NCM 119 – SEMIFINALS • Solid Horizontal Line – represent same positions but different functions.

• Solid Vertical Line – chain of command form authority to subordinates

ORGANIZING (line authority)
Nursing Management Functions

Organizing • Formal structure - through departmentalization and work division,

provides a framework for defining managerial authority, responsibility,
• In the organizing phase, relationships are defined, procedures are and accountability.
outlined, equipment is readied, and tasks are assigned.
− In a well-defined formal structure, roles and functions are
• Organizing also involves establishing a formal structure that provides defined and systematically arranged, different people have
the best possible coordination or use of resources to accomplish unit differing roles, and rank and hierarchy are evident.
objectives.
• Informal structure - is generally a naturally forming social network of
• Organizing process includes: employees.

1. Identifying and defining basic tasks. − It is the informal structure that fills in the gaps with connections
2. Delegation of authority and assigning responsibility and relationships that illustrate how employees network with
3. Establishing relationships one another to get work done. (Hartzell, 2003–2016)

− Because informal structures are typically based on camaraderie,

Three Forms of Authority
1. Line authority – is a direct supervisory authority from supervisor to
subordinates.
• Grapevine communication - is at the heart of the informal organization;
• Chain of Command – unbroken line of reporting relationships that
extends through the entire organization. The line defines the chain
of command and the formal decision making structure.
• Unity of Command – each person in the organization should take
orders and reports only to one person.
• Span of Control – refers to the number of employees that should be
placed under the direction of one leader-manager. The number of
people directly reporting to any one supervisor must be the number
that maximizes productivity and worker satisfaction
they often result in a more immediate response from individuals,
saving people’s time and effort (Schatz, 2016).
it is the conversations that occur in the break room, down the halls,
during the carpool, and in between work that allows the relationships
of informal groups to develop.
− Although grapevine communication is fast and can facilitate
information upward, downward, and horizontally, it is difficult to
control or to stop.
− With little accountability for the message, grapevine
communication often becomes a source for rumor or gossip.

2. Staff Authority – authority that is based on the expertise and which

usually involves advising the line managers.

3. Team Authority – is granted to committees or work teams involved in an

organization’s daily operations. Work teams are group of operating
employees who shared a common vision, goals and objectives.

Organizational Chart

• Drawing that shows how the parts of the

organizations are link.
• It depicts the formal organizational
relationship, areas of responsibility and
accountability and channel of
communication.
• Depicts an organization’s structure

Organizational Structure

• Depicts and identifies role and expectations, arrangement of positions

and working relationships.

• Dotted line – represents staff positions/staff authority (advisor to the

line managers).

• Centrality – refers to the location of a position on an organizational

chart where frequent and various types of communication occur.
Determined by organizational distance; those with small organizational
distance receive more information than those who are more
peripherally located.
Bureaucratic

Decision Making Within the Organizational Hierarchy

1. Centralized decision making, a few managers at the top of the

hierarchy make the decisions and the emphasis is on top-down
control.

2. Decentralized decision making diffuses decision making

throughout the organization and allows problems to be solved by
the lowest practical managerial level.

3. Stakeholders are those entities in an organization’s environment

that play a role in the organization’s health and performance or
that are affected by the organization

(e.g. Patients, Dietitian, nursing homes, nursing schools)

4. Organizational culture - the values and behaviors that contribute

to the unique social and psychological environment of an
organization.

Matrix Organization Structure

Organizing Patient Care
STAFFING

• Process of assigning competent people to fulfill the roles designated for

the organizational structure through recruitment, selection, and
development, induction and orientation of the new staff of the goals,
vision, mission, philosophy.

• Staffing is an especially important phase of the management process in

health-care organizations because such organizations are usually labor
intensive

• Centralized staffing where staffing decisions are made by personnel in a

central office or staffing center.

• Such centers may or may not be staffed by registered nurses

(RNs), although someone in authority would be a nurse even
when a staffing clerk carries out the day-to-day activity.

• Decentralized staffing, the unit manager is often responsible for covering

all scheduled staff absences, reducing staff during periods of decreased
patient census or acuity, adding staff during periods of high patient
census or acuity, preparing monthly unit schedules, and preparing
holiday and vacation schedules.
D
7 Steps Staffing Formula

1. Categorize the patients according to levels of care needed.

2. Find the number of nursing care hours (NCH) needed by patients at

each level of care per day.

3. Find the total NCH needed by patients per year.

4. Find the actual working hours rendered by each nursing personnel

per year.

5. Find the total number of nursing personnel needed

6. Categorize to professional and non-professional personnel ratio of

prof to non-prof in a tertiary hospital.

7. Distribute by shifts