DIRECTING Introduction Directing is getting the work done through others.

It is management of people which is the heart of the administrative process to be properly understood and practiced by a nurse manager. Directing in nursing is giving orders and directions to others to attain quality patient care. This function of a nurse manager is administrative in nature which involves two major aspects, namely: the human and technical aspects. NATURE AND CHARACTERISTICS OF DIRECTING THE NURSING SERVICES Directing is the issuance of assignments, orders and instructions that help the nursing personnel to understand what are expected of them. It also refers to supervision and guidance of every one in the organization so that they can efficiently and maximally contributes to the attainment of organizational objectives in general and the attainment of quality nursing service objectives focused on quality client care, in particular. Leadership, motivation, communication, delegation and supervision characterized the directing function of the nurse manager. DIRECTING IS RELATED TO LEADERSHIP PROCESS The nurse manager, being an administrator, affects the human relations more than anyone else in the nursing system. He or she is so involved with motivation, communication, daily off operations, and the decision-making process, being in the key position to affect the human resources in the organization. The relationship between the nurse managers and staff members should be based on mutual trust and confidence. COMMUNICATION ON MANAGEMENT Communication is viewed as a process of symbol using understanding, interaction, and reduction of uncertainty, transference and transmission of information (Bormann, 1980). It functions in the linking the individual to the environment establishing commonality, exercising power, time binding and replicating memories. At a general level, communication refers to a process of acting on information. The encouraging climate of the organization facilitates upward communication. Staff nurses should feel a responsibility for initiating upward-or lateral (sideward)-communication that is accurate and pertinent. Communication is used for varied reasons and purposes by nurse managers. Communication enhances the nurse manager¶s capability to facilitate work, enhance motivation, provide innovations, effect optimum care, add more worker satisfaction and ensures coordination within the organization.

FLOW OF ORGANIZATION Flow of information. Communication on management maybe downward, upward, and lateral or sideward. Downward communication. This may come in forms of policies, manuals and guidelines for information and compliance of everyone in the organization. Memoranda, job descriptions, performance appraisals, and the likes are other forms of downward communication. Upward Communication. This usually comes form subordinates to top management. It is done in the form of feedback informing the administration as to the effect of the downward communication-the extent of which it has been received and acted upon. Lateral or Sideward Communication. This is being observed between employees, personnel, units or departments on similar level. It comes out in various forms like endorsements between shifts, nursing rounds, conferences, or meeting or in making referrals between service departments.

DECISION MAKING Decision making has important implications in the directing function of the nurse manager. Many authorities view decision making as the most important administrative activity since it is involved in the other process of administration such as planning, organizing, coordinating, directing, controlling, and evaluating. Decision making is generally recognized as the heart of organization and the process of administration. CATEGORIES OF DECISIONS Personal Decisions. These are those which every staff member does in discharging duties. These duties are related to every nurse¶s assessment of the patient¶s needs, planning and implementing care, and evaluating of outcomes. Organizational Decisions. This relates to the operations of a unit or department or the entire system and they are of concern to all members of the aforementioned organizational groups.



Following are the steps that believed to be involved in every decision- making process in relation to problem ± solving: Recognize, define, and limit the problem; Analyze and evaluate the problem; Establish criteria or standards by which the solution will be evaluated or judged as acceptable and adequate to the need; Collect the necessary data and information; Formulate and select the preferred solutions or actions; Put into effect the selected or preferred by: Programming the solution Controlling the activities in the program Evaluating the results and the process


It included the right to extract obedience from subordinates. Ibid. improved self-respect. An organizational chart is a line drawing that shows how the parts of an organization are linked. ability. areas of responsibilities. It includes developing job descriptions by defining the qualifications and functions of personnel. but the doing as well (Myers.PERSONNEL PARTICIPTION IN DECISIONMAKING Two advantages: First. 2 . One of these factors is the rise in economic status of the less privileged members of the employee group. THE NURSE MANAGER DIRECTING THE NURSING SERVICES Being a nurse manager and a nurse manager greatly differs in meanings (semantics). ORGANIZING THE NURSING SERVICE Organizing Organization consists of the structure and process which allow the agency to enact its philosophy and utilize its conceptual framework to achieve its goals. a wider range of doing or performance and more trust in the employee. determining the staff needed by developing and maintaining staffing patterns and distributing them in the various areas as needed. organizing. CONFLICT RESOLUTION Two major factors work to eliminate or resolve the gap between labor and management. together with rising expectations The second factor goes with an increasing awareness and acceptance by managers about the demographic pattern in organizational leadership. including all other matters that are relevant to he patient¶s health care delivery system. methods. Job Enrichment in Conflict Resolution A way to encourage and let more employees to think for their welfare is job enrichment. direct and control the workers activities. Eventually. directing or leading. person to whom one is accountable and channels of communication. knowledge. 1970). It refers to body persons. the discussion provides maximum input with regard to the decision. It enhances creativity. roles and relationships. Labor unions have impact in formalizing and widening the gap between the employer and the employees. It involves setting up the organizational structure through identification of groupings. Second. Definition of Terms MANAGEMENT CONFLICT Management conflict are usually attributed to the customary ideas about what a manager performs ± planning. the staff members who are involved in a decision ± making process implement the decision better. Organizational managers are the ones who have been presumed to possess the maturity. authority flows down in an organization. and controlling compared with the traditional role of the worker ± doing manual labor (Myers.). A nurse manager who may have experienced that of being on the labor side of the management/ labor conflict may be able to show greater empathy for his or her employees at all job levels. Decisions may as well be made by the nursing personnel as there are directly with the implementation. and responsibility to plan. A primary nurse who works with a limited number of patients utilizes the process of management as he or she provides and manages the care of the patients. policies and procedures arranged in a systematic process through the delegation of functions and responsibilities for the accomplishment of the purpose. job enrichment enables every member to satisfy more his personal needs and as it happens there comes the success of agency and patient care. Nature and Causes Traditional organizations have conflicting views regarding role relationships between managers and workers. Organizing is the process of establishing a formal authority. In legal sense. Job enrichment builds better interest. Elements of Organizing setting up the organizational Structure staffing Scheduling developing job descriptions Types of Organization Classified by Nature of Authority Line Organization Informal Organization Staff Organization Functional Organization Five Major Characteristics of Organizational Chart Division of Work Chain of Command Type of Work to be performed Grouping of work segments Level of management Definition of Terms Authority²is the right to act or make decisions without approval of higher administrators. and pride. This concept of the job enrichment for all employees. It depicts the formal organizational relationships. and not just he manager is one that includes not only the planning and control functions.

Distribute by shifts. 37% for the afternoon shift. Multiply the total number of patient by the percentage of patients at each level of care (whether minimal. or rejected by the line officer. or 3 ½ days of 12 hours per day and 3 ½ days off per week. Staff personnel provide advice. 4 days a week. Teaching program or the extent of staff involvement in teaching activities. STAFFING FORMULA 1.15 (for those working 40 hours per week) or by 0. supplies. fringe benefits. and equipment. intensive or highly specialized). intermediate. Professional activities and priorities in nonpatient activities like involvement in professional organizations. and 18% for the night shifts. In the Philippines the distribution usually followed is 45% for the morning shift.. FACTORS AFFECTING STAFFING The type. formal educational development. Add the number of relievers of the total number of nursing personnel needed. FACTORS AFFECTING STAFFING Budget including the amount allotted to salaries. 6. and Patterns of work schedule²traditional 5 days per week. 5. FACTORS AFFECTING STAFFING Standards of care desired which should be available and clearly spelled out. PLACEMENT It is important for a manager to consider some factors when assigning employees to a position or area where these 3 . participation in research and staff development. Multiply the total nursing care hours needed per day by the total number of days in a year. This is influenced by the 40-hour week law. altered.. The population served or the kind of patients served whether pay or charity. including education. PRC-ANSAP¶S Standards of Safe Nursing Practice and/or the hospitals themselves may formulate/develop their own standards. and objectives of the hospital and the nursing service. level of preparation. Responsibility²is the obligation to perform the assigned task Power²is the ability to influence another to behave in accordance with one¶s wishes. weekends and holiday off-duties. Organizing Principles Unity of Command Scalar principle or hierarchy Homogenous assignment or departmentation Span of Control Exception Principle Decentralization or the proper delegation of authority STAFFING Staffing is the process of determining and providing the acceptable number and mix of nursing personnel to produce a desired level of care to meet the patient¶s demand. Get the sum of the nursing care hours needed at the various levels. Communication²is the transmission of information between persons. supplies and materials. Status²is the rank a group bestows on a person in accord with the group¶s estimation of the persons value and significance to group goals. 4. Accountability²means taking full responsibility for the quality of work and behavior while engaged in the practice of the profession. FACTORS AFFECTING STAFFING Expected hours of work per annum of each employee. 7. Multiply the number of nursing personnel needed by 0. Find the actual number of nursing care hours needed by the given number of patients. Multiply the number of nursing personnel according to the ratio of professionals to nonprofessionals. counsel or technical support that may be accepted. Layout of the various nursing units and resources available within the department such as adequate equipment. and for the night shift 1518 percent. Find the number of relievers. Find the number of patients at each level by the average number of nursing care hours needed per day. ten hours per day and three days off. FACTORS AFFECTING STAFFING Availability and characteristics of the nursing staff. 3. materials. 2. Find the total number of nursing personnel needed. Administrative policies such as rotation. Multiply the number of hours on duty per day by the actual working days per year. Categorize the nursing personnel into professional s and nonprofessionals. Find the actual number of the working hours rendered by each nursing personnel per year. Categorize the number of patients according to the levels of care needed.Line authority is the simplest and most direct type in which each position has general authority over the lower positions in the hierarchy. DISTRIBUTION OF SHIFTS Studies have shown that the morning day shift needs the most number of nursing personnel at 45 50 51 percent. Divide the total number of nursing care needed per year by the actual number of working hours rendered by an employee per year. 8 hours per day.12 (for those working 48 hours per week). philosophy. The number of patients and severity of their illness knowledge and ability of nursing personnel are matched with the actual care needs of patients. mix of personnel number and position. for the afternoon shift 34 to 37 percent. Find the total number of nursing care hours needed by the patients at each category level. Institutions may utilize the ANSAP¶S Standards of Nursing Practice.

. personnel¶s ADVANTAGES OF CYCLICAL SCHEDULES It is fair to all. controlling. Management . and sick leaves are more stable. CONTENT OF A JOB DESCRIPTION Identifying data Job summary Qualification requirements Job Relationships Specific and actual functions and activities USES OF JOB DESCRIPTION For recruitment and selection of qualified personnel.employees have very good chances for success. Favoritism is minimized as all nursing personnel get their fair share of rotation to the various shifts. and poor image for the agency. holidays. is getting things done through other people (1979 . For job placements. Weekends. It is an important management tool to make certain that responsibilities are wisely dedicated that work is efficiently distributed. or meetings. Inappropriate placement often result in frustration. trainings and experience Fairness to the staff Stability Flexibility TYPES OF SCHEDULING Centralized Decentralized scheduling Cyclical Schedule VARIABLES TO BE CONSIDERED IN SCHEDULING Length of scheduling period whether two or four weeks. organizing actuating and controlling performed to determine and accomplish the objective by the use of people and resources. however. As an aid in evaluating the performance of the employee. maximizes productivity and organizational goals have better chances of being met. Holiday offs. or handling. It saves time as the schedule does not have to be redone every week or two. DEVELOPING JOB DESCRIPTIONS A job description is a statement that sets the duties and responsibilities of a specific job. SCHEDULING A schedule is a time table showing planned work days and shifts for nursing personnel. Permanent shifts. Productivity is improved. and morale s maintained. or when day opt to continue their formal education. USES OF JOB DESCRIPTION For determining departmental functions and relationships to help define the organizational structure For classifying levels of nursing functions according to skill levels required To identify training needs As basis for staffing To serve as channel of communication What is management? Definition and Overview Management. afternoon and night shifts as prolonged night shifts may affect the heath of 4 . The objective in scheduling is to assign working days and days off to the nursing personnel so that adequate patient care is assured. wedding anniversary etc. Proper placement fosters personal growth provides. Special days (birthdays. art. the personnel. motivation of others. To orient new employees to their jobs. It is desirable that there be equal share of morning. the control of the labor. ASSESSING A SCHEDULING SYSTEM Ability to cover the needs of the unit Quality to enhance the nursing knowledge. is ³the act. transfer or dismissal. staffing of the positions. or manner of managing. a motivating climate for the employee. It enables the employees to plan ahead for their personal needs preventing frequent changes in schedule. Job categories. Many nursing personnel would prefer the morning shift duty but this is given most frequently to senior nurses. rapid turn-over.) Scheduled events in the hospital. social and recreational lives. The nursing personnel feel a sense of belonging with the other personnel in the unit and in the same shifts. give several advantages. training programs. ROTATING WORK SHIFTS Rotating work shift is common in most hospitals. poor quality of work. It includes the needed characteristics or qualifications of the individual to perform such duties successfully.AMA) Management is working with and through other people to accomplish the objectives of both the organization and its members. For budgeting purposes. organization of works. executive ability´ The accomplishment off an organization¶s goals by defining of goals. that talent are fully used. material and evaluate of the completed effort What is management? Distinct process consisting of planning. Shift rotation. Scheduled leave coverage such as vacation. skill in managing. direction. Continuing Professional Education Programs.. They are able to adjust their family. Vacation leaves. reduce organizational efficiency.

The management resource of a firm determines to a large extent. labor and capital. supplier and rhe organization INFORMATIONAL ROLE A manager who monitors information Disseminates information from both external and internal resources As spokesperson or representative of the organization. firing of subordinates. Organized knowledge about management is science. ³The emphasis in any activity that is classed as an art is on applying skills and knowledge and accomplishing of an end through deliberate efforts. As industrialization increases . The trend toward a democratic and participative approach follows as employees receive higher education Management as class and status system Managers have become an elite group of brains and education. a designer to improve projects that direct and control change in the organization. Managing as practice ia an art. Is the effective motivation of men and the efficient utilization of resources for the attainment of predetermined objective. techniques . Intended to provide best services to the client. new ideas. Management process ± is self-regulating and self. Management is a science It is a body of knowledge dealing with a body of facts or truths systematically arranged and showing the operation of acceptable standard of laws. Is a technique by means of the purpose and objective of particular human group are classified and effectuated Management: Art and Science Some management authorities regard management as an art. on objectives rather than just a things or activities Adds the concepts that accomplishment of the members¶ personal objectives should be integrated with accomplishment of the organizational objectives From the definition we can say that management. The new managers continue to expand their horizons in the effort to attain the ultimate in life. Optimum benefits for personnel Essential component of professional nursing care. Entrance to this class is based on education and knowledge. experience and observations. directing. Management Process Consist of achieving organizational objectives through planning.correcting Importance of management in management of Nursing Care Intended to assist the nurse in the patient care unit/ward toward gaining a better understanding of factors involved in management of patient care.fold concept to emphasize the broader scope of management AN ECONOMIC RESOURCE One of the factors in production together with land. It also involves application of skills and techniques to achieve desirable results´. Workers have to be motivated so that they perform the assigned to them as programmed by management. its productivity and profitability. 5 . It involves ³ proficiency in the practical application of knowledge acquired through study. problem discoverer.Differences between the two definitions Places greater emphasis on human being in the organization Focuses attention on the results to be accomplished. Three. This is followed by constitutional management which emphasizes definite and consistent concern for policies and procedures in dealing with the working group. which establishes the broad policies under whhich they are to operate and which gives general oversight to the continuing effectiveness of te total operation in relizing the objectives Management is the process and agency which directs and guides the operations of an organization in realizing of the established aims. Humanitarian concepts have later developed paternalistic approaches. and judges As a liaison between outside contracts such as community. encourages. and looses of clients As negotiator when conflicts arise. organizing. Coordination of needs. A trouble-shooter who handles unexpective situations such as resignation of subordinates. ROLES OF MANAGERS INTERPERSONAL ROLES As symbol because of the position he/she occupies and consist of duties as signing papers As a leader who hires. trains. and controlling human and physical resources. Management is used to extensively in industries experiencing innovation. To solve all nursing care problems as possible when and where required. management is substituted for labor and capital. fires. As a system of authority Management first develops with top individuals determining the course of actions for the rank and file. procedures and approaches Smooth functioning of units to attain their goal of quality care through judicious use of available human and material resources within specific periods Relationship between management and administration Administration± is a process and gency which is responsible for determination of the aims for which an organization and its management are to strive. remunerates. She/he represents the subordinates to superiors and the upper management to the subordinates Decisional role Makes her/him an entrepreneur or innovator.

thus developing and maintaining staffing pattern. Job descriptions define the qualifications and scope of responsibilities. The process covers recruiting. The selected personnel are then destributed in various areas of the agency where they are qualified to belong Staffing schedules are made to meet the needs of clients. actions and/or discipline. updating policies and procedures Supervising of personnel to harmonize work through adequate guidance and leadership. Allocating resources Planning It permeates into other functions which are dependent on it. roles and relationships within the agency. Strategic planning 1. these are the activities or steps an organization should go through continuously usually moving through one cycle during a budget or other designated period. and set up organizational controls for each budget cycle. By preparing budget. tools and resources can be allocated while establishing polies and procedures that will define the course of action and standards. Directing Actuates efforts to accomplishment of goals. personnel and agency. This is controlling. monitor and review progress. Coordinating personnel and service toward a common goal Communicating via various routes to ensure common understanding. By forecasting one can estimate the future By setting objectives the results to be achieved can be determined. Know the basics There are 3 major activites. assign responsibilities. Controlling A. Staffing includes determining the staff needed. and finally. You should remember 5. set up specific project controls. solve problems along the way. planning. This includes utilization of various modalities of nursing care through the nursing process. The type of control with which we are nost concerned with human resource. Controlling Leads to assessment and regulation of performance of workers. management control ( ensuring efficient and effective use of resources) 1. we essentially break down our objectives and hand out responsibility for those pieces to 6 . Developing people by providing staff development programs Making sound decisions. To ensure the attainment of objectives. appraise individual performance. relationships and authorities of personnel. controlling and during evaluation cycle and feedback.There are three major activities in the cyclic management process Planning Controlling Evaluation and feedback A. Certain standards are utilzed to measure performance. \Organizing Establishes formal authority. By developing and scheduling programs.The key steps in operational planning are defining objectives and assigning responsibilities. Monitor and evaluate nursing care including utilization of resources. Assigning responsibilities 4. When we assign responsibilities. the activities needed can be defined. Controls promptly reveals deviations from set plans and standards necessitating immediate corrective measures. At the end of the cycle we evaluate how well we did in achieving our objectives and prepare to begin the cycle again. The major outcome of strategic planning is the setting of goals for the organization . Setting goals Operational planning Designing the organization in the best wa y to achieve the goals and objectives 3. Developing individual standards Designing project controls (such as work plans and milestone charts) Motivating Reviewing progress Solving problems Coaching and counseling Performance appraisal OPERATIONAL CONTROL (ensuring that specific tasks are carried out efficiently and effectivel y ) Scheduling Establishing procedures 111. The two major kinds of planning are strategic planning and operational planning. we develop individual standards of performance with our subordinates. orienting and developing personnel to accomplish the goals of the organization. EVALUATION AND FEEEDBACK TO THE NEXT CYCLE You should remember Once we have the goals set through strategic planning. motivate our employees to ful fill their responsibilities. In controlling. It set up the organizational structure by identifying groupings. coach and counsel when necessary. The circle represents the cyclic nature of the process. We the enter into day-to-da y process of ensuring that we meet our objectives . we define objectives. selecting. in others words. Designing organizational controls( timetables and measures of the organization¶s performance as a whole) 11.

deliberation. y It is the kind of decision that is necessarythe kind that managers are paid to make. The two basic t ypes of control are management control (ensuring efficient and effective use of resources) and operation control ( the detailed scheduling and procedures that become routine functions) Standards of performance are conditions that should exist when responsibilities are carried out well. It follows that standards of performance successfull y added together will equal the achievement of the assigned responsibility. alive. Ten-Second Decisions y Are those we make during daily operation. In ever y decision-making circumstance. 3.there are more. and experience) y The will. In most cases . Analyze and Identify the situation . take time to write out the advasntages and of each alternatives. (This attribute requires volition. When the assigned responsibilities are fulfilled and added up . One of the differences bet ween decision making and problem sol ving is that a proper solution to a problem is sure ±fire.g. Before leaping in and ³solving the problem´ determine first what you are trying to accomplish. Some of these decisions. may be made at approximately y 4. y The overriding factor in a ten-second decision is the pressure to make it quickly. STEPS IN TEN-SECOND DECISIONS y Determine first whether the situation really requires one. Clarify first the situation you¶re trying to resolve. you¶ve practically sure of getting the results desired. Find out what¶s wrong and why it¶s wrong before you proceed. y Determine what alternatives are available. Before making a decision.) TYPES OF DECISIONS y Considered Decisions± are usually those of great magnitude± that is. it is possibl e that the most likely alternative becomes self-evident. There are few cases where you are lucky enough to have one alternative that represents the likelihood of 100 % satisfaction. If js crucial. a conscious activit y of the will to make a decision. developing standards of performance. y If the previous steps have been done carefull y. decisions affecting relationships among people in an organization. y Swallow. A CONSIDERED DECISION REQUIRES TIME y Time to find alternatives y To seek other opinions y To get dissent y To determine implementation problems. and they may prevent problems as well as solve them. Know the basic Controlling enables us to make sure on a day-to-da y use basis that our objectives will be met. objectivit y. e. Usuall y each alternative has the advantages and disadvantages. Standards of performance are developed for each responsibility assigned. The major components of the system for managing for results are defining objectives. what could go wrong in the future if you pursue y A given course of action? DECISION MAKING PROCESS 1. If it is indeed the right solution. and appraising performance the same time each day. either taking action or not. keep it ready. they should equal the successful accomplishment of our objectives. Compare alternatives. assigning responsibilities. y The nurse manager is a decision maker and therefore plays a vital role in achieving the goals and objectives of the organization. All achieved responsibilities added together will equal the accomplishment of the objective. and running well. motivation and commitment to choose. take into consideration the circumstances. in fact. because the perceptions and ideas of other people often provide multiple alternatives that help in approaching the problem situation 2. there are at least two possi ble actions. y Once you have considered alternatives.various units or individuals. y Determine the major objective of that decision. y They are the decisions that bring operation together. When decision.Hard Decisions y Are those that are often personally uncomfortable to make because they ma y result in discomfort or uneasiness for subordinates or others y These can be generally classified as decisions impacting interpersonal relationship± that is. y DECISION MAKING y Decision making is choosing options that are directed toward the resolution of organizational problems and the achievement of organizational goals. they tend to be completed and call for considerable reflection. Rate the risk. Incorporating these elements in a decisionmaking situation leads to appropriate decisions that can be implemented with minimum probability of success Operational Decisions Are those we make practically everyda y. STEPS y Select the best alternative. the last question concerns implications. Develop alternatives. That is. 7 . ATTRIBUTES OF A DECISION MAKER y The freedom to make decision in question y The capacity and ability to make a wise decision (Doing so requires sound judgment. They requires interaction with others.

) y Assessment is done continuously throughout dynamic process. and analysis. 4. and creative is critical to being able to consider a range of possible options. y The options should be ranked in the order in which they are likely to result in the desired goals and objectives y The solution selected should be the one that is most feasibl e and satisfactory and have the least undesirable consequences. may properly persuade you not take any action. Observe these positive role models in action. Personal characteristics 3. EVALUATE y It is important to establish early in the process how evaluation and monitoring y will take place. the manager would determine when follow-up surveys should be distributed. y Criteria for evaluation might include variables such as cost. for example. Merge two or more alternatives The´ resources fact or´ may swing your decisi on. and philosophical background. by the values. who will be responsible for it. issue. PRIMARY STEPS OF DECISION MAKING y Define the Problem. make it operative. y y y FACTORS AFFECTIING DECISION MAKING INTERNAL FACTORS 1. or situation ( problem identification is influenced by information available. Decision maker¶s physical and emotional state 2. cost-effectives. y Learn how other people approach problem situations. y Risk using new approaches through problem resolution through experimentation. because no move you think of at time promises to be successful. social. y Talk to colleagues and superiors who you believe are effective problem solvers and decision makers. collection. open-minded. DEVELOP SOLUTIONS y The goal of generating options is to identify as many choices as possible y Being flexible. y Self-a wareness. 8 . knowledge. y In collaboration with nursing staff. shold they appear. Cultural. Alternative A may have more advantages than alternative B Get into gear. CHARACTERISTICS OF AN EFFECTIVE DECISION MAKERS y Courage y Willingness to take risks. Interest. y Read journal articles and relevant sections of textbooks to increase your knowledge base. It is important to differentiate a problem from a symptoms of a problem. a more appropriate solution can be identified and implemented. who will be responsible for their distribution. attitudes and experiences of the decision makers and by time. and philosophical background. y Certain personality fact ors such as self esteem and self confidence affect whether one is willing to take risks in solving problems or making decisions. and when it will take place. the decision maker should be prepared to institute ³plan B´ should need arise. The risk involved in all alternatives. social. as well as positive outcomes that may be derived. y In essence. y Information gathered should be valid. Accurate relevant to the issue and timely. and attitudes EXTERNAL FACTORS y Environmental conditions and values y Values are determined by one¶s cultural. and how the findings will be communicated to appropriate personnel. After you have made a decision. IMPLEMENT y The implementation phase should include a contingency plan to deal with negative consequences. and legal or ethical considerations. time. ANALYZE DATA y Data are analyzed to further refine the problem statement and identify possi ble solutions or options.y y y y No alternative is desirable. y By distinguishing the problem from the symptoms of the problem . y Energy y Creativity y Sensitivity y Flexibility TIPS FOR PROBLEM SOLVIING SOLVING AND DECISION MAKING y Seek additional information from other sources even if it doesn¶t support the preferred action. SELECT SOLUTION y The decision maker should the objectivel y weigh each option according to its possible risks and consequences.

volume and type of supplies needed. While the mechanical budgeting process gives empirical information . Benefits ‡ C. Ideas are traded thus fostering interest in and understanding of the budgetary process. Since hospital departments are interrelated. gains and losses can be detected. this consists of four components‡ A revenue budget ‡ An expense budget ‡ A cash budget ‡ A capital budget REVENUE BUDGET ‡ Summarizes the income which management expects to generate during the planning. A NURSING BUDGET is a plan for allocation of resources based on preconceived needs for proposed series of programs to deliver patient care during one fiscal year. The budget process stimulates team approach. the budget becomes a stimulant to employee commitment and efficiency. 9 . It anticipates future opportunities or problems and prepares for them. The budgeting process gives the administration an opportunity to evaluate the thinking of the budget contributor. the cost. the quantity and quality of service to be given a patient should closel y equal the expected revenue. a financial ³road map´ and plan which serve as an estimate of future costs and a plan for utilization of manpower material and other resources to cover capital projects in the operating programs. BENEFITS DERIVED FROM THE BUDGETARY PROCESS (Categorized under the major functions of planning. If monthly trends are defined. coordination and control) 1. A budget ‡ A budget is simply a plan for future activities expressed in operational as well as financial or monetary terms. their cost of fixed assets when needed. PLANNING ‡ A. CAPITAL BUDGET ‡ Capital budget outlines the programmed acquisitions. The budgetary process has a balancing effect on the total organization. By enabling reach team member to contribute to organizational planning as well as to see the results of good team play. In health care institutions. These expectations are derived from the best judgment of needs manpower. Budgeting encourages exchange of information. ‡ B. COMPREHENSIVE CONTROL ‡ A.EXPENSE BUDGET-describes the expected activity in operational and financial terms for a given period of time. ‡ Hospital Budget ‡ Hospital budget is a financial plan to meet future serve expectations. equipment and supplies so that both services are provided as the highest level of quality at a minimum cost. cast collect ons and disbursement. COORDINATION ‡ A. It leads to specific planning such as the volume and type of services to be rendered and revenue to be derived therefrom. Budget preparation stimulates action and interaction. that is. the number and type of personnel required. ‡ C. disposals and improvements in an institution¶s physical capacity ‡ Cash budget represents the planned cash receipts and disbursements as well as the cash balances expected during the planning period. Budgeting stimulates thinking in advance. additional benefits result from the organizational thinking process that is generated and the worthwhile interrelationships that devel op. ‡ B. and an effective guide to proper utilization of resources. Is the budget planning realistic? Are the standards Preparing the Budget A BUDGET ‡ A BUDGET is the annual operating plan. future plans of one department must complement the plans of other affected departments.

Request of capital equipment for the replacement of capital equipment must be supported with documented justification. sterile supply. length of stay in the hospital and the acuteness of the illness. Each supervising nurse works with head nurses to determine the staff requirement for each unit. ‡ The chief nurse his/her assistant is usually a member of he budget committee. D. the size and plan of wards or units. ‡ 4. ‡ The Chief Nurse compiles and completes the draft of the budget and presents this to the Budget Officer or Hospital Administrator. B.‡ ‡ ‡ too high or low? The budget may be an aid in evaluating quality and initiative in performance. 13. surgical.The nursing service requirements of the auxiliary departments. pediatric. It consists of the beginning cash balance estimates of the receipts and disbursement . The amount and kind of labor-saving devises and equipment intercommunication system. The method of documentation 9. Standards of nursing care e. Reports required by administration whether simple or complex and THE BUDGETARY PROCESS ‡ The budget committee must be well defined. The nursing division is directly concerned with the operating budget and capital expenditures. and increased cost-effectiveness. The type of patient (medical. C. 8. ‡ 3. FACTORS IN BUDGET PLANNING ‡ 1. Cost consciousness is enhanced throughout the institution ‡ Affiliation of nursing students or medical students e. estimates and forecasts. The size of the hospital and its bed occupancy. This committee can assist the budget officer in budget preparation and in monitoring the budget. The grouping of patients such as those in specialized areas e. The method of performing nursing care whether simple or complex. The method of patient assignment. Once the budget standards are set comparisons between actual expenditures and budgeted standards can be made with little or no effort. 11. Participation of nursing personnel in budget preparation and control leads to cost consciousness. ‡ 2. ‡ The extend of vacation and sick leaves. and the estimated balance for a given period corresponding to that of operating and capitals. maternity. admitting office. chronically ill). The amount of centralized service provided.g. clinics. COMPONENTS OF BUDGET ‡ The budgetary control program consists of three major budgets. Within the nursing service the chief nurse works with the supervisors and head nurses in preparing the budget for the nursing service. ‡ The next step to ascertain the amount and kind of supplies needed for the operation of each nursing unit. treatment rooms.g. ‡ Operating budget ‡ Cash budget ‡ Capital expenditure budget ‡ These may be supplemented by other financial plans. central oxygen service. ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ 5. ‡ Any new activities/programs should be considered such as new patient services. communicable disease. The proportion of nursing care provided by professi onal nurse and those given by noonprofessi onals 10. Though the budgeting process is flexible. The physical layout of the hospital. Staff development programs or changes in hospital services that affect the required nursing services. The efficiency of job description and job classification 12. team or primary. 15. A careful planned budget presentation usually reflects favorable action from the administration. it tends to define fixed and agreed upon goals. 7. the nurses station. linen supply. holidays and ‡ Provision for staff devel opment programs including instructional staff. 14. whether functional.g. ‡ The cast budget is prepared by estimating the amount of money to be 10 . CASH BUDGET ‡ Forecasts the amount of money received. ‡ Past operations must be analyzed and overall master staffing plan must be reviewed . Te kind and amount of care to be given as it affects the number of hours of bedside care. it is helpful to know what cash budget means. Personnel policies ‡ Salaries paid to various types of nursing personnel including pay for overtime or shift differential. awareness of he activities. case. ER 16. The amount and quality of supervision available and provided. A review of the fast expenses and consumption provides data for planning. inexperienced students need more equipment and supplies. Goal setting enables the administration to prevent persistent efforts of individuals or groups to seek out only their own goals which is often tend to break the hospital organizational apart. Etc. intensive care units 6.

professional magazines.collect ed from patients and allocating it to cash disbursements required to meet obligations promptly as they come. priorities and timing as well as the feasibility of acquisition. contractual services. travels to professional meetings. supplies. laundry services drugs and pharmaceuticals. ‡ The combination of individual reports provides information about anticipated procurements. among others. ‡ These include estimated costs and sources of funds for expected replacements. in-service education. OPERATING BUDGET ‡ Deals primarily with salaries. The operating budget is composed of the revenue and expense budget. books. THE CAPITAL EXPENDITURES BUDGET ‡ Consists of accumulated data for fixed assets that are expected to be acquired during the budgeted period. 11 . and maintenance. improvements and additions to fixed assets. periodicals. ‡ The cost of estimated requirements together with the anticipated dates of acquisition should be made in an organized manner for each areas of responsibility. employee benefits.

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