are evident in the
statements that define the organization and the processes used to achieve its mission and
vision.

Developing a Values Statement

1. Values represent the core priorities in the organization‘s culture, including what drives
members‘ priorities and how they truly act in the organization, etc. Values are increasingly
important in strategic planning. They often drive the intent and direction for
―organic‖ planners.

2. Developing a values statement can be quick culture-specific, i.e., participants may use
methods ranging from highly analytical and rational to highly creative and divergent, e.g.,
focused discussions, divergent experiences around daydreams, sharing stories, etc. Therefore,
visit with the participants how they might like to arrive at description of their organizational
values.

3. Establish four to six core values from which the organization would like to operate.
Consider values of customers, shareholders, employees and the community.
 Mr. Channabasappa. K.M

4. Notice any differences between the organization‘s preferred values and its true values (the
values actually reflected by members‘ behaviors in the organization).

5. Incorporate into the strategic plan, actions to align actual behavior with preferred
behaviors.

OBJECTIVES

 Objectives are the ends toward which activity is aimed-they are the end results to
ward which activity is aimed.
 ―Objectives are goals, aims or purposes that organizations wish over varying periods
of time‖-McFarland
 ―A managerial objective is the intended goal that prescribes definite scope
and suggests direction to the planning efforts of a manger‖-Terry and Franklin

GUIDELINES FOR OBJECTIVE SETTING

Objectives

 Must be clearly specified

 Must be set taking into account the various factors affecting their achievement
 Should be consistent with organizational mission
 Should be rational and realistic rather than idealistic
 Should be achievable but must provide challenge to those responsible for achievement
 Should start with ―to‖ and be followed by an action verb
 Should be consistent over the period of time
 Should be periodically reviewed
 Should have hierarchy

Organisational objectives

 Should have social sanction

 An organization may have multiple objectives
 Can be changed

NATURE OF OBJECTIVES

 Each organization or group of individuals have some objectives

 Objectives may be broad or they may be specifically mentioned
 Objectives may be clearly defined
 Objectives have hierarchy.
 Organizational objectives have social sanction, that is, they are created within the
social norms.
 An organization may have multiple objectives.
 Organizational objectives can be changed

FUNCTIONS OF OBJECTIVES

 To define an organization
 To provide directions for decision making
 To set standards of performance
 To provide a basis for decentralization
  Integrate organization, group and individual

PHILOSOPHY

The statement of philosophy is defined as an explanation of the systems of beliefs that

determine how a mission or a purpose is to be achieved. An organisation‘s philosophy states
the beliefs, concepts and principles of an organization.

NURSING SERVICE PHILOSOPHY

The nursing service philosophy is a statement of beliefs that flows from and is
congruent with the institution‘s philosophy. The belief system of the nursing philosophy
should reflect the nursing division member‘s ideas and ideals for nursing and should be
endorsed by others.

COMPONENTS OF NURSING SERVICE PHILOSOPHY

1. NURSING/NURSING PRACTICE

Nursing is a health care service mandated by society; the practice of nursing stems
from the beliefs and ideals of the nursing service department.

In the first area, nursing theory, the task for the nurse manager is to decide whether and how
to incorporate theory. Three different methods may be considered.

 One method is to use an eclectic approach, selecting ideas and constructs from
various nursing theories and incorporating these into the philosophy.
 A second method is to use one theory throughout the philosophy.
 A third approach is to adopt a theory, then attach the entire document describing the
theory to the philosophy and refer to the theory at appropriate places in the
philosophy.

A second set of values related to nursing/nursing practice center around practice, education
and research.

 Values specific to education are essential content for most departments of nursing.
The beliefs may focus on the need for continuing education off staff members. The
third value related to the concept of nursing practice is research and this include the
department‘s commitment to applying research findings or supporting others in their
research efforts. The beliefs held about the areas of impact of administration will
influence the formation of philosophy. The last content area related to
nursing/nursing practice is nursing ‗s role in over all organization.

2.PATIENT/CLIENT

The patient is the main reason for the institution‘s existence, examine patient‘s rights. Beliefs
concerning patient's rights will be influenced in part by institutional policies and practices .

3.NURSES

Nurses are essential in the day-to –day operations of the hospital organization. They
are the providers of nursing acts which result in quality, care. To keep the organization
 Mr. Channabasappa. K.M

functioning smoothly ,it is necessary to address values related to and beliefs about nurses.
These values and beliefs center around nurses rights, advancement criteria and
responsibilities to other health professionals, as well as professional organizations.

PHILOSOPHY OF NURSING EDUCATION

“Philosophy of nursing education is the written statement of the believes, values,

attitudes and ideas which the faculty as a group agreed upon in relation to the nursing
educational programme such as health, disease, nursing, nurse, nursing profession, education,
learner, society, patient, nursing education and preparation of nurses.‖

Philosophy of f nursing education is a perfect combination of nursing and philosophy of

education, more precisely, philosophy of nursing and philosophy of education is the
application of the fundamental belief of nursing and education in the field of nursing. In the
philosophy of education, importance is given to the students. The objectives formulated with
a philosophical basis of education focus on the student life and the all round development.

FACTORS INFLUENCING PHILOSOPHY OF NURSING EDUCATION

Beliefs and values of faculty members regarding god, man, life, health, disease, nursing etc

 The philosophical values and beliefs of the institution

 The environment where the education takes place
 The student and activities
 Health needs of the society
 The culture and background of the people
 Developments in nursing, medicine and allied fields
 Philosophy of nursing service administration
 The goals and objectives of the health care delivery system
 The disease pattern, the health awareness and health facilities available
 The available resources in terms of man, money and materials

CONCLUSION

Mission, vision, value statements, objectives and philosophy act as a basis for any
organization. So an administrator has to be vigilant while formulating these.

REFERENCES

1. Basavanthappa BT. Nursing Administration. 1st edn. New Delhi: Jaypee Brothers;
2000
2. Wehrich H, Koontz H. Management A global perspective. 11th edn.New Delhi: Tata
McGraw-Hill Publishing company ltd;2005
3. Marquis BL,Huston CJ. Leadership and Management Functions in Nursing- Theory
and application. 5th edn. Philadelphia: Lippincott Williams and Wilkins; 2006
4. Ward MJ, Price SA .Issues in nursing administration. St.Louis: Mosby;1991.
5. Marquis B.L. ,Hutson C.J . Leadership roles and management functions in nursing–
Theory and application. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2006.
6. Douglass L M. The effective nurse- leader and manager. 5th ed. Mosby: St. Louis;
1996.
7. Morrison M. Professional skills for leadership. Mosby: US; 1993.
 8. CURRENT TRENDS AND ISSUES IN NURSING

ADMINISTRATION INTRODUCTION:

Administration is the activities of group co-operating to accomplish common goals. In other

words, it is the organisation to use man and materials to accomplish a purpose. It is the just as
definitely as an engineer has the skill of building structures. The term administration is also in a
narrower sense refers to those patterns of behaviour that are common to many kinds of co-
operating groups and do not depend upon either the specific goals towards which they are co-
operating or the specific technological method used to reach these goals.

TRENDS IN NURSING ADMINISTRATION:

The development of nursing service has been enhanced greatly by advances made in
professional skills and technical proficiencies. But it is apparent that the same advancement has
not confined in nursing administration. So, followings are the trends of nursing service
administration.

NURSING SERVICE IN THE ANCIENT TIMES:

Introduction to simple nursing can be traced to the ancient civilization. In the book of
Charaka it is mentioned that ―the physician, drug, nurse and patient constitute an aggregate
of four. Also in the time of Hippocrates, we can see the emergence of different categories of
workers to carry out specific nursing tasks.

INFLUENCE OF CHRISTIAN ERA IN THE NURSING SERVICES:

During the Greek medicine and Christian era, nursing becomes a respected occupation
in which the most unpleasant work was made dignified by a sense of devotion. As the church grew
in strength, it created positions designated to provide simple services to members of the
community. In that period, nursing was only an art. Scientific knowledge and its application to
nursing were unknown in the middle age. The nursing personnel were illiterate and overworked.

EMENGENCE OF MODERN NURSING SERVICES:

In the 18th century as men came up with new ideas about the material world and the
world of human society, the development of modern medicine and nursing followed. With the
emergence of modern medicine and hospitals, adequate nursing service becomes a prime
necessary. In 1960, Florence Nightingale‘s concept of a new system of nursing became a reality
through the establishment of a training school at St. Thomas Hospital. London.

EMERGENCE OF NURSING SERVICE STANDARD:

During 1935-1950 social forces has a tremendous influence upon the development of
nursing services. The value of scientific method and facts were seen in the horizon of nursing
service administration. As the hospital grew at the time of industrial revolution, it accepted norms
of modern business organization. Administration was concerned with placing of nursing service as
a whole in the hospital. The director of nurses won control over many administrative aspects of
nursing services. With the expansion of services to the patient, the nursing director was force to
 Mr. Channabasappa. K.M

delegate more responsibility and authority to the nurse‘s of the patient‘s unit. The role of graduate
nurse in most hospitals became one of co-ordinating and controlling nursing services and hospital
services.

NURSING SERVICE IN THE BUREAUCRATIC SYSTEM:

The second phase of hospital and nursing service administration is called the
bureaucratic system of control. The nursing service groups were brought under one line of
authority. During this system, the decisions were usually made through the interaction of three
groups: the administration, the medical staff and the board of trustees. The nursing services were
ignored.

HOSPITAL NURSING SERVICE AT MID CENTURY:

During the period from 1950, numerous studies were performed on problems related to
nursing care. Nurses, educators, physicians, hospital administrators and others were actively
engaged in various projects and experimentation.

EMERGENCE OF NURSING SERVICE ADMINISTRATION:

The National Council published its report ‗Nursing for the future‘ which is known as the
Brown‘s report. The report indicated that in nursing service, administrative and supervisory staffs
tend to be authoritarian and nurses had little freedom in taking decision and judgements for the
care of patients. Brown‘s report pointed out the need of sound legislation regarding the training
and functions of practical nurse and other health workers.
In 1950, the WK Kellog Foundation conducted a 5 month seminar on nursing service
administration, education and in nursing research.

MODERN TECHNIQUES OF NURSING ADMINISTRATION:

Trends mean change. The nursing administration also changing day by day in
response to the technological improvement and the high demand of the consumer. So, the trends of
nursing administration are mainly based on 2 techniques.

i. Qualitative techniques
ii. Quantitative techniques

QUALITATIVE TECHNIQUES:

These are also known as ‗Behavioural technique‘. Followings are the major
behavioural techniques.

(a) ORGANIZATIONAL DESIGN:

Organization means the formal structure of authority calculated to define, distribute
and provide for the co-ordination of tasks and contribution to the whole.
Each organisation has a formal and informal structure that governs work flow and
interpersonal relationship. The formal structures are planned and publicised and the informal
structures are unplanned and covert.
Poor organization is a waste of resources. It is a theory of management that
organization must be suited to its current situation and the needs to be served. The organisation of
the health services should therefore be so designed as to meet the health needs and demands of the
people. Further, the organizational design should be reviewed every few years because of
changing concept of purpose, changing problems and changing technology.
There have been several changes is taking place in the health care delivery
system. Due to these developments a new type of formal organization structure ‗Adhocracy‘ or
matrix structure, has been adopted by more innovative nursing organisation. It is a relatively flat
hierarchical structure in which a constantly changing project team organisation is superimposed on
a fully functionalised line and staff organisational structure.

(b) PERSONAL MANAGEMENT :

It is a responsibility of all those who manage people as well as being a description
of the work of those who are employed as specialists. It is that part of management which
is concerned with people at work and within an enterprise. It applies not only in industry
and commerce but to all fields of employment.
The areas of personal management identified the following areas-------
i. Staffing
ii. Training and development
iii. Wage and salary administration
iv. Motivation
v. Working condition and employee welfare
vi. Labour relation
vii. Employee record

OBLIGATIONS OF PERSONAL MANAGEMENT:

i. It must satisfy the employees by ensuring the security of the job, income, prestige
and opportunity to rise.
ii. It must satisfy the owners by maximising the economic efficient.
iii. It must satisfy the community and community at large, by supplying them goods
and services as efficiently as possible and by preserving and advancing goodwill,
morale, loyalty and its reputation.

FUNCTIONS OF PERSONAL MANAGEMENT:

i. Anticipating vacancies.
ii. Recruitment.
iii. Organisational planning.
iv. Selection of employees.
v. Classification of employees.
vi. Induction of new employees.
vii. Transfer and promotion.
viii. Manpower development.
ix. Training of employees.
x. Evaluation of jobs.
 Mr. Channabasappa. K.M

(c) COMMUNICATION:

Communication is the basic element of human interaction that allows people to establish,
maintain and improve contacts with others. Nursing is a communicative intervention and the
foundation of nursing lies in the ‗communicative attitude‘.

Levels of Communication may be of

---- Intrapersonal

---- Interpersonal

---- Public communication.

Types of communication may be of

---- Verbal communication

---- Non-verbal communication

Better communication contributes to effective functioning of an organisation. Communication

barriers are responsible for delays in regular reporting and notification delays in the compilation of
statistics, delays in prompt remedial measures and release in supplies and salaries.

(d) HEALTH INFORMATION SYSTEM:

Information is needed for the day-today management of health system. Appropriate

decision making and programme planning in the health and related fields are not possible without
establishing an effective health information system. The function of an information system
consists of classification, transmission, storage, transformation and display of information. A good
information system provides data for monitoring and evaluation of health programmes and gives
the requisite feedback to health administration and planners at all levels.

A nationwide organisational set-up should be established to procure essential health

information. Such information is required not only assisting in planning and decision making but
also to provide timely planning about emerging health problems and for reviewing, monitoring
and evaluating the various ongoing health programmes. The building up of well conceived health
information system is also necessary for assessing medical and health manpower requirements and
taking timely decision, on a continuing basis, regarding the manpower requirements in the future.

(e) MANAGEMENT BY OBJECTIVES (MBO):

According to Goerge S. Odiorne, MBO is

―A process whereby the superior and the subordinate managers of an enterprise jointly
identify its common goals, define each individuals major areas of responsibility in terms of the
results expected to him, and use these measures as guides for operating the units and assessing the
contribution of each of its members‖.
 STEPS OF MBO:

i. Setting the organisational objectives and its purposes.

ii. Key result area.
iii. Setting subordinates objectives.
iv. Matching resources with objectives.
v. Appraisal.
vi. Recycling.

BENEFITS OF MBO:

I. Helps in better managing the organisational resources and activities.

II. Organisational objectives are defined clearly and they help in relating the
organisation with its environment.
III. Provides a greatest opportunity of personal satisfaction.
IV. It stimulates organisational change and provides a framework and guidelines
for planned change, enabling the top management to initiate plan direct and
control the direction and speed of change.

PROBLEMS AND LIMITATION OF MBO:

I.It requires a large amount of time and requires a large amount of the most scare
resources in the organisational time of senior manager.

ii. Sometimes the manager fails to understand and appreciate this new approach.

Iii.MBO requires verifiable objectives and setting of such objectives may be difficult
in some areas.

Iv.MBO represents the danger of inflexibility in the organisation, particularly when

the objectives need to be changed.

V.MBO Emphasises on short term objectives which may help in performance

appraisal but there always a danger in giving the emphasis in long term objectives because of
certain specific problems.

QUANTITATIVE TECHNIQUE:

Quantitative techniques are derived from the field of economics, operation research.
Some of the techniques have a great role in a management of health services.

(A) COST BENEFIT ANALYSIS:

Cost-benefit analysis is a planning technique that answers the following questions.

----What are the costs of pursuing a goal, an objective, a programme or a
specific nursing intervention?
----How do costs compare with the benefits?
----Is the project worthwhile?
 Mr. Channabasappa. K.M

It is a management technique which is attracted the widest attention for application in the health
field. The economic benefits are expressed in monitory terms to determine whether a given
programme is economically sound and to select the best out of several alternative programmes.

OPERATING OR CASH BUDGET:

The cash budget is the actual operating budget in detail, usually excluding the capital
budget. A cash budget indicates whether cash flow will be adequate to meet anticipated payment
including replacement and expansion of facilities, unanticipated requirements, payroll, payment of
supplies and services and a prudent investment programme.

The cash budget is the day-to-day budget and represents money coming in and going
out. It is advisable to have a cash reserves so that cash flow and the money coming will pay the
bills.

NEGETIVE CASH FLOW:

The 4 major factors that influence negative cash flow are as follows----

 Time lag between delivery of services and collection of payments.

 The difference in cycles between the timing of net income and flow of cash.
 Lag created by large up and down cycles of volume during different seasons.
 Labour expenses paid out in salary and wages does not cycle concurrently with
collections.

A cost benefit ratio (Z) is defined as the ratio of the value of benefits of an alternative to the value
of alternative cost.

Z= Present value of economic benefit/ Present value of economic costs.

The analysis consists of the following steps.

 A clear statement of objectives.

 Identifying all alternative actions that can achieve the objectives.
 Converting all costs and all benefits with each for each alternative to monitory
value and quantitative evaluation of costs and benefits of each.
 Selection of best cost effective approach

DRAWBACK:

The main draw back with this technique is that the benefits in the health field. As a result of a
particular programme cannot always be expressed in monitory terms. We generally express the
benefits in terms of births and deaths or illnesses avoided or overcome. Hence the scope of
applying this method is rather vague.

(B) COST EFFECTIVE ANALYAIS:

Cost effective methods are those that search for the least costly way of achieving the
defined result. Cost effective analysis is easier to make, as that is clear. It helps the administrator
in managing his health resources at the local level. The problem is to find the way of achieving the
objectives at the lower cost.
 This is a promising tool for application in the health fields than cost benefit. Eg: number
of life saved or number of people free from disease.

(C) ABC ANALYSIS:

It is a technique which would enable a busy executive to chase those activities ardently
which would quicken the wheel of administrative machinery. By arranging his work into an order
of priorities, he can decide on which item to concentrate first, which can be deal later and yet
which others to delegate to his assistants. When done it more systematically and in quantitative
terms, this system building up priorities of work called the ABC analysis.

ABC analysis can be of great use in dealing with materials management. Here it is the analysis of
store items on cost criteria.
A- Items high cost centres
B- Items intermediate cost centres
C- Items low cost centres

In so far an inventory control is concerned the following guidelines will help in keeping the
system optimum.

A items --
 Tight control
 Rigid estimates
 Strict and close watch
 Safety stocks should be low
 Management of items should be at top management level

B items—

 Moderate control
 Purchase based on rigid requirements
 Reasonably strict watch and control
 Safety stocks moderate
 Management be done at middle level

C items—

 Ordinary control measure

 Purchase based on usage estimate
 Control exercises by store keeper
 Safety stocks high
 Management be done at lower level

VED METHOD:

In this method each stock item is classified as vital, essential and desirable based on how
critical the item is for providing health services. The vitals items are stocked in abundance,
 Mr. Channabasappa. K.M

essential items are stocked in medium amount, and desirable items are stocked in small amounts.
By stoking items are always in stock which means a minimum disruption in the services offered.

(d) COST ACCOUNTING:

It provides basic on cost structure of day programme. Financial records are kept by a
manager permitting costs to be associated with the purpose for which they are incurred. The
important purposes of cost accounting in health services are cost control planning and allocation
of people and financial resources.

(e) INPUT OUT ANALYSIS:

Input analysis is an economic technique in the health field. Input refers to all health
service activities which consume resources, manpower, material and time. On the other hand
output refers to such useful outcome as treated lives saved or inoculations performed. Input-output
table shows how much of each input is needed to produce a unit of output.

(f) SYSTEM ANALYSIS:

It is a scientific and detailed definition of a system that it examines:

---- The system purpose

----Overall requirements

----Number and type of subsystem

----Nature of subsystem interaction

The purpose of the system analysis is to keep the decision maker to choose and appreciate course
of action by investigating his problems, searching out objectives, finding out alternative solutions,
evaluation of alternative solutions, evaluation of alternatives in terms of cost effectiveness, re-
examine the objectives if necessary and finding out the cost effectiveness of the alternatives.

(g) NETWORK ANALYSIS:

A network is a graphic plan of all activities to be composed greater discipline in planning.

The two common types of network technique are--

 PERT—Programme evaluation review technique

 CPM--- Critical path method

PERT:

The programme evaluation and review technique was developed by a special Projects Office of
the US Navy and applied to the planning and control of the Polaris weapon system in 1958. The
PERT system has been widely applied as a controlling process in business and industry. It can be
considered as a road map of a particular project in which all major events have been identified and
relationship among events clearly indicated.
 PERT uses a network of activities, each of which is represented as a step on a chart.
A time measurement and an estimated budget should be worked out that include the following.

 Finished product or service desired.

 Total time and budget needed to complete the project or programme.
 Start and completion dates.
 Sequence of steps or activities required to accomplish the project or programme.
 Estimated time and cost of each step or activity.
 Three paths for steps 4 and 5:
 Optimistic time----This occasionally happens when everything goes
right. This estimate is predicted on minimal and routine difficulties in the
activity.
 Most likely time----It represents the most accurate forecast based on
normal developments if only one estimated was given, this would be it.
 Pessimistic time This is estimated on maximum potential difficulties.
The assumption is that here is whatever can go wrong will go wrong.

The formula based on the probability distribution of time involves in performing the activity is
then used. The formula is-----

Activating time= (O+4M+P)/6

Whereas, O is optimistic time

M is most likely time,

and P is pessimistic time

 Calculation of the critical path, the sequence of the events that would take the longest
time to complete the project or programme by the planned completion date. This is the
critical path because it will leave the slack time.
 The longest pathway between events is the critical path. It is used as a planning,
scheduling, organising, co-ordinating and controlling technique.
 Atypical PERT analysis may run into hundred of events.

NEEDS FOR PERT SYSTEM FOR A NURSE MANAGER:

 It forces planning and shows how the pieces fit for all nursing line managers
involved.
 It establishes a system for periodic evaluation and control at critical points in the
programme.
 It reveals problems and is forward-looking.

ADVANTAGES:

 Provides logical sequence of activities.

 Clarifies where additional resources are required to complete the task.
 Clarifies where delays are permissible and where not essential deadlines become
evident.
 Mr. Channabasappa. K.M

 Depicts a large number of independent activities that make up the total task.
 Every principle activity can assign to a person whose attention is constantly drawn to
deadlines in particular areas.

CPM:

CPM is the most versatile planning and control technique used in business. It was first
employed by the E.I. Nemours Company. Unlike PERT it is applied in those projects where
activity timings are relatively well known. It is used for planning and controlling the most logical
sequences of activities for accomplishing a project.

The critical path method is basically a technique to reduce the time required to
implement a project. By breaking the project into activities that must be undertaken for its
implementation and by determining their time sequence, it is possible to isolate the most critical
path schedule in their implementation.

Under CPM, the project is analysed into different operations or activities and their
relationships are determined and show on the network diagram. The network or flow plan is then
used for optimizing the use of resources and time. It is based on the assumption that the expected
time is actually time taken to complete the project. CPM is suitable for construction of projects
and plant maintenance.

CPM requires greater planning than required otherwise thus it increases the
planning cost, but this increases in cost is justified by concentrating on critical paths and avoiding
expenses on the strict supervision and control of whole project. Besides asserting the schedule
CPM provides standard method of communication project plans, schedule and costs.

ADVANTAGES:

 It provides on analytical approach to the achievement of project objectives which

are defined clearly.
 It identifies most critical demands and paths more attention on these on these
activities.
 It helps in ascertaining the time schedules.
 It makes use of better and detailed planning.
 It assists in avoiding waste a time, energy and money on unimportant activities.
 It provides a standard method for communication project plan schedules and
costs.

STEPS IN PERT/CPM:

The application of network technique in project management involves following step:

(a) IDENTIFICATION OF COMPONENT:

The first step in the application of PERT/CPM is identification of all key activities and
phases or events necessary for the completion of the project. It is denoted by a circle in a network
diagram. E.g. A Construction Company having a project for the construction of storied
commercial complex can identified the broad activities from 1 to 10.

Activity Expected time in week

1. Procurement of materials 5
2. Foundation of work 10
3. Construction of 1st floor 20
4. Construction of 2nd floor 22
5. Plumbing 6
6. Electrical fittings 10
7. Instillation of doors and windows 8
8. Plastering 15
9. Flooring 8
10. Painting 8

(b) SEQUENCING OF ACTIVITIES AND EVENTS:

A network diagram is prepared to show the sequence of activities and events. It has a
beginning point and a termination point of the project. It also depicts the number of paths or
activities from beginning to the completion of the project. Each event is given serial number for
the sake of convenience. It may be noted that some activities have to be undertaken sequentially
while others are to be carried out concurrently.

(c) Determination of estimated time:

It is essential to determine the expected time required to complete each activity.

(d) Determinant of critical path:

Under this stage, it is required to identify the sequence of those activities whose
completion of the project. The line in the network diagram connecting the critical activities from
start to finish of the project is the critical path.

(e) Modification of initial plan:

The project analysis should not after the critical plan been identified, the potential exist for
substantially impression upon critical plan.

(f) Controlling the project:

The project managing has to be in constant touch with the persons engaged in the critical
activities. If there has been and difficulties or obstacles, there are to be removed.

(g) Planning, programming and budgeting system (PPBS):

PPBS is a system to help decision makers to allocate resources of an organisation are used
in the most effective way in achieving its objectives. Another approach is known as zero budget
approach i.e. all budgets start of zero one gets any budget that he cannot specifically on a year to
year basis.
 Mr. Channabasappa. K.M

(h) Job analysis:

Job analysis is the process of gathering information on all aspects of a specific job. Job
analysis is a scientific study and statement of all the facts about the job, which reveal tent and the
modification and the modifying factors, which surround it.

GANTT CHARTS:

Early in the 20th century, Henry L. Gantt developed the Gantt chart as a means of controlling
production. The chart, which is usually used for the production activities, depicts a series of events
essential to the completion of a project or programme.

A Gantt chart can be applied to a major nursing administration programme or

project. The five major activities identified are segments of a total programme or project. The
chart could be applied to a project. The chart applied to a project such as implementing a modality
of primary nursing or implementing case management. The following are the possible nursing for
a project:

 Gather data
 Analyze data
 Develop a plan
 Implement a plan
 Evaluation, give feedback and modify the plan as needed.

Application of this controlling process by nurse managers would be specific to the project or
programme and the time elements for the various activities would vary.

CRITICAL CONTROL POINTS AND MILESTONES OF GANTT CHART:

Master evaluation plans should have critical control points, specific points in production
of goods or services at which the nurse administrator judges whether the objectives are being met
qualitatively and quantitatively. Critical control points tell whether the plan is progressing
satisfactorily. Milestones are segments or phases of specific activities of a project of programme
that are projected to occur within a time frame.

A critical path is

1 2 3 4 5 6 7 8 9 17 18

Line 5 represents the evaluation of all nursing actions. This illustration is a simplified version of a
control technique. Case management also uses critical paths with milestones and control points.

Application of the milestones technique involves establishing and network of

controllable pieces when planning a project or programme. Each piece of the project or
programme is also allocated a prorated portion of the total budget. A nurse manager could use this
technique to evaluate the actual expenditure amount versus the estimated budget at the end of each
step of activity of the project or programme. This will be the control points, as each would
culminate in the achievement of a milestone. Bar graph are frequently used to depict milestone
budgeting. Budgeting is a major controlling technique in any of its forms.

Educational trends

 FMHW Programme :

1. Meant to work at sub centers.

2. Main thrust: MCH service, implementing intervention of national health
programme.
3. Including IMR, MMR child mortality rates.

 Old ANM programme

1. Meant to meet the demands generalized service

 GNM programme

 Bachelor’s degree programme .

 Post certificate diploma programme in

1. Public health nursing

2. Psychiatric nursing
3. Pediatric nursing
4. Cancer nursing
5. Nursing education and administration
6. Other nursing specialities

 M.Sc.

 M Phil

 PhD programmes

1. University of Delhi.
2. Jawaharlal Nehru University.
3. Calcutta university
4. MGR university of health science, madras
5. Madras university
6. IGNOU
7. RGUHS
8. MANGALORE UNIVERSITY
9. SNDT university
10. Punjab university, Chandigarh
11. MAHE- maniple
 Mr. Channabasappa. K.M

 Central institutions.

1. AIIMS ,New Delhi

2. All India institute of hygiene and public health, Calcutta
3. PGI, Chandigarh
4. IPGMER, Pondicherry
5. MAHE, maniple
6. NIMHANS, Bangalore.&NIHFW, New Delhi.

ISSUES OF NURSING ADMINISTRATION:

As far as nursing administration is concerned, it is in pathetic condition. Both union and

state governments have decided to give some gazetted ranks to the nurses. Accordingly, we have
very few gazetted posts but there is no independent power or authority.

Most of the equivalent posts of other cadres in the government elevated to the
gazetted ranks group A and B but the key post like Nursing Superintendent grade 1 is only group
B.

Now the situation has gone from bad to worse, worst to the extent that for filling up of
the vacancies of nursing cadre, the government nurses association has go to an agitation. After
strike they will fill up some vacancies. Like this so many problems, prevailing in the nursing
administration are given below:

i. Issues related to non-involvement:

Non-involvement of nursing administrators in planning and decision-making in the

government hospital administration.

Ii.Assignment of non specific power:

No specific power has been assigned to the nursing superintendent, but he/she has
been made in-charge of all inventories and linen of hospital.

Iii.Issues related to sanctioning leave:

Nursing superintendent will have no authorities to sanction leave to their subordinate.

Iv.Lack of technical expertise:

Administrators always depend on the advice of clerical staff in all matters including
technical aspects.

V. Lack of knowledge:

Nurses don‘t have enough knowledge in management of hospital and how to manage the
staffs and other subordinates.

Vi.No written policies:

 Nurse don‘t have proper written policies and manuals and there is no proper job
description for various cadres.

Vii. Lack of staff development programme:

In many hospital and institutions do not organize staff development programme which
includes in-service education, continuing nursing education etc.

Viii. No special incentives:

No special incentives like Rajyotsava Award, Republic Day Award as government itself
honour these awards to other government employees like teachers, police persons.

CONCLUSION:

Administration is a enabling process for achieving the laid down objectives of an

organisation through formulated plans and policies whereas management as the processes of
putting administration into practice or effect. In other words administrators are responsible
for formulating policies, plans and procedure to achieve expected goals.

BIBLIOGRAPHY:

(1) Lucita Mary, Nursing: Practice and Public Health Administration (2nd Edition),
Published by Elsevier, New Delhi. Page no 3-19.
(2) Roussel Linda, Management and Leadership for Nurse Administration (4th Edition) ,
Jones and Bartlett Publishers, Sudbury. Page no 392-401.
(3) Trained Nurses Association of India, Nursing Administration and Management. Page
no 256-267.
(4) Samson Rebecca. Leadership and Management in Nursing Practice and Education (1st
Edition) Jaypee Brothers Publisher Ltd, New Delhi. Page no 64-69
(5) Basavanthappa BT. Nursing Administration ( 1st Edition) ) Jaypee Brothers Publisher
Ltd, New Delhi. Page no 538-539 and 258-260.
 Mr. Channabasappa. K.M

9. THEORIES AND MODELS

A. SCIENTIFIC MANAGEMENT THEORY:
Principles: the scientific management focuses on

 Observation
 The measurement of outcome

The pioneers of scientific management are:

1. Frederick W. Taylor (1856-1915)
2. Gantt Henry I. Gantt (1861-1910)
3. Emerson (1853-1936)
1) Frederick W. Taylor (1856-1915):
Taylor is recognized as father of scientific management. He conducted Time-And-
Motion studies to time the workers, Analyze their movements and set their standards. He
used stop watches. He applied the principles of observation, measurement and scientific
comparison to determine the most effective way to accomplish a task.

Achievements of Taylor:
1. He trained his workers to follow the time to complete the task given. The most
productive workers were hired even when they were paid an incentive or wage.
2. Labour costs per unit were reduced as a result.
3. Responsibilities of management were separated from the functions of the workers.
4. Developed systematic approach to determine the most efficient means of production.
5. He considered management function is to plan.
6. Working conditions and methods to be standardized to maximize the production.
7. It was the management‘s responsibility to select and train the workers rather than
allow them to choose their own jobs and train by themselves.
8. He introduced an incentive plan to pay the workers according to the rate of production
to minimize workers dissent and reduce resistance to improved methods.
9. Increased production and produce higher profits.

The effect of time- motion study of Taylor:

1. Reduced wasted efforts
2. Set standards of performance
3. Encouraged specialization and stressed on the selection of qualified workers who
could be developed for a particular job.

2) Gantt Henry I. Gantt (1861-1910):

Gantt was concerned with problems related to efficiency. He contributed to scientific
management by refining the previous work of Taylor than introducing new concepts.
1. He studied the amount of work planned or completed on one axis to the time needed
or taken to complete a task on the other axis.
2. Gantt also developed a task and bonus remuneration plan whereby workers received a
guaranteed day‘s wages plus a bonus for production above the standard to stimulate
higher performance.
 3. Gantt recommended to select workers scientifically and provided with detailed
instructions for their tasks.
4. He argued for a more Humanitarian approach by management, placing emphasis on
service rather than profit objectives.
5. He recognized useful non –monetary incentives such as job security and encouraging
staff development.
3) Emerson (1853-1936):
His emphasis was on conservation and organizational goals and objectives.
He defined principles of efficiency related to:
1. Interpersonal relations and to system in management.
2. Goals and ideas should be clear and well-defined as the primary objective is to
produce the best product as quickly as possible at minimal expense.
3. Changes should be evaluated-management should not ignore ―commonsense‖ by
assuming that big is necessarily better.
4. ―Competent counsel ―is essential.

His theory explains about

1. Management can strengthen discipline or adherence to the rules by justice, or equal
enforcement on all records, including adequate, reliable and immediate information
about the expenses of equipment and personnel should be available as a basis for
decisions.
2. Dispatching or production scheduling is recommended.
3. Standardized schedules, conditions and written instructions should be there to
facilitate performance.
4. ―Efficiency rewards ―should be given for successful completion of tasks.
5. Emerson moved further beyond scientific management to classic organizational
theory.
4. Charles Babbage (1792-1871): Charles Babbage ,a scientist mainly interested in
mathematics, contributed to the management theory by developing the principles of cost
accounting and the nature of relationship between various disciplines. Charles Babbage
laid the foundation for much of the work that later come to be known as scientific
management. He concentrated on production problems and stressed the importance.

1) Division and assignment of work on the basis of skill and

2) The means of determining the feasibility of replacing manual operations with automatic
machinery.
B. CLASSIC ORGANIZATIONAL
THEORY: Importance of classic
organization theory:
 The classic administration-organization thinking began to receive attention in
1930.
 Organization is viewed as whole rather than focusing solely in production.
 The concepts of scalar levels, span of control, authority, responsibility,
accountability, line staff relationships, decentralization, and departmentalization
become prevalent.
 Mr. Channabasappa. K.M

Three pioneers of Classic organizational theory:

1) Henry Fayol (1841-1925):
Fayal was a French industrialist known as father of the management process school
concerned with management of production shops. He studied the functions of managers and
concluded that management is universal.
Functions of management:
1. Planning policies, programs and procedures.
2. Organization based on hierarchy of authority
3. Directing the business in order to gain optimum return from all workers.
4. Coordination, signifying harmony in activities of the organization and to facilitate
its working
5. Control, the errors of the functionaries of organization and ensure that such errors
do not occurs.
Fayol divided all the work carried out in a business enterprise into the following
categories.
1. Technical activities (production, manufacture, etc)
2. Commercial activities (buying, selling, personnel, and industrial relations)
3. Financial activities( to have optimum use of capitals)
4. Security activities(production of property and persons)
5. Managerial activities(planning organizing, commanding, directing, coordination
control, communication, motivation .leadership)
Principles by which good organization can be recognized. They are as follows:
1. The number of organization units should be the minimum needed to cover the major
enterprise functions.
2. All related functions should be combined within one unit.
3. The number of levels of authority should be kept to a minimum.
4. There should be room for initiative with the limit of his assigned authority.
5. Functions should be assigned so as to minimize cross relations between organizational
units.
6. No more employees should report to a superior than he can effectively direct and
coordinate.
2) Max Webber theory (1864-1920):
He is German psychologist. He earned the title of father of organizational theory. His
emphasis was on rules instead of individuals and on competencies over favoritism. His
conceptualization was on bureaucracy, structure of authority that would facilitate the
accomplishment of organizational objectives:
The three basis for authority:
1. Traditional authority, which is accepted because it seems things have always been that
way such as the rule of a king in a monarchy.
2. Charisma, having a strong influential personality.
3. Rational legal authority which is considered rational in formal organizations because
the person has demonstrated the knowledge, skills and ability to fulfill the position.
3) James Mooney Theory (1884-1957):
Moony believed that management to be the technique of directing people and
organization the technique of relating functions. Organization is managements responsibility.
Four universal principles:
1. Coordination and synchronization of activities for the accomplishment of goal.
2. Functional affects the performance of one‘s job description.
3. Scalar process organizes level of commands.
4. Arrange authority in to a higher Archie.
Consequently people get their right to command from their position in the organization.

C. HUMAN RELATION THEORY:

The human relations movement began in 1940s.
 Focused on the effect that the individuals have on the success or failure of an
organization.
 Classic organization and management theory concentrated on the physical
environment fail to analyze the human element.
Instead of concentrating on the organizations structure, managers encourage workers to
develop their potentials and help them meet their needs for
 Recognition
 Accomplishment
 Sense of belonging

1). Follett theory (1868-1933):

1. Follett stressed the importance of coordinating the psychological and sociological
aspects of management in 1920s.
2. She perceived the organization s a social system and management as a social process.
3. Indicated that legitimate power is produced by a circular behaviour where by
superiors and subordinates mutually influence one another.
4. The law of the situation dictates that a person does not take orders from another
person but from the situation.
2). Lewin theory (1890-1947):
1. Lewin focused on the Group dynamics.
2. He maintained that groups have personalities of their own: composites of the
member‘s personalities.
3. He showed that group forces can overcome individual interests.

D. BEHAVIORAL SCIENCE THEORY:

Emphasis is on:
1. Use of scientific procedures to study the psychological,
2. Sociological,
3. Anthropological aspects of human behaviour in organization.
 Mr. Channabasappa. K.M

Behavioural Science Indicated:

1. The importance of maintaining a positive attitude toward people,
2. Training managers,
3. Fitting supervisory actions to the situation,
4. Meeting employees needs.
5. Promoting employees sense of achievement,
6. Obtaining commitment through participation in planning and decision making.

1) Douglas McGregor’s Theory (1932):

McGregor‘s is the father of the classical theory of management which termed theory.
He developed the managerial implications of Maslow‘s theory. He noted that one‘s style of
management is dependent on ones philosophy of humans and categorized those assumptions
as theory X and theory Y.

Theory X
1. The manager‘s emphasis is on the goal of organization.
2. The theory assumes that people dislike work and avoid it.

Consequence of theory X
 Workers must be directed
 Controlled
 Coerced
 Threatened
So that organizational goals can be met.
According to theory X
1. Most people want to be directed and to avoid responsibility because they have little
ambition.
2. They desire security.
Managers who accept the assumption of theory X
1. Will do the thinking and planning with little input from staff associates.
2. They will delegate little, supervise closely.
3. Motivate workers through fear ad threats
4. Failing to make use of the workers potentials.

Theory Y
It is focuses on goal.
1. People do not inherently dislike the work and that work can be a source of
satisfaction.
2. Workers have the self direction and self control necessary for meeting their
objectives.
3. Will respond to the rewards for the accomplishment of those goals.

Managers who believe in this Y theory:

1. Will allow participation
2. They will delegate
 3. Give general supervision than close supervision
4. Support job enlargement
5. Use positive incentives such as praise and recognition.
They believe that under favourable conditions: people seek responsibility and display
imagination, unity and creativity. According to theory Y human potentials are only partially
used.

2).Rensis Likert’s theory:

Dr Rensis Likert has studied human behaviour within many organisations. After
extensive research, Dr. Rensis Likert concluded that there are four systems of management.
According to Likert, the efficiency of an organisation or its departments is influenced by their
system of management. His theory of management is based on his work at the University of
Michigan‘s institute for social research.Likert categorised his four management systems as
follows;
He identified three variables in organizations.
1. The casual variable includes leadership behaviour.
2. The intervening variables are perceptions, attitudes and motivations.
3. The end results variables are measures of profits, costs and productivity.

Factors measured by likert scale

The scale measures several factors related to leadership behaviour process:
 Motivation
 Managerial
 Communication
 Decision making process
 Goal setting
 Staff development
Four types of management system according to likert, effcets on the management systems:
a). Exploitive-authoritative:
1. He associates the first system with the least effective in performance.
2. Managers show less confidence in staff associates and ignore their ideas.
3. Consequently staff associates do not feel free to discuss their jobs with their managers

b). Benevolent- authoritative:

1. Staff associates ideas are sometimes sought, but they do not feel free to discuss their
jobs with the manager.
2. Top and middle management are responsible for setting goals.
3. There is minimal communication. Mostly downward and received with suspicion.
4. Decisions are made at the top with some delegation.

c). Consultative system:

1. The manager has substantial confidence in staff associates.
2. Their ideas are usually sought.
3. They fell free to discuss their job with the manager.
4. Goal setting is fairly general.
 Mr. Channabasappa. K.M

5. It has limited accuracy and accepted with some caution.

6. Broad policy is set at the top level.
7. There are decisions making throughout organization.
8. Control functions are delegated to lower level where.
9. Reward and self guidance are used.
10. There is some resistance from informal groups in the organization.

d) Participative group:
Group Participative is the most effective performance. Managers have complete confidence
in their staff associates. Their ideas are always sought, and they feel completely free to
discuss their jobs with the manager. Goals are set at all levels. There is a great deal
communication- upward, downward, and later that is accurate and received with open mind.

E. MODERN MANAGEMENT THEORIES:

The modern era is characterized by trends in the management through viz:-
1. Microanalysis of human behaviour, motivation, group dynamics leadership leading to
many theories of organization.
2. The macro search for fusion of the many systems in business organization-economic
social technical political and quantitative methods in decision- making.
Modern management theories era can be father classified as the three streams viz:
1. Quantitative approach
2. System approach
3. Contingency approach
Indicating further refinement, extension and synthesis of all the classical and neo-
classical approaches to management.
1. Quantitative approach: Management science refers to the application of Quantitative
methods to management. Management science has an interdisciplinary basis in other words
management science is a combination and interaction of different scientists.
2. System approach:-according to system approach the organization is the unified,
purposeful systems composed of interrelated parts and also interrelated with its environment.
Each unit must mesh/ interact with the organization as a whole, each manager most interact/
communicate and deal with executives of other unites and the organization itself must also
interact with other organizations and society as whole
3. . Contingency approach:

 The contingency approach can be described as the behavioural approach.

 Contingency theory does not prescribe the application of certain
management principles to any situation.
 Contingency theory is recognition of the extreme importance of
individual manager performance in any given situation.
 It rests on the extent of manager power and control over a situation and the
degree of uncertainty in any given situation.
  The role of management in the contingency approach is to develop an
appropriate management solution for any given organizational environment.
 It is principally directed at the management practitioner seeking to control a
distinct Organizational environment.

An open system model

Ludwing Von Bertanffy:

Bertanffy, a biology is credited with coining the general system theory. His contention were
that it was possible to develop a theoretical framework for describing relationship in the real
world and different disciplines with similarities could be developed into a general systems
model. The similarities were:
1. Study of organization
2. State of equilibrium
3. Openness of all systems and their influence o the environment and environment
influence on the system.

Luther Gulick:
He was influenced by Taylor and Fayol. He used Fayal‘s five elements of administration
viz.Planning,Organizing,Command,Coordination and Control as a frame work for his
neutral principles. He condensed the duties of administration into a famous
acronym‖POSDCORB‖.Each letter in the acronym stands for one of the seven activities
of the administrator as given below:
 Planning (P): working out the things that need to be done and the methods for doing
them to accomplish the purpose set for the enterprise.
 Mr. Channabasappa. K.M

 Organising (O): establishment of the formal structure of authority through which

work subdivisions are arranged, designed and coordinated for the defined objective.
 Staffing (S): the whole personnel function of bringing in and training the staff, and
maintaining favourable conditions of work.
 Directing (D): continuous task of making decisions and embodying them in specific
and general orders and instructions, and serving as the leader of the enterprise.
 Coordinating (CO): all important duties of interrelating the various parts of the work.
 Reporting (R): keeping the executive informed as to what is going on, which includes
keeping himself and his subordinates informed through records, research and
inspection.
 Budgeting (B): all that goes with budgeting in the form of fiscal planning, accounting
and control.
Luther Gulick was very much influenced by Fayal‘s 14 basic elements of administration in
expressing his principles of administration as follows:
1. Davison of work or specialization
2. Bases of departmental organization
3. Coordination though hierarchy
4. Deliberate coordination
5. Decentralization
6. Unity of command
7. Staff and line
8. Delegation
9. Span of control

Lyndal urwick:
Lyndal urwick also one of the among classical theorist, attached more important to the
structure of organization than the role of the people in the organization.
Lyndal urwick concentrated his efforts on the discovery of principles and identified eight
principles of administration applicable to all organization as given below:
1. The ―principle of objective‖-that all organizations should be an expression of a
purpose.
2. The ―principle of correspondence‖-that authority and responsibility must be co-equal.
3. The ―principle of responsibility‖-that the responsibility of higher authorities of
the work of subordinates is absolute.
4. The ―scalar principle‖-that a paramedical type of structure is build up in an .
5. The ―principle of span control‖-
6. The ―principle of specialization‖-limiting ones work to single function.
7. The ―principle of coordination‖-
8. The ―principle of definition‖-clear prescribed of every duty.

4. Critical theory versus critical thinking:

Steffy and Grimes note that a strict natural science approach to social science is native, since
subjective or qualitative analysis is important to quantitative research. This holds true for
management and, consequently for nursing management. The authors suggest a critical
theory approach to organizational science rather than a phenomenological or hermeneutic
approach.
Phenomenological approach uses second order constructs ―interpretations of interpretation.
―The nurse manager would interpret the meaning of nursing of nursing management
experience or observations and arrive at a nursing management theory from aggregate of
meanings.
Hermeneutic approach is the art of textual interpretation. She would consider the specific
context and historic dimensions of data collected, and would reflect on the relationship
between theory and history.

Critical theory: Critical theory is an empirical philosophy of social institutions. It is

translated into practice by decision makers, in these case nurse managers. It includes
organizational development, management by objectives or results, performance appraisal, and
other practice- oriented activities performed by managers.

Aims:

 To critique the ideology of scientism, ―the institutionalized form of reasoning which

accepts the idea that the meaning of knowledge is defined what the sciences do and
thus can be adequately explicated through analysis of sciencetific producers.
 ‗To develop an organizational science capable of changing organizational processes.
―it is used the practice of clinical nursing and nursing management.

Critical thinking:
Concept analysis is advocated as a strategy for promoting critical thinking. The
rudiments of critical thinking: recalling facts, principles, theories, and abstractions to make
deductions, interpretations, and evaluations in solving problems, making decisions, and
implementing changes. Concept analysis uses critical thinking to advance the knowledge base
of nursing management as well as nursing practice.
Definition: critical thinking is reflecting on a situation, a plan an event under the rule of
standards and antecedent to making a decision.
(Mackenzie)
Critical thinking is both a philosophical orientation toward thinking and a cognitive process
characterized by reasoned judgment and reflective thinking.
(Jones and brown)
 Mr. Channabasappa. K.M

Abraham H. Maslow (1908-1970)

• Receiving his doctorate in psychology, Abraham Maslow was the first psychologist
to develop a theory of motivation based upon a consideration of human needs.

Maslow’s theory of human needs has three assumptions

Human needs are never

completely satisfied

Human behaviour is purposeful and is motivated by need satisfaction.

Hierarchical structure of importance from the lowest to highest

Factor within Person

Maslow‘s need hierarchy
– Physiological. The need for food, drink, shelter and relief from pain
– Safety and Security. The need for freedom from threat, that is, the
security from threatening events or surroundings.
– Belongingness, Social and love. The need for friendship affiliation interaction
and love
– Esteem. The need for self-esteem and for esteem from others
– Self- Actualization. The need for fulfill oneself by making maximum use of
abilities skills and potential.
Douglas McGregor (1906-1964)
• McGregor is the other major theorist associated with the Human Relations School of
management.
• McGregor believes there are two basic kinds of managers. One type of manager,
Theory X, has a negative view of employees assuming they are lazy, untrustworthy
and incapable of assuming responsibility while the other type of Manager,
• Theory Y, assumes employees are trustworthy and capable of assuming responsibility
having high levels of motivation.

Herzberg’s two factor theory:

This theory was developed in 1959.It is based on realisation that work motivation and job-
satisfaction are two dimensions that influence the productivity of an employee. Herzberg‘s
finding that good working conditions, adequate salary, good physical facilities, good human
relation, quality of supervision might contribute to job satisfaction, of employees, which are‖
hygiene‖ factors. Whereas factors like recognition of work done, status, opportunities for
growth, challenging task, play an important role in creating work motivation for employees,
which are the motivation factors.ltter, many authors interpreted that all the motivation factors
described by Herzberg do not give equal amount of satisfaction to all employees.

Implications of management theories in nursing:

1. Taylor‘s theory can be implemented in nursing to study complexity of care and
determine staffing needs and observe efficiency and nursing care.
2. Nurses can utilize Emerson‘s theory of early notion of the importance of objectives
setting in an organization.
3. Nurses should be aware of the managerial tasks as defined by Fayol: Planning,
Organizing, Directing, Coordinating and Controlling.
4. The theory of human relations of Follett and Lewin emphasise the importance for
nurse managers to develop staff to their full potential and meeting their needs for
recognition, accomplishment and sense of belonging.
5. Mc Gregon and Likert support the benefits of positive attitudes towards people,
development of workers, satisfaction of their needs and commitment through
participation.