PALMAR (Brainhub) Authority

- legitimate to right to give command

Leadership and Management - officially sanctioned responsibility

Leadership Power
- Use of one’s skills to INFLUENCE others to perform to - ability to obtain, retain, and motivate other people to
the best of their ability perform

Uses different influence tactics: Sources of Power:

 Assertiveness (sending direct messages - standing up  Legitimate power (people who hold position in the
for your own rights without stepping the rights of organization)
others)  Reward power (give incentives and benefits - token
 Ingratiation (making others feel good or look good enemy)
before making a request)  Coercive power (give fear and punishment)
 Rationality (relying on a detailed plan, reason, logic)  Connection power ( connection - people you know)
 Coalition (backing up a request with co-members)  Referent power (pertains to charisma)
 Upward appeal (using the name of a superior formally  Information power (people who knows)
or informally)  Expert power (people with special skills and abilities)
 Blocking - black mail (threatening somebody to  Self-power (emanates from self due to maturity,
damage his opportunity for advancement or not being experience, or gender)
friendly to another person until he grants the request)
 Exchange (reminding somebody of a previous favor or Note: In leaders, not all have authority, but all have power
return favors)
 Sanction (either giving or preventing incentives, Management
benefits, or promotions) - Art of getting things done with and through the people so
that the goals of the organization can be achieved
There are 2 types of leaders - FOCUS: goals
1. Formal - people who hold position in the organization
- has three levels Functions of management
a. top - focuses on the organization 1. Planning - knowing where you are and where you want
- chief nurse, nursing director (monitors to be
entire nursing organization a. Strategic planning
b. middle - coordinates with top and first level - long term planning
leaders - implemented in 3-5 years
- supervisors, coordinators, dept - benefits organization
heads - done by top level
c. first - focuses on the operations b. Operational planning
- head nurses (unit managers) - short term planning
- usually changed annually, monthly, weekly;
2. Informal - people who do not hold position in the depending on need;
organization but can motivate members to - benefits operations
perform - done by first level
- usually the senior staff
- charge nurse SWOT Analysis
- Strength, weakness, opportunity, threats
4 STYLES OF LEADERSHIP
- 3 common styles usually used Planning Formula
1. What action is necessary
1. Autocratic 2. Where take place
- leader focused 3. When take place
- best during emergency or crisis (anxiety) 4. Who will do it
2. Democratic 5. How will it be done
- members have a voice, leader acts as facilitator
- compliance of members Tools in Planning
3. Laissez-Faire 1. Mission - reason for existence
- member focused: member is followed Vision - what the agency wants to achieve; futuristic;
- when members are matured enough to be globally…
- may happen if a member is new in the unit 2. Philosophy - statement of beliefs, values, and
4. Bureaucratic principles; value-centered; we believe…
- not usually used because focuses on rules and 3. Goals - general statement of aims and purposes
regulations 4. Objectives - specific statements of aims and purposes
that are used to carry out the goals
Contingency Theory 5. Policies - plans reduced to statements that helps the
- a leadership style may or may not be effective depending organization in decision making; all
on the situation stakeholders affected;general; not subject to
regulation
6. Procedures - step by step instructions There are 2 majors forms of organization structure:
7. Rules - guidelines for action and non-action; 1. Centralized
employees affected; specific; subject to - 1 person who has the responsibility for decision
regulation making
- Advantage: Cost effective; Easier management
Budget - Disadvantage: Cannot monitor all; Not readily adapt
- systematic way of meeting with the expenses to change; No quick decisions
- FOCUS: revenues (income) and expenses (cost)
2. Decentralized
- 4 TYPES OF BUDGET - - bigger organization broken down into smaller units
1. Capital and responsibility for decision making is delegated to
- for long term use the ones nearest the majority of workers
- buying - Advantage: better interpersonal relationship; greater
creativity and imagination
2. Operational - Disadvantage: not cost-effective; problems in
- day to day expense breakdown in communication;
- maintenance problems in role communication
- repair and maintenance
- salary of part timers Job Description
-both part timers and full timers - performance responsibility
- spells out precise (exact) job content
3. Personnel
- salary of full time employees (8 hrs a day, 5 times a - PURPOSES -
week); prepared ahead of time 1. Prevents malpractice (with license);
negligence (without license)
4. Cash 2. Delegation
- available all the time but for emergency purpose 3. Evaluation
- repair 4. Staffing - assigning of competent people to
fill roles of organization
2. Organizing - you establish formal structure of
organization and create the job qualification and Employment Procedures
description 1. Recruitment
- filling up of vacancies and selection of personnel
Note: Purpose of organizational structure is for work - classified ads, flyers, job fares, job agencies, referrals,
distribution tv, radios, posters

Elements is needed to establish organizational structure: 2. Induction

1. Levels of Authority (depends on size of organization) - employee formally becomes a part of organization
a. top - activities:
b. middle a. make sure you are INCLUDED in the
c. first payroll
- contract signing
2. Lines of Communication
a. solid line b. arrange for DEDUCTIONS
- direct relationship - SSS, pag-ibig, Philhealth, TIN
- unity of command (one command)
- scalar chain (chain of command - follow c. submit necessary requirements and
hierarchal order) documents
- reporting relationship - report - NBI clearance, diploma, TOR, birth
to the immediate superior ALWAYS certificate, marriage certificate, medical
- IF COMPLAIN - address to the immediate certificate, certificate of trainings and
superior of the person you seminars, license (certificate of
are complaining registration) - different from I.D.
(represents license)
CN ——— Supervisor ——— Head Nurse - - - MD
3. Orientation
b. broken line - familiarize organization
- indirect relationship - job description is the most important to remember
- no superior subordinate relationship
- coordinated relationship only Staffing Process
1. Conventional
3. Span of Control - oldest method
- number of workers that DIRECTLY report to a - can either be centralized or decentralized (no system
superior or number of workers that a superior handles being followed)
2. Cyclic 3. Directing (delegation) - issuance of orders,
- schedule repeats itself assignment, and instructions
- create base schedule first which will be repeated
2 Aspects of Delegation
3. 40 Hours (pre-pandemic) 1. Technical
- usually mandated by law in the Philippines - Tasks, procedures, materials, and equipment
- 8 hrs per day, 2 days off - Show, teach, demonstrate, supervise, perform or do it
- if with emergency, you can work until the 6th day with the nurse
(overtime)
- PRIVATE: Labor code 2. Interpersonal
- Attitudes, behaviors, and styles of direction giving
4. 7 days (during pandemic) - Verbalization of feelings (cannot solve problem
- minimum of 10 hours a day for 7 days a week, unless cause is known)
followed by 7 days week off - STYLE: assertiveness (therapeutic)

Nursing Care System (Modalities of Nursing Care/ What and Who

Patterns of Nursing Care) 4 Pointers of Delegation
- system used to deliver nursing care 1. Position of staff (licensed - scope of nursing practice or
unlicensed - dirty task)
1. Case Nursing/ Case Method 2. Ward (where from and where to go)
- total care nursing 3. Capabilities of staff (depends on position in ward)
- 1:1 4. Condition of the patient
- private duty nursing
- ideal in the ICU*** Note: What can be assigned to floating nurse from
telemetry unit?
2. Functional Nursing - A telemetry nurse reads cardiac monitors, thus
- task delegated among the staff focuses on patients with cardiac problems.
- focus on task assigned only - KAWASAKI: inflammation in lining of vessels =
cardiac related
3. Team Nursing
- group of nurses assigned to a group of patients, where Communication
in there is a team leader - sending of messages from sender to receiver and vice
- CI and student nurses versa and hoping what is being sent is understood

4. Primary Nursing - ELEMENTS-

- 24 hour continuous comprehensive nursing service of 1. Message
5-6 patients from admission to discharge 2. Encoding
- 1:5 or 1:6 (1 nurse per shift, but handled by many 3. Transmitting via channels of communication (mode of
nurses) transmission)
- primary nurse: to whom the case was endorsed; 4. Decoding
replaced by associate primary nurse during off - putting meaning
- primary nurse - associate primary nurse (cannot 5. Feedback or action
change in NCP except if there is sudden change in - depends on receiver
condition provided he will report it to primary)
- TASKS: create NCP - BARRIERS IN COMMUNICATION -
- same set of nurses from admission to discharge 1. Physical
- ideal in the ward*** - environmental
- noise, distance
5. Modular Nursing
- combination of team and primary nursing 2. Social-Psychological
- there is a GEOGRAPHICAL ASSIGNMENT of - relationship with other people plus the state of mind
patients - lack of trust, echolalia
- sending of nurses to other places
- during pandemic covid surge, DOH sent nurses from verbigeration - repeating words
Visayas and Mindanao to Manila echolalia - repeating what others are saying
echopraxia - repeating of actions
6. Case Management/ Nursing Case Management perserveration - repeating of ideas
- utilizing the health care delivery system where in the
goals are to deliver quality care, to promote quality of 3. Semantic
life, to decrease fragmentation, and to contain costs - misinterpretation of signs and symbols
- nursing homes, rehab centers, psych facilities
- cases usually require long term treatment Grapevine Communication
- decrease fragmentation (decrease isolation); contain - Gossip (75% accurate)
cost (decrease spending on doctor’s fee and - Note: always solve problem immediately, helps in solving
medications - costs are more expensive in the problems because it gives the manager opportunity
hospital)
Conflict 4. Evaluate the overall results
- misunderstanding or disagreement between two or more - go back to the 2 aspects of directing
persons, agencies, organizations
Note: There is a new equipment brought in the unit, staff
- CONFLICT RESOLUTION STRATEGIES - does not know how to use. One staff still does not use even
1. Avoidance if taught, in the evaluation phase what to do?
- “Let us not talk about it.” - Technical directing
- does not talk about the conflict If insists using the old one
- Interpersonal
2. Dominance and Suppression
- “I am the manager here, you have no choice.” 4. Controlling - seeing to it that what is planned is done
- negative for employees - OTHER TERMS: evaluating/reviewing/checking/
determining/ comparing
3. Restriction / Power
- “I am the manager here, I will do what is best for 4 basic steps of controlling
everybody.” 1. Develop standards (best answer as basis for
- positive for employees evaluation***) and criteria
- standard (pre-determined level of care); criteria
4. Majority Rule (characteristics used to meet the level of care)
- “Let us divide the house.” - creating basis for evaluation
- voting - 3 types of standards:
a. Structure
5. Smoothing - facilities, equipment, materials, and
- unacceptable appears to acceptable management system
- if manager is the one doing
6. Compromise
- meeting halfway b. Process
- plans and procedures
7. Collaboration - if nurse is the one doing
- working hand in hand in solving the problem
- brainstorming (number 1 rule: ALL ideas are c. Outcome
welcome, but best solution is selected) - results

Note: Reporting is NOT a conflict resolution 2. Determine compliance to standard and criteria
a. nursing audit (patient-focused)
There are 4 approaches in problem solving 1. concurrent nursing audit
1. Win-lose (solve at the expense of others) - Dominance - evaluate as the care is GIVEN
and Suppression
2. Lose-win (solve at your own expense) - Restriction 2. retrospective
and Power - source of evaluation is PATIENT’S
3. Lose-lose (both parties sacrifice) - Compromise CHART (co-owned by hospital and
4. Win-win (both parties benefit from solution) - patient)
Collaboration
b. performance appraisal (staff-focused)
Note: First part - manager or me; Second part - members or 1. informal
others - incidental (no plans to evaluate), but due to
incident, evaluation is done
Change Management
- any alteration in the status quo (present situation) 2. formal
- systematically done; scheduled evaluation;
Change Process usually ends in a review session
1. Perceive the need to change - reveal positive first before negative
- identify problem, determine
- accept that there is something need to change 3. Identify strengths and weaknesses
- concentrate on strengths and weaknesses; SHOULD
2. Initiate a group interaction*** ALWAYS BE BOTH
- bring the group together, meeting, conference
(planning) 4. Act to reinforce the strength and take corrective
- best thing to do in problem solving*** actions on weaknesses
- KEY: group - go back to 2 aspects of delegation

Note: Code of Ethics: BON Res. 220 s. 2004 NOTE: All functions are ongoing process, but controlling
is the last function.
3. Implement the plan ONE STEP AT A TIME
- done gradually to prevent resistance