LM Midterm PPT Compilation

LEADERSHIP
and
MANAGEMENT
WILFREDO S. ISRAEL JR.

1st Semester 2021-2022
Course Outline
 LEADERSHIP AND MANAGEMENT
 Definition of Leadership
 Distinguishing characteristics
 Leadership Theories
 Leadership Styles
 Management Process
 Levels of Managers
 Management Roles
 Management Skills
 Management Performance
 Qualities of a Manager
 Management Theories
Learning Outcomes:
Demonstrate leadership and management skills in the care of a

group of clients in the community and hospital setting
At the end of the course, the students will be able to:

 Define management.
 Describe the management process.
 Distinguish roles that managers fulfill in an organization.
 Explain management theories.
 Discuss motivation theories.
 Define leadership and explain its importance for organizations.
 Determine the importance of leadership in nursing
 Infer pertinent facts on the different theories of leadership
 Appreciate one’s capacity in becoming a nurse leader
 To identify the differences between a leader and manager

Describe what do you see on this picture?
LEADERSHIP
Occurs whenever one person influences another to work toward
predetermined objective (Dessler)
The process of influencing the activities of an organized group

in its effort toward goal setting and goal achievement (Stogdill)
MANAGEMENT
The art of getting things done through people (Mary Parker Follet)
Is the process of planning, organizing, leading and controlling the

efforts of organizational resources in order to achieve the
organizational goals.
Differences between
Leader and Managers
COMPARISONS
Leaders Managers
 May not have delegated  Have assigned
authority positions
 Obtain power through  Obtain power through
influence delegated authority
 Possess a wide variety  Expected to carry out
of roles specific functions
 May not be part of the  Part of the formal
formal organization organization
COMPARISONS
Leaders Managers
 Emphasize  Manipulate people and
interpersonal resources to achieve
relationship goals
 Direct willing followers  Direct willing and
unwilling subordinates
 Have goals that may or  Have greater formal
may not reflect the responsibility and
formal organization accountability
COMPARISONS
Leaders Managers
 Focus on group  Emphasize control,
process, information decision making,
gathering, feedback and decision analysis and
empowering others results
TRADITIONAL DEFINITION
Leadership is an interpersonal influence directed toward

the achievement of a goal or goals
Three key principles involved:

 Interpersonal - Deals with more than one person
 Influence - The power to affect others
 Goals - The end that one strives to attain
The process of influencing the actions of a person or group to attain desired

objective
CONTEMPORARY DEFINITION:
Leadership is a dynamic relationship that is based on

mutual influence and common purpose between leaders
and collaborators which leads both parties to higher levels
of motivation and moral development as they evoke “real”
change.
3 Key Principles involved:
 Relationship - Connection between people
 Mutual - Something in common is shared
 Collaborators - Work together
An individual induces a group to take action that is in accordance with the

leader’s purpose or the shared purpose of all
Leadership
- is a dynamic, interactive process that involves three dimensions
The The The

Leader Follower Situation
- involves people
- involves unequal distribution of power
between leaders and group members
Leader’s role
 Decision maker  Critical thinker

 Communicator  Buffer
 Evaluator  Advocate
 Facilitator  Visionary
 Risk taker  Forecaster
 Mentor  Influencer
 Energizer  Creative problem solver
 Coach  Change agent
 Counselor  Diplomat
 Teacher  Role model
THE ESSENCE OF GOOD LEADERSHIP IS
THAT PEOPLE WILL FOLLOW YOU
Evolution of
Leadership Theory
aim to understand, explain, and predict why some leaders are more effective than others
Great Man Theory

Trait Theory
Behavior Theory
Contingency Theory
The Path-Goal Theory
The Managerial Grid
The Great Man Theory
Asserts that some people are born to lead, whereas other are born to be lead
 Basis for most leadership research until mid-1940’s

 Few people are born with necessary characteristics to be great
 Leaders are well-rounded and simultaneously display
instrumental and supportive leadership behavior – considered
great men and supposedly effective leaders in any situation
 Its assumption is that great leaders will arise when there is a great
need.
 The idea of the Great Man also strayed into the mythic domain,
with notions that in times of need, a Great Man would arise,
almost by magic
Trait Theory
Assume that some people have certain characteristics or personality traits that
make they better leaders than others
 Personal qualities of an individual
 This theory states that if someone had “true leadership traits”
they could lead regardless of the situation.
 It focused on “what a person is” and not on what they could
accomplish
 Emphasizes that leaders are born not made - People are born
with inherited traits.
 Proposes that leadership is a function of these inborn traits. e.g.
intelligence, perception - There are people who become good
leaders because they have the right combination of traits.
 Hold that possession of certain traits permit certain individuals
to gain position of leadership - Some traits are particularly suited
to leadership
Some common leadership traits
1. Leaders need to be more intelligent than the group they lead

2. Leaders must possess initiative, the ability to perceive and start
courses of action not considered by others
3. Creativity is an asset
4. Emotional maturity with integrity
5. Communication skills are important
6. Persuasion is used by leaders
7. Leaders need to be perceptive enough
8. Leaders participate in social activities
4 PRIMARY TRAITS BY WHICH LEADERS
COULD SUCCEED OR DERAIL
BY McCALL AND LOMBARDO
1. Emotional stability and composure: calm, confident and

predictable when under stress.
2. Admitting error: Owning up to mistakes, rather than putting
energy into covering up.
3. Good interpersonal skills: able to communicate and persuade
others without resorting to negative or coercive strategies
4. Intellectual breath: able to understand a wide range of areas
Behavior Theory
- involves human skill aspect of a leader
 Studies leadership by looking at leaders in terms of what they do.

 Effectiveness is judged in terms of individual subordinate
outcome
 Attempts to explain leadership on the basis of what the leader
does rather than what the leader is
 It is not the characteristics of the leader but rather the way the
leader behaves towards followers that determine effectiveness
 Leadership capability can be learned, rather than being inherent.-
It is assumed that if success can be defined in terms of
describable actions, then it should be relatively easy for other
people to act in the same way
 This opens the floodgates to leadership development
Basic assumptions
2 major functions that leader perform
1. Accomplishing the task (task-oriented leader or structure
oriented)
- Concern for the task to be accomplished
- Initiating structure, job centeredness, task orientation
- Emphasizes behaviors, set clear standards, high regard with
production, set rules and regulations for doing the job
2. Satisfying the needs of group members (people-oriented
leader)
- Concern for the people doing the work
- Consideration, employee centeredness and relationship
orientation
- Has social rapport to his subordinates, attention is focused
to the individuals
Behavior of a leader who has a high regard
for task emphasizes
 Plan and define work to be done
 Assign talk responsibilities
 Set clear standards
 Job routines are established and deadlines are set
 Urge task completion and monitor results
 The task-oriented leader perceives his role as accomplishing the
operations of the unit
Behavior of a leader who has a high regard
for people convey
 Warmth and social rapport with subordinates
 Respect for the feelings of others
 Sensitivity to other’s needs
 Leader’s role is to help operate as a unit by fostering
social ties
 Attention is on individual
 Suggestions are encouraged, freedom is permitted in
how work is done and subordinates’ personal problems
receive attention
 Characterized by trust, mutual respect and emphasis on
interpersonal relations
CONTEMPORARY THEORIES OF
LEADERSHIP
Contingency Theory/ Situational Theory
 States that an analysis of leadership involves not only the individual
traits and behavior but also a focus on the situation.
 The effectiveness of the leader behavior is contingent upon the

demands imposed by the situation.
 Depends on the situation, different situations calls for different

behavior and approaches
 If the situation changes, the style changes
 leader’s ability to lead is contingent upon various situational factors,

including the leader’s preferred style, the capabilities and behaviors
of followers and also other various situational factors.
 there is no one best way of leading and that a leadership style that is
effective in some situations may not be successful in others
Situational Factors include:
1. Needs and characteristics of followers

2. The nature of the task
3. Environmental pressures and demands
4. How much information is available to the
leader
3 Major Component that are significant for
leadership effectiveness
1. Individual differences among

leaders
2. Differences among situations
3. The manner in which these two
variables are related
SITUATIONAL Leadership Approach
developed by Hersey & Blanchard
 Emphasizes follower readiness as a factor in determining leadership

style
 Predicts the most appropriate leadership style from the level of

maturity of the followers
 Based upon the premise that different types of situation demand

different types of leadership
 Focus is on the situation in which the leadership is exercised and

not upon the leader.
SITUATIONAL Leadership
Effective Styles
High High task and

relationship high
and low task relationship
Low High task and

relationship low relationship
and low task
(Low) Task Behavior (High)

FIEDLER’S Contingency Theory
- leadership style will be effective or ineffective depending on the situation
No leadership style is ideal for every situation

Leader’s behavior is dependent upon the interaction of
the leader’s personality and the needs of the situation
Interrelationships between group’s leader and members
were influenced by manager’s ability to be a good leader
Three aspects of a situation that structure the leaders role
1. Leader – member relations

2. Task structure
3. Position power
Leader-member relations
- involve the amount of confidence and loyalty the followers have with
regard to their leader
Feelings and attitudes of followers regarding acceptance, trust and credibility of the leader
 Leadership is assessed by a group-atmosphere scale
 Developed a scale to identify different types of leaders

called the Least Preferred Co-Worker Scale (LPC)
LPC
 reflects primarily the style of leadership
 Assesses how favorable or unfavorable the leader describes his least
preferred co-worker
High LPC score leader
 One who sees even the least preferred co-worker in relatively favorable
terms and is more relationship-oriented
Low LPC leader
 more task oriented
Group-Atmosphere Scale
8 7 6 5 4 3 2 1
 Friendly Unfriendly
 Accepting Rejecting
 Satisfying Frustrating
 Enthusiastic Unenthusiastic
 Productive Nonproductive
 Warm Cold
 Cooperative Uncooperative
 Supportive Hostile
 Interesting Boring
 Successful Unsuccessful
Task Structure
- degree to which work is defined with specific procedures, explicit
directions and goals
 High is it is easy to define and measure a task

 Low if it is difficult to define task and to measure progress
toward its completion
Four Criteria to determine degree of task structure

1. Goal clarity: extent to which a goal is understood by followers
2. Extent to which a decision can be verified: knowing who is
responsible for what
3. Multiplicity of goal paths: number of solutions
4. Specificity of solution: number of correct answers
Position Power
- refers to the authority inherent in a position, the power to use
rewards and punishment and the organization’s support of one’s
decision
High position Power

– right to hire and fire, promote and adjust salaries
- directors of nursing, managers and patient care coordinators
Low position Power
– may be elected, function in an acting position or be subject to
removal by peers and subordinates
- elected committee chairpersons, team leaders and staff nurses
Path-Goal Theory
(Robert J. House)
 Describe the way that leaders encourage and support their followers in
achieving the goals they have been set by making the path that they should
take clear and easy
 Emphasizes that the leader behavior be such as complement the group work
setting and aspirations
 Based upon the expectancy theory of motivation and reflects the workers
belief that efforts will lead to successful results.
 Leaders set up clear path and clear guidelines through which the subordinates
can achieve both personal and work-related goals and assist them in achieving
these goals
Leaders would:
a. Clarify the path so that subordinates may know their direction.
b. Remove obstructions that may hinder them to achieve their goal or goals.
c. Increasing the rewards along the process.
In this leadership approach, the leader works to motivate followers
and influence goal accomplishment.
 Directive Style provides structure through direction and authority;

leader is focused on the task and getting the job done.
 Supportive Style is relationship-oriented; the leader provides

encouragement, interest, and attention.
 Participative Style focuses on involving followers in the

decision-making process.
 Achievement-oriented Style provides high structure and direction as well as

high support through consideration behavior.
Two (2) types of leaders in
management
 Transactional leader
 Transformational leader
TRANSACTIONAL THEORY
- exchange posture that identifies needs of followers and provides rewards to meet those
needs in exchange for expected performance
 Concerned with day-to-day operations

 Contract for mutual benefits that has contingent rewards
 view the leader-follower relationship as a process of exchange.
 The leaders uses his or her position in in order to encourage
desired behaviors and tends to gain compliance by offering
rewards for performance and compliance or threatening
punishment for non-performance and non-compliance.
 does not focus on the individual needs of the follower, nor does
the leader focus on the personal development of the follower. The
leaders are influential because it is in the best interest of the
follower to do what the leader asks
TRANSFORMATIONAL THEORY
based on the idea of empowering others to engage in pursuing a
collective purpose by working together to achieve a vision of a
preferred future
 The manager is committed, has a vision, able to empower others with this
vision
 Focuses on the leader and employee working together for the greater good
 Places strong emphasis on one individual engaging others and creating a
connection that elevates the level of motivation and morality in both the
leader and the follower
 Merges ideals and focuses to unite both the employee and the nurse manager
 Promotes change.
 The key to this kind of leadership is to actively listen and come up with
pertinent suggestions that not only promote patient outcomes, but also help
build a base of leadership with the new nurse.
 Vision is the essence; implies the ability to picture some future state and
describe it to others so they will begin to “share the dream”
Comparison of Transactional and
Transformational Leadership
Transactional Transformational
 Focuses on management tasks  Identifies common values
 Is a caretaker  Is committed
 Uses trade-offs to meet goals  Inspires others with vision
 Shared values not identified  Has long term vision
 Examines causes  Looks at effects
 Uses contingency reward  Empowers others
Leadership Activities
 Effective leaders resolves disagreements among members by
arbitrating
 Leaders makes suggestions more often rather than giving orders
 Effective leaders supply objectives that are common and
acceptable to the group
 Leaders provide security by maintaining positive and optimistic
attitude – even in the face of problem
 Leader represents followers on various issues common to
followers – acts as a symbol of unity of the followers
 A leader through his attitude, behavior and objectives inspire
others
 A leader acknowledges support of his followers and praises their
effort and contribution
Leadership Skills
Rate Yourself
The best leaders have strengths in at least half-dozen key

emotional-intelligence competencies out of 20 or so. To see how
you rate on some of these abilities, assess how the statements
below apply to you.
While getting a precise profile of your strengths and weaknesses

requires a more rigorous assessment, this quiz can give you a
rough rating. More important, we hope it get you thinking about
how well you use leadership skills-and how you might get better
at it.
Statement Seldom Occasionally Often Frequently
I am aware of what I am feeling
I know my strength and weakness
I deal calmly with stress
I believe the future will be better than the
past
I deal with changes easily
I set measurable goals when I have a
project
Others say I understand and I am sensitive
to them
Others say I resolve conflict
Others say I build and maintain relationships
Others say I inspire them
Others say I am a team player
Others say I helped to develop their abilities
Total number of checks in each column
Seldom _____ x 1 = _____
Occasionally _____ x 2 = _____

Often _____ x 3 = _____
Frequently _____ x 4 = _____
Total _____
Interpretation:
36+ An overall score of 36 or higher suggest you are using

key leadership abilities well but ask a co-worker or
partner for his or her opinion, to be more certain
30-35 Suggest some strength but also some under-
used leadership abilities
29 or less Suggest unused leadership abilities and room
for improvement
Leaders are unique, and they can show their talent in different ways.
To further explore your leadership strengths, you might ask people
whose opinions you value: “When you have seen me do really well
as a leader, which of these abilities am I using? If a number of
people tell you that you are the same quality when doing well, you
have likely identified a leadership strength that should be
appreciated and nurtured
Approaches to Leadership
- Focused on identifying qualities of a

good leader and styles of leadership
managers use
TRAITS
- These are distinctive internal qualities or characteristics,
personal factors that distinguish the leaders
• Physical characteristics
• Social characteristics
• Personality
• Intelligence characteristics
• Work related characteristics

These traits are not universal in nature
Not all these traits work all the time
“A person does not become a leader by virtue of

these possession of traits, but the pattern of
personal characteristics of the leader must bear
some relevant relationship to the characteristics,
activities and goals of the followers.” (Ralph
Stogdill)
Types of Leaders
 Formal
 One who is appointed
 Chosen by administration
 Given official or legitimate authority to act
 Informal
 Do not have official sanction to direct activities of others
 Chosen by the group
 Become leaders because of:
 Age
 Seniority
 Special competencies
 Inviting personality
 Ability to communicate and counsel other
Nurse Leader do not have to be in formal
management position with a management title
Nurse leaders demonstrates leadership

qualities and competencies
LEADERSHIP BEHAVIOR
(STYLES)
- ways a leader behaves toward his followers influencing them to accomplish goals
Autocratic Leaders
 Democratic Leaders
 Laissez-faire Leaders
Autocratic Leadership
- crisis, emergencies, start up of business
• Unilateral decisions
• Dictate work method
• Limit worker knowledge about goals to

justify the next step to be performed
• Give punitive feedback
Behaviors:
 Strong control is maintain over the work group
 Other are motivated by coercion
 Others are directed with commands
 Communication flows downward
 Decision making does not involve others
 Emphasis is on difference in status (“I” and “you”)
 Criticism is punitive
Results:
 Well-defined group actions
 Productivity is high
 Creativity, self-motivation and autonomy are

reduced
Autocratic Leadership
Advantages Disadvantages
 Results in central control and  Results in low morale
coordination  Not as much opportunity for
people to develop their
 More consistency in policy potential
interpretation and  One-way communication does
implementation not lead to understanding
 Quicker decisions.  Results in hostility, alienation
and inflexibility
 Contributes to strong leadership  Little autonomy creativity and
that is important in generating self motivation
change and meeting crises  Have little trust and confidence
 Good quantity and quality of with subordinates
output  Subordinates fear the manager
Democratic or Participative or Consultative Leadership
- stable
• Involve the group in decision making
• Let group determine work methods
• Make overall goals known
• Use feedback as an opportunity for helpful coaching

• They welcome suggestion and feedback and are open to new ideas
Behaviors:
 Less control is maintained
 Economic and ego awards are used to motivate
 Others are directed through suggestions and

guidance
 Communications flows up and down
 Decision making involves others
 Emphasis is on “we” rather than “I” and “you”
 Criticism is constructive
 Results:
 Appropriate for groups who work together for
extended periods
 Promotes autonomy and growth
 Effective when cooperation and coordination
between groups
 Less efficient quantitatively than authoritative
leadership
Democratic or Participative or Consultative Leadership
 Extremely motivational  Takes time to get others
involved
 Makes better use of the skill and
knowledge of the group  Results in compromise and
watered-down decisions
 Builds effective work groups  Inaction can result from the
 People are more committed to diffused responsibility
an organization and its activities  Participation may hold down
 Emphasizes the worth and the innovative, far-sighted
importance of the individual leader
 People are better informed.  Participative styles are difficult
to learn
Develop personal skills
 Works well only under certain
 Encourages open conditions
communication
Laissez-faire Leaders
(Free-reign)
 Give group complete freedom

 Provide necessary materials
 Participate only to answer

questions
 Avoid giving feedback
Laissez-faire or Ultraliberal or Permissive Leadership
- full stability
 Shows low concern for both people and task
 Very permissive, nondirective, passive and inactive
 Turn most decisions over to the group and show little interest in the
work process or it results
 Absence of direct leadership
 Task is presented to the group, which establish it own goals and
works out it own techniques for accomplishing goals within the
framework of organizational policy
 Leaves subordinates to freely set objectives and work procedure
 Leader acts as liaison between outside sources and the group and
ascertain that necessary resources are available to the group
 Leader allows complete freedom in planning activities and offers
guidance in response to direct questions
 Emphasis is on encouraging individual performance by providing an
unrestricted environment
Behaviors:
 Permissive with little or no control
 Motivates by support when requested by group or

individual
 Provides little or no direction
 Uses upward and downward communication

between members of the group
 Disperses decision making throughout the group
 Places emphasis on the group
 Does not criticize

Results:
 Frustrating; group apathy and disinterest can
occur
 Can result in creativity and productivity if
members are highly motivated and self-
directed
 Appropriate when problems are poorly
defined and brainstorming is needed to
generate alternative solutions
Laissez-faire Leadership
 Highly motivational to those  Can result in chaos
people who seek freedom and
independence
because of lack of central
 Maximizes the potential of the
control and coordination
individual  Personal rather than group
 Encourages a free flowing goals may predominate
adaptive organization  Easy for conditions to get
out of hand before
corrective action is taken
Comparison of Leadership Styles
AUTOCRATIC DEMOCRATIC LAISSEZ-FAIRE
Leader
Holds Absolute Power Limited Power No Power
Knowledge Unique Shared Same or Less
Behavior Dominates Participates Joins
Position Inflexible Flexible Neutral
Followers
Relates Dependent Expects involvement Independent
Knowledge Less Different More
Behavior Submissive Involved Independent
Situation
Appropriate Crisis, emergency General goals, No clear purpose
or grate skill control and time Control or time
required of leader pressure pressure
understood
Research has shown and indicated that
DEMOCRATIC LEADERSHIP
could lead to both good quantity and
good quality of work as well as
satisfied workers
Leadership style may vary from one
situation to the other
Leadership must promote high level of

performance efficiently with little
disruption
Factors affecting Leadership Styles
 Ability, skill and knowledge of the subordinates
 Manager’s personality/ preference, training, education & background
 Nature of task
 Organizational culture and climate
 The expectation of superior, from colleagues or peers

End of Slides
ORGANIZING

Learning Outcomes
 Define Organizing
 Describe the different forms of organizational structure
 Discuss the components, importance, purpose & principles of organization

Organization
 Is a pattern of relationships, through which people under the
direction of managers pursue their common goals
 A collection of people working together for some common

objective
 Refers to:
 Body of persons
 Methods
 Policies and procedures
 Delegation of functions & responsibility
Characteristics of Organization
 Common goal or purpose

 Coordination of effort
 Division of labor
 Establish delegation of authority
Why do People form Organization
 Enable people to accomplish things individuals alone

would find it difficult or impossible to achieve
 Provide continuity of knowledge
 As a source of career
 Gains in productivity
 Synergy occurs
 Overall to satisfy personal needs
Organizing
 Process by which an organization is formally structured into departments or
working units and the framework of the firm is established.
 Process by which management seeks its objectives by combining the efforts
op people under its supervision
 Process of arranging work and resources so that planned goals can be
achieved
 Involves
Identifying the task that have to be done
Allocating the task among members
Integrating efforts to achieve its goals
Concepts of Organizing
 Role
 Power
 Authority
 Centrality
 Communication
Components of Organizing
 Responsibility
 Accountability
 Delegation
 Coordination
 Cooperation
 Division of Work
 Chain of Command
 Unity of Command
 Formal Organization Structure
 Informal Organization Structure
Steps in Organizing
Determine what is to be done

Departmentalize
Decide how to achieve coordination
Decide on span of control
Decide how much authority to designate
Draw an organizational chard or structure
Elements of Organizing
 Setting up the Organizational structure

 Staffing
 Scheduling
 Developing Job Description
Importance & Purpose of Organizing
Create a coordinated authority and task structure

Translate strategy into an ongoing productive operation.
Spells out who does what and who reports to whom
Enhances team work and team building
Advantages of Organizing
 Harmony
 Saves time
 Increase production
Disadvantages of Organizing
 Confusion
 Slow paperwork
 Poor communication/ coordination
 Individual growth stifled
How do you detect poor organization?
 No system
 Low morale
 No defined roles and authority
 Goals not clear
 Illogical assignment of roles and duties
PRINCIPLE OF ORGANIZING
 PRINCIPLE OF UNITY OF
COMMAND
 PRINCIPLE OF EXCEPTION
 PRINCIPLE OF REQUISITE
AUTHORITY
 PRINCIPLE OF ORGANIZATIONAL
CENTRALITY
 PRINCIPLE OF CONTINUING
RESPONSIBILITY
PRINCIPLE OF UNITY OF COMMAND
 an employee may interact with many individuals in the course of work but should be
responsible to only one supervisor.
 Assign workers to be responsible for a single area and to report only to one supervisor
 no member of the organization should report to more than one superior on any given
function
To achieve unity of command, observe the following rules:

 Centralize authority & responsibility in the head of the organization
 See that no person occupying a single position in an organization is subjected to definite
orders from more than one source
 Know whom you report to and who report to you
PRINCIPLE OF EXCEPTION
 Subordinate should report only from normal functioning, so managers can
limit their attention to events that are unresponsive to routine control
mechanism.
 Recurring decisions should be handled in a routine manner by lower level

managers whereas problems involving unusual matters should be referred
to the higher level.
 Enable subordinates to learn how to make decisions at their own level &
free executives from being bogged down by routine details that can be
handled as well by subordinates
PRINCIPLE OF REQUISITE AUTHORITY
 Some amount of participation among the lower level managers.
 Responsibility
 Authority
 Guidelines to achieve efficiency in delegating:

 Let few people accomplish the task
 Systematically align all personnel & activities so that you can delegate the authority &
responsibility for specific & well-defined duties
 Never give orders to subordinates who are under a responsible superior.
 Do not change the scope of responsibility of a position without a definite understanding of the
effects on all persons concerned
 See to it that there is no overlapping of authority ( two or more supervisors having control of
the same function)
PRINCIPLE OF ORGANIZATIONAL CENTRALITY
 Workers interact with greatest number of other workers receive the

greatest amount of work related information.
 Middle managers have a broader view of organization than other level

of management
 Middle manager has large degree of Centrality

PRINCIPLE OF CONTINUING RESPONSIBILITY
 When a manager delegates a function to a subordinate, the

manager’s responsibility for that function is not diminished
Responsibility Authority
Delegation
Accountability
Organization Structure
 Formal mechanism through which the organization is managed (
Stoner)
 Official arrangement of positions or working relationships that

will coordinate efforts of workers of diverse interests and
abilities.
 Refers to the process or way group is formed and its channels of

authority, span of control and lines or channel of
communication.
4 Elements of Organizational Structure
 Clustering of individual position into units and of units
into departments and larger units to form an
organization hierarchy
 Various mechanism required to facilitate vertical
coordination and degree of delegation of authority
 Span of Control
Setting up the Organizational structure
The creation of an organizational system compatible

with the philosophy, conceptual framework, & goals of
the organization
Understanding the organizational structure as a whole

Purpose of organizational structure :
Informs member of their responsibilities

Allows manager & individual workers to concentrate on
specific role & responsibilities.
Coordinates all organizational activities
Reduces chances of doubt & confusion
Major Characteristics of an Organizational Structure
Division of work
Chain of command
Type of work performed
Groupings of work segments
Levels of management
Formal Organization
 Planned & publicized official arrangement of positions into

patterns of working relationship that coordinate the efforts of
workers with diverse tasks & abilities.
 It describes the positions, the responsibilities of those occupying

the positions and the working relationships among the various
units or departments
2 Basic forms of formal organizational
structure:
 Hierarchic or Bureaucratic Model
 Adaptive/ Adhocracy/ Organic Model
Hierarchic or Bureaucratic Model
 designed to facilitate large scale administration by coordinating work of personnel.
 associated with subdivisions, specialization, technical qualifications, rules & standards,

impersonality & technical efficiency.
 has straightforward, a direct chain of command pattern that emphasizes superior
 Provides clear authority-responsibility relationships between workers at all levels & requires less
information transmission between managers & workers than do more complex organizations.
 provide for equal treatment for all employees, reliance on expertise skill and experience relevant
to the job, maintenance of records as work and output and setting up the enforcement of rules
and regulations that serve the interest of the organization
Characteristics of a Bureaucratic Structure
 Specialization
 Hierarchy
 Rules
 Impersonality
 Hiring by qualification &
promotion by merit
 Written records
Advantages of Bureaucracy
 Provide equal treatment for all employees

 Maintenance of records as work and output
 Set up of rules and regulations that serve the interest of the
organization
 Establish a framework of rules and systems within which
decision making can be delegated with reasonable predictable
results.
Disadvantages of Bureaucracy
 Produce rigidity and make it difficult for an

organization to change
 Reduce motivation potential of employee performance
 Reduce individual discretion
 Stifles upward communication
 Stifles personal growth
Adaptive/ Adhocracy/ Organic Model
Newer organizational frameworks that are more

free form, open, flexible, and fluid than the older
bureaucratic models.
Characteristics of organic model
Motivation is not derived from supervision but rather from the
needs of the system, peer pressure & task-related factors
Rewards & recognitions are based on the results of individual &

group work rather than on subjective evaluations from
supervisors or managers.
Management is participative.
Several types of Adhocracy organizational models
 Free Form
 Collegial Management
 Project management
 Task Forces
 Matrix Organization
Informal Organization
 Unplanned & covert, consist of unofficial personal relationship among
workers that influence work effectiveness.
 Network of personal and social relationship that may have nothing to do

with formal authority relationship Not formally planned
 Develops spontaneously from people’s interaction
 Loosely organized, flexible, ill-defined
 Unofficial channel of communication – Grapevine -

Organization Design
 It is the process of developing an organizational

structure
Organizational Charts
 Pictorial or diagrammatic representation of the company’s internal
structure at a particular point in time
 A line diagram that depicts the broad outlines of an organization structure
 Portrays formal relationship developed from organizing

 major functions, departments or position
 way the position are grouped into specific units
 reporting relationship
 line of communication information
 downward flow of authority
Uses of Organizational Chart
 Outlines administrative control

 Policy making & planning
 Evaluate strengths & weaknesses of present structure
 Shows the relationships with other departments &
agencies
 Orient new personnel to the organization.
Purpose of Organizational Chart
 Serves as an informational device for orientating new

employees
 Work plan for considering expanding the organization
 An information piece for the general public/ special
groups as needed
Limitations of the Organizational Chart
 Lack of clarity as to who does what

 Does not indicate the organization’s informal relationships and
channels of communication
 Does not reflect the power and status at each management
level.
 Many organization may depend to a large extent on outside
specialist of many kind
Vertical Organization/ Chart or
Tall Structure
 Depicts the chief executive at the top
with lines of authority flowing down the
hierarchy
 Most effective when managers desire
better coordination & effective
communication defines the relationships
between & among the different levels in
the organization
 More attention is given to message which
come from managers than those from
lower levels
 Members are given more opportunities to
participate in decision-making activities
Horizontal Organization/ Chart or
Flat Chart
 Depicts manager at top with wide span of control
 Levels of management are not shown in a flat chart.
 Employees in this structure report to one manager.
 More freedom
 Communication is direct, simple and fast with minimal distortions of messages
Concentric Charts
 Shows outward flow of formal
authority which is from the center
moving outward
 Minimizes or reduces the
implications of status or positions
 Depicts top management in the
center
 Those in the middle & lower levels
of management
5 Major Characteristics of an Organizational Chart:
 Division of Work
 Type of work to be performed
 Grouping of Work to be performed
 Levels of management
Benefits of Charts Limitations of Charts
 Shows the firm’s structure and  Static

lines of communication  Do not show all details of the firm
 Indicate the flow of authority
Types of Organization
1. Line Organization – organization is divided into various

departments, each department have controlling head
who is the department manager
 simple and rigid, straight forward, direct chain of command
pattern that emphasize superior-subordinate relationship
Line Organization
Advantages of Line Organization
 Simple and readily understood
 Promotes rapid decision because of the direct nature of the chain of
command
 Simplifies coordination between personnel in the same department
 Effective delegation is facilitated
 All members of the department can be made aware of and readily
understand their position and status in the department hierarchy
 Staff discipline is easier to maintain than in other forms of organization
 Extent of responsibility, authority and duties can be clearly defined and
recognized by those concerned
Disadvantages of Line Organization
 Potential rigid and inflexible
 Effectiveness is very much dependent on the capacity of the
head of department
 Expansion of the department may prove difficult
 Cooperation and coordination between different department
may provide difficult, and is very much dependent on the
attitude of the department head
Line and Staff Organization
 functional experts appointed but have no executive

powers and act in an advisory capacity only
 commonly found in companies
 example is that of a personnel manager (staff) advising
an accountant (line) in the recruitment of new members
of staff
Line and Staff Organization
Legend
Advisory
relationship
Advantages
 Direct lines of responsibility and authority are maintained
 Control of departments remains with the department levels
 Promotes departmental efficiency
 Departmental and interdepartmental coordination and
cooperation are facilitated because the specialist interest spread
throughout the undertaking
Disadvantages
 Line officers are not bound to follow the advice of the staff officers and
sometimes do not
 Staff officers can sometimes try to usurp the authority of the line officers
 This form of organization can be confusing for the workers

Committee
 Members may be appointed or may be elected
 It is impossible for an organization to be managed

entirely by committee
Advantages
 More than one point of view on any problem can be considered
 The advice of experts on particular matters can be made
available
 Full discussion and consideration can be given to any problem
before the organization is committed to a particular solution
 Implementation of decisions will be well-coordinated and
cooperation between different sections of the organization will
be better assured
Disadvantages
 Committees are often slow in reaching decisions
 No individual responsibility can be fixed for decisions reached,

and no individual accountability for failure can be apportioned
 Decisions are likely to be the result of compromise and are

therefore likely to lead to less positive active action than would
be case where an individual made the decision
 Differences of opinion between members of the committee

may result in decisions being postponed to another meeting,
with the result that day-to-day operations may suffer
 Not possible to obtain rapid decisions from individual

members of a committee where urgent action is required
Line & Staff Relationship
Authority
Accountability
Authority Relationships
 Line Activities and Staff Activities
 Line and Staff Authority
 Line authority
 Staff Authority
Authority
Right to give orders and the power to exact obedience
Top-down authority
Bottom-up authority
Power
- ability to do something
 Sources of Power
 Reward Power
 Coercive Power
 Legitimate Power
 Referent Power
 Expert Power
 Position power – powers determined by the organization for each formal leadership position
 Personal power – powers depends largely on the traits and behavior of the person who
occupies a leadership position
Responsibility
- an obligation which the person owes to the organization to

function in a certain activity
Embodies three characteristics

Obedience
Dependability
Compliance
Accountability
concerns with the fact that each person who is given

authority and responsibility must recognize that the
executive above him will judge the quality of his
performance
accountability cannot be delegated

Delegation
 defined as the transfer of authority from the superior to the
subordinate
 process by which a person with authority transfers part of

authority to subordinate or group of subordinates
 Reasons for delegating

• Little time for managers to do everything by themselves
• complicated procedures and techniques
• Size of organization
Advantages of Delegation
 Frees managers of routine tasks
 Develops subordinates
 Greater involvement by staff
 Improves morale and motivation
 Better and faster decisions

Barriers to Delegation
Company atmosphere
Managers’ unwillingness to delegate
Employees unwillingness to accept
Lack of Incentives
Delegation of Authority
 pushing down of authority from superior to subordinate (Dessler)
 Decision-making passed down from superior to subordinates
(Longnecker and Pringle)
 Assignment of responsibility and authority by a superior to a
subordinate to carry out specific activities (Stoner)
 The more manager delegate, the more the organization is
decentralized
Importance of Delegation
 Relieves the delegator of certain time-consuming work
 The more task managers are able to delegate, the more opportunity they have to seek and
accept increased responsibility from higher level managers
 Delegation frequently leads to better decisions since subordinates closest to the firing line
are likely to have a clearer view of the facts
 Effective delegation speeds up decision-making
 Delegation contributes to development of subordinates
 General personnel respond to delegated authority favorably

Reasons Why Managers Do Not Delegate Authority
 Some managers get trapped in the can do it better myself fallacy
 The feelings of importance attached to the exercise of power
 Manager’s feeling of insecurity
 Fear loss of power if subordinate does too good a job
 Manager’s lack of ability
 Some managers lack confidence in their subordinates

Reasons why subordinates avoid being delegated tasks
 Many subordinates fear criticism for mistakes

 Some hesitate to accept new assignments when there is a lack of necessary
information and resources to do a good job
 Some subordinates lack self-confidence, and are apprehensive about
accepting authority
 Some subordinates just find it easier to ask the boss to decide for themselves
how to deal with a problem
 Rewards for assuming the additional job may be inadequate
 Insecurity
Chain of Command
Delegation creates “chain of command”
Direct authority flows from upper management levels to

each lower management position
Each person knows who is responsible to whom.

Problem arise when the chain of command is too long
 Complexity of communication and coordination problem exist
 Decision and communication process takes longer and is of

poorer quality
 Depersonalization and deterioration of management-employee

relation results
 Causes undue delay and leads to the label of red tape being
given
Management pyramid
Top
Middle
Operating
Span of Management Control
Refers to the number of people reporting directly to a

manager/ superior
In developing organization structure

Wide span
Narrow span
Narrow span of control
Manager is responsible for a few subordinates only

Leads to a tall organization structure
Advantages of Narrow Span of Control
 Managers able to supervise more closely
 Executives can give more time to planning and

decision-making since they have fewer
subordinates to supervise
 Managers can better manage fewer/ more

specialized people and activities
 Necessarily develop a greater number of

managers since there are more management
position to be filled
Disadvantages/ Limitations of Narrow Span of Control
 Many levels in the firm
 Complexity of communication and coordination problems may

exist in the organization
 Deterioration of management-employee relations
 Expensive to employ many managers

Broad Span of Control
Manager is responsible for many subordinates

Results in a flat organization structure
Advantages of Wide Span of Control
 Reduced cost for fewer manager and their staff
 Better and easier communication structure
 Subordinates are forced to make decisions, take more

responsibilities and act more on their initiative since they cannot
be running constantly to supervisors for approval of their actions
 Morale tends to be higher

Disadvantages of Wide Span
 Manager is unable to exercise direct control and

supervision
 Higher quality and more costly people are needed
 Manager’s day is overly occupied with supervision

Factors affecting Span of Control
 Competence of the Manager
 Complexity of the Functions Supervised
 Similarity of Functions Supervised
 Abilities of the Subordinates
 Geographical Dispersion of the Subordinates

Centralization / Decentralization
Factors affecting Centralization/ Decentralization

Organizational Environment
Size of organization
Geographical location of business
Ability of lower managers
Manager’s preference
Decentralization
- means more authority is delegated to lower levels
Characteristics
Greater number of decisions are made at lower levels in the organization
Closer the level at which the decisions is made in relation to the point where
the problem arose
More important are the decisions that can be made at the lower levels
Lesser a subordinate has to check with his supervisor before making decision
Advantages of Decentralization
 Reduces the workload on over-burdened executives
 Decisions can be made much faster
 Can result in better decisions
 People learn faster when the can participate or have the

responsibility for performance
 Improves morale
Disadvantages of Decentralization
 Control at the top may be more difficult
 Lack of uniformity of standards and policies among organizational units
 Creates problems of coordination between separate organizational units
 Capable managers are not always available or willing to participate in

decision-making
 Duplication of efforts may arise

Centralization
- degree to which authority and control is retained at the top

levels of the company
Advantages of Centralization
 Top management are more aware of the overall need of the
organization and are more likely to make decisions in the
organization’s best interests
 Greater uniformity of action and policy when decisions are made

by the executive office
 Easier to maintain secrecy of strategic plans and proposal

Disadvantages of Centralization
 Slow decision making
 Inflexibility
 Top management time is not well-utilized
 Reduces initiatives and morale
 Information may get distorted as it travels down

Coordination
 process of integrating the objectives and activities of the separate
units of an organization in order to achieve organizational goals
efficiently
 process of integrating work of different sections and departments

of an organization towards the effective achievement of the
organizational goals and tasks
Importance of Coordination
 Timing of activities is synchronized or maximum usage of labor and effort
 Direction of activities is planned for maximum efficiency and effectiveness
 Service or staff functions provide the basis and backup for the line
departments so they can meet objectives
 Control procedures can be implemented for comparing actual with desired

results
Reasons why coordination failed
 Poor communication
 Management might fail to provide a plan which is acceptable to everyone

within the organization
 Differences in leadership style within the organization
 Coordination depends on the design of the organization structure

 Organization’s performance might be uncoordinated
 Interpersonal or interdepartmental jealousies and dislike

Improving coordination
 Conflict should be controlled, by improving informal relationship
 Organization structure should be designed so that when two departments

have to integrate their activities, coordinating level of management exist
 Appointment of liaison or integration officers who coordinate the efforts of

different department
 Appointment of committees or project groups which include representation

from all the departments whose work need to be coordinated
 Friendly, informal communication should be build up between managers of

different departments, enabling managers to coordinate their activities
 System of planning and control within the organization should recognize the
need for integration of different departmental interest in the pursuit of
organizational goals
 Policies, system and procedures should be formulated so that fresh

decisions do not have to be made on routine matters
End of Slides
STAFFING

STAFFING PROCESS
NURSING CARE ASSIGNMENT
 This is also called modalities of nursing care,

system of nursing care, or patterns of nursing
care.
 Historically, 4 methods are used: functional, total
care, team nursing and primary nursing.
NURSING CARE ASSIGNMENT
FUNCTIONAL NURSING it is task-oriented in which a

particular nursing function is assigned to each worker.
 One RN may be responsible for giving medications,

another for admission and discharges while nursing
attendants change linen, provide hygienic care or do
simple nursing procedures for which they are trained.
 It is best used when there are many patients and

professional nurses are few.
ADVANTAGES
 It allows most work to be accomplished in the

shortest time possible, workers learn to work fast
and they gain skill faster in a particular task.
 There is also greater control over work activities

and it is aimed at conservation of workers and
cost.
DISADVANTAGE
 Fragmentation of nursing care therefore holistic

care is not achieved, nurse’s accountability and
responsibility are diminished, patient cannot
identify who their real nurse, nurse-patient
relationship is not fully developed, evaluation of
nursing care is poor and outcomes are rarely
documented, it is difficult to find a specific person
who can answer the patient’s questions.
TOTAL CARE OR CASE NURSING
 One nurse is assigned to one patient for the

delivery of total care.
 The nurse plans, coordinates, implements,

evaluates and documents the nursing care she has
given during her shift.
 In this modality, the nurse is accountable for her

own actions.
TOTAL CARE OR CASE NURSING
 She provides holistic care to her patient, who in

turn can relate well with her.
 This method works best when there are plenty of

nurses and patients are few.
 Nurses may not be familiar with patients in other

areas.
TEAM NURSING
 A decentralized system of care in which a

qualified prof nurse leads a group of nursing
personnel in providing for the nursing needs of a
group of patients through participative effort.
 The team leader assigns patients and task to team

member according to job descriptions. The leader
is also responsible for coordinating the total care
of a group of patients.
TEAM NURSING
 The intent is to provide patient-centered care.
 The heart of team nursing is team conference.

Through this plan the contribution of all team
members are recognized and priority is given to
strengthening their weaknesses.
 Through supervision the team leader identifies the

nursing care goals and focuses in attaining them
through guidance and setting of high standard
care.
DISADVANTAGE
 It can lead to fragmentation of care, finding time

for conferences and planning is sometimes
difficult to attain, team leader has only the
significant responsibility and authority and care
may resemble functional method if leader does
not keep members informed.
PRIMARY NURSING
 A form of assigning responsibilities for patient care, is
the extension of the principle of decentralization of
authority.
 Each RN is responsible for the total care of a small

group of patients from admission to discharge.
 The nurse assess the needs of the patients, sets goals,

writes NCP, evaluate outcomes and make necessary
changes or adjustments.
 The primary nurse communicate directly to any

member of the health team within the hospital and
the community.
ADVANTAGE
 Provision of or increased autonomy on the part of

the nurse thereby increasing motivation,
responsibility and accountability
 It assures continuity of care
 Makes available the increased knowledge of the

patient’s psychosocial and physical needs
ADVANTAGE
• Leads to increased rapport and trust between the

nurse and the patient establishing therapeutic
relationship
• It improves communication with members of the

health team and eliminates the use of nursing
aides.
.
DISADVANTAGE
. It increases staffing and costs

OTHER NURSING ASSIGNMENTS
 MODULAR METHOD modification of team and

primary nursing.
 It differs from team nursing in that the RN

provides direct nursing care with assistance of
aides. The prof nurse provides leadership, support
and instruction to the non prof.
 It is similar to primary nursing in that each pair or

trio of nursing personnel is responsible for the
care of the patients from admission to discharge.
 MODULAR METHOD
 The greatest responsibility falls on the RN who

assesses the patient’s needs, plans and
implement.
 It may therefore be observed that the role of the

nurse in the modular form of assignment is more
difficult that in primary nursing.
 CASE MANAGEMENT is a system of patient care

delivery that focuses on the achievement of
outcomes within effective and appropriate time
frames and resources.
 It focuses on an entire episode of illness, crossing

all settings in which the patients receives care.
 Care is directed by a case manager who is ideally

is involved in a group practice.
POLICIES, PROCEDURES, RULES AND
REGULATIONS
 Policies, procedures, rules and regulations are

standing plans of an organization.
 Nursing service exist for standardization and as a

source of guidance for nursing staff.
POLICIES
 POLICIES falls into several categories: patients,

personnel, environment where patients are cared
for and where personnel work, those that pertain
to relationships with other disciplines or
departments.
 It promote consistency of action and stability.

They speed up decision making. They conserve
time by setting standards. Uniformity of standards
promotes fairness and prevents conflicts.
POLICIES
 Usually written and made available as manuals

and used by personnel.
 Provision for their periodic review and revision is

necessary.
PROCEDURE MANUAL
 Procedure manual outlines a standard technique or

method of performing duties.
 It serves as a guide for action.
 It contains detailed plans for nursing skills and steps

in proper sequence.
 They should cover instructions to nursing personnel

in regard to new equipment or to the technique in
using them.
PROCEDURE MANUAL
 Bear in mind that the safety and comfort of
patients are the prime considerations while
performing nursing procedures and treatment.
 Like policies, procedures are updated by a

committee of professional nurses.
SUPERVISION
 To supervise means to inspect, to guide, evaluate
and improve work performance of employees
through a criteria against which the quality and
quantity of work production and utilization of time
and resources are made.
 SUPERVISORY TECHNIQUES:
. Observation of workers while making rounds
. Spot checking of charts through nursing audits
. Asking the patients about the care they receive
. Looking into the general condition of the units
. Getting feedback from co-workers
. Asking questions discretely to find out
problems
SUPERVISION
 Comments given in soft, courteous manner will be

taken willingly and accepted as a challenge to
improve performance
 Comments given harshly specially in public, builds

up resentment. Ill-will and poor quality work.
PARTICIPATORY MANAGMENT
 In PARTICIPATORY MANAGEMENT, authority and
responsibility has been delegated. The nurses are given
increasing authority to manage themselves.
 In this case there is mutual trust and support.
 There is increased accountability of the head nurse and of

the employee through self-supervision.
 Outcome are high morale, team work and participation.
 Participation increases individual and organizational

capabilities to learn, adapt and develop toward higher
levels of excellence.
COMMUNICATION
 Why nurses communicate: facilitate work

. Increase motivation
. Effect change
. Optimize care
. Increase worker’s satisfaction
. Facilitate coordination
. Communication binds the organization to ensure
common understanding.
. It is also essential in terms of health teachings
rendered by nurses.
COORDINATION
 It unites personnel and services toward a common
objective.
 Synchronization of activities among the various services
and departments enhances collaboration of efforts
resulting in efficient, smooth and harmonious flow of
work.
 It prevents overlapping of functions, promotes good
working relationships and work schedules are accomplished
as targeted.
 Whom to coordinate with:
. Medical service . Dietary service
.Administrative service . Medical social service
. Laboratory services . Medical records service
. Radiology service . Com agencies, civic org
. Pharmacy service
STAFF DEVELOPMENT
 Nurses are given opportunities to attend
conferences or seminars conducted by other
agencies or associations or to go back to
formal schooling by enrolling in graduate
schools. Policies governing these are
observed properly.
 DECISION MAKING is a course of action that

is consciously chosen from available
alternatives for the purpose of achieving a
desired result.
Conflict Management
 Clash between two opposing and oftentimes
hostile parties.
 Is a warning to managers that something is wrong
and needs solution through problem solving and
clarification of objectives, establishment of group
of norms, and determination of group boundaries.
 Conflict that is managed instead of being ignored
or suppressed can be used effectively. It can
stimulate competition, identify pertinent
differences within the institution.
 Unresolved conflict is debilitating and oftentimes
frustrating. Productivity declines and the
possibility of mistakes often occur.
SOURCES OF CONFLICT
. It is characterized by competition, domination
and provocation.
. It arises from differences in knowledge, skills,

values, interest, scarcity of resources, rivalry, role
ambiguity, unworkable organizational structure
and unacceptable leadership style.
. It is a dynamic process. It is a type of behavior

involving two or more parties in opposition to each
other.
TYPES OF CONFLICT
 Covert conflict is more dangerous because it is not

what appears on the surface. It results in harbored
feelings that drain both physical and psychological
energy.
 Vertical conflict, differences in opinions between

superiors and subordinates are caused most often
by inadequacy in communication, opposing
interest and lack of shared perceptions and
attitudes.
.
TYPES OF CONFLICT
 Horizontal conflict arises as a common struggle or

strife between departments or services wherein
the degree of interdependence and collaboration
determines the success in achieving objectives.
TYPES OF CONFLICT
 Behavioral and process standpoint.

• Behavioral standpoint, it is a perceived condition
that exist between two parties, when one or more
parties perceive goal incompatibility and some
opportunity for interfering with goal achievement
of the other.
• Process standpoint, what occurs when real or
perceived conflict exist in goals, values, ideas,
attitudes, beliefs and the like. It can occur within
one individual; between two or more individuals;
within one group or between groups.
CONFLICT RESOLUTION
• Avoidance commonly used by group who do not
want to do something that may interfere with
their relationship. Neutrality is maintained at all
times. This is appropriate for those who wishes to
reduce tension and gain composure.
• Accommodation means self practice. The person

neglects his own needs to meet the goals of the
other party. It is used to preserve harmony and
gain social credits that can be used later.
CONFLICT RESOLUTION
 Collaboration inspires mutual attention to the

problem and utilizes the talents of all parties. It
focuses on problem-solving to find mutually
satisfying solutions. Generally, this is the most
effective method of conflict resolution.
 Compromise both parties seek expedient,

acceptable answers for short periods when goals
are only moderately important and the parties
have equivalent power.
CONFLICT RESOLUTION
 Competition the supervisor or nurse manager
exerts power at the subordinate’s expense. It is
expressed through suppression of conflict through
authority-obedience approach. This enforce the
rule of discipline.
 Smoothing where disagreements are ignored so
that surface harmony is maintained in a state of
peaceful co-existence. This method may be
appropriate in solving minor problems but issues
also remain unresolved and may later resurface
CONFLICT RESOLUTION
 Withdrawing one party is removed thereby

making it possible to resolve the issue. It
produces the same result as smoothing.
 Forcing it yields an immediate end to the

conflict but leaves the cause of the conflict
unresolved. It may be appropriate in life
and death situations but otherwise
inappropriate.
BASIC RULES IN MEDIATING CONFLICT
 Establish clear guidelines and make them known to all.
 Do not postpone indefinitely.
 Create environment that makes people comfortable to
make suggestions.
 Keep a two way communication.
 Stress a peaceful resolution rather than confrontation.
 Emphasized shared interests.
 Follow-up on the progress of plan.
END OF SLIDES
CONTROLLING

What is CONTROLLING?
 An on-going function of management which
occurs during planning, organizing, and directing
activities. It includes assessing and regulating
performance in accordance with the plans that
have been adopted, the instruction issued, and
the principles established.
 The controlling process opens opportunities for
improvement and comparing performance
against set standards. It provides information
about how well processes and people function
so they can be motivated to perform better in
the future.
 Use of formal authority to assure the attainment
of the purpose of action to the fullest extent
possible
 It is the management function in which

performance is measured & corrective action is
taken to ensure the accomplishment of
organizational goals.
 It is also a forward-looking process; thus you

anticipate deviation & seek to prevent them.
CONTROLLING
 Control measures utilized by the
Nursing Service:
 Quality Assurance
 Nursing Audit
 Performance Appraisal
 Records and Reports
 Budget
Reasons For Conducting Evaluation
Evaluation plays an im portant role in quality

and productivity im provem ent for several
reasons:
 Evaluation ensures that quality nursing care is

provided.
 It allows for the sitting of sensible objectives
and ensures compliance with them.
 It provides standards for establishing
comparisons.
Reasons For Conducting Evaluation
 It promotes visibility and a means for employees

to monitor their own performance.
 It highlights problems related to quality care and
determines the areas that require priority
attention.
 It provides an indication of the costs of poor
quality.
 It justifies the use of resources.
 It provides feedback for improvement.
Evaluation Principles
I n order that em ployees m ay be evaluated

accurately and fairly, certain principles
m ust be observed:
 The evaluation must be based on the behavioral

standards of performance which the position
requires. The goals and objectives are clearly
presented to the employee and performance
evaluation is based on these.
 In evaluating performance, their should be enough

time to observe employees behavior. Usual and
consistent behavior should be evaluated rather than
those isolated or typical actuations
 The employee should be given a copy of the job

description, performance standards and evaluation
form before the scheduled evaluation conference. This
way, the rater and the employee to be rated can
discuss issues from the same frame of reference.
 The employee’s performance appraisal should

include both satisfactory and unsatisfactory
result with specific behavioral instances to
exemplify these evaluative comments.
 Areas needing improvement must be prioritized

to help t5he worker upgrade his/her
performance.

 The evaluation conference should be scheduled
and conducted at a convenient time for the rater
and the employee under evaluation, in a
pleasant surrounding and with ample time for
discussion.

 The evaluation report and conference should be

structured in such a way that it is perceived and
accepted positively as a means of improving job
performance.
Characteristics of an Evaluation Tool
 Objective – free from bias
 Reliable – refers to the accuracy or precision of

the tool such that it will produce the same
results if administered twice
 Sensitive – can measure fine lines of

differences among the criteria being measured
 Validity – relevancy of the measurement to the

performance of the employee
Basic Components of the Control
Process
1. Establishment of standards, objectives, and

methods for measuring performance
 Standards are desirable sets of conditions &

performance necessary to ensure the quality of
nursing care services which are acceptable to
those instrumental to or responsible for setting
& maintaining them.
 3 Types of Performance Standards:
 Standards on structure- are those that focus

on the structure or management system used to
deliver care. (They include the number &
categories of nursing personnel, their education,
personal & professional qualities & proficiencies,
their function, physical facilities & equipment)
 Process Standards-refer to decisions & actions
of the nurse relative to the nursing process
which are necessary to provide good nursing
care.( These include assessment, plan of care,
nursing intervention)
 Outcome Standards- are designed to measure

the results of care provided in terms of changes
in the health status of clients served, changes in
level of their knowledge, skills & attitudes and
satisfaction of those served including the
members of the nursing & health team.
Establishing of Objectives & Methods for
measuring Performance
 Measurable criteria or objectives specific to

giving nursing care must be developed to
evaluate process & outcome.
 The establishment of objectives provides clear

direction & communication of expected levels of
achievement.
 There should be full commitment in the form of

a performance contract.
Important Considerations:
 The greater the participation of the employee, the
greater the motivation to achieve.
 Agreed-upon performance objectives therefore should

be developed by everyone concerned.
 Objectives should be challenging but attainable.
 Performance expectations must be clearly stated &

should lie within the individual’s scope of control.
Most commonly used methods for measuring
nursing care:
 Task Analysis- actions & procedures such as written

guides, schedules, rules, records & budgets are
inspected. It uses tools as time studies & checklists.
 Quality Control- refers to the activities &

techniques employed to achieve & maintain the quality
of a product, service or process. It includes a monitoring
activity but it is also concerned with finding & eliminating
causes of problems so that the requirements of the
customer are continually met. In quality control the level
of nursing care provided & its effects on the clients are
assessed.
Process
2. Measurement of actual performance.
 Measurement of performance is an on-going,

repetitive process with the actual frequency
dependent on the type of activity being
measured. ( for example, nursing care to
patients is continuously monitored, whereas, a
formal performance appraisal may be done only
twice a year)
 Measurement may be scheduled in advance,
maybe done at periodic but unannounced
intervals or may occur at random.
 The purpose of measurement should be clarified

& the staff should be informed about the tasks &
levels of care that need attention.
Process
3. Comparison of results of performance with

standards and objectives and identifying
strengths and areas for correction and/or
improvement
 Comparing the results of performance with

standards & objectives is one of the easiest
steps in the control process.
 If performance matches standards & objectives,
managers are assured that the needs of patients
are met.
 However, if performance is contrary to

standards & objectives set, then necessary
action should be taken.
Process
4. Action to reinforce strengths and successes
 Positive feedback stimulates motivation, consistently

high performance & growth of the employee.
5. Implementation of corrective action as necessary
 Corrective actions are applied to improve

performance.
Controlling Guidelines for Nursing
Service Administrators:
1. Determine what information requirements of the

Nursing Service is needed which will help in:
 Evaluating performance
 Relating progress to program schedules
 Maintaining status of funds, staff, plan

equipment, supplies and materials
2. Establish a system to generate required data.

3. Develop standards for cost, quality and

production for individual work operations
4. Set up a system of control using records and

reports to collect and summarize these
information for administrative use
5. Develop a system of operational audit as a

continuing control device
6. Determine the information required regarding
the program’s effect on the community and
provide for its collection
7. Provide a system whereby management stress

of the organization is controlled through the
establishment of long range objectives and
short-range goals
8. Formulate a human resource development

program
Quality Assurance
 The process of establishing standards of

excellence of nursing intervention and taking
steps to ensure that each patient receives the
expected levels of care.
 It is the estimation of the degree of excellence

in patient health outcomes & in activity & other
resource outcomes.
Quality Assurance
 It is the measurement of the actual level of
service provided plus the efforts to modify when
necessary the provision of these services in light
of the results of such measurement
 A fulfillment of the social contract between

society and professions.
Quality Assurance
Purpose:
 To assure the consumer of a specified

degree of excellence through continuous
measurement & evaluation.
Quality Assurance
 Standard – is a desirable set of condition and
performance necessary to ensure the quality of
nursing care services which are acceptable to
those responsible for setting and maintaining
them
 Quality – is the “degree of excellence” and

assurance means “formal guarantee of a degree
of excellence”, it assures patients that an
acceptable standard of care will be provided
them.
Quality Assurance
 Quality assurance – describes all activities
related to the establishment, maintenance &
assurance of high quality care for patient which
includes assessment of patient care & correction
of problems identified.
 Quality Nursing Care – presence of all

elements/characteristics specified in the
standards relative to structure, process and
outcome
Principles Underlying Quality Assurance:
1. All health professionals should collaborate in the effort to
measure & improve care.
2. Coordination is essential in planning a comprehensive

quality assurance program.
3. Resource expenditure for quality assurance activities is

appropriate.
4. There should be focus on critical factor such as functions

& activities that promise to yield the greatest health &
financial benefit to reveal significant findings.
5. Quality patient care is accurately evaluated through
adequate documentation.
6. The ability to achieve nursing objectives depends upon

the optimal functioning of the entire nursing process &
its effective monitoring.
7. Feedback to practitioners is essential to improve

practice. It perpetuates good performance & replaces
unsatisfactory interventions with more effective
methods.
8. Per pressure provides the impetus to effect prescribed
changes based on the results of assessment & needed
improvements on the quality of care.
9. Reorganization in the formal organizational structure

may be required if assessment reveals the need for a
different pattern of health care.
10. Collection & analysis of data should be utilized to

motivate remedial action.
Steps in Developing a Quality
Assurance Program
1. Formulation or Review of the Nursing

Division’s philosophy and objectives
2. Formulation or Review of standards
3. Formulation of evaluation tools
4. Data Collection
5. Data analysis
6. Taking action
Quality Assurance & Performance
Evaluation
 Performance Evaluation – focuses on the

worker. It asks questions about how well the
worker satisfies the requirements of his or her
job within the organization.

 Quality Assurance – focuses on the care &

service the patient receives than on how well
the professional performs the duties that the
position requires.
Nursing Service Audit
 Official examination of nursing records,

physical facilities and personnel involved
in patient care for the purpose of
evaluation, verification and improvement
 Serves as a means of improving nursing

care by revealing existing deficiencies
Objectives of Nursing Audit
 Review systematically the nursing records of
hospital patients
 Maintain the record of performance of each

professional nurse or staff
 Provide a biographical index of the quality of

nursing care received by every patient
 Develop a more valuable and pertinent

information for the health care received by every
team and staff
Objectives of Nursing Audit
 Develop and improve the quality of nursing care
and nursing notes
 Develop a means to reveal areas of strengths

and weaknesses in the hospital services
 Develop better cooperation/collaboration among

nurses and members of the health care team
 Provide a means for self-evaluation of nursing

care
Functions of Nursing Audit Committee
 Act as a liaison between the Nursing Service and

the Health Care Team
 Serve as a means of correcting shortcomings
 Aid in establishing a cooperative spirit among

the nursing personnel
 Keep confidential all information obtained during

audits
Performance Appraisal
 Done to help an employee improve his work methods

to ensure the achievement of organizational goals
 It is a control process in which employee’s

performance is evaluated against standards.
 It is the most valuable tool in controlling human

resources & productivity.
 It reflects how well the nursing personnel have

performed during a specific period of time
Purposes of Performance Appraisal
 Determine salary standards & merit increases
 Select qualified individuals for promotion or

transfer
 Identify unsatisfactory employees for demotion

or termination
 Make inventories of talents within institution.

 Determine training & developmental needs of
employees.
 Improve the performance of work groups by

examining, improving, correcting
interrelationships between members
 Improve communication between supervisors &

employees & reach an understanding on the
objectives of the job.
 Establish standards of supervisory performance.
 Discover the aspirations of employees &

reconcile these with the goals of the institution
 Provide “employee recognition” for

accomplishment
 Inform employees “Where they stand”

Evaluation Principles:
 For a worker’s performance evaluation to be

valid, it must be based on his job description
and performance standards
 The nurse should be provided with a copy of his

job description, performance standards and
evaluation form to review prior to the scheduled
evaluation .
 An adequate and representative sampling of the

nurse’s behavior should be observed in he
process of evaluating performance. Care must
be taken to evaluate his usual or consistent
behavior. Focusing on, or magnifying an isolated
instance of either extremely capable or
extremely inept behavior on the part of the
nurse should be avoided.
 In documenting the employee’s performance

appraisal, the manager should indicate clearly
those areas in which the worker’s performance
is satisfactory and those which needs
improvement.

 If there is a need to improve the nurse’s

performance in several areas, the manager
should indicate which areas should be given
priority by the nurse.
 The evaluation interview should be scheduled at

a time convenient for both the nurse and the
manager. It should be held in a pleasant
surrounding and should allow time for both
parties to ask questions and discuss the
evaluation at length.
Factors Contributing to a Successful
Performance Appraisal System:
Compatibility between the criteria for individual

evaluation & organization goals
Direct application of the rated performance to

performance standards & objectives expected of
the worker.
Development of behavioral expectations which

have been mutually agreed upon by both the
rater & the worker
Factors Contributing to a Successful
Performance Appraisal System:
Understanding the process & effective utilization of
procedure by the rater
Rating of each individual by the immediate supervisor
Concentration on the strengths & weaknesses to

improve individual performance
Encouragement of feedback from the rated employees

about their performance needs & interest
Types of Evaluation Devices:
 Free Response Report

 Evaluator is asked to submit a written report
on the quality of nurse’s performance in a
particular position over a given period of time
 Simple Ranking
 Requires evaluator to rank the employee
according to how he/ she fared with co-
workers with respect to certain aspect of
performance
 Performance Checklist
 Consist of a list of performance criteria with
corresponding blank wherein the evaluator is
asked to indicate for each criterion, whether
the nurse has or ha not exhibited the desired
behavior.
 Graphic Rating Scale

 Includes a series of items representing
different activities or tasks included in the
nurse’s job description. Evaluator checks the
appropriate point on a numerical scale or
selecting the appropriate phrase in a series of
phrases indicating the quality of the nurse’s
performance
 Forced-Choice Comparison
 The evaluator is asked to choose from a
group of weighted descriptive statements
those that best describe the nurse being
evaluated and those that least describe
him/her
 Favorable and unfavorable items are grouped

in such a manner that the evaluator is forced
to select from a group of unfavorable as well
as favorable statements to describe the
nurse’s performance
 Ex am ple of Forced-Choice Com parison
Select from among the following statements the

one which best describes the nurse being
evaluated and the least that describes him/her.
 Enjoys the respect of co-workers
 Tends to complain about assignments
 Prompt in reporting changes in patient’s

condition
 Frequency of Evaluation:
 First Evaluation - after the end of the

orientation
 Second Evaluation - on the third month
 Third Evaluation - on the sixth month,
before permanency
 Bi-annual - every six months
 Annual - using the Performance
Appraisal System
End of Slides…
Thank you for your

active listening and
participation!
DIRECTING/
COORDINATING

DIRECTING
Connecting link between organizing for work &
getting the job done.
Directions must be complete, understandable, &
given in a logical order.
Includes delegation of work to be performed,
utilization of policies & procedures, supervision of
personnel, coordination of services,
communication, staff development, & making
decisions.
DELEGATION
• It is the process by which manager
assigns specific task/duties to
workers with commensurate
authority to perform the job.
• The worker in return assumes
responsibility for its satisfactory
performance & is held accountable
for its result.
Ways for Nurses & Nurse Managers to
Delegate successfully
1. Train & develop subordinates. It is an investment.
2. Plan ahead. It prevents problems.
3. Control & coordinate the work of subordinates.
Visit subordinates periodically.
4. Emphasize employees solving their own
problems.
5. Emphasize employees solving their
own problems.
6. Accept delegation as
desirable.
7. Agree on performance
standards.
8. Assess results.
9. Give appropriate rewards.
10. Do not take back delegated
tasks.
Reasons for Delegating:
1. Assigning routine tasks
2. Assigning tasks for which the
nurse manager does not have
the time or knowledge
3. Problem solving
4. Capability building
Techniques for Delegating
• Prepare lists of duties that can be
delegated (know your nurse practice
act)
• Rank the duties according to time
required to perform them &
importance to the organization
• Delegate one duty at a time
IMPORTANT CRITERIA
• The ability of the worker to carry out the task
• Fairness not only to the employee but to the
team as a whole.
Principles of Delegation:
1.Select the right person to whom the job is to
be delegated – capability, accountability, &
authority of the worker to do the job.
2.Delegate both interesting & uninteresting
tasks
Uninteresting Jobs - can be used to challenge, motivate, &
increase a person’s performance & commitment.
Interesting Jobs - draw out the best among
employees & inspire them to higher
achievement.
3. Provide subordinates with enough time to
learn – expertise, training, & experience
4. Delegate gradually. New versus longer
employee.
5. Delegate in advance – set time frame,
describe specific results expected.
6. Consult before delegating
- clarification minimizes problems &
promotes teamwork.
7. Avoid gaps and overlaps
Gap – job left out, no one taking
responsibility
Overlap – two or more people have
responsibility for one job causing
confusion and low morale
What cannot be delegated:
1. Overall responsibility, authority, &
accountability for satisfactory completion of all
activities in the unit.
- Nurse managers cannot be absolved for poor
performance of subordinates by blaming them.
2. Authority to sign one’s name is never
delegated. The worker that performed the task
should be one to sign in.
3. Evaluating the staff & or taking the necessary
correction or disciplinary action.
4.Responsibility for maintaining
morale or the opportunity to say a
few words of encouragement to the
staff especially the new ones.
5. Jobs that are too technical & those
that involve trust & confidence.
6. The power to discipline
7. Duties involving trust or confidence.
COMMON DELEGATION
ERRORS
• UNDERDELEGATING
• OVERDELEGATING
• IMPROPER DELEGATING
EFFECTIVE DELEGATING
1. Plan ahead
2. Identify necessary skills and levels
3. Select most capable personnel
4. Communicate goal clearly
5. Empower the delegate
6. Set deadlines and monitor progress
7. Model the role and provide guidance
8. Evaluate performance
9. Reward accomplishment
End of Slides
LEADERSHIP
and
MANAGEMENT

WHAT IS MANAGEMENT?
- Is the process of planning, organizing, leading and controlling the efforts of
organizational resources in order to achieve the organizational goals
Input + Management = Output

Manpower Planning Goals of
Money Organizing the firm
Materials Staffing
Machinery Directing
Methods & Systems Controlling
Communicating
(Resources) Motivating
Functions of Manager
 Planning
 Organizing
 Staffing
 Leading/ Directing
 Controlling
Planning
 defining the goals of the organization and determining the
activities and resources required to achieve them
 requires information, judgment and decision-making
Need to Plan
1. Activities will be consistent with the organization’s goals
2. Correct type of amount of resources can be acquired

Takes into account variables in the environment
Economic Social Political
Legal Technological
Able to foresee and reduce risk
Organizing
 Involves acquiring the resources that the organization needs to

achieve its aims
 Creating an organizational structure that is suitable for the

achievement of the agreed objectives
 Allocating of task and duties to the staff and to coordinate them

in order to achieve the organization objectives
Staffing
 Ensures all labor requirements are met

Directing
 provides direction and leadership to motivate staff to perform

task within the specified time frame and with utmost efficient
use of resources.
Controlling
 to check or to regulate
3 Elements involving controlling function

1. Steps must be taken to set work standards
2. To communicate them to the staff
3. A system of measures must be devised
Managerial Roles
Role
- An organized set of behavior that is associated
with a particular office or position
Interpersonal Roles
 Grow directly out of the authority of a manager’s position
 Involves developing and maintaining positive relationships
with significant others
 Figurehead
 Leader role involves building relationships with
subordinates
 Includes communicating with motivating and coaching
subordinates
 Liaises between the organization and outsiders
Informational Roles
 Pertains to receiving and transmitting information so that

managers can serve as nerve centers of the organizational
units
 Monitor role
 Disseminator role
 Liaison
Decisional Roles
- Making significant decisions that affect the organization
 Act as Entrepreneur
 Disturbance Handler
 Allocates resources
 Represents the organization or unit in major negotiations

Managerial Skills
Skills
- Ability to engage in behavior that are
functionally related to one another and that lead
to desired performance level in a given area
Managerial Skills
 Technical Skills
 Human Skills
 Conceptual Skills
Management Performance
 Effectiveness
– ability to choose appropriate goals and achieve them
 Efficiency
– ability to make the best use of available resources in the
process of achieving goals
Managerial Job Hierarchy
 First-Line Managers
 Middle Managers
 Top Managers
Qualities of a Manager
 Self-confidence
 Initiative
 Drive
 Decisiveness
 Judgment
 Adaptability
 Stamina
 Emotional maturity
 Human Understanding
 Adequate Education Standard
Schools of Management Theory
CLASSICAL SCHOOL
Henry Fayol
One of the pioneer of management of thought
 Founder of the Classical Organization

 Father of management process school
 Postulate the 14 principles of management
14 Principles of Management
1. Division of labor 10. Order
2. Authority and responsibility 11. Equity
3. Discipline 12. Stability of staff
4. Unity of command 13. Initiative
5. Unity of direction 14. Esprit de Corps
6. Subordination of individual interest to the organization’s interest
7. Remuneration
8. Centralization
9. Hierarchy
Management Functions identified
 Planning
 Organization
 Command
 Coordination
 Control
Seven activities of management
- expanded by Luther Gulick
POSDCORB
 Planning
 Organizing
 Staffing
 Directing
 Coordination
 Reporting
 Budgeting
Five functions of the management process
 Planning encompasses determining philosophy, goals, objectives, policies,
procedures and rules, carrying out long- and short-range projections,
determining a fiscal course of action and managing planned change.
 Organizing includes establishing the structure to carry out plans, determining

the most appropriate type of patient care delivery and grouping activities to meet
unit goals. Other functions involve working within the structure of the
organization and understanding and using power and authority appropriately.
 Staffing function consist of recruiting, interviewing, hiring and orienting staff. It

also includes scheduling, staff development, employee socialization and team
building.
 Directing sometimes includes several staffing functions, however, this phase’s

functions usually entails human resources management responsibilities such as
motivating, managing conflict, delegating, communicating and facilitating
collaboration
 Controlling functions include performance appraisal, fiscal accountability,

quality control, legal and ethical control and professional and collegial control
Management Process
Planning
Controlling Organizing
Directing Staffing
Simplified Nursing Management
Process Process Function
ASSESSING Planning
Planning
PLANNING Staffing
Organizing
Organizing
IMPLEMENTING
Directing
EVALUATING Controlling
Management process is similar in many
ways to the nursing process
 Planning – Nurse manager spent part of day working on budget

 Organizing – met with the staff about changing the patient care
management delivery system from primary care to team nursing
 Staffing- altered staffing policy to include 12-hour shift
 Directing – held a meeting to resolve a conflict between nurses
and physicians
 Controlling – gave an employee a job performance evaluation
Contributions of the Classical School
 Made planners aware that there are certain

management principles that make for
effective management not only in business
but in other fields as well
 Isolated some areas of practical concern to

managers that are still relevant today –
division of labor and use of managerial
authority
BUREAUCRACY
Max Weber
 Saw the need for legalized, formal authority and consistent rules
and regulations for personnel in different positions
 Father of Organization Theory
 Conceptualize Bureaucracy
 Emphasized:
Rules instead of individuals
Competence over favoritism
3 Bases of Authority
 Tradition Accepted because things have been that way

King in the Monarchy
 Charisma
 Rational, Legal Authority
Because of knowledge, skill and ability to fulfill position

 All personnel selected for competence
 Division of labor, authority and responsibility is clearly defined
 Positions are organized into a hierarchy

SCIENTIFIC MANAGEMENT
SCHOOL
Frederick W. Taylor
- Father of Scientific Management

- turned to scientific analysis to better ways of managing
Postulated the “if workers could be taught the one best way to accomplish task,
productivity would increase
Scientific Management School
1. Observe and analyze all jobs to determine the best method to

accomplish them
2. Scientifically select and train the best man for the job
3. Pay the worker on an incentive basis commensurating salary
with productivity
4. Management should be put in charge of planning, preparing
and inspecting work.
Contribution of Scientific Management School
 led to the development of the efficient production line

technique through time and motion studies
 the stress it places on the scientific selection of workers has

made us recognize the importance of ability and training in
increasing the effectiveness of worker
 development of work design has led managers to seek the

“one best way” to get a job done
 Standardized to maximize profit

Gilbreth
 Frank Gilbreth
 Lilian Gilbreth – first lady of management
Emphasized
 Benefits of job simplification
 Establishment of work standards
 Studied effects of wage plans and fatigue on work

performance
 Reduced number of motions in accomplishing task
Henry Gantt
 Introduced the Gantt chart
 Forerunner of the PERT chart
(Program Evaluation and Review Technique)
 Depicts the relationship of work planned or completed on one axis to
the amount of time needed or used on the other
 Developed task and bonus remuneration plan
- workers guaranteed day’s wage plus bonus for production above
standard to stimulate higher production
 Argued for a more humanitarian approach by management
- emphasized on service rather than profit objectives
- recognize non-monetary incentives like job security and staff
development
Human Relations Management
Behavioral School
Mary Parker Follett
 Suggested basic principles “participative decision

making or participative management”
 “Managers should have authority with, rather than

over, employees” – a need existed for collective
decision making
Elton Mayo
 famous study of human behavior at the
Hawthorne Plant of western Electric company
3 Phases of Hawthorne Experiment

 Test Room Studies
 Interviewing Studies
 Observational Studies
“Hawthorne Effect” – people respond to the fact that they are

being studied, attempting to increase whatever behavior they
feel will continue to warrant the attention
Results of the experiment
 When special attention is given to workers by management,
productivity is likely to increase, regardless of actual
changes in the working conditions
 Economic rewards by themselves have little effect in

production level.
 leadership is a crucial element in the work situation and

there is difference in formal and informal leadership
 Recommends more employee participation in decision

making
Contributions of the Behavioral School
 discovered that a genuine concern for the

individual worker leads to increased
productivity
 teaching of people skills has become an

important aspect of management training
Douglas Mc Gregor
 Theory X and Theory Y focuses on two contrasting attitudes
 Theorized managerial attitudes about employees and directly

correlated with employee satisfaction
 Concludes how managers motivate and supervise their workers

depends on their assumption about their employees
Theory X Assumptions
- managers take negative view of their employees
Managers believed that employees
 Employees are lazy

 Hate work and will avoid work if possible
 Interested only in money and job security
 Do not like responsibility
 Needs constant supervision and direction
 Indifferent to organizational needs
 Uncreative
 Must be coerced or threatened to get them to work
Theory Y Assumptions
- Managers have a positive perception of workers
Managers believed that workers
 Like to work, enjoy work and see work as natural as play

 Committed, independent, self-motivated
 Creative, exercise imagination and ingenuity
 Willing to work hard to meet personal and organizational goals
 Exhibit self-control and discipline
 Creative
Chris Argyris
 Supported McGregor and Mayo
 Managerial domination causes workers to become

discouraged and passive
 “if self-esteem and independence needs are not

met, employees will become discouraged and
troublesome or may leave the organization
 Stressed the need for flexibility within the

organization and employee participation in decision
making
The Managerial Grid
(Robert Blake/Jane Mouton)
 Plays an important part in managerial behavior in

organizational development
 Shows managerial orientation is terms of two variables
Purpose of the Grid

1. A tool for identifying Management style
2. Back-up style, used when normal style fails to get

results
• The grid provides a reasonable indication of
health of the organization as well as the
ability of the managers.
• It is the objective of the management to
move as close to coordinate 9.9 as possible
• Managers should be carefully selected on
the basis of their ability to coordinate people
and tasks for optimum benefit
5 coordinates are identified to reflect
various styles of leader behavior
(1.1) Impoverished Management. The manager makes minimum effort or concern either
for staff or to get work done, the manager is lazy.
(9.1) Task Management. Excellent work design. Well-established procedures. Almost

total concentration on achieving results. People’s need are virtually ignored and
conditions of work are so arranged that people cannot interfere to any significant
extents
(1.9) Country club management. Personal and meaningful relationship with people.
Friendly atmosphere and high morale. Loosely structured work design. Manager is
attentive to staff and has developed satisfying relationships. Little attention is paid to
achieving results
(5.5) Middle of the road or the dampened pendulum. Satisfactory performance achieved
by equating the necessity for performance and reasonable morale. Adequate
performance through balancing the necessity to get out work wile maintaining
morale of people at a satisfactory level
(9.9) Team. High performance manager. Ultimate in managerial efficiency. Thoroughly

dedicated people. Trustworthy and respectable atmosphere. Highly organized task
performances. Managers achieves high work accomplishment through leading
committed people who identify themselves with the organizational aims
The Managerial Grid
9
C Country Club Team
O 8 Management Management
N
C 7
E
6
R
N 5
Organization Man
for 4 Management
P 3
E
O 2
P
1
L
E Impoverished Authority
Management Obedience
0 1 2 3 4 5 6 7 8 9
CONCERN for TASK/ PRODUCTION

MANAGEMENT THEORY
DEVELOPMENT
Theorist Theory
Taylor Scientific management

Weber Bureaucratic organization
Fayol Management functions
Gulick Activities of management
Follett Participative management
Mayo Hawthorne effect
McGregor Theory X and Theory Y
Argyris Employee participation
Conceptual Process of the Nursing Service Administration
End of Slides
LEADERSHIP
and
MANAGEMENT
PLANNING

This course will discuss
PLANNING
as it applies to the nursing profession
 PLANNING
 Introduction to Planning
 Importance of Planning
 Types of Planning
 Principles of Planning
 Planning Process
 Advantages of Planning
 Barriers to Planning
Strategic Planning Process
Course Outline

 Decision Making
 Types of Decisions
 Decision Making Process
 Group Decision Making
 Creative Decision Making
 Decision Making Tools
 Time Management
 Budget
 Types of Budget
 The Budget Process
 Cost Containment
Objective
At the end of the lecture, the students will be able to:
 Gain basic knowledge of planning as a management function, its

principles, theories and processes and correlate the concepts
with actual practice
 Explain the meaning of planning and importance to nursing
management
 Discuss nature and purpose of planning
 Describe various phases of planning process
 Define budget process
Planning
The most basic and fundamental activity of management process
• Deciding in advance what to do, who is to do it, how, when and

where it is to be done
• Involves choice: necessity to choose among alternatives
• A predetermined course of action in order to arrive at a desired
result
• Continuous process of assessing, establish goals and objectives,
implementing and evaluating them
Planning
Forecasting of events, making decisions, setting goals and priorities,
developing policies and setting standards
Process whereby management bridges the time span between where it

is at present and where it wants to be at some point in the future
Planning directs thinking toward

• What activity we expect to do?
• Why it will be done?
• Where it will be done?
• When we expect to do it?
• How it will be done?
• Who is going to do it?
Scope of Planning
 Top Management
 Covers over-all management of the organization’s nursing service
 Nursing director, chief nurse or directors of nursing
 Middle Management
 Direct activities to actually implement the operating policies

 Nursing supervisors
 Lower Management
 Do daily and weekly plans for administration of direct patient care
in their respective units.
 Head Nurses or Senior Nurse
Types of Planning
 Strategic Planning
 Operational Planning
Strategic Planning
 Determines long term objectives of the institution and the policies that
will be used to achieve these objectives
 Done at the executive level of management
 Future-oriented
Purpose:
1. Help clarify belief and values of the organization
2. Gives direction to the organization
3. Improve communication and coordination of activities
4. Improve efficiency
5. Eliminate duplication of effort
6. Allow adaptation to the changing environment
7. Set realistic and attainable goals
SWOT Analysis
- a tool used before making a strategic plan
Weakness or Strength Threats

 Competition
 Expertise of nursing and
 Decrease in patient load
medical personnel staff
 Low patient satisfaction
 Qualifications  Increase in charges
 Over or understaffed  Legal threats
 Financial Status
Opportunities
 Quality of patient care
 Improved or new facilities
 Abundance or scarcity of  Recruitment of medical and
medical equipment and nursing personnel
supplies  Referrals
 New health care programs

Operational planning
 Deals with day to day maintenance of activities
 Done in conjunction with the preparation of budget
Unit planning
 In Nursing, Daily planning is related to the care done on the patient
 Taking of health history of the client
 Assessing health status
 Formulating nursing diagnosis
 Implements nursing care plan
Functional planning
 Planning performed at a service or department
 Relates to a specialty service within a nursing division
Division planning
 Used during the initial phase of planning
 Analyse:
 Mission
 Strengths
 Weakness
 Environment
Major Aspects of Planning
 Planning should contribute to objective
 Planning precedes all other aspects of management
 Planning pervades all levels
 Planning should be efficient

Characteristics of a Good Plan
A well-developed plan should:
 Have clearly worded objectives
 Be guided by policies and procedures
 Indicate priorities
 Develop actions that are flexible and realistic
 Develop logical sequence of activities
 Include the most practical methods for achieving each objective

Purpose / Importance of Planning
 Leads to the achievement of goals and objectives
 Gives meaning to work
 Provides effective use of available resources and facilities
 Helps cope in crisis situations
 Cost effective
 Based on past and future activities
 Leads to realization of need for change
 Necessary for effective control
Functions of Planning
 To focus attention on objectives
 To gain economic attention
 To facilitate control
 To effect focus certainty and change

Elements of Planning/ Steps in Planning
 Forecasting
 Setting the Vision, Mission, Philosophy, Goals and Objectives
 Developing and Scheduling programs
 Preparing the budget

Forecasting
 Looks into the future including the environment in which the plan will be
executed
 Who will be the client

 Equipments
 Facilities
 Supplies
The Planning Hierarchy
Vision
Mission
Philosophy
Goals
Objectives
Policies
Procedures
Rules
Vision
 Outlines the organization’s future role and function
 Gives the institution something to strive for

Purpose or Mission Statement
 is a brief statement identifying the reason that an
organization exist and its future aim or function.
 This identifies the organization’s constituency and addresses

its position regarding ethics, principles and standards of
practice.
 Broad declaration of the basic, unique purpose and scope of

operations that distinguishes the organization from others of
its type
Mission Statement Components
 Clients
 Products/ Services
 Location
 Technology
 Concern for survival
 Philosophy
 Self-concept
 Concern for public-image
 Concern for employees
Department of Health
 Vision
 The leader of health for all in the Philippines
 Mission
 Guarantee equitable, sustainable and quality health for all
Filipinos, especially the poor, and to lead the quest for
excellence in health.
Vision/ Mission of FEU
Far Eastern University

aims to be
a private university of choice in Asia.
Committed to the highest

intellectual, moral and cultural standards,
it strives to produce
principled and competent graduates.
It nurtures
a service-oriented community
that seeks to contribute
to the advancement of global society.
Vision of the Institute of Nursing
The Institute of Nursing envisions

that among the schools offering
Nursing courses, FEU-IN will be
the choice school in the next five
(5) years because we will produce
graduates who can function/
practice independently in any
setting and not only looking at
employment as the sole career
opportunity after graduation.
Mission of the Institute of Nursing
The institute envisions competent graduates who are God-

fearing, nationalistic and responsive to the changing needs of
society – local, national and international.
The institute is committed to the provision of quality education

through a program of study that aims for academic excellence
and the development of nursing student as a total person
The educational program is given substance in a competency

based, community health-centered curriculum complemented
with co and extracurricular activities on socio-cultural and
spiritual aspects, in and off campus
Philosophy
 flows from the purpose or mission statement and delineates
the set of values and beliefs that guide all actions of the
organizations
 Sense of purpose of the organization and the reason behind

its structure and goals
 It is the basic foundation that directs all further planning

toward the mission.
 Provides parameter for decision making in determining what

is critical to an organization.
The Philosophy of the Institute of Nursing
The educational Program of the Institute of Nursing is found on the Faculty’s belief
about Man, health, society, education and nursing
The faculty believes that:

 MAN is created in the image and likeness of God. He is a bio-psychosocial, spiritual,
emotional, intellectual being capable of reasoning, seeking, attaining and enjoying
truth
 HEALTH is a basic right and personal responsibility of every individual, family and
community. It is a social phenomenon and a dynamic state wherein Man is able to
function to his maximum and he adapts to the ever changing environment
 SOCIETY is an open system composed of people who interact with one another and
are affected by culture, creed, ideologies and economic conditions. A democratic
dynamic society has the potential for continued development
 NURSING EDUCATION is a continuous self realizing process. It embraces all
those experiences which develops skills, attitudes and potentialities. It enables Man to
have deeper understanding and appreciation of the attainment of immediate and
ultimate purposes of life and of national development goals
 NURSING is a vital component of health system and must be responsive to the
needs of the society. Its primary concern is to promote, maintain, and restore health,
prevent illness. Alleviate human sufferings and assist in peaceful and dignified death
Goal
 The desired result toward which effort is directed.
 It is the aim of the philosophy.
 It change with time and require periodic reevaluation and

prioritization.
 It is global in nature
 It may direct and maintain the behavior of the organization.
 Long- and short-term goals are usually set for services rendered,
economics, use of people including people, funds and facilities,
innovations and social responsibilities.
Benefits of Goal
 Increases performance
 Helps clarify expectations
 Facilitates controlling function
 Increases motivation
Levels of Goals
Strategic Goal
Tactical Goal
Operational Goal
Strategic Goal
 Official Goal
 Broadly defined targets or future end results set by top

management
Tactical Goal
 Targets or future end result usually set by middle management

for specific department or units
 Spells out what must be done by various departments to achieve

the expected results
Operational Goals
 Targets or future end results set by lower management that

address specific measurable outcomes required from the lower
levels
How to set goals
 Specify the goal to be reached or tasks to be done

 Specify how the performance will be measured
 Specify the standard or target to be reached
 Specify the time span involved
 Prioritize the goal
 Determine coordination requirement
Objectives
 are similar to goals in that they motivate people to a specific end and are
explicit, measurable, observable, retrievable and obtainable.
 Time frame in the completion of the objectives are specified and the
objectives should be stated in behavioral terms, be objectively evaluated and
identify positive rather than negative outcomes.
Objectives:
In consonance with the Far Eastern University’s Philosophy of developing of
academic excellence, the Institute of Nursing through the Baccalaureate Program aims
to provide for the maximum development of the student as a person, as a nurse and as
a member of a dynamic society
A Graduate of the Baccalaureate Program of the Far Eastern University Institute of

Nursing who has been provided with and has participated in the intellectual, physical,
psychosocial, cultural and spiritual experiences is expected to:
 Have an integrated personality

 Function as a Professional Nurse in varied nursing situations utilizing the
nursing process and other approaches in the care of the individual, the family
and the community and assumes accountability for his actions
 Assume and initiate leadership and participate in professional and community
activities in consonance with the changing needs of the society
 Initiate and participate in research and advance studies to promote personal
and professional growth and to contribute to the body of knowledge of health
and nursing
 Demonstrate critical thinking in varied situations
Specific Level Objectives:
Level IV
 Projects an integrated personality

 Utilizes readily the nursing process in varied situations
 Assumes leadership responsibilities willingly with minimum supervision
 Conducts simple research studies relevant to nursing practice
 Seeks opportunities for personal and professional growth
Developing and Scheduling Programs
Programs
 Are determined, developed and targeted within a time frame
to reach the set goals and objectives

Time management
 A technique to allocate one’s time through setting of goals,

assigning priorities, identifying and eliminating wasted time and
using managerial technique to reach goals efficiently
3 basic steps in time management
1. Time be set aside for planning

and establishing priorities
2. Completing the highest priority

task whenever possible and
finishing one task before
beginning another
3. Reprioritize the task to be

accomplished based on new
information received
Priority Setting
Most critical skill in good time

management
5 Priority setting traps
 Whatever hits first

 Path of least resistance
 Squeaky wheel
 Default
 Inspiration
Whatever hits first
Occurs when an individual simply responds to things

as they happen rather than thinking first and then
acting
Path of least resistance
Individual makes and erroneous assumption that it is

always easier to do a task by himself or herself and
fails to delegate appropriately
Squeaky wheel
The individual falls prey to those who are

most vocal about their requests
Default
Individual feels obligated to take on tasks

that no one else has come forward to do
Inspiration
Individuals wait until they become

inspired to accomplish a task
3 categories in prioritizing
 don’t do
 do later
 do now
Don’t do
 Problems that will take care of themselves

 Outdate
 Better accomplished by someone else
 Manager removes unneeded clutter from his
or her work area
Do later
 Reflect trivial problems

 Those that do not have immediate deadline,
thus procrastinated
Procrastination
to put off something until a future time, to

postpone, or to delay needlessly
Do now
 Reflects a unit’s day-to-day operational

needs
 Daily staffing needs
 Dealing with equipment shortages
 Meeting schedules
 Conducting hiring interviews
 Giving performance appraisal
List
 Helpful in prioritizing all the do now list

 It is a plan, not a product and that the
creation of the list is not the final goal
 A planning tool
Managing time at work
Principles that may assist on planning
work
 Gather all the supplies/ equipment that will be
needed before starting an activity
 Group activities that are in the same location
 Use time estimates
 Document nursing interventions as soon as possible
after an activity is completed
 Always strive to end the workday on time
Taking breaks
Taking regularly scheduled breaks from work is

important
Allow worker to refresh both physically and mentally
Dealing with interruptions
Lower level managers experience more

interruptions than higher-level managers
External Time-wasters
 Telephone interruption
 Socializing
 Meetings
 Lack of information
 Poor communication
 Lack of feedback
 Lack of adequately described policies and procedures
 Incompetent co-workers
 Poor filing system
 Paperwork and reading
Dealing with time waster
1. Don’t make yourself overly accessible

2. Interrupt
3. Avoid prompting socialization
4. Be brief
5. Schedule long-winded pests
6. If you would like to chat and have time to do so,
use coffee breaks and lunch hours
Time Management Principles
 Anticipates problems that will rise from actions without thoughts
 Task to be accomplished should be done in sequence and

prioritized according to importance
 Setting deadlines in one’s work and adhering to them
 Deferring, postponing or putting off decisions, actions or

activities can become a habit which oftentimes cause lost
opportunities and productivity
 Delegation permits a manager to take authority for decision

making and to assign task to the lowest level possible consistent
with judgment, facts and experience
Time saving techniques, devices and
methods to better use of time
 Time Saving techniques

 Conduct an inventory of your activities
 Set goals and objectives and write them down
 With the use of calendars, executive planners, logs or journals, write what you
expect to accomplish yearly, monthly, weekly or daily
 Break down large projects into smaller parts
 Devote a few minutes at the beginning of each day for planning
 Organize your work space so it is functional
 Close your door when you need to concentrate
 Learn to delegate
 In a meeting, define the purpose clearly before starting
 Take or return calls during specified time
 Develop effective decision-making skills
 Take rest breaks and make good use of your spare time
Decision Making Tool
Program Evaluation and Review
Technique (PERT)
Developed by Booz-Allen-Hamilton organization and

the US Navy in connection with the Polaris missile
program
PERT
 A popular tool to determine the time of

decisions
 A flowchart that predicts when events and
activities must take place if a final event is to
occur
 Network system model for planning and
control under uncertain conditions
PERT
 Recognizes that certain task must be

completed before the total project can be
completed and subtask must be completed
before others can be started
 Key events are identified, labeled or

numbered on the flowchart
3 projected time determined
 Optimistic time (t0)

 Most likely time (tm)
 Pessimistic time (tp)
(t0) + 4(tm) + (tp)

(te) = -------------------------
6
GANTT
Highly developed schedules that allow one

to visualize multiple tasks that have to be
done
Henry L. Gantt
 Graphic device which a manager can plan

and monitor work time for complex project
 It is a grid with columns labeled

 Task
 Responsibilities
 Time Frame (minutes, hours, days, weeks,
months, year or decades)
GANTT CHART
Task Responsible Mon Tue Wed Thurs Fri
Collection
information
Type Report X
Revise Report X
Submit Report X
Fiscal Planning
Responsibility Accounting
Essential feature of fiscal planning

Organization’s revenues, expenses, assets
and liabilities is someone’s responsibility
Budget
 Annual operating plan

 Serves as an estimate of future cost
 Plan for utilization of manpower, material and other resources
 Plan for future activities expressed in operational as well as
financial monetary terms
Nursing budget
 Plan for allocation of resources based on preconceived needs for a
proposed series of programs to deliver patient care during one fiscal year
Hospital budget
 Financial plan to meet service expectations
Factors in Budget Planning
 Based on valid objectives to provide a

product or service
 Ensure clients receive nursing services they
want and need
 Simple, flexible and balance
Centralized Budgeting
 Developed and imposed by comptroller,

hospital administrator and director of nursing
 No or little consultation with lower level
managers in the preparation
 Top-down approach in implementing of
budget
 Middle managers has no autonomy or right to
control the budget
Decentralized Budgeting
 Middle managers are actively involve in the

planning and budgeting process
 Unit managers have an intimate view of their
needs
 Enhances morale and satisfaction of
individuals who participated in the
preparation of budget
Classification of budget
 Fixed expenses
 Variable expenses
 Controllable expenses
 Noncontrollable expenses
Fixed expenses
 Do not vary with volume
 Building’s mortgage payment or manager’s

salary
Variable expenses
 Vary with volume
 Payroll of hourly wage employees

 Cost of supplies
Controllable expenses
 Can be controlled or varied by the manager
 Number of personnel working on a certain

shift
 Staffing mix
Noncontrollable expenses
 Cannot be controlled by the manager
 Equipment depreciation
 Number and type of supplies needed by
patient
 Overtime
Types of Budget
Cash Budget
Personnel Budget
Operating Budget
Capital Budget
Cash Budget
 Forecast the amount of money received
 Beginning cash balance, estimates of

receipts and disbursements and the
estimated balance for a given period
corresponding to that of the operating and
capital budget
Personnel Budget
 Work force budget

 Largest of the budget expenditures
Calculating Nursing Care Hours (NCH)
per patient-day
Nursing hours worked in 24 hours

NCH/PPD = -------------------------------------
Patient Census
Operating Budget
 Reflects expenses that change in response to

the volume of service
 Cost of electricity
 Repairs and maintenance
 Medical/ surgical supplies
Capital Budget
 Plan for the purchase of buildings or major

equipments
 Composed of long-term planning, major
acquisitions component and short-term
budgeting component
Four Budget Components in Health Care Institutions
1. Revenue Budget
 Summarizes income which management expects during planning period
2. Expense Budget
 Expected activity in operational and financial terms for a given period of
time
3. Capital Budget
 Outlines programmed acquisition, disposals and improvements in an
institution’s physical capacity
4. Cash Budget
 Represents planned cash receipts and disbursement as well as cash
balances expected during planning period
 Forecast the amount of money received
Benefits from Budgetary Process
 Planning
 Stimulates thinking in advance
 Leads to specific planning
 Budget preparation stimulates action and
interaction
 Coordination
 Has a balancing effect on the total organization,
the quantity and quality of service to be given a
patient should closely equal the expected revenue
 Encourages exchange information
 Stimulates team play or team approach
 Control
 Gives administration an opportunity to evaluate
the budget contributor
 Comparisons between actual expenditures and
budgeted standards can be made with little or no
effort
 Define fixed and agreed upon goals
 Cost consciousness is enhanced
Policies
 are plans reduced to general statements or instructions that direct
organizations actions in their decision making.
 Explain how goals will be met and guide the general course and
scope of organizational activities.
 Direct individual behavior toward the organization’s mission and

define broad limits and desired outcomes of commonly recurring
situations while leaving some discretion and initiative to those
who must carry out that policy
Personnel Policies
 Absences
 Assignments
 Employee Benefits
 Health Programs
 Holidays
 Hospitalization
 Leaves
 Promotion
 Uniform
 Performance Evaluation
Nursing Service Policies
 Professional and Ethical Standards for Nursing

Practice
 Staffing
 Assignments
 Job Descriptions
 Nursing Audit
 Infection Control and Fire Safety
 Administration of Meds
 Performance Appraisal
 Patient Care
 Continuing Education
Procedures
 are plans that establish customary or acceptable ways of
accomplishing a specific task and delineate a sequence of steps of
required action.
 It identifies the process or steps needed to implement a policy

and are generally found in manual in at the unit level of the
organization.
Saves staff time

Facilitate delegation
Reduce cost
Increase productivity
Means of control
 Ward Administrative Manual
 Procedure Manuals
 Standard of Safe Nursing Care Manual
Rules and regulations
 are plans that define specific action or non-action in respect to a

certain situation.
 Generally included as part of policy and procedure statements, it

describes situations that allow only one choice of action.
Least flexible type of planning

There should be as few rules as possible
Existing rules should be enforced to keep morale from breaking down
and to allow organizational structure
EXERCISES:
1. This is a common trait of a leader which is defined as his ability to possess honesty,
responsibility, and maturity in the working area.
 A. Integrity
 B. Personality
 C. Intelligence
 D. Flexibility
2. You are the head nurse in the pediatric department. Your roles in the planning process in the
hospital include the following, except one:
 A. Act as a link between higher-level managers and non-managers
 B. Directly responsible for the actual production of nursing services
 C. Represent the organization
 D. Answers A & B
3. In planning, conceptualizing the purpose and the aspirations of the organization is essential.
What statement gives a false description of a vision?
 A. It reflects what the organization wants to be
 B. It is written to magnify the various activities and it is projected with a broad time frame
 C. It reflects why the organization exist
 D. It uses action words in the present tense
4. Which describes an informal leader?

 A. Anna who is appointed because of her competencies and continuing education
 B. Maria who becomes the leader of the team because of her years of experience in
the department
 C. Eduard who is considered the leader of the team since he was given the legitimate
authority to act as one.
 D. Alexandra who is chosen by the administration because of her age and knowledge in the
area of work.
5. You are asked by your instructor to differentiate between a leader and a manager. Which one
is incorrect?
 A. A leader is focused on purposes but a manager is focused on structures and processes.
 B. A leader does the right thing and a manager does each task the right way.
 C. A leader has a short term view while a manager views work in long term duration
 D. A leader rely on trust while a manager relies on control
6. Julius is a newly-appointed nurse manager of Estabillo-Ponelas Medical Center, a tertiary

hospital located within the heart of Rizal Province. He thinks of scheduling planning workshop
with his staff in order to ensure an effective and efficient management of the department. Should
he decide to conduct a strategic planning workshop, which of the following is NOT a
characteristic of this activity?
 A. Long-term goal-setting
 B. Extends to 3-5 years in the future
 C. Focuses on routine tasks
 D. Determines directions of the organization
 7. Which of the following statements refer to the vision of the hospital?
A. The Estabillo Ponelas Medical Center is a trendsetter in tertiary health care in the
Philippines in the next five years Goal
B. The officers and staff of Estabillo-Ponelas Medical Center believe in the unique nature of the
human person
C. All the nurses shall undergo continuing competency training program.
D. The Estabillo-Ponelas Medical Center aims to provide a patient-centered care in a total
healing environment.
 8. The statement, “Estabillo-Ponelas Medical Center aims to provide patient-centered care in

a total healing environment” refers to which of the following?
A. Vision
B. Goal
C. Philosophy
D. Mission
9. He discusses the goal of the department. Which of the following statements is a goal?
 A. Increase the patient satisfaction rate
 B. Eliminate the incidence of delayed administration of medications
 C. Establish rapport with patients.
 D. Reduce response time to two minutes.
10. Which of the following guidelines should be least considered in formulating objectives for
nursing care?
 A. Written nursing care plan
 B. Holistic approach
 C. Prescribed standards
 D. Staff preferences
11. Stephanie considers shifting to transformational leadership. Which of the following
statements best describes this type of leadership?
 A. Uses visioning as the essence of leadership.
 B. Serves the followers rather than being served.
 C. Maintains full trust and confidence in the subordinates
 D. Possesses innate charisma that makes others feel good in his presence.
12. A nurse-manager appropriately behaves as an autocrat in which situation?

 A. planning vacation time for staff
 B. directing staff activities if a client has a cardiac arrest
 C. evaluating a new medication administration process
 D. identifying the strengths and weaknesses of a client education video
13. A nurse manager has identified a problem on the nursing unit and holds unit meetings for all
shifts. The nurse manager presents an analysis of the problem and proposals for actions to team
members and invites the team members to comment and provide input. Which style of
leadership is the nurse manager specifically employing?
 A. charismatic
 B. laissez-faire
 C. democratic
 D. authoritarian
14. A nurse manager has implemented a change in the method of documenting nursing care. A
Nursing Assistant is resistant to the change and is not taking an active part in facilitating the
process of change. Which of the following would be the best approach in dealing with the
Nursing Assistant?
 A. ignore the resistance
 B. tell the NA that the registered nurse will do all of the documentation
 C. confront the NA, and encourage verbalization of feelings regarding the change
 D. tell the NA that she must comply with the change
 15. A nurse manager is planning to implement a change in the method of the documentation
system for the nursing unit. Many problems have occurred as a result of the present
documentation system, and the nurse manager determines that a change is required. The initial
step in the process of change for the nurse manager is which of the following?
 A. plan strategies to implement the change
 B. set goals and priorities regarding the change process
 C. identify the inefficiency that needs improvement or correction
 D. identify potential solutions and strategies for the change process
16. The nurse manager is planning to implement a change in the nursing unit from team nursing
to primary nursing. The nurse anticipates that there will be resistance to the change during the
change process. The primary technique that the nurse would use in implementing this change is
which of the following?
 A. introduce the change gradually
 B. confront the individuals involved in the change process
 C. use coercion to implement the change
 D. manipulate the participants in the change process
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LEADERSHIP

WILFREDO S. ISRAEL JR.

Demonstrate leadership and management skills in the care of a

At the end of the course, the students will be able to:

 Describe the management process.

 Distinguish roles that managers fulfill in an organization.

 Explain management theories.

 Discuss motivation theories.

 Define leadership and explain its importance for organizations.

 Determine the importance of leadership in nursing

 Infer pertinent facts on the different theories of leadership

 Appreciate one’s capacity in becoming a nurse leader

 To identify the differences between a leader and manager

The process of influencing the activities of an organized group

Is the process of planning, organizing, leading and controlling the

Leadership is an interpersonal influence directed toward

Three key principles involved:

The process of influencing the actions of a person or group to attain desired

Leadership is a dynamic relationship that is based on

An individual induces a group to take action that is in accordance with the

The The The

 Decision maker  Critical thinker

Great Man Theory

 Basis for most leadership research until mid-1940’s

1. Leaders need to be more intelligent than the group they lead

1. Emotional stability and composure: calm, confident and

 Studies leadership by looking at leaders in terms of what they do.

 The effectiveness of the leader behavior is contingent upon the

 Depends on the situation, different situations calls for different

 If the situation changes, the style changes

 leader’s ability to lead is contingent upon various situational factors,

1. Needs and characteristics of followers

1. Individual differences among

 Emphasizes follower readiness as a factor in determining leadership

 Predicts the most appropriate leadership style from the level of

 Based upon the premise that different types of situation demand

 Focus is on the situation in which the leadership is exercised and

High High task and

Low High task and

(Low) Task Behavior (High)

No leadership style is ideal for every situation

Three aspects of a situation that structure the leaders role

1. Leader – member relations

 Developed a scale to identify different types of leaders

 High is it is easy to define and measure a task

Four Criteria to determine degree of task structure

High position Power

 Directive Style provides structure through direction and authority;

 Supportive Style is relationship-oriented; the leader provides

 Participative Style focuses on involving followers in the

 Achievement-oriented Style provides high structure and direction as well as

 Concerned with day-to-day operations

The best leaders have strengths in at least half-dozen key

While getting a precise profile of your strengths and weaknesses

Seldom _____ x 1 = _____

Occasionally _____ x 2 = _____

36+ An overall score of 36 or higher suggest you are using

- Focused on identifying qualities of a

• Work related characteristics

Not all these traits work all the time

“A person does not become a leader by virtue of

Nurse leaders demonstrates leadership

• Dictate work method

• Limit worker knowledge about goals to

Seldom _ x 1 = _

Occasionally _ x 2 = _