Nursing

Management
DR.C.SUSILA,COLLEGE OF
NURSING

Definitions

Process that involves the coordination

of human and material resources
towards the accomplishment of
certain objectives
Accomplishment of objectives
through efforts of other people
Process by which the execution of a
given purpose is put into operations
and supervised (Terry)

What
What is
is Management?
Management?
A

set of activities

planning

and decision making, organizing,

leading, and controlling
directed
human,

at an organizations resources

financial, physical, and information

with

the aim of achieving

organizational goals
in an efficient and effective
manner.
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Management

Management refers to the tasks and activities

involved in directing an organization or one of
its units: planning, organizing, leading, and
controlling.

The process of reaching organizational goals by

working with and through people and other
organizational resources.

Management: Science or
Art?

The

Science of Management

Assumes

that problems can be approached using

rational, logical, objective, and systematic ways.
Requires technical, diagnostic, and decisionmaking skills and techniques to solve problems.
The

Art of Management

Decisions

are made and problems solved using a

blend of intuition, experience, instinct, and
personal insights.
Requires conceptual, communication,
interpersonal, and time-management skills to
accomplish the tasks associated with managerial
activities.
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CONCEPTS OF MANAGEMENT
DEFINITION:
It is difficult to define
Management because it is looked in
to by different scholars from different
way

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Management can be seen

as
A process
2. A profession
3. A factor of production
4. A field of study
5. A group of people that supervise an
organization
1.

The Economist consider

Management as a resource like
Land, Labour, Capital and
Organisation.
The Bureaucrats consider it as an
authority
The Sociologists consider managers
as a part of the class elite class
10/20/16

Henry L.Sisk
Defines Management is the
coordination of all resources through
the process of Planning, Organizing,
Directing and Controlling in order to
attain stated objectives

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Ralph C.Davis
Defines Management as a function of
Executive Leadership

Peter Drucker
Defines Management as a Multi purpose
organ that manager a business, Manager
Mangers and Managers workers and
work.
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10

Concepts of Management

i.

The terms management has been

interrupted in several ways as below.
Management as an Activity:
It is an activity like playing, studying,
teaching etc. It is an art of getting
things done through the effort of
others

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11

ii. Management as a Process:

It is include the process of Planning,
Organizing, Staffing, Directing and
Controlling functions. As a process the
management includes social process,
integrated process, continuous
process and interactive process

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12

iii. Management as an Economic

Sources:
Management occupies the
central place among other 4 ms
Man
Power and Money
Men, Machine,
Material
Money

Manageme
nt

Material

Machine
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13

Management as a Team
Managers operate at different levels
of authority like top, Middle,
Operating etc. Management is
managing all these activities in a
team sprit. Managers have become
elite class in society occupying
position with enormous power and
prestige.
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14

Management as an Academic
Discipline
Management has became a very
popular field of study since offers a
very rewarding and challenging
career.

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15

Management as a group
Management means the group of
persons occupying managerial
position like executives,
departmental head, supervisor etc.

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16

NATURE AND
CHARACTERISTICS OF
MANAGEMENT

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17

(i) Management as a goal

oriented
The main goal of Management is to
ensure efficiency and economy is the
utilisation of human, physical and
financial resources

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18

(ii) Management is Universal

All type of organization like family,
club, university, government, army,
cricket team (a) business, require
management

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19

(iii) Management is an
interactive force
Management reconciles the
individual goals with organizational
goals. It integrates human and other
resources

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20

(iv) Management is a social

process
Management is done by the people,
through the people and for the
people concerned with interpersonal
relationship. A good manager is a
leader and not a boss

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21

(v) Management is
Multidisciplinary
Management depends up on wide
knowledge derived from several
discipline like engineering, sociology,
psychology, economics etc.

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22

(vi) Management is a
Continuous process
Management is a continuous process
which continues until the goal is
achieved

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23

(vii) Management is
intangible
It is invisible force. It cannot be seen
but its presence can be felt

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24

(viii) Management Art as well

as Sciences
Management consists of theoretical
knowledge as well as practical
application of such knowledge

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25

Objectives of Management
(i)

Organisational objectives :- It includes

(a) Reasonable Profit
(b) Survival and solvency of business
(c) Growth and expansion of the
enterprise
(d) Improve the Good will and
reputation

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26

(ii) Personal Objectives

(a) Fair remuneration
(b) Reasonable working conditions
(c) Training and Development
(d) Participation is Management
(e) Security of Service

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27

(iii) Social Objectives

(i) Prompt payment of Taxes
(ii) Conservation of energy
(iii) Preservation of ethical value

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28

Management in
Organizations
Planning
and decision

Organizing

making
Inputs from the environment
Human resources

Goals attained

Financial resources

Efficiently

Physical resources

Effectively

Information resources

Controlling

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Leading

29

Figure 1.2
The Management Process

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30

The Management Process

(contd)
Planning and Decision Making
Setting

an organizations goals and selecting a

course of action from a set of alternatives to
achieve them.

Organizing
Determining

grouped.

how activities and resources are

Leading
Getting

organizational members to work together

to advance the interests of the organization.

Controlling
Monitoring
10/20/16

organizational progress towards goals.

31

FUNCTIONS OF
MANAGEMENT

PRESENTATION BY:
ZOHRA RUBAB

PLANNING

According to KOONTZ, Planning is

deciding in advance - what to do, when to
do & how to do. It bridges the gap from
where we are & where we want to be.
Planning is necessary to ensure proper
utilization of human & non-human
resources. It is all pervasive, it is an
intellectual activity and it also helps in
avoiding confusion, uncertainties, risks, PRESENTATION BY:
ZOHRA RUBAB
wastages etc.

ORGANIZING

According to Henry Fayol, To organize a

business is to provide it with everything
useful or its functioning i.e. raw material,
tools, capital and personnels.
PRESENTATION BY:
ZOHRA RUBAB

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.
PRESENTATION BY:
ZOHRA RUBAB

STAFFING

According to Koontz & O'Donnell, Managerial

function of staffing involves manning the
organization structure through proper and
effective selection, appraisal & development
of personnel to fill the roles designed un the
structure.
PRESENTATION BY:
It is the function of manning the organization
ZOHRA RUBAB
structure and keeping it manned.

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.
PRESENTATION BY:
ZOHRA RUBAB

DIRECTING

It is that part of managerial function which actuates

the organizational methods to work efficiently for
achievement of organizational purposes.

Direction has following elements:

Supervision
Motivation
Leadership
Communication

PRESENTATION BY:
ZOHRA RUBAB

CONTROLLING

According to Koontz & O'Donnell Controlling

is the measurement & correction of
performance activities of subordinates in
order to make sure that the enterprise
objectives and plans desired to obtain them
as being accomplished.

The purpose of controlling is to ensure that

PRESENTATION BY:
everything occurs in conformities with the
ZOHRA RUBAB

Therefore controlling has 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.
PRESENTATION BY:
ZOHRA RUBAB

Principles of management
14 PRINCIPLES OF MANAGEMENT DESCRIBED BY
HENRI FAYOL
Division of Labor

Party of Authority & Responsibility

Principle of One Boss
Unity of Direction
Equity
Order
Discipline

14 PRINCIPLES OF MANAGEMENT
DESCRIBED
BY HENRI
Initiative
FAYOL

Fair Remuneration
Stability of Tenure
Scalar Chain
Sub-Ordination of Individual Interest to General Interest
Espirit De Corps
Centralization & De-Centralization

DIVISION OF LABOUR

stressed on the specialization of jobs

work of all kinds must be divided and allotted to various

persons

simpler and results in efficiency

helps the individual in acquiring speed, accuracy in his

performance

Specialization leads to efficiency & economy in spheres

of business

Party of Authority & Responsibility

co-existing
Authority is given to a person, he should also be
made responsible.
He should also have concerned authority, if anyone is
made responsible.
Authority refers to the right of superiors. responsibility
means obligation for the performance of the job assigned.
Should be a balanced.
Authority- Responsibility = Irresponsible Behavior
Responsibility- Authority= Ineffective

Principle of One Boss

A sub-ordinate should receive orders and be accountable to only boss at a

time.

a sub-ordinate should not receive instructions from more than one person

Dual sub-ordination should be avoided

The enterprise a disciplined, stable & orderly existence

Harmonious relationship between superiors and sub-ordinates

a sub-ordinate should not receive instructions from more than one person

UNITY OF DIRECTION

One head one plan

Related activities should be grouped together

Efforts of all the members of the organization should be directed

towards common goal

Without unity of direction, unity of action cannot be achieved.

Unity of command is not possible without unity of direction.

Order

Concerned with proper & systematic arrangement of

things and people.

Arrangement of things is called material order

Placement of people is called social order.
Material order-should be safe, appropriate and
specific place

for every article

Social order-Selection and appointment of most

suitable person on the suitable job

Discipline

Sincerity, Obedience, Respect of Authority & Observance of

Rules and Regulations of the Enterprise.
subordinate should respect their superiors and obey their
order.
smooth running of the enterprise
subordinates but also on the part of management.
Discipline can be enforced if -Good superiors
- Clear & fair agreements with workers
- Sanctions are judiciously applied

INITIATIVE

Encouraged to take initiative in the work assigned to

them

Initiate actions without being asked to do

Management should provide opportunity to its
employees

Helps in developing an atmosphere of trust

Enjoy working in the organization because it adds to

their zeal and energy

Suggest improvement in formulation &

implementation of place

Fair Remuneration

Paid to the workers should be fair of the efforts

Satisfaction to both employer and the employees

Determined on the basis of cost of living, work

assigned etc,

Provision of other benefits such as free education,

medical & residential facilities to workers

Management creates harmonious relationship and

pleasing atmosphere of work.

Stability of Tenure

Employees should not be moved

frequently from one job position to another
Once they are appointed their services
should be served
Time is required for an employee to get
used to a new work fayol
Money spent on training the worker will go
waste
Stability of job creates team spirit& a
sense of belongingness among workers
-ultimately increase the quality as well as
quantity of work

Scalar Chain

The chain of superiors ranging from the

ultimate authority to the lowest
Every orders, instructions etc. has to pass
through Scalar chain.
For the sake of convenience & urgency,
this path can be cut this short cut -Gang
Plank
Temporary arrangement between two
different points to facilitate quick & easy
communication
Modified as per the requirements of

Sub-Ordination of Individual Interest

to General Interest

An organization is much bigger than

the individual
As far as possible, reconciliation
should be achieved between
individual and group interests.
Case of conflict, individual must
sacrifice for bigger interests
In order to achieve this attitude
- Employees should be honest & sincere.

- Proper & regular supervision of work.

- Reconciliation of mutual differences

Espirit De Corps
It refers to team spirit
Inspires workers to work harder
Interest of the undertaking in the
long run.
The managers should infuse team
spirit & belongingness
Espirit De Corps following steps should
be undertaken

proper co-ordination
should be encouraged to develop informal relations among themselves.
create enthusiasm and keenness among subordinates
employees should be rewarded

Centralization & De-Centralization

Centralization-concentration of authority at the top level

De-centralization-disposal of decision making authority to all

the levels of the organization

Increases the role of subordinate is decentralization & Decreases

the role of subordinate is centralization

It is not feasible, organization should strike to achieve a lot

between the two.

Management Theories
Classical Theories

Scientific Management
Theory

Frederick W. Taylors One Best Way

from his time and motion studies
Taylor is the Father of Scientific
Management
Machine Model viewed man as a
means of production rather than the
end (economic man model)

Scientific Management
Theory

Productivity at the level of the worker

(skills, physical attributes)
His management said reduced wasted
efforts, set standards for performance,
encourage specialization and, stress the
selection of qualified workers who could be
developed for a particular job.

Scientific Management
Theory

Basic Principles of the Machine

Model

Division of labor and specialization

Unity of command and centralization of
decision-making
One way authority

Narrow span of control

Scientific Management
Theory

Concept of 3 Es
Efficiency
Effectiveness
Economy
Restricted focus weakness of
machine model

Scientific Management
Theory

Concerned with optimizing effort at

the shop or operator level and
therefore utilizes micro approach

Administrative Management
Theory

Henry Fayol(1841-1925)
Treated administration as a process
as opposed to the prevailing practice
wherein administration is under
control of specialists.

Administrative Management
Theory

According to Fayol, administrative management

was concerned or focused on the formal
organization structure and the delineation of the
basic processes of general management:

Planning examining the future and drawing up

the plan of action

Organizing building up the structure, material,

human resources of the undertaking

Command maintaining activity among the

personnel

Coordination binding together

Control conformity

Administrative Management
Theory

Fayols 14 Management Principles

Division of Work- This principle is the

same as Adam Smiths division of
labor.
Authority-Managers must be able to
give orders. Authority gives them this
right. Along with authority, however,
goes responsibility. Wherever authority
is exercised, responsibility arises.

Administrative Management
Theory

Fayols 14 Management Principles

Discipline- Employees must obey and respect

the rule that govern the organization. Good
discipline is the result of effective leadership, a
clear understanding between management and
workers regarding the organizations rules and
the judicious use of penalties for infarctions of
the rules.
Unity of Command- Every employee should
receive orders from only one superior..

Administrative Management
Theory

Fayols 14 Management Principles

Unity of Direction- Each group of

organization activities that have the same
objective should be directed by one manager
using one plan.
Subordination of Individual Interests to the
General Interest- The interest of any one
employee should or group of employees
should not take precedence over the
interests of the group as a whole.

Administrative Management
Theory

Fayols 14 Management Principles

Remuneration- Workers must be paid a

fair wage for their services.
Centralization- This term refers to the
degree to which subordinates are involved
in decision making. Whether decision
making is centralized (to management) or
decentralized (to subordinates) is a
question of proper proportion. The task is
to find the optimum degree of
centralization for each situation.

Administrative Management
Theory

Fayols 14 Management Principles

Scalar Chain- The line of authority from

top management to the lowest ranks
represents the scalar chain.
Communications should follow this chain.
However, if following the chain creates
delays, cross communications can be
allowed if agreed to by all parties
superiors are kept informed.
Order- People and materials should be in
the right place at the right time.

Administrative Management
Theory

Fayols 14 Management Principles

Equity- Managers should be king and fair to

their subordinates.
Stability of Tenure of Personnel- High employee
turnover is inefficient. Management should
provide orderly personnel planning and ensure
that replacements are available to fill
vacancies.
Initiative- Employees who are allowed to
originate and carry out plans will exert high
levels of effort.

Administrative Management
Theory

Fayols 14 Management Principles

Esprit de Corps- Promoting team spirit

will build harmony and unity within the
organization.

Management was a universal

function that could be defined in
terms of the various processes
that the manager performed

Luther Gullick and Lyndall Urwick

(1937) incorporated Fayols theory
into American administration
Duties of an administrator

Planning
Organizing
Staffing
Directing
Coordinating
Reporting
Budgeting

Bureaucratic Model

Relies on rational set of structuring

guidelines, such as rules and
procedures, hierarchy, and a clear
division of labor
The bureaucracy is a formal
organization

Bureaucratic Model

Max Weber popularized the model

Max Webers Bureaucratic characteristics
1. Division of Labor
2. Fixed authority and official jurisdiction
3. Hierarchal arrangement of officers
4. Written formal rules
5. Impersonality
6. Specialization
7. Security of tenure

Bureaucratic Model

Webers rules (criteria on how to

construct organizaions
1.

2.
3.
4.

5.

Organizations are impersonal and are subject to

authority
Organized in clearly defined heirarchy of offices
Each office has area of competence
Office is filled by way of a free contractual
relationship and there is free selection for the
positions
Technical qualification is basis of selection

Bureaucratic Model
6.

7.
8.
9.

10.

Members are remunerated by fixed salaries; right to

pensions; salary scale according to rank; right to resign
Office is sole primary occupation of the members
Office constitutes a career with a promotion system
Official work seperated from ownerhip of the means of
administration
Members subject to strict and systematic discipline and
control in the conduct of the office

Management Theories
Human Resources Approach

Elton Mayo

a.
b.
c.

One of fathers of human relations

movement
Basic principles of human relations
from Mayo and Hawthorne
experiments:
Social norms and supervision
The group or democratic administration
Rewards and sanctions

Hawthorne Studies

Conducted by Western Electric industrial

engineers to examine the effect of
various illumination levels on workers
productivity
Mayo concluded that behavior and
sentiments were closely related, that
group influences significantly affected
individual behavior, that group standards
established individual workers output,
and that money was less a factor in
determining output than group standards

Humanism

Creation and development of human

centered organizations to fulfill the
needs and wants of the human
personality.
Mary Parker Follet viewed
management as a social process and
the organization as a social system

Theory X and Theory Y

Proposed by Douglas McGregor

Theory X: essentially negative view
of people- little ambition, dislike
work, avoids responsibility, and
needs to be closely directed to work
effectively

Theory X and Theory Y

Theory Y: positive view people can

exercise self- direction, accept
responsibility and consider work to be
as natural as rest or play
Theory Y assumptions best captured
true nature of workers and should
guide management practice.

Management Theories
Contemporary/ Modern
Theories

Quantum Theory

Each person needs to be

acknowledged for his or her own
talent and potential, and each needs
to be acknowledged and helped to
grow in all possible kinds of ways.
The leader is the one responsible to
facilitate growth among his
subordinates.

Quantum Theory

Approaches leadership through lens

provided by new science and
naturally-occurring events
Recognizes interplay among all
members of a group as a critical
factor in determining outcomes

Chaos Theory

Recognizes that events are rarely

controlled.
Suggests that systems become more
complex and also more volatile and
must expend more energy to maintain
the complexity.
Trend continues until system splits,
combines with another complex system
or falls apart entirely.

Contingency Theory

Asserts that when managers make a

decision, they must take into account
all aspects of the current situation.
The best style depends on the
situation.
It depends approach

CONTIGENCY THEORY

Contingency Theory

Most important managerial skills are

Decision-making
Inter- personal skills
Communication
Negotiating skills
Delegating

Functions of manager

Basic Managerial Functions

(adapted from Figure 1.2)

Organizing

Directing

Planning

Controlling

What is a Manager?
Someone

whose primary
responsibility is to carry out the
management process.
Someone who plans and makes
decisions, organizes, leads, and
controls
human, financial, physical,
and information resources.
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93

- People responsible for

directing the efforts aimed
at helping organizations
achieve their goals.
- A person who plans,
organizes, directs and
controls the allocation of
human, material, financial,
and information resources
in pursuit of the
organizations goals.

Kinds of Managers by
Level
Top Managers
The

relatively small group of executives who

manage the organizations overall goals,
strategy, and operating policies.

Middle

Managers

Largest

group of managers in organizations

Implement

top managements policies and plans.

Supervise and coordinate lower-level managers
activities.
First-Line

Managers

Managers

who supervise and coordinate the

activities of operating employees.
95
10/20/16

Skills and the Manager

Technical Skills
Interpersonal Skills
Fundamental
Fundamental
Management
Management Skills
Skills

Conceptual Skills
Diagnostic Skills
Communication Skills
Decision-Making Skills
Time-Management Skills

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96

Fundamental Management
Skills
Technical
Skills

necessary to accomplish or understand

the specific kind of work being done in an
organization.

Interpersonal
The

ability to communicate with, understand,

and motivate both individuals and groups.

Conceptual
The

managers ability to think in the abstract.

Diagnostic
The

managers ability to visualize the most

appropriate response to a situation.

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97

Fundamental Management
Skills (contd)
Communication
The

managers abilities both to convey ideas and

information effectively to others and to receive
ideas and information effectively from others.

Decision-Making
The

managers ability to recognize and define

problems and opportunities correctly and then to
select an appropriate course of action to solve
the problems and capitalize on opportunities.

Time-Management
The

managers ability to prioritize work, to work

efficiently, and to delegate appropriately.
98
10/20/16

Figure 1.1
Kinds of Managers by Level and
Area

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99

Management Level and Skills

A Model of Managerial
Competencies
(adapted from Figure 1.1)
Communication
Competency
Teamwork
Competency

Planning and
Administration
Competency

Global
Awareness
Competency

Strategic
Action
Competency

Self-Management
Competency

A Model of Managerial
Competencies
(adapted from Figure 1.1)
Communication
Competency
Teamwork
Competency

Global
Awareness
Competency

Managerial
Effectiveness
Self-Management
Competency

Planning and
Administration
Competency

Strategic
Action
Competency

The Nurse Manager in the

Health Facility

Nurse Managers
(Sullivan and
Decker, 1988)

1. Perform these roles simultaneously:

Subordinates
Superiors
Customer service representatives
2. Key leadership position directly related to the
delivery of
nursing care

Characteristics of an
Integrated Leader-Manager
(Gardner, 1990)

They think long term.

They look outward, toward the larger
organization.
They influence others beyond their own group.
They emphasize vision, values and motivation.
They are politically astute.
They think in terms of change and renewal.

Job Description of a Nurse

Manager (Sullivan and Decker,
1988; Marquis and Huston,
2006)
Position Purpose
Serves as the official supervisor of an
assigned division and functions to:
plan, direct, coordinate, implement,
control, evaluate and improve the
quality of patient care delivered

Specific Responsibilities

Plans and executes administrative

programs within the framework of total
nursing service program.
Interviews, selects, formally evaluates and
terminates nurses in the unit.
Establishes standards, goals, objectives,
priorities and facilities change based on
the needs of patients and their families,
physicians and staff based on the results
of various recommendations.

Specific Responsibilities

Holds regularly scheduled staff meetings,

which provide opportunities for
discussion of division problems,
orientation to new projects, procedures,
changes in care approaches, etc.
Contributes to creating a work climate
that encourages positive staff morale,
motivation and commitment.

Specific Responsibilities

Supervises the allocation of division resources

while remaining accountable to an established
budget.
Controls work time schedules for entire staff
and makes the scheduling adjustments when
necessary.
Equitably delegates patient care/division
maintenance assignments and authority
according to perceived strengths and limitations
of subordinates and maintaining accountability.
It requires:

Specific Responsibilities

Advocates for both patient and staff

and convince the administration of
the need and value of individualized
care.
Evaluates the quality of care
provided alongside the standards
and policies.

Classifications
Public Health Nurse Manager

1.

Directs, manages, supervises and

coordinates program development, fiscal
management and programs and activities of
the Districts health care programs
Provides innovations in services and
programs
Collaborates and contracts for activities with
other health care professionals and outside
agencies

Classifications
Clinical Nurse Manager

2.

Provides direction and clinical supervision of

patient care in a particularly assigned area
in the hospital
Be a professional caregiver with clinical and
supervisory experience that promotes an
atmosphere that is responsive to the need
of the patients, nursing and medical staff
Promotes the philosophy, goals and
objectives of the hospital

Levels

Charge Nurse

Liaison to the nurse amanager, assisting in

shift by shift coordination and promotion of
quality patient care as well as efficient use of
resources.
Often troubleshoots problems, assists in
decision making
Role model, mentor, educator
May have more informal power than manager

Levels

Staff Nurse

Not formally a manager

Supervises others to ensure safe, quality
patient care

Mintzbergs Behavioral
Description
1.

Interpersonal Roles
a.

b.

c.

Figurehead - performs ceremonial

duties
Leader - Defines work environment and
responsible for subordinates work
Liaison - Expands outside information
sources and networks

Mintzbergs Behavioral
Description
2.

Informational Roles
a.

b.

c.

Monitor- Internally seeks information

about organization
Disseminator- Shares information
within organization
Spokesperson shares information
outside organization

Mintzbergs Behavioral
Description
3.

Decisional Roles
a.

b.

c.

d.

Entrepreneur Seeks ways to solve

problems/ improve organizations
Disturbance handler responds to
problem
Resource allocator manages time and
coordinates efforts
Negotiator- mediates resources/
decisions with outside forces

ITS QUERY TIME