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Leadership and Management

By A%y capili

• Management
o Art of ge5ng things done with and through people so that the goals of the
organiza9on can be achieved.
o Always about goal and achievement
o Func,ons of management:
§ Planning knowing where you are and where you want to be
• Strategic – long term plan
o Type of plan implemented within 3 to 5 years
o Organiza9on mostly benefits
o Top level leaders
• Opera,onal – Short term plan
o Usually changed annually depends on the opera9on
o Opera9ons benefits
o First level leaders
• SWOT analysis
o Strengths
o Weakness
o Opportuni9es
o Threats
• Hierarchy of planning
o Mission and vision
§ Mission = reason
§ Vision = wants to achieve (futuris4c)
o Philosophy
§ statement of beliefs, values, and principles
§ “Believe” = philosophy
§ Values centered
o Goals
§ general statements of aims and purposes
o Objec9ves
§ specific statements of aims and purposes that are
used to reach your goals
o Policies
§ plans reduced to statements that helps the
organiza9on in decision making
§ General applica9on, for everyone to follow.
o Procedures
§ step by step instruc9ons.
o Rules
§ guidelines for ac9on and non-ac9on
§ Directed to employees
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§ Subject to regula9on
• Budget
o Systema9c way of mee9ng with the expenses
o Focus of budget revenues and expenses / income and cost
§ Revenues = income
§ Expenses = cost
o Both dapat ang lumabas, pagka isa lang, mali yun
o Types of budgets:
1. Capital budget
a. usually expensive
b. Regardless of the price, basta it is For
long term-use
c. Ex: bumili ng airco
2. Opera,onal budget
a. Day to day
b. Payment for electricity; consumable
materials etc.
c. Ex: maintenance ng aircon
3. Personnel budget
a. Salary of the full-9me employee
(Working 8 hours / 5 days a week)
b. Prepared ahead of 9me, only
available on the day of salary
4. Cash budget
a. available all the 9me for emergency
purpose
b. Pe]y cash / Cash-on-hand /
Emergency cash / fund
c. Ex: pag nag cacash advance ang
empleyado kasi personnel budget
only available sa day ng salary; Repair
ng aircon
§ Organizing establish a formal structure of a organiza4on and job
qualifica4on and job descrip4on.
• For work distribu9on
• 3 Elements of Organiza,onal Structure
o Levels of authority – there should always be a blood
§ Remember that Levels depends on the size of
organiza4on.
o Lines of communica9on
§ Solid line DIRECT RELATIONSHIP
• Represent superior-subordinate rela9onship
• Unity of Command is present
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• Scalar Chain is present

• Lines of communica9on
§ Broken or doRed line INDIRECT RELATIONSHIP
• A coordinated rela9onship (doctors are not
your boss.)
• If this is a doctor’s order pertaining to pa9ent
care, you need to follow. RA 9173
§ Span of control
• number of workers that directly report to a
superior
• major forms of organiza9onal steuctures
o centralized models – central (center)
§ one person who has responsibility for decision
making
• advantage
o cost effec9ve (less cost)
• disadvantage
o increase size of the organiza9on
o cumbersome (masikip)
o diluted a]en9on to staff
o Decentralized or par,cipa,ng approached (BIGGER)
§ Bigger organiza9on broken down into smaller unit
and the responsibility for decision making is
delegated to the one nearest the majority of the
workers
• Advantage
o Be]er interpersonal rela9onship
o The staff has a voice in decision
making
o Greater/be]er
imagina9on/crea9vity
• Disadvantage
o Costly (Mas magastos)
o Danger of breakdown in
communica9on
o Problems in communica9on (unity of
command)
• Job descrip,on – also termed performance responsibility.
o Most important thing you need to know in your work
o Spells out your precise job content
o Purpose
§ Can prevent malprac9ce
§ Used for delega9on
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§ Point of evalua9on
§ Used for staffing
o Staffing – signing of competent people to fill the roles of the
organiza9on.
§ 4 methods of staffing process
1. Conven,onal – oldest method
2. Cyclic – schedule repeats itself
3. Forty hours – work for 8 hours a day, 5 days
a week, with 2 days off
a. Mandated by the law in the PH
i. Supposed by the PD 442:
labor code.
ii. 6th day may be allowed or
requested by the hospital
provided that it is over9me
b. Pre-pandemic
4. Seven days – work for 10 hours a day, 7 days
a week, followed by 7 days off.
a. Used during pandemic
• Nursing care system – system that is used to deliver nursing care or
modali9es of nursing care or pa]erns of nursing care
o Case nursing or case method – total care nursing
§ 1:1 this is when 1 nurse is assigned to 1 pa4ent
§ Private duty nursing
§ Ideal used in the ICU but not common prac4ce.
o Func,onal nurse – tasks are delegated among staff
§ This is a per func9on nurse
o Team nursing – group of nurses assigned to a group of
pa9ents where in there is a team leader
§ Team leader assess the situa9on and delegates tasks
o Primary nursing – 24 hours con9nuous coordinated
comprehensive nursing service of 5-6 pa9ents from
admission to discharge
§ 1:5 or 6 maximum
§ Primary nurse
• nurse where the pa9ent is endorsed too.
• Who makes the NCP
• Cannot be altered by the associate except if
there is change in the pa9ent’s condi9on
provided that he will report it to the primary,
• Ideal used in the ward.
§ Associate primary nurse – subs9tute or who works
with the primary nurse
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§ Reliever – if primary and associate nurse is at their

day off.
§ Ideal used in the ward
o Modular nursing – combina9on of team and primary
nursing
§ Group of nurses assigned to a group responsible for
24 hours nursing care
§ Geographical assignments of pa9ents
§ Take care of pa9ents or case finding
§ Used in disaster or crisis
o Case management – u9lizing the health care delivery
system where in the goals are:
§ To deliver quality care
§ To promote the quality of life
• Focus is long term treatment to ensure that
the pa4ent receives the care he/she needs.
• Rehabilita9on centers and psychiatric
facili9es.
§ To decrease fragmenta9on
• Decrease feeling of isola9on
§ And to contain cost
• Cost effec9ve
§ U9lized in nursing homes
§ Direc,ng delega4on or delega4ng
• 2 aspects of direc9ng:
o Technical – use of tasks, procedures, materials and
equipment’s.
§ Problems with technical, guide for board exam:
• Show
• Teach
• Demonstrate
• Supervise
• Do/perform the procedure with the nurse
o Interpersonal – a5tude, behaviors and styles of direc9ng
giving problems with:
§ AVtude and behavior
• Verbaliza9on of feelings
§ Styles of direc,ng giving
• Asser9veness – not being boasmul when
asking someone to do something and
maintaining the therapeu9c communica9on.
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• If the ques,on falls under what and who delega,on: remember

the 4 pointers of delega4on:
1. Consider the posi9on of other staff à know if licensed or not
a. Licensed – go back to the ward na pinaggalingan,
kung anong ginagawa niya sa ward nila before, yung
ang kaya niyang gawin
b. Unlicensed – simple tasks
2. Ward à alamin saan ward galling and saan ward pupunta
3. Capabili9es of the staff à which will depend on the posi9on
in the ward
4. Condi9on of the pa9ent
• Telemetry nurse – reads cardiac monitor, can also read ECG,
therefore they handle pa9ent with cardiac problem.
• Conflict – misunderstanding and disagreement between 2 or more
person, agencies and organiza9ons
o Remember: conflicts are normal
o Priority: to solve the problem immediately
o Resolu,on strategies for conflict
§ Avoidance
• Manager: “let us not talk about it.”
§ Dominance and suppression
• Manager: “I am the manager here, you have
no choice.”
§ Restric9on/power
• Manager: “I am the manager here, I will do
what is best for everybody”
• sino may power → siya gumagawa ng paraan
§ Majority rule
• Manager: “Let us divide the house”
• Vo9ng
• Madalas na ginagamit
§ Smoothing
• the unacceptable appears to be acceptable
• ang mali ay ginagawang tama
§ Compromise
• mee9ng halfway
• both may sina-sacrifice
§ Collabora9on
• working hand in hand in solving the problem
• brainstorming - all ideas are welcome, accept
all ideas
• if manager is wai4ng for reports, repor4ng bago gumawa ng ac4on
sa issue → Automa4cally a wrong answer kasi walang par4cipa4on
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si manager, just wai4ng for the report na hindi siya gumawa, nag
aantay lang ng report, di sigurado
• 4 approaches in problem-solving
1. Win – lose: able to solve the problem at the expense of
others
a. Dominance and suppression
2. lose - win: able to solve the problem at your own expense
a. Restric9on / power, Smoothin
3. lose - lose: both par9es sacrificed in the solu9on of the
problem
a. Compromise
4. win - win: both par9es benefit from the solu9on of the
problem
a. Collabora9on
o In all these approaches the manager solved the problem,
che-check lang kung sino ang.
• Change management aQer a conflict has been resolved
o Any altera9on in the status quo (present situa9on)
o Perform problem-solving
• Change process – problem solving
1. Perceive the need for change - iden9fy the problem,
determine the issue, accept that there is something that
needs to be changed.
a. always remember, most of 4me 4me sinusulat na ng
BON sa situa4on, di na need perceive, proceed to the
next step
2. Ini9ate a group interac9on - bring the group together,
mee9ng / conference with the group / members → do
planning, find the best solu9on
a. This step is the key to problem solving
b. Who is the key? The Group
c. need their support, have open communica4on with
them
3. Implement the plan one step at a 9me
a. do it gradually to prevent resistance
4. Evaluate the overall results
a. go back to the 2 aspects of direc9ng (Technical and
Interpersonal)
• Example
o There's new equipment that was brought in the unit, the
staff does not know how to use the new equipment.
Together with the staff, you taught them gradually how to
use the new equipment. Everyone learned but one staff
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member s9ll had difficulty in using the new equipment.

What are you going to do?
• Go back to the 2 aspects of direc9ng: Technical ang problem
o show, teach, demonstrate, supervise, do / perform the
procedure with the nurse
• Same scenario, but the staffs, learned but resist to use the old
equipment
o Problem with interpersonal
o verbaliza,on
§ controlling Seeing to it that what is planned is done
• Controlling = Evalua9ng / Reviewing / Checking / Determining /
Comparing
• 4 basic steps of controlling
1. Develop standard and criteria – basis for evalua9on
a. Standard - predetermined level of care → naka set na
b. Criteria - characteris9cs use to meet the level of care
Ex. Scrubbing
c. Basta controlling, evalua9on → ang sagot ay always
STANDARD
i. 3 Types of Standards “S.P.O” → memorize this
1. Structure - facili9es, equipment’s,
materials and management system
2. Process - includes plans and procedures
3. Outcome - results
a. Remember:
i. Check If the ques9on ask for
the results → Outcome
ii. Tingnan if may ginagawa and
kung sino:
1. if may ginagawa si nurse,
→ Process
2. if manager ang gumawa
→ management system
→ Structure
2. Determine compliance to standard and criteria
2 types of evalua9on
a. Nursing audit – pa9ent focused
i. 2 types
1. Concurrent (current) - evaluate as the
care is given, pagka gawa ng
interven9on, evaluate agad response /
result ni pa9ent.
2. Retrospec9ve (past) – reviewing
pa9ent’s chart
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b. Performance appraisal – staff-focused

i. 2 types
1. Informal – incidental performance
appraisal
2. Formal – systema9cally done based on
the procedure, usually ends up in review
sessions
3. Iden9fy the strength and weakness
a. both dapat, if isa lang lumabas sa boards,
automa9cally wrong
b. Tip:
i. Also the same with delega9on. Delega9on
and evalua9on compliment each other. So,
delegate both strengths and weaknesses.
AlWAYS BOTH
4. Act to reinforce strengths and to take correc9ve ac9ons on
the weaknesses
a. How are you going to correct the weaknesses of the
staff? ➔ go back to the 2 aspects of direc9ng
• Leadership
o The use of one’s skills to influence others to perform to the best of their ability
towards goal achievement.
• Different influence tac,cs: AIRCUBES
o A – Asser,veness: sending direct message, standing up for your own right without
stepping on the right of others (can mo4vate the members)
o I – Ingra,a,on: making others feels good or look good before making a request
o R – ra,onality: use of reasoning
o C – Coali,on: backing up a request together with your co-members
o U – Upward appeal: using the name of a superior formally or informally
o B – Blocking: threatening somebody to damage his opportunity for advancement
or not being friendly to another person un9l he grants the request.
§ Blackmail
o E – Exchange: reminding somebody of a previous person or return of favor
o S – sanc9on
• 2 types of leaders
o Formal leaders
§ These are the people who holds a posi9on in the organiza9on.
• Top level leaders
o Focuses on the organiza9on
o Monitor the en9re organiza9on
• Middle level leaders
o Middleman
o Coordinates with the top and first level leaders
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• First level leaders

o Focuses on the opera9ons
o Monitors the happening in the ward
o Informal leaders
§ People who do not hold a posi9on in the organiza9on but they can
mo9vate members to perform
• Seniors staff or charge nurses
• 3 styles of leader
o Autocra,c – leader focused, leader decides, and members does not have a voice.
§ Best used in emergencies
§ Staff level of anxiety ranges severe to panic incapable of decision making
o Democra,c – members have a voice in decision making and the leader acts as a
facilitator.
§ Best used when you need the compliance of the members.
§ Raises mo9va9on.
o Laisse-faire – members focused, members decide, leader is just a decora9on
§ Best used when members are matured
§ But also happens when the manager is new in the unit
§ Leader monitors decides what is right and wrong
§ Danger of abusing temporary authority if members are immature
• Bureaucra9c – rules and regula9ons (not always used)
• Con,ngency theory – a leadership style may or may not be effec9ve depending on the
situa9on.
• Authority
o legi9mate right to give command and to act on the interest of an organiza9on
o an officially sanc9oned responsibility
• power
o ability to obtain, retain, and mo9vate people and to organize informa9onal and
material resources to accomplish a task