CHAPTER I

INTRODUCTION TO MANAGEMENT
AND NURSING SERVICE
ADMINISTRTION
 Objectives

At the end of this chapter, you are expected to:

 Define management and nursing service

administration
 Explain the difference between Mgt. and
administration
 Discuss the management function
 Describe the managerial level, skills and roles
Definition of management and nursing service
Administration
 It is the process used to accomplish organizational
goals through planning, organizing, directing, and
controlling people and other organizational resources.

 Management is the art of getting things done through

other people. (Nursing management is the process of
working through nursing staff members to provide care,
cure and comfort to patient).

 It is the process of reaching organizational goals by

working with and through people and other
organizational resources.
 Cont’d…

 It is the process of directing, coordinating, and

influencing the operation of an organization so as to
obtain desired result and enhance total performance.

 It is both an art and science.

 Management often encompasses to deployment and

manipulation of human resources, financial resources,
technological resources, and natural resources.
In general management is
 Taking place within a structured organizational
setting with prescribed role and function

 Directed towards achievement of goals and

objectives.

 Achieved through the effort of other people and

organizational resources

 Using system and procedure.

Nursing service administration

 It is both an art and science.

 Is the process of planning, organizing, leading and

controlling that encompasses human, material,
financial, and informational resources in an
organizational environment to achieve the
predetermined objectives.

 Is the process composed of the set of interrelated

social, technical and functional activities occurring
within a formal organizational setting to accomplish
predetermined objectives through the utilization of
human and other resources.
The primary objective of the role of nursing
service administration is
 The provision of continuous nursing service to
individual, group, and community, including whatever is
necessary.

The subsidiary objectives of this role are

 The professional activities of administration, which

includes human relations, communications, teaching,
research, and personal development, designed to
further the primary objective.
 Management Vs administration

Management: - Administration: -
 has wide varieties of  Seen as a narrow activity
duties ranging from  Considered as part of the
management process
planning activities to
 Concentrated with the design
producing, from
and implementation of
motivating to system and procedure to
controlling. helps to meet stated
 executes policy or Objectives,
doing function. i.e. determine/set broad policy.
Management function
o Henry Fayol (1925) first identified the functions of
management. They are;
 Planning, Organization, Command, Co-ordination and
Control (POCCC)

 Later Luther Gullick (1937) expanded these activities by

introducing two more activities in addition. (POSDCORB)
 Planning, Organizing, Staffing, Directing, Co-
ordinating, Reporting and Budgeting.
Management function

 TheMajor FIVE elements of

Management process as follows;
 Planning

 Organizing

 Staffing

 Directing and
 Controlling
Management function

Planning
 Planning is deciding in advance what to do, when,
where, how, by whom, and with what resources.

 It is also defined as an ongoing process of developing

the organizations’ mission and objectives and
determining how they will be accomplished.
 Cont’d…
 Planning involves:
 assessing, setting goals, establishing priorities,
developing action plans, and evaluating whether
the actions are meeting the objectives.

 Planning:
 provides direction for the people involved,
 meaning for the work activities, and
 a scheme for efficient use of the people, space, and
equipment.
 helps in avoiding confusion, uncertainties, risks, wastages etc.
 It bridges the gap from where we are & where we want to be”.
 Organizing

o It is the process of coordinating the work

to be done and establishing the internal
organizational structure of the
organization.

 The focus is on division, coordination and

control of tasks and the flow of information
within the organization.
Organizing as a process involves:
 Identification of activities.
 Classification of grouping of activities.
 Assignment of duties.
 Delegation of authority and creation of
responsibility.
 Coordinating authority and responsibility
relationships.

 The purpose is to achieve coordinated effort

among all the elements into the organization.
 Staffing

 It is filling of job position with the right people at

right time.
 The main purpose of staffing is to put right person on
right job i.e. square pegs in square holes and round
pegs in round holes
 Staffing involves:
 Manpower Planning (estimating man power in terms of searching,
choose the person and giving the right place).
 Recruitment, Selection & Placement.
 Training & Development
 Remuneration
 Performance Appraisal
 Promotions & Transfer.
 Employee socialization, and team building and scheduling
 Directing
 It is leading, guiding, and motivating employees to work
effectively to accomplish organizational goals and
objectives.
 Direction is the inter-personnel aspect of management which deals
directly with influencing, guiding, supervising, motivating sub-
ordinate for the achievement of organizational goals.

Direction has the following elements:

 Supervision

 Motivation

 Leadership

 Communication
 Elements of direction

 Supervision- implies overseeing the work of subordinates by their

superiors. It is the act of watching & directing work & workers.

 Motivation- means inspiring, stimulating or encouraging the sub-

ordinates with zeal to work. Positive, negative, monetary, non-
monetary incentives may be used for this purpose.

 Leadership- may be defined as a process by which manager

guides and influences the work of subordinates in desired
direction.

 Communications- is the process of passing information,

experience, opinion etc from one person to another. It is a bridge of
understanding.
 Controlling

 is checking that plans are being carried out as

planned and evaluating the outcome of actions.

 Controlling is the process of checking whether or not

proper progress is being made towards the
objectives and goals and acting if necessary, to
correct any deviation”.

 The purpose of controlling is to

 ensure that everything occurs in conformities with the
standards.
 helps to predict deviations before they actually occur
controlling has the following steps:

 Establishment of standard performance.

 Measurement of actual performance.
 Comparison of actual performance with
the standards and finding out deviation if
any.
 Corrective action.
The management process

Controlling planning

Directing organizing

Staffing
o For theoretical purposes, it may be convenient to separate the function
of management but practically these functions are overlapping in nature i.e.
they are highly inseparable. Each function blends into the other & each
affects the performance of others.
 Types of Manager
Manager
 is an individual employed by an organization who
is responsible and accountable for efficiently
accomplishing the goals of the organization.
Or
 Is responsible and accountable for achieving
organizational objectives (goals) through efficient
and effective use of organizational resources.
 Responsibilities of the manager
 Coordinating and integrating resources using the
function of planning, organizing supervising,
staffing, evaluating, negotiating and representing.

 Interpersonal skill is important, but a manager also

has authority, responsibility, accountability and
power defined by the organization.

 Define the mission and goals of the organization

 Cont’d…
 Clarify organizational structure,

 Choose the means by which to achieve goals,

 Assign and coordinate tasks,

 Developing and motivating as needed and

 Evaluate out comes and provide feedback.

 Types of Manager

A. By level, which includes

- Top level manager
- Middle level manager
- First line (front line)

B. By Function, which includes

- General manager - oversees a complex unit of the
organization
e.g., General Service manager

- Functional manager - is the one who is responsible

for a single organizational activity.
e.g., Financial Manager.
Despite the difference in types of manger, the following
are common attributes to all, regardless of their title or
level

 Formally appointed to positions of authority by the

organization.

 Direct work effort of the others (charged with

directing and enabling others to do their work
effectively)

 Responsible for resource utilization

 Accountable to superiors for work result.

Levels of Management

Generally, three levels of management are used in

nursing
- Top –level
- Middle – level and
- First level management
 Top Level Manager
 Top-level managers, or top manager, are also called
senior manager or executives.

 These individuals are at the top one or two levels in an

organization, and hold titles such as president, vice
president, Chief Executives Officer (CEO), Chief
Operational Officer (COO).

 Top-level managers look at the organization as a

whole, coordinating internal and external influence,
and generally make decisions with few guidelines or
structure.
 Cont’d…
 They are primarily responsible for establishing
organizational goals, policies and strategic plans

 They are ultimately responsible for the performance

of the organization,

 Top managers do not direct the day-to- day activities

of the firm;

 They are not involved in routine daily operation as of

lower level managers.
 Middle Level Managers
 are those in the levels, below top managers.

 Middle level managers job titles includes: - General

mangers, Nursing supervisors, Director of nursing.

 They Supervises a number of first level manager,

usually with in related specialties or in a given
geographic area.
 Cont’d…
 They are responsible for the people and
activities within the department they supervise,
and they have 24 hours responsibility for their
defined area.

 Typically, a Middle Level manager acts as a

liaison (channel) between upper management
and first level manager.
 Cont’d…
 They usually
 coordinate nursing activities of several units;

 receive broad, overall strategies and policies from

top manager and
 translate them into specific objectives and
programs.

 They may also communicate upward, by offering

suggestions and feedback to top-level managers.

 Middle managers can motivate and assist first line

managers to achieve objectives.
First Level Manager
 are also called first-line managers or supervisors.

 These managers have job titles such as shift

supervisor, department manager, case manager,
and primary care Nurse.

 is responsible for
 supervising the work of non- managerial personnel
and
 day-to-day activities of the specific work unit (s).
 Cont’d…
They are also responsible for the actual production of
nursing service which includes :
 clinical nursing practice, patient care delivery,

 use of human, fiscal and other resources;

 personnel development

 motivating the staff;

 compliance with regulatory and professional

standards;
 fostering interdisciplinary, collaborative relationship
Cont’d…
 They typically do not set goal for the organization

 They have a very strong influence on the company.

These are the managers that most employees
interact with on a daily basis,

 They have 24-hours accountability for the

management of a unit(s) or area(s) within the
health care organization.
 Managerial skills

 There are three basic management skills: -

- Technical,
- Human relation and communication, and
- Conceptual Skill.
 Technical Skill

 It is pertaining to what is done, working with things,

and one’s ability to use technology to perform an
organization task.

 It is the ability to use tools, techniques, and

specialized knowledge to carry out a method,
process and procedure.

 It implies an understanding of and proficiency in a

specific kind of activity, particularly one involving
methods, processes, procedures, or techniques.
Human Relation and Communication Skill
 It is pertaining to how something is done, working
with people, and one’s ability to work with others to
achieve goals.

 It requires both personal and interpersonal skills

including leadership, motivation, coaching,
communication, morale buildings, training and
development, help and supportiveness, and
delegating.
 Cont’d…
 Human skills are much more difficult to acquire
because interpersonal relationship involves
attitudes, emotional and the cultural characteristics
of many individuals and groups, including nurse
leaders, workers and supervisors.
 Conceptual skill
 Conceptual skill pertaining to why something is
done, one’s view of the organization as a whole
picture, and one’s ability to understand the
complexities of the organization as it affects and is
affected by its environment.

 This skill involves the ability to see the organization as

a whole and the relationships of various parts to
perform tasks such as planning, organizing,
controlling; system development, problem analysis,
decision-making, coordinating, and delegating.
Managerial Roles

 A role is an organized set of behaviours belonging

to identifiable offices or position.

 Henry Mintzberg has identified ten roles common

to the work of all managers.

 The ten roles are divided into three groups:

interpersonal, informational, and decisional
Mintzberg’s Managerial Roles

• Interpersonal • Decisional
• Figurehead • Entrepreneur
• Leader • Disturbance hander
• Liaison • Resource allocator
• Negotiator
• Informational
• Monitor
• Disseminator
• Spokesperson
Interpersonal Roles

 The interpersonal management role consists of

figurehead, the leader, and liaison.

 These roles derived from the manager’s authority

and status in the organization.

 It requires managers to direct and supervise

employees and the organization.
 Figure Head
 This role is the simplest of all managerial roles.
Because of the position of the managers in the
organization,
 They are required to perform various symbolic, legal,
inspirational, or ceremonial duties such as
- Greeting visitors
- Making speech at organizational
events
- Signing legal documents
- Well coming new employee at
orientation or attending social events.
 Leader

 The second of interpersonal role is the role of

leader.

 The leader role describes and defines the

interpersonal relationships of the manager with
his/her subordinates.

 It is the most widely recognized of all managerial

roles.
 Cont’d…
 In the role of leader, the manger must
attempt to motivate subordinates, take
responsibility for hiring, training, promotion,
and firing of subordinates.

 As a leader, the manager defines the work

environment of the organization and
determines the mission and objectives of the
organization and sees that they are
accomplished efficiently.
Liaison Role

 The third interpersonal role that the manager

carries out is the Liaison role.

 This role focuses on the manager’s dealing

with people outside of his/her own
organization.

 In the role of liaison, the manager develops a

network of contact that can be used to obtain
information that may be useful for future
negotiation.
 Cont’d…

 The chief executive officer has a large liaison

role outside of the organization than does a
middle manager. The middle manager in
nursing may find the liaison role to be more
internal.
Informational Roles

 Informational roles are those of monitor,

disseminator, and spokesman.

Monitor
 The manager constantly seeking and receiving
internal and external information from many sources
to obtain a thorough knowledge of the environment
and the organization.

 The manager informally seeks information about

the organization through internal networks, gossip,
and observations.
 Cont’d…

 Tours of the organization, as well as formal and

informal meetings provide the manager with
information about the needs and functions of the
organization.

 The manager evaluates the performance of others

and takes corrective action to improve that
performance.

 S/he also watches for changes in the environment

and within the company that may affect individual and
organizational performance.
 .
 Disseminator role
 The disseminator role is assumed when passing on
information to subordinates, as when a supervisor
tells subordinates about a new work method.

 As a disseminator, the role of the manager is to

transmit information received from outsiders into the
organization.

 In this role the manger either shares information

between work units or share information outside the
organization.
 Spokesperson
 The spokesperson transmits information about the
organization to outsiders.

 A manager as spokesperson is a public relation

person for the organization.

 The spokesperson role is crucial for the nurse

manager in defining the organization to outsiders.
Decisional Roles

 Decisional roles require managers to plan

strategy and utilize resources. The
decisional roles are those of entrepreneur,
disturbance handler, resource allocator,
and negotiator.
Entrepreneur Role

 The manager will be responsible for initiating

change.

 Mintzberg envisions the entrepreneurial role of the

manager as one in which he/she continually
searches for opportunities to solve problems and to
initiate improvement through change in the
organization.

 Reorganization of supplies, staff redesign, and

creation of new roles are all examples of
entrepreneurship
 Disturbance handler

 The Disturbance handler correct un anticipated

problems, which facing the organization from internal
or external environment.

 The more a nurse manager is involved in the day -to -

day work of the organization the more likely to be
heavily involved in the role of disturbance handler.

The disturbance handler responds to unforeseen

circumstances; such as replacement of staff for seek
call, nosocomial outbreaks, or missing equipments.
 Resource allocator

 Involves determining which work units will get which

resources.

 As a resource allocator, managers schedule their own

time, determine division and coordination of work, and
authorize the timing and implementation of major
decision.

 Top managers are likely to make large, over all budget

decisions, while middle managers may make more
specific allocation.
 Negotiator Role

 The final decisional role is that of negotiator.

 The negotiator role is one in which the manger

deals with those outside of the organization.

 Examples of the role of negotiator would be the

part played by the nurse manager in labor
contract negotiations for the staff, or in
justifying the budget to superiors in the
organization.